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au:MENEZES, MARIA LUIZA BEZERRA

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Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: doença inflamatória pélvica
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Menezes, Maria Luiza Bezerra

; Giraldo, Paulo Cesar

; Linhares, Iara Moreno

; Boldrini, Neide Aparecida Tosato

; Aragón, Mayra Gonçalves

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. spe1 elocation e2020602

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo O tema doença inflamatória pélvica está contemplado no Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. A doença inflamatória pélvica é a infecção aguda do trato genital superior feminino decorrente da ascensão canalicular de microrganismos cervicovaginais endógenos e, principalmente, os de transmissão sexual. Entre os agentes etiológicos envolvidos, destacam-se Chlamydia trachomatis e Neisseria gonorrhoeae. As sequelas mais importantes são dor pélvica crônica, infertilidade e gravidez ectópica. O diagnóstico clínico apresenta-se como a abordagem prática mais importante. O tratamento com antibióticos deve ser iniciado imediatamente diante da suspeição clínica. Descrevem-se orientações para gestores e profissionais de saúde sobre testes diagnósticos, tratamento preconizado, seguimento, aconselhamento, notificação, manejo de parcerias sexuais e de populações especiais. Com a maior disponibilidade da técnica de biologia molecular no Brasil, recomenda-se o rastreio de C. trachomatis e N. gonorrhoeae como estratégia preventiva da doença.

Abstract Pelvic Inflammatory Disease is a topic included in the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Pelvic inflammatory disease is an acute infection of the upper female genital tract due to canalicular spread of endogenous cervicovaginal microorganisms, in particular sexually transmitted organisms. Standing out among the etiological agents involved are Chlamydia trachomatis and Neisseria gonorrhoeae. The most important sequels are chronic pelvic pain, infertility and ectopic pregnancy. Clinical diagnosis is the most important practical approach. Antibiotic treatment should start immediately upon clinical suspicion. The article contains guidance for health service managers and health professionals on diagnostic tests, treatment, follow-up, counseling, notification, handling of sexual partnerships and special populations. In view of increased availability of the molecular biology technique in Brazil, C. trachomatis and N. gonorrhoeae screening is recommended as a disease prevention strategy.

Resumen El tema de la enfermedad inflamatoria pélvica está incluido en el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral para Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. La enfermedad inflamatoria pélvica es una infección aguda del tracto genital superior femenino resultante del ascenso canalicular de microorganismos cervicovaginales endógenos y, principalmente, los de transmisión sexual. Entre los agentes etiológicos involucrados, se destacan Chlamydia trachomatis y Neisseria gonorrhoeae. Las secuelas más importantes son: dolor pélvico crónico, infertilidad y embarazo ectópico. El diagnóstico clínico es el enfoque práctico más importante. El tratamiento con antibiótico debe iniciarse inmediatamente ante la sospecha clínica. Se describen pautas para gestores y profesionales de la salud sobre pruebas de diagnóstico, tratamiento, seguimiento, asesoramiento, notificación, manejo de parejas sexuales y poblaciones especiales. Con la mayor disponibilidad de la técnica de biología molecular, se recomienda el cribado de C. trachomatis y N. gonorrhoeae como estrategia preventiva para la enfermedad.

https://doi.org/10.1590/s1679-4974202100011.esp1 2311 downloads

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: sífilis congênita e criança exposta à sífilis
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Domingues, Carmen Silvia Bruniera

; Duarte, Geraldo

; Passos, Mauro Romero Leal

; Sztajnbok, Denise Cardoso das Neves

; Menezes, Maria Luiza Bezerra

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. spe1 elocation e2020597

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Resumo Os temas sífilis congênita e criança exposta à sífilis compõem o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil em 2020. Tal documento foi elaborado com base em evidências científicas e validado em discussões com especialistas. Este artigo apresenta orientações para o manejo clínico da sífilis em gestantes e da sífilis congênita, enfatizando a prevenção da transmissão vertical do Treponema pallidum. Nele estão contemplados aspectos epidemiológicos e clínicos desses agravos, bem como recomendações aos gestores no manejo programático e operacional da sífilis. Também se incluem orientações para os profissionais de saúde na triagem, diagnóstico e tratamento das pessoas com infecções sexualmente transmissíveis e suas parcerias sexuais, além de estratégias para ações de vigilância, prevenção e controle da doença.

Abstract The topics of congenital syphilis and children exposed to syphilis are part of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. The Protocol and Guidelines have been developed based on scientific evidence and validated in discussions with specialists. This article provides guidelines for clinical management of both syphilis in pregnant women and also congenital syphilis, emphasizing prevention of vertical transmission of Treponema pallidum. Epidemiological and clinical aspects of these infections are presented, as well as recommendations for health service managers regarding the programmatic and operational management of syphilis. The article also includes guidelines for health professionals on screening, diagnosing and treating people with sexually transmitted infections and their sex partners, in addition to strategies for syphilis surveillance, prevention and control actions.

Resumen Los temas sífilis congénita y niños expuestos a la sífilis componen el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil en 2020. Tal documento fue elaborado con base en evidencia científica y validado en discusiones con especialistas. Este artículo presenta directrices para el manejo clínico de la sífilis en mujeres embarazadas y de la sífilis congénita, con énfasis en la prevención de la transmisión vertical del Treponema pallidum. Se contemplan aspectos epidemiológicos y clínicos de la infección, así como recomendaciones para gestores en la gestión programática y operativa de la sífilis. También se incluyen directrices para profesionales de la salud en la detección, diagnóstico y tratamiento de personas con infecciones de transmisión sexual y sus parejas sexuales, además de estrategias para acciones de vigilancia, prevención y control de la enfermedad.

https://doi.org/10.1590/s1679-4974202100005.esp1 5433 downloads

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: violência sexual
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Menezes, Maria Luiza Bezerra

; Araújo, Maria Alix Leite

; Santos, Adriano Santiago Dias dos

; Gir, Elucir

; Bermúdez, Ximena Pamela Díaz

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. spe1 elocation e2020600

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

Resumo Este artigo aborda a violência sexual, tema que compõe o Protocolo Clínico e Diretrizes Terapêuticas para Atenção Integral às Pessoas com Infecções Sexualmente Transmissíveis, publicado pelo Ministério da Saúde do Brasil. São apresentadas orientações aos gestores para o manejo programático e operacional, com foco na rede de atendimento às pessoas em situações de violência sexual, recomendações aos profissionais de saúde acerca de medidas profiláticas de gravidez e de infecções sexualmente transmissíveis virais e não virais, além das estratégias para as ações de vigilância. A violência sexual constitui um problema amplo, extrapola o campo de saúde e envolve desafios conceituais e programáticos tanto para os profissionais de saúde, na linha de frente na atenção às pessoas afetadas, quanto para a sociedade, em termos de possíveis formas de prevenção.

Resumen Este artículo aborda la violencia sexual, tema que integra el Protocolo Clínico y Directrices Terapéuticas para la Atención Integral a Personas con Infecciones de Transmisión Sexual, publicado por el Ministerio de Salud de Brasil. Se brinda orientación a los gestores en la gestión programática y operativa con enfoque en la red de servicios para personas en situación de violencia sexual, recomendaciones a los profesionales de la salud sobre medidas profilácticas del embarazo e infecciones de transmisión sexual virales y no virales, además de estrategias para acciones de vigilancia. La violencia sexual es un problema amplio que va más allá del campo de la salud e implica desafíos conceptuales y programáticos tanto para los profesionales de la salud, que están a la vanguardia de la atención a las personas afectadas, como para la sociedad, en cuanto a posibles formas de prevención.

Abstract This article addresses sexual violence, a topic that makes up the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Ministry of Health of Brazil. Guidance is given to managers in programmatic and operational management with a focus on the service network for people in situations of sexual violence, recommendations to health professionals about prophylactic measures of pregnancy and viral and non-viral sexually transmitted infections, in addition to strategies for surveillance actions. Sexual violence is a broad problem that goes beyond the health field and involves conceptual and programmatic challenges for both health professionals, who are at the forefront of care for affected people, and for society, in terms of possible forms of prevention.

https://doi.org/10.1590/s1679-4974202100018.esp1

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: violência sexual
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Menezes, Maria Luiza Bezerra

; Araújo, Maria Alix Leite

; Santos, Adriano Santiago Dias dos

; Gir, Elucir

; Bermúdez, Ximena Pamela Díaz

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. spe1 elocation e2020600

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

https://doi.org/10.1590/s1679-4974202100018.esp1 847 downloads

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: doença inflamatória pélvica
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Menezes, Maria Luiza Bezerra

; Giraldo, Paulo Cesar

; Linhares, Iara Moreno

; Boldrini, Neide Aparecida Tosato

; Aragón, Mayra Gonçalves

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. spe1 elocation e2020602

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

https://doi.org/10.1590/s1679-4974202100011.esp1

Protocolo Brasileiro para Infecções Sexualmente Transmissíveis 2020: sífilis congênita e criança exposta à sífilis
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Domingues, Carmen Silvia Bruniera

; Duarte, Geraldo

; Passos, Mauro Romero Leal

; Sztajnbok, Denise Cardoso das Neves

; Menezes, Maria Luiza Bezerra

Epidemiologia e Serviços de Saúde

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2021, Volume 30 N. spe1 elocation e2020597

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

https://doi.org/10.1590/s1679-4974202100005.esp1

Brazilian Protocol for Sexually Transmitted Infections, 2020: congenital syphilis and child exposed to syphilis
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Domingues, Carmen Silvia Bruniera

; Duarte, Geraldo

; Passos, Mauro Romero Leal

; Sztajnbok, Denise Cardoso das Neves

; Menezes, Maria Luiza Bezerra

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 Suppl. 1 elocation e2020597

Abstract: En | Text: En | PDF: En

Abstract The topics of congenital syphilis and children exposed to syphilis compose the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Such document was elaborated based on scientific evidence and validated in discussions with specialists. This article provides guidelines for syphilis in pregnant women and congenital syphilis clinical management, emphasizing the vertical transmission of Treponema pallidum prevention. Epidemiological and clinical aspects of these infections are presented and recommendations for managers in the programmatic and operational management of syphilis. The article also includes guidelines for health professionals in screening, diagnosing, and treating people with sexually transmitted infections and their sex partners, in addition to strategies for surveillance actions, prevention, and control of the disease.

https://doi.org/10.1590/0037-8682-597-2020 484 downloads

Brazilian Protocol for Sexually Transmitted Infections 2020: sexual violence
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Menezes, Maria Luiza Bezerra

; Araújo, Maria Alix Leite

; Santos, Adriano Santiago Dias dos

; Gir, Elucir

; Bermúdez, Ximena Pamela Díaz

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 Suppl. 1 elocation e2020600

Abstract: En | Text: En | PDF: En

Abstract This article addresses sexual violence, as part of the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health. Guidance is provided in programmatic and operational management, focusing on the service network for people in situation of sexual violence, recommendations to health staff about pregnancy and viral and non-viral sexually transmitted infections prophylactic measures, in addition to surveillance action strategies. Sexual violence is an encompassing issue that includes wider areas than the health field. It involves conceptual and programmatic challenges for health staff, at the forefront of care for affected people and also to the implementation of prevention strategies addressed to the whole society.

https://doi.org/10.1590/0037-8682-600-2020 316 downloads

Brazilian Protocol for Sexually Transmitted infections, 2020: pelvic inflammatory disease
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Menezes, Maria Luiza Bezerra

; Giraldo, Paulo Cesar

; Linhares, Iara Moreno

; Boldrini, Neide Aparecida Tosato

; Aragon, Mayra Gonçalves

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 Suppl. 1 elocation e2020602

Abstract: En | Text: En | PDF: En

Abstract Pelvic Inflammatory Disease is a topic included in the Clinical Protocol and Therapeutic Guidelines for Comprehensive Care for People with Sexually Transmitted Infections, published by the Brazilian Ministry of Health in 2020. Pelvic inflammatory disease is an upper female genital tract acute infection due to canalicular spread of endogenous cervicovaginal microorganisms and especially the sexually transmitted microorganisms. Standing out among the etiological agents involved are Chlamydia trachomatis and Neisseria gonorrhoeae. The main sequelae are chronic pelvic pain, infertility, and ectopic pregnancy. Clinical diagnosis is the most important practical approach. Antibiotic treatment must start immediately after the clinical suspicion. Guidelines for health service managers and health professionals on diagnostic tests, treatment, follow-up, counseling, notification, handling sexual partners and special populations are described. Given the increased availability of the molecular biology techniques in Brazil, C. trachomatis and N. gonorrhoeae screening are recommended as a disease prevention strategy.

https://doi.org/10.1590/0037-8682-602-2020 415 downloads

10.

Comments on Ricardo F Savaris' Letter to the Editor regarding the publication in the JBSTM-Brazilian Protocol for Sexually Transmitted Infections, 2020: “Pelvic Inflammatory Disease”
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Menezes, Maria Luiza Bezerra

; Giraldo, Paulo Cesar

; Linhares, Iara Moreno

; Boldrini, Neide Aparecida Tosato

; Aragon, Mayra Gonçalves

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0457-2021

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0457-2021 4 downloads

11.

Neurofibromatosis: part 2 – clinical management
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Batista, Pollyanna Barros

; Bertollo, Eny Maria Goloni

; Costa, Danielle de Souza

; Eliam, Lucas

; Cunha, Karin Soares Gonçalves

; Cunha-Melo, José Renan

; Darrigo Junior, Luiz Guilherme

; Geller, Mauro

; Gianordoli-Nascimento, Ingrid Faria

; Madeira, Luciana Gonçalves

; Mendes, Hérika Martins

; Miranda, Débora Marques de

; Mata-Machado, Nikolas Andre

; Morato, Eric Grossi

; Pavarino, Érika Cristina

; Pereira, Luciana Baptista

; Rezende, Nilton Alves de

; Rodrigues, Luíza de Oliveira

; Sette, Jorge Bezerra Cavalcanti

; Silva, Carla Menezes da

; Souza, Juliana Ferreira de

; Souza, Márcio Leandro Ribeiro de

; Martins, Aline Stangherlin

; Valadares, Eugênia Ribeiro

; Vidigal, Paula Vieira Teixeira

; Waisberg, Vanessa

; Waisberg, Yehuda

; Rodrigues, Luiz Oswaldo Carneiro

Arquivos de Neuro-Psiquiatria

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jun 2015, Volume 73 N. 6 Pages 531 - 543

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

A primeira parte desta diretriz abordou o diagnóstico diferencial das neurofibromatoses (NF): neurofibromatose do tipo 1 (NF1), neurofibromatose do tipo 2 (NF2) e schwannomatose (SCH). As NF compartilham algumas características, como a origem neural dos tumores e sinais cutâneos, e afetam cerca de 80 mil brasileiros. O aumento do conhecimento científico sobre as NF tem permitido melhor manejo clínico e redução da morbidade das complicações, resultando em melhor qualidade de vida para os pacientes com NF. A maioria dos médicos é capaz de realizar o diagnóstico das NF, mas a variedade de manifestações clínicas e a dificuldade de se prever o surgimento e a gravidade de complicações, torna o manejo da NF um desafio para o clínico e envolve diferentes especialistas para o tratamento adequado e aconselhamento genético, especialmente a NF2 e a SCH. O presente texto sugere algumas orientações para o acompanhamento dos portadores de NF, com ênfase na NF1.

Part 1 of this guideline addressed the differential diagnosis of the neurofibromatoses (NF): neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH). NF shares some features such as the genetic origin of the neural tumors and cutaneous manifestations, and affects nearly 80 thousand Brazilians. Increasing scientific knowledge on NF has allowed better clinical management and reduced rate of complications and morbidity, resulting in higher quality of life for NF patients. Most medical doctors are able to perform NF diagnosis, but the wide range of clinical manifestations and the inability to predict the onset or severity of new features, consequences, or complications make NF management a real clinical challenge, requiring the support of different specialists for proper treatment and genetic counseling, especially in NF2 and SCH. The present text suggests guidelines for the clinical management of NF, with emphasis on NF1.

https://doi.org/10.1590/0004-282X20150042 13090 downloads

12.

Prevalence of human papillomavirus infection, distribution of viral types and risk factors in cervical samples from human immunodeficiency virus-positive women attending three human immunodeficiency virus-acquired immune deficiency syndrome reference centres in northeastern Brazil
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Martins, Albert Eduardo Silva

; Lucena-Silva, Norma

; Garcia, Renan Gomes

; Welkovic, Stefan

; Barboza, Aureliana

; Menezes, Maria Luiza Bezerra

; Maruza, Magda

; Tenório, Terezinha

; Ximenes, Ricardo AA

Memórias do Instituto Oswaldo Cruz

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sep 2014, Volume 109 N. 6 Pages 738 - 747

Abstract: En | Text: En | PDF: En

Human immunodeficiency virus (HIV)-positive patients have a greater prevalence of coinfection with human papillomavirus (HPV) is of high oncogenic risk. Indeed, the presence of the virus favours intraepithelial squamous cell lesion progression and may induce cancer. The aim of this study was to evaluate the prevalence of HPV infection, distribution of HPV types and risk factors among HIV-positive patients. Cervical samples from 450 HIV-positive patients were analysed with regard to oncotic cytology, colposcopy and HPV presence and type by means of polymerase chain reaction and sequencing. The results were analysed by comparing demographic data and data relating to HPV and HIV infection. The prevalence of HPV was 47.5%. Among the HPV-positive samples, 59% included viral types of high oncogenic risk. Multivariate analysis showed an association between HPV infection and the presence of cytological alterations (p = 0.003), age greater than or equal to 35 years (p = 0.002), number of partners greater than three (p = 0.002), CD4+ lymphocyte count < 200/mm3 (p = 0.041) and alcohol abuse (p = 0.004). Although high-risk HPV was present in the majority of the lesions studied, the low frequency of HPV 16 (3.3%), low occurrence of cervical lesions and preserved immunological state in most of the HIV-positive patients were factors that may explain the low occurrence of precancerous cervical lesions in this population.

https://doi.org/10.1590/0074-0276140070 2435 downloads

13.

Impacto das malformações congênitas na mortalidade perinatal e neonatal em uma maternidade-escola do Recife
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Amorim, Melania Maria Ramos de

; Vilela, Paulo Carvalho

; Santos, Aleksana Regina Viana Dutra

; Lima, Ana Luiza Medeiros Vasconcelos

; Melo, Eduardo França Pessoa de

; Bernardes, Hildenice Ferreira

; Menezes Filho, Paulo Fernando Bezerra de

; Guimarães, Vilma Bezerra

Revista Brasileira de Saúde Materno Infantil

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may 2006, Volume 6 Suppl. 1 Pages s19 - s25

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVOS: determinar a incidência de malformações congênitas em recém-nascidos assistidos em uma maternidade-escola de Recife e avaliar o impacto destas malformações na mortalidade perinatal e neonatal. MÉTODOS: realizou-se um estudo longitudinal durante os meses de setembro de 2004 a maio de 2005, analisando-se todos os partos assistidos no Instituto Materno Infantil Prof. Fernando Figueira, IMIP. Determinou-se a freqüência e o tipo de malformações congênitas e foram calculados os coeficientes de mortalidade fetal, mortalidade perinatal, mortalidade neonatal precoce e tardia. RESULTADOS: a freqüência de malformações foi de 2,8% (em 4043 nascimentos). O percentual de malformações entre os nativivos foi de 2,7%, e entre os natimortos foi de 6,7%. Dentre as malformações, as mais freqüentes foram as do sistema nervoso central (principalmente hidrocefalia e meningomielocele), as do sistema osteomuscular e as cardiopatias. Não houve associação entre malformações e sexo, porém a freqüência de prematuridade e baixo peso foi maior entre os casos de malformações. Constatou-se, entre os malformados, mortalidade neonatal precoce de 32,7% e tardia de 10,6%. Os casos de malformações representaram 6,7% dos natimortos, 24,2% das mortes neonatais precoces e 25,8% do total de mortes neonatais. CONCLUSÕES: a freqüência de malformações correspondeu a 2,8% dos nascimentos. As malformações representaram a segunda causa mais freqüente de mortes neonatais, depois da prematuridade.

OBJECTIVES: to determine the incidence of congenital malformations in newborns in a university maternity hospital in Recife and assess the impact of malformation in perinatal and neonatal mortality. METHODS: a longitudinal study was performed from September 2004 to May 2005 with all deliveries at the Instituto Materno Infantil Prof. Fernando Figueira, IMIP analyzed. The type and incidence of congenital malformations were determined, and fetal mortality, perinatal mortality, early and late neonatal mortality coefficients were calculated. RESULTS: malformation incidence was of 2.8% (in 4.043 births). Malformation percentages among live births was of 2.7% and among stillbirths of 6.7%. The most frequent malformations involved the central nervous system (principally hydrocephaly and meningomyelocele), the skeletal and muscular system and cardiopathies. There was no association between malformation and gender, but prematurity and low birthweight were more frequent among the malformation cases. It was determined that among malformed infants early neonatal mortality was of 32.7% and late neonatal mortality was of 10.6%. Malformation cases were 6.7% of stillborn babies, 24.2% of early neonatal deaths and 25.8% the total of neonatal deaths. CONCLUSIONS: malformation incidence corresponded to 2.8% of the births. Malformation was the second more frequent neonatal death cause following prematurity.

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