Pregnancy / high-risk – ABC CARDIOL

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Research Letter

COVID-19 Infection in a Cardiopatic Pregnant Woman

Lucianna Serfaty de Holanda et al. Laíses Vieira Maria Talita Campos Vitor Bruno Teixeira de Holanda … Ivy Almeida Cavalcante e Silva Daniel Serfaty Feliciano Mendes Vieira Junior

Introduction

Regarding the obstetric aspects of COVID-19 infection, one should consider that it is a recent disease, with no specific knowledge on the theme to draft medical care protocols. For this reason, various guidelines are based on its comparison with infections caused by other viruses (SARS-CoV, MERS-CoV, and H1N1); therefore, all information concerning current evidence on the issue is subject to change due to new discoveries.

Infections caused by SARS-CoV and MERS-CoV have tended to be regionally bound, but the few obstetric cases published in the literature point to the need for advanced medical support for pregnant women with severe involvements identified in maternal prognoses. All of these highlight the importance of care against the dissemination of the virus.^–

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Editorial

COVID-19: A New Challenge in Pregnancy and Heart Disease

Walkiria Samuel Avila et al. Regina Coeli de Carvalho

The outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic by the World Health Organization on March 11, 2020. Although SARS-CoV-2 isolation, gene sequencing, and structural analysis have been completed,therapies for COVID-19.

The first epidemiological data have pointed to a worse outcomes and higher mortality of COVID-19 in patients with chronic diseases, such as heart disease and arterial hypertension. Subsequently, the Brazilian Health Ministry included in the high-risk group pregnant, puerperal and post-abortion women.

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Original Article

Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women

Alina Coutinho Rodrigues Feitosa et al. Luciana Tedgue Barreto Isabela Matos da Silva Felipe Freire da Silva Gilson Soares Feitosa Filho

Abstract

Background:

There is a physiologic elevation of total cholesterol (TC) and triglycerides (TG) during pregnancy. Some authors define dyslipidemia (DLP) in pregnant women when TC, LDL and TG concentrations are above the 95th percentile (p95%) and HDL concentration is below the 5th percentile (P5%) for gestational age (GA).

Objective:

To compare the prevalence of DLP in pregnant women using percentiles criteria with the V Brazilian Guidelines on Dyslipidemia and the association with maternal and fetal outcomes.

Results:

Pregnant women with high-risk conditions, aged 18-50 years, and at least one lipid profile during pregnancy was classified as the presence of DLP by two diagnostic criteria. Clinical and laboratorial data of mothers and newborns were evaluated.

Conclusion:

433 pregnant women aged 32.9 ± 6.5 years were studied. Most (54.6%) had lipid profile collected during third trimester. The prevalence of any lipid abnormalities according to the criteria of the National Guidelines was 83.8%: TC ≥ 200 mg/dL was found in 49.9%; LDL ≥ 160 mg/dL, in 14.3%, HDL ≤ 50 mg/dL in 44.4% and TG ≥ 150 mg/dL in 65.3%. Any changes of lipid according to percentiles criteria was found in 19.6%: elevation above the P95% for TC was found in 0.7%; for LDL, 1.7%; for TG 6.4% and HDL lower than the P5% in 13%. The frequency of comorbidity: hypertension, diabetes, smoking, obesity and preeclampsia was similar among pregnant women when DLP was compared by both criteria.

Conclusion:

The prevalence of DLP during pregnancy varies significantly depending on the criteria used, however none demonstrated superiority in association with comorbidities.

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Artigo Original

Study on the major maternal risk factors in hypertensive syndromes

Thaís Rocha Assis et al. Fabiana Pavan Viana Salvador Rassi

BACKGROUND: There are several risk factors for hypertensive syndromes in pregnancy (HSP), and these can be related to regional and ethnic factors. Studies on this issue are scarce in the State of Goiás. OBJECTIVE: To investigate maternal risk factors for HSP. METHODS: Case-control study based on the analysis of medical records of parturients from the Maternity Service of Hospital das Clínicas da Universidade Federal de Goiás (HC-UFG) in 2005. Risk factors were analyzed using Logistic Regression Analysis and Fisher’s Exact Test. RESULTS: In 2005, there were 890 deliveries in the Maternity Service of HC-UFG, and 129 pregnant women were diagnosed with HSP (14.5%). The multivariate analysis identified obesity as a risk factor both for gestational hypertension – GH (OR: 17.636; 95% CI: 2.859 to 108.774) and for preeclampsia superimposed on chronic hypertension – PESCH (OR: 27.307; 95% CI: 4.453 to 167.440). Primiparity was a risk factor for GH (OR: 5.435; 95% CI: 1.923 to 15.385). Age above 30 years was a risk factor for PESCH (OR: 5.218; 95% CI: 1.873 to 14.536) and a protective factor against preeclampsia – PE (OR: 0.035; 95% CI: 0.003 to 0.364). Non-white race was an independent risk for PE (OR: 13.158; 95% CI: 1.672 to 100.000) and previous PE for PESCH (OR: 4.757; 95% CI: 1.261 to 17.938). Of the pregnant women with chronic hypertension (CH), 73.5% developed PESCH (p < 0.001). CONCLUSION: The factors identified – obesity, non-white race, previous PE, age above 30 years and CH, were similar to those found in the majority of studies in the literature.

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COVID-19 Infection in a Cardiopatic Pregnant Woman

Introduction

COVID-19: A New Challenge in Pregnancy and Heart Disease

Impact of the Use of Different Diagnostic Criteria in the Prevalence of Dyslipidemia in Pregnant Women

Abstract

Background:

Objective:

Results:

Conclusion:

Conclusion:

Study on the major maternal risk factors in hypertensive syndromes

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