• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
10.11606/D.5.2011.tde-27022012-110505
Document
Author
Full name
Rogério Caixeta Moraes de Freitas
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2011
Supervisor
Committee
Ruano, Rodrigo (President)
Bunduki, Victor
Pires, Claudio Rodrigues
Title in Portuguese
Estudo do volume pulmonar fetal na predição dos resultados perinatais de fetos com derrame pleural "isolado
Keywords in Portuguese
Derrame pleural
Feto
Hidrotórax
Pulmão/crescimento & desenvolvimento
Quilotórax
Terapias fetais
Ultrassonografia pré-natal
Abstract in Portuguese
OBJETIVO: O objetivo deste estudo foi predizer o prognóstico perinatal em fetos com derrame pleural isolado por meio da medida do volume pulmonar estimado pela ultrassonografia tridimensional. MÉTODO: Estudo retrospectivo, entre julho de 2005 e julho de 2010, com 19 fetos com derrame pleural isolado (ausência de causas infecciosas, imunes, anomalias cromossômicas ou estruturais associadas) acompanhados no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Os volumes pulmonares foram obtidos pela ultrassonografia tridimensional (Voluson 730 Expert, GE Medical System, Kretzechnick, Áustria) em dois períodos, no momento do diagnóstico (20 26 semanas) e próximo ao parto (duas semanas antecedentes ao parto ou até 36 semanas), e mensurados pela técnica VOCAL (Virtual Organ Computer Aided Analysis) com rotação de 30º. Os volumes obtidos (observados) foram comparados com valores esperados para idade gestacional, e a razão entre o volume total fetal observado/esperado (VPTo/e) foi avaliada de acordo com a mortalidade perinatal e morbidade neonatal (necessidade de ventilação mecânica por mais que 48 horas). RESULTADOS: Dezenove fetos com derrame pleural isolado foram analisados no período do estudo. Doze (63,2%) crianças sobreviveram. Dos sobreviventes, sete (58,3%) apresentaram morbidade respiratória. O VPTo/e no primeiro exame ultrassonográfico não se associou significativamente com mortalidade (VPTo/e: 0,42±0,19 nos sobreviventes contra 0,30±0,08 nos não sobreviventes, p=0,11). No segundo exame, por outro lado, VPTo/e foi significativamente menor nos casos que faleceram (0,24±0,08) em relação aos sobrevivente (0,58±0,21; p<0,01) e nos que necessitaram de ventilação mecânica prolongada (0,35±0,08) comparados aos que não necessitaram (0,68±0,10; p<0.01). CONCLUSÃO: O volume pulmonar fetal medido pela ultrassonografia tridimensional pode ser utilizado para predizer o prognóstico de fetos com derrame pleural isolado.
Title in English
Three-dimensional ultrasonographic assessment of fetal lung volume as a prognostic factor in isolated pleural effusion
Keywords in English
Chylothorax
Fetal therapies
Fetus
Hydrothorax
Lung/growth & development
Pleural effusion
Ultrasonography prenatal
Abstract in English
OBJECTIVE The aim of the present study was to predict the perinatal outcome in isolated pleural effusion using fetal lung volumes assessed by three-dimensional ultrasonography. METHODS: A retrospective study conducted between July 2005 and July 2010, in which 19 fetuses with isolated pleural effusion (absence of infection, immunological causes, chromosomal anomalies and associated structural anomalies) at Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Fetal lung volumes were assessed by three-dimensional ultrasonography (Voluson 730 Expert, GE Medical System, Kretzechnick, Áustria) in two periods: at diagnosis (20-26 weeks) and nears the delivery (2 weeks before delivery or at 36 weeks), by VOCAL technique (Virtual Organ Computer Aided Analysis) with rotation of 30o. The observed volumes were compared to expected values for determine gestational age, and the observed/expected total fetal lung volume ratio (o/e-TFLV) was evaluated according to perinatal death and neonatal morbidity (need for mechanical ventilation longer than 48 hours). RESULTS: A total of 19 fetuses with isolated pleural effusion were evaluated during the study period. Twelve (63.2%) infants survived. Among the survivors, seven (58.3%) had severe respiratory distress at birth. The o/e-TFLV at the first ultrasound examination was not associated statistically with mortality (o/e-TLFV: 0.42±0.19 in survivors x 0.30±0.08 among those that died, p=0.11). On the second ultrasound examination, on the other hand, the o/e-TFLV was significantly reduced in those cases that died (0.24±0.08) whilst in survivors (0.58±0.21; p<0.01) and in those that needed mechanical ventilation (0.35±0.08) when compared to those that did not need it (0.68±0.10; p<0.01). CONCLUSION: Fetal lung volumes measured by three-dimensional ultrasonography may be useful to predict perinatal outcome in fetuses with primary pleural effusion
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2012-03-01
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
Centro de Informática de São Carlos
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2020. All rights reserved.