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Advisor(s)
Abstract(s)
Introdução: A deteção precoce de Malformações Congénitas desempenha um papel
fundamental na promoção da saúde fetal e materna, pois permite a identificação
precoce de anomalias, o planeamento dos cuidados adequados, a intervenção médica
mais oportuna e o suporte emocional necessário aos pais e restantes familiares.
Existem diversos fatores associados ao desenvolvimento destas anomalias, pelo que é
de grande importância o seu estudo. A ecografia é um método de imagem não invasivo
e seguro que permite a visualização e monitorização do feto no ambiente uterino. Sendo
utilizada para examinar cuidadosamente a anatomia fetal em busca de possíveis
malformações, é uma das ferramentas mais importantes que permitiu o aumento
progressivo de deteção destas anomalias e, consequentemente, o aumento de
notificação das mesmas ao Registo Nacional de Anomalias Congénitas.
Objetivos: Dada a elevada importância deste tema, este projeto pretende fazer um
levantamento e uma análise dos casos de Malformações Congénitas detetadas por
ultrassom no serviço de Ginecologia e Obstetrícia do Centro Hospitalar Universitário
da Cova da Beira e avaliar possíveis associações com Fatores de Risco Modificáveis e
Não Modificáveis.
Metodologia: A pesquisa foi conduzida através de uma abordagem retrospetiva, nas
gestantes seguidas em Consulta de Ultrassonografia Obstétrica no serviço de
Ginecologia e Obstetrícia do Centro Hospitalar Universitário Cova da Beira no período
entre 2016 e 2022, através dos processos clínicos disponíveis no SClínico. As amostras
em estudo incluem um grupo experimental (composto por gestantes onde foram
detetadas Malformações Congénitas por ultrassom) e o grupo controlo (composto por
um número idêntico ao grupo experimental, escolhido de forma aleatória, mas com
gestantes onde não foram detetadas Malformações Congénitas por ultrassom).
Resultados e Discussão: A amostra do grupo experimental é composta por 139
gestantes e a amostra do grupo controlo é composta por 141 gestantes. No grupo
experimental foram detetadas 117 gestações com apenas 1 malformação e 22 com mais
do que uma. A Malformação Congénita mais detetada foi do tipo Renal com 47,3%,
seguida por MC do Sistema Nervoso Central (17,4%), Osteomuscular (10,2%), Cardíaca
(10,2%), Craniofacial (9,6%), Genitourinária (5,4%), Digestiva e da Parede abdominal
(3,0%) e do Trato Respiratório (0,6%). Relativamente às associações entre os grupos experimental e controlo com os fatores não modificáveis, não existem associações
estatisticamente significativas. Enquanto que relativamente às associações com os
fatores modificáveis, apenas no fator obesidade existiu uma associação estatisticamente
significativa, sugerindo que as duas variáveis sejam dependentes. No entanto, admitese ter havido um viés na comparação dos dois grupos visto que os números
considerados entre eles não são idênticos (devido à existência de um número maior de
missing cases num dos grupos), pelo que a viabilidade desta associação fica
comprometida.
Conclusão: Apesar de não se terem conseguido associações estatisticamente
significativas para nenhum dos fatores de risco, este estudo é relevante para o contínuo
levantamento de dados e possíveis comparações futuras dos resultados, no sentido de
fazer um levantamento das malformações congénitas mais comuns neste centro
hospitalar e arranjar estratégicas de planificação, gestão e combate, para uma melhor
prestação dos cuidados materno-infantis.
Introduction: Early detection of Congenital Malformations plays a fundamental role in promoting fetal and maternal health, as it allows for early identification of anomalies, planning appropriate care, timely medical intervention, and necessary emotional support for parents and other family members. There are various factors associated with the development of these anomalies, making their study highly important. Ultrasound is a non-invasive and safe imaging method that allows visualization and monitoring of the fetus in the uterine environment. This tool is used to carefully examine the fetal anatomy for possible malformations, making it one of the most important tools that enabled the progressive increase in the detection of these anomalies and the rise in reporting them to the National Registry of Congenital Anomalies. Objectives: Given the high importance of this topic, this project aims to survey and analyze cases of Congenital Malformations detected by ultrasound in the Gynecology and Obstetrics service of the University Hospital Center of Cova da Beira and to evaluate possible associations with Modifiable and Non-Modifiable Risk Factors. Methodology: The research was conducted through a retrospective approach, on pregnant women followed in Obstetric Ultrasound Consultation at the University Hospital Center of Cova da Beira in the period between 2016 and 2022, through clinical records available in SClínico. The study samples include an experimental group (composed of pregnant women where Congenital Malformations were detected by ultrasound) and the control group (composed of an identical number to the experimental group, randomly chosen pregnant women where Congenital Malformations were not detected by ultrasound). Results and Discussion: The experimental group sample consists of 139 pregnant women and the control group sample consists of 141 pregnant women. In the experimental group, there were 117 pregnancies with only 1 malformation and 22 with more than one detected. The most detected Congenital Malformation was of the Renal type with 47,3%, followed by the congenital anomaly of the Central Nervous System (17,4%), Musculoskeletal (10,2%), Cardiac (10,2%), Craniofacial (9,6%), Genitourinary (5.4%), Digestive and Abdominal Wall (3,0%), and Respiratory Tract (0,6%). Regarding associations between the experimental and control groups with non-modifiable factors, there are no statistically significant associations. Whereas regarding associations with modifiable factos, only in the obesity factor was there a statistically significant association, indicating a dependence between the two variables. However, there may have been bias in the comparison between the two groups due to diferences in the numbers considered (attributable to a larger number of missing cases in one of the groups), compromising the validity of this association. Conclusion: Despite the lack of statistically significant associations for any of the risk factors, this study holds significance for the ongoing collection of data and potential future comparisons of results, in order to carry out a survey of the most common congenital malformations in this hospital center and devise planning, management and intervention strategies, for a better provision of maternal and child care.
Introduction: Early detection of Congenital Malformations plays a fundamental role in promoting fetal and maternal health, as it allows for early identification of anomalies, planning appropriate care, timely medical intervention, and necessary emotional support for parents and other family members. There are various factors associated with the development of these anomalies, making their study highly important. Ultrasound is a non-invasive and safe imaging method that allows visualization and monitoring of the fetus in the uterine environment. This tool is used to carefully examine the fetal anatomy for possible malformations, making it one of the most important tools that enabled the progressive increase in the detection of these anomalies and the rise in reporting them to the National Registry of Congenital Anomalies. Objectives: Given the high importance of this topic, this project aims to survey and analyze cases of Congenital Malformations detected by ultrasound in the Gynecology and Obstetrics service of the University Hospital Center of Cova da Beira and to evaluate possible associations with Modifiable and Non-Modifiable Risk Factors. Methodology: The research was conducted through a retrospective approach, on pregnant women followed in Obstetric Ultrasound Consultation at the University Hospital Center of Cova da Beira in the period between 2016 and 2022, through clinical records available in SClínico. The study samples include an experimental group (composed of pregnant women where Congenital Malformations were detected by ultrasound) and the control group (composed of an identical number to the experimental group, randomly chosen pregnant women where Congenital Malformations were not detected by ultrasound). Results and Discussion: The experimental group sample consists of 139 pregnant women and the control group sample consists of 141 pregnant women. In the experimental group, there were 117 pregnancies with only 1 malformation and 22 with more than one detected. The most detected Congenital Malformation was of the Renal type with 47,3%, followed by the congenital anomaly of the Central Nervous System (17,4%), Musculoskeletal (10,2%), Cardiac (10,2%), Craniofacial (9,6%), Genitourinary (5.4%), Digestive and Abdominal Wall (3,0%), and Respiratory Tract (0,6%). Regarding associations between the experimental and control groups with non-modifiable factors, there are no statistically significant associations. Whereas regarding associations with modifiable factos, only in the obesity factor was there a statistically significant association, indicating a dependence between the two variables. However, there may have been bias in the comparison between the two groups due to diferences in the numbers considered (attributable to a larger number of missing cases in one of the groups), compromising the validity of this association. Conclusion: Despite the lack of statistically significant associations for any of the risk factors, this study holds significance for the ongoing collection of data and potential future comparisons of results, in order to carry out a survey of the most common congenital malformations in this hospital center and devise planning, management and intervention strategies, for a better provision of maternal and child care.
Description
Keywords
Diagnóstico Pré-Natal Ecografia Malformações
Congénitas Obstetrícia Rastreio Pré-Natal