title: PP139. The elective prematurity birth and its perinatal effects of syndromes in hypertensive pregnancy.
abstract: BACKGROUND
  The hypertensive pregnancy disorders affect 7.5% of Brazilian women, being a major cause of maternal and perinatal morbidity and mortality, affecting 6-10% of primigravidae. They represent a significant cause of prematurity birth, with elective responsible for 20-30% of premature births, with higher incidence of neonatal morbidity due to high rates of complications in short and long term.
  
  
  OBJECTIVE
  Identify the repercussions in a short time, on caused by elective obstetric parity decisions in women with hypertensive neonatals pregnancy syndromes.
  
  
  METHODS
  Retrospective analysis of medical records of pregnant women admitted to Hospital Guilherme Álvaro, in the city of Santos/SP - Brazil, between Jan/2005 to Jan/2012. Calculations were performed for dichotomous variables and an epidemiological analysis with data obtained on pregnant women with hypertension with a single fetus, subjected to delivery before 37 weeks. Classification of Hypertensive Syndromes followed the criteria of the NHBPEP - 2000, after blood pressure measurements were calibrated following standard technique: Chronic hypertension (CH), Pre-eclampsia, superimposed pre-eclampsia and late gestational hypertension and multiple births were excluded, premature labor and fetal malformations, totaling 102 cases.
  
  
  RESULTS
  Throughout the study, it was observed that 67.6% are appropriate for gestational age, birth weight 1500-2500grams (43.1%). Support in the neonatal were excluded ICU was necessary in the vast majority (75.7%), and length of stay exceeding 28 days in 29.3% of cases. The main indication was respiratory distress syndrome (63.6%) requiring intubation orotraquel and jaundice in 18.2% of premature infants was a common comorbidity (39.4%). Even with all the support in-hospital, the neonatal mortality was present in 8.1% of cases. The main indication of the resolution was for obstetric maternal complications (61.8%) where pre-eclampsia and preeclampsia superimposed were expressions which caused more frequent (42.2 and 40.2% respectively), showing the level of proteinuria between two -4.9g (32.1%). Gestational age at delivery was 32-34 weeks (43.1%), corticosteroid therapy was not performed (54.9%) and cesarean delivery was (94.1%). The most frequent age group was 20-34 years (53.9%), Caucasian (54.9%), primigravida (62.7%) and less than five prenatal visits (36.3%) were performed.
  
  
  CONCLUSIONS
  The hypertensive pregnancy are risk factors for preterm elective delivery and is more frequent before 34 weeks, resulting in high perinatal morbidity and mortality, especially in cases of preeclampsia with severe clinical presentation and long hospital stays, with consequent costs and conducting excessive procedures in the neonate. Enable early referral to specialist services and consequent prenatal follow up, enables the adoption of early action, such as clinical support in a timely manner to facilitate the handling of cases which are still stable, optimizing the opportunity for administration of antenatal corticosteroids. It is necessary to review decisions about the mode of delivery in prematurity related to hypertension cases, with the aim of increasing the occurrence of vaginal deliveries.
authors.affiliation: Obstetrics, Guilherme Álvaro Hospital, São Paulo, Brazil.
authors.forename: N B F
authors.initials: NB
authors.lastname: Marra
authors.affiliation: Obstetrics, Guilherme Álvaro Hospital, São Paulo, Brazil; Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: F L P
authors.initials: FL
authors.lastname: Sousa
authors.affiliation: Obstetrics, Guilherme Álvaro Hospital, São Paulo, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Scarpelini
authors.affiliation: Obstetrics, Guilherme Álvaro Hospital, São Paulo, Brazil; Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: J M
authors.initials: JM
authors.lastname: Garcia
authors.affiliation: Obstetrics, Guilherme Álvaro Hospital, São Paulo, Brazil; Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: V M G
authors.initials: VM
authors.lastname: Marçal
authors.affiliation: Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: P G
authors.initials: PG
authors.lastname: Figueiredo
authors.affiliation: Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: S S T
authors.initials: SS
authors.lastname: Uchiyama
authors.affiliation: Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: S M
authors.initials: SM
authors.lastname: Reimão
authors.affiliation: Obstetrics, Guilherme Álvaro Hospital, São Paulo, Brazil; Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: S F
authors.initials: SF
authors.lastname: Toledo
authors.affiliation: Obstetrics, Guilherme Álvaro Hospital, São Paulo, Brazil; Obstetrics, UNILUS - Lusíada Foundation, Faculty of Medical Sciences of Santos, Santos, Brazil.
authors.forename: R G R
authors.initials: RG
authors.lastname: Guidoni
authors.affiliation: Obstetrics, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: N
authors.initials: N
authors.lastname: Sass