Banca de QUALIFICAÇÃO: ANTONIO ARILDO REGINALDO DE HOLANDA
Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.DISCENTE : ANTONIO ARILDO REGINALDO DE HOLANDA
DATA : 10/08/2016
HORA: 11:00
LOCAL: Sala de Aula do Departamento de Tocoginecologia
TÍTULO:
MAMMARY PHYSIOLOGICAL CHANGES DURING PREGNANCY AND LACTATION: ULTRASOUND AN DOPPLER FLOWMETRY ASPECTS.
PALAVRAS-CHAVES:
Pregnancy. Lactation. Breast ultrasound. Doppler flowmetry of internal mammary arteries.
PÁGINAS: 27
GRANDE ÁREA: Ciências da Saúde
ÁREA: Medicina
RESUMO:
INTRODUCTION: Breasts undergo significant changes during pregnancy and lactation that are not fully understood. Ultrasound is the imaging method that best assesses breasts during the pregnancy-puerperium period. It requires a solid knowledge of the anatomy, of possible diseases of the mammary gland during this period and some adaptation techniques on acquiring images. The literature is poor on breast images related to anatomy and physiology during this period and is inconsistent. OBJECTIVE: To evaluate ultrasound breasts characteristics and the internal mammary arteries hemodynamic index in normal pregnant and breastfeeding women and compare them to women in both phases of the normal menstrual cycle. METHODS: A cross-sectional observational study conducted between August 2013 and October 2015, with 204 women distributed into six groups: control group (CG), secretory phase group (SG), 1st trimester group (G1), 2nd trimester group (G2), 3rd trimester group (G3) and lactating group (LG). The dependent variables were skin thickness, subcutaneous adipose tissue, fibroglandular tissue, retromammary adipose tissue, duct diameter, as well as the pulsatility (PI) and resistance index (RI) of internal mammary artery. The different moments of assessment were the independent variables. For statistical analysis, means and standard deviations were calculated, using two MANOVA (Multivariate Analysis of Variance) models to assess the effect of groups on the mean values obtained, and ANOVA models were fit to mean values individually. The Tukey-Kramer multiple comparison test was applied when there was an intergroup difference, in order to characterize each group. A significance level of 5% was set. RESULTS: The mean age was 27,12 ± 4,25 (G1), 26,90 ± 4,85 (G2), 25,83 ± 4,79 (G3), 26,030 ± 4,62 (LG), 28,095 ± 4,93 (CG) e 28,03± 5,12 (SG) years, which showed no significant intergroup difference. There were significant intergroup differences in terms of skin thickness, fibroglandular and duct diameter measures with a p-value < 0.0001 and subcutaneous adipose tissue with p = 0.002. Hemodynamic indices also exhibited significant intergroup differences with p < 0.0001. Skin thickness, fibroglandular tissue and duct diameter measures increased gradually across pregnancy and lactation compared to the control and secretory phase groups, with significant differences. By contrast, the subcutaneous adipose tissue measure showed lower values statistically significant decline across pregnancy. The hemodynamic indices of the internal mammary arteries, higher in the control and secretory phase groups, exhibited lower values across pregnancy, but higher in lactation in relation to the third trimester. CONCLUSION: the data obtained contributed to characterize breast anatomy and physiological changes during pregnancy.
MEMBROS DA BANCA:
Externo ao Programa - 1149381 - ANA CRISTINA PINHEIRO FERNANDES DE ARAUJO
Externo ao Programa - 3242546 - REGINALDO ANTONIO DE OLIVEIRA FREITAS JUNIOR
Presidente - 130.491.274-49 - TÉCIA MARIA DE OLIVEIRA MARANHÃO - UFRN