Introduction: Maternal and child care is one of the priority health issues that have been identified as requiring urgent attention in South Africa. Despite various efforts, South Africa has not seen improvements in maternal and perinatal outcomes. It is therefore essential that services and practices in hospitals rendering maternity care be reviewed and audited, so that current services can be improved and new services developed if necessary. In Schweizer-Reneke Hospital the clinical outcomes and clinical practices at the maternity unit have never been clearly described. The aim of the study was to describe the clinical outcomes and the associated clinical practices in the maternity unit of the hospital from 1 January 2009 to 31 December 2009. Methodology: The study setting was the maternity unit of Schweizer-Reneke District Hospital, a level 1 district hospital in a rural district of the North West Province. It comprised of a retrospective review of data from the District Health Information System and of the delivery records, specifically the partogram from 1 January 2009 to 31 December 2009. The study also examined records of Perinatal Problem Identification Programme and Mortality and Morbidity Review meetings. The study population included all the patients who delivered at the maternity unit during the study period. The measurement tools for data collection were data capture sheets on excel spreadsheets. The source of the data was the maternity register, maternity case records, Perinatal Problem Identification Programme records, District Health Information System and Unit Administration files (for records of meetings). The researcher personally captured the data. Results: Out of 699 deliveries conducted at the hospital 80.1% were normal deliveries, 16.3% caesarean sections and 3.6% vacuum-assisted deliveries. The record review revealed errors in the number of caesarean sections and vacuum-assisted deliveries on the DHIS. The perinatal mortality rate was calculated to be 56 per 1000 live births during the study period. Again the record review identified more perinatal deaths (41) than what was reported on the DHIS. No maternal deaths were recorded during the study period. A total of 295 records were analysed for completeness of the partogram. Out of the 295 partograms analysed none of them had data completed according to standard. The analysis of the completion of the partogram show that there is a significant association between recording of certain aspects of the partogram (risk factors, parity, age, fetal heart, contractions, cervical dilatation, problems and management plan) and mode of delivery whereas with other aspects there is no significant association. The aspects of the partogram that were completed according to standard by the perinatal outcome were poorly recorded, ranging from 0% to 54%. The association between mode of delivery and perinatal outcome was found to be statistically significant (p value 0.000). All of the fresh stillbirths and 90% of macerated stillbirths were born by normal vertex delivery. For the period under study one MMR meeting was conducted. Conclusion: The study found that there were poor clinical practices and outcomes in the maternity unit of Schweizer-Reneke Hospital. There are signs of poor information management as indicated by the discrepancies between data on hospital records and the DHIS. The reasons for this could not be established. Perinatal Problem Identification Problem and Mortality and Morbidity Review meetings were not conducted regularly and therefore could not be used to improve clinical practices and outcomes. Recommendations: Major steps need to be taken to improve clinical governance within the maternity unit of Schweizer-Reneke Hospital. Strategies to recruit and retain Professional Nurses need to be developed. The high percentage of macerated stillbirths needs to be investigated at district level and antenatal care needs to be improved. Studies focusing on the direct effect of inadequate recording on mortality and morbidity and the causes or reasons for inadequate completion of the partogram are necessary.

Made available in DSpace on 2019-03-29T23:50:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-12-12 / Against the national scenario for reducing neonatal mortality and humanization, it becomes essential to know in what way this aggravating situation is interpreted by the grieving mothers in an attempt of adoption of effective actions to face the grief in a less traumatic way. The reason of this work is to show the experience of perinatal death and the elaboration of mourning by their parents in two public hospitals located in the city of Fortaleza, Ceará. To describe the context in which occurs the perinatal death was used the technique of participant observation, with entries made in field journal, building a dense description of the whole context, with entries made in local journal, building a dense description of the whole context. In order to critically evaluate the conduct of the delivery room team, in front of perinatal death, were carried out ethnographic interviews merged with, narratives of lived moments and of participant observation. To capture and compare the reaction experienced by parents on the announcement of perinatal death in both hospital environments, was unveiled the way was given the news of death, and the moment to say goodbye. There were taken notes in the journal, related to the place where the news was given as well as the funeral rituals. The reaction of parents and professionals, was also observed. After transcription, the data were analyzed according to the methodology "Analysis of the Systems of signs, meanings and actions". It was possible to identify the improvement in hospital structures in order to receive and carry out properly the humanized childbirth, and therefore humanize the perinatal death and integration, awareness and commitment of the multidisciplinary team. We suggest that bereaved mothers should receive a psychological support in the short and medium term for healthy development of neonatal mourning. Only through the law and establishment of the obligation to carry out the humanized childbirth in hospital environment and with escort, it is insufficient. / Diante do cenário nacional para redução e humanização da mortalidade neonatal, torna-se imprescindível conhecer de que maneira este agravo é interpretado pelas mães enlutadas na tentativa da adoção de medidas e estratégias eficazes para a elaboração do luto de uma maneira menos traumática. O objetivo deste trabalho é contextualizar a experiência do óbito perinatal e elaboração do luto pelos pais em dois hospitais públicos, comparáveis, localizados em Fortaleza, Ceará. Para descrever o contexto em que ocorre a morte perinatal, foi utilizada a técnica da observação participante, com anotações feitas em diário de campo, construindo uma descrição densa de todo o contexto. Com o intuito de avaliar criticamente a conduta da equipe de sala de parto, diante do óbito perinatal, foram realizadas entrevistas etnográficas mescladas com narrativas de momentos vividos e observação-participante. Para captar e comparar a reação vivenciada pelos pais diante da comunicação do óbito perinatal em ambos os ambientes hospitalares, foi desvelada a maneira como foi dada a notícia do óbito e o momento da despedida. Foram feitas no diário de campo anotações relacionadas à maneira, ao local em que a notícia foi dada e aos rituais fúnebres. A reação dos pais e profissionais, também foi observada. Após a transcrição, os dados foram analisados segundo a metodologia Análise dos Sistemas de Signos, Significados e Ações . Foi possível identificar que apesar de muito já ter sido feito como a implantação do parto humanizado, muito ainda precisa ser feito, como a conscientização dos profissionais de saúde, a melhora nas estruturas hospitalares para poder receber e realizar adequadamente o parto humanizado, e consequentemente, humanizar o óbito perinatal e a integração, conscientização e comprometimento da equipe multidisciplinar. Uma sugestão seria que as mães enlutadas deveriam receber um suporte psicológico a curto e médio prazo para elaboração saudável do luto neonatal. Apenas a formulação da lei e estabelecimento da obrigatoriedade em realizar o parto humanizado, em ambiente hospitalar e com acompanhante é insuficiente.

No description available.

No description available.

El presente estudio de tipo retrospectivo, descriptivo se efectuó con el objeto de determinar la morbimortalidad y además describir el desempeño de la escala predictiva de mortalidad denominada Índice de Mortalidad Pediátrica – PIM 2. El estudio se realizó en la Unidad de Cuidados Intensivos Pediátricos del Hospital Nacional Daniel Alcides Carrión de Callao – Perú, durante el periodo comprendido entre el 1 de enero al 31 de diciembre del año 2003 siendo atendidos 171 niños. De este grupo fallecieron 33 dando una tasa de mortalidad de 19.3%. El grupo de estudio quedó conformado por 126 niños de los que fallecieron 19 siendo la mortalidad de 15.1%. La estancia hospitalaria en la unidad fue 5 ±5.4 días. En base a su mortalidad predicha calculada mediante la escala PIM 2, la población en estudio fue asignada en los siguientes grupos: Muy Bajo Riesgo, Riesgo Bajo, Riesgo Moderado, Riesgo Alto y Muy Alto Riesgo. La mayoría de la población quedó asignada al grupo de Riesgo Bajo. La tasa de mortalidad esperada durante el año 2003 fue 11.4% y la tasa de mortalidad observada fue de 15.1%. Las patologías más frecuentes fueron hipertensión endocraneana y bronconeumonía-SOBA. Las patologías con mayor porcentaje de fallecidos fueron Shock séptico e hipertensión endocraneana. La mayoría de ingresos a la UCIP vinieron procedentes de Emergencia Pediátrica. De ellos, el mayor riesgo de morir lo tuvieron los niños procedentes de su casa (14.7%) frente al grupo que vino referido de otro centro asistencial (8.1%). Se halló asociación significativa entre el estado nutricional y mortalidad observándose que sólo el 7% de los eutróficos fallecen frente al 20% de fallecidos de los niños desnutridos. Con respecto al PIM 2, los 19 niños que fallecieron tuvieron los más altos índices de riesgo de morir con un promedio de 28,8% de riesgo de mortalidad frente al 8.1% del grupo de niños que sobrevivió mostrando diferencia significativa. El PIM 2 tiene alta especificidad (95.6%) y al evaluar su desempeño se encontró que el área bajo la curva ROC fue de 0.797 considerada como aceptable. / The present retrospective descriptive study was performed with the aim to determine the morbimortality and describe the performance of the Paediatric Index of Mortality – PIM 2. The study was undertaken at the Pediatric Intensive Care Unit of the Hospital Nacional Daniel Alcides Carrión of Callao – Perú. During the period between January 1 to December 31 of 2003 with 171 children attended. Of this group, 33 children died and its mortality rate was 19.3%. The study group was conformed for 126 children and 19 of them died showing a mortality rate of 15.1% The hospital stay in the Unit was 5 + 5.4 days. With the predicted mortality calculed with the PIM 2, the study group was divided in the following groups: Very Low Risk, Low Risk, High and Very High Risk. The majority of the study group was assigned to the Low Risk group. The expected mortality rate in 2003 was 11.4% and the observed mortality rate was 15.1%. The most frequently pathologies were endocranean hypertension and pneumonia-SBO. The pathologies with the highest percentage of died children were septic shock and endocranean hypertension. The majority of patients admitted came from Emergency Pediatric. The most risk of mortality was obtained for the group of children who came from their home (14.7%) in comparison with the group that arrived from another hospital (8.11%). A significative association was found between malnutrition and mortality. Only 7% of eutrofic children died in comparison with the 20% of the malnourished children. In relation to PIM 2, the dead children group obtained the highest risk for die (28.8%) in comparison with the survivor children group (8.1%). The PIM 2 had a high specificity (95.6%) and the area under the ROC curve was 0.797.

Thesis (Ph.D.)--York University, 2007. Graduate Programme in Sociology. / Typescript. Includes bibliographical references (leaves 217-233). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR39000

The thesis consists of seven Sections. Each Section contains a set of published papers, reports or chapters which describe epidemiological aspects of the Cerebral Palsies (CPs). These have, in the main, made use of of the Western Australian Cerebral Palsy Register. Several of the chapters are from a recent book (Stanley and Alberman, 1984), which was an invited monograph in a series published jointly by Spastics International Medical Publications and Blackwells, Oxford. The published work in each Section is introduced and moulded together by text with the aim of making it flow as a composite whole. The numbers and rates differ between papers as the register is continually being updated and recent figures are more accurate and complete than in earlier publications. The Register was established in 1977, with the aims of being basically descriptive: to provide accurate numerator data on the major cause of childhood motor handicap. In addition it was planned to utlisie the data base as a population sampling frame for epidemiological studies searching for causes of the CPs. It is now an ongoing collection and it is the only population-based Cerebral Palsy Register in Australia. Four others exist in the world, one in Denmark (Hansen, 1960; Glenting, 1976), one in Sweden (Hagberg et al., 1975a, 1975b, 1976), one in County Cork, Ireland (Cussen et al., 1978), and one in Newcastle-Upon-Tyne in UK (Hey, personal communication). It is of considerable current interest, as paediatric research is expanding into the causes of childhood handicaps generally, and perinatal researchers are keen to monitor the trends of major handicap in relation to changes in perinatal care.

SOUSA, F. J. (2016) Fatores associados à prematuridade no município de sobral, ceará. 2016. 106 f. Dissertação (Mestrado em Saúde da Família) - Universidade Federal do Ceará, Programa de Pós Graduação em Saúde da Família, Sobral, 2016 / Submitted by Mestrado Saúde da Família (saudedafamiliasobral@gmail.com) on 2016-11-23T18:47:36Z No. of bitstreams: 1 2016_dis_fjsantossousa.pdf: 2704609 bytes, checksum: 7313a175f9645d864e10c50612e6821a (MD5) / Approved for entry into archive by Ana Márcia Sousa (marciasousa@ufc.br) on 2017-01-19T12:21:40Z (GMT) No. of bitstreams: 1 2016_dis_fjsantossousa.pdf: 2704609 bytes, checksum: 7313a175f9645d864e10c50612e6821a (MD5) / Made available in DSpace on 2017-01-19T12:21:40Z (GMT). No. of bitstreams: 1 2016_dis_fjsantossousa.pdf: 2704609 bytes, checksum: 7313a175f9645d864e10c50612e6821a (MD5) Previous issue date: 2016-07-14 / Prematurity is the leading cause of death in the first 24 hours of life, being a major concern for managers and health professionals around the world, and it constitutes one of the biggest challenges to reducing child mortality. Additionally, the preterm birth is associated with the after-effects that can be severe and painful, both for the baby and for the family, contributing significantly to increased neurological morbidity, pulmonary and ophthalmologic. Thus, knowledge about the complexity of the relationship between premature birth and its determinants is essential so that you can plan interventions that are effective to reduce prematurity and especially the death of newborn preterm. This study aims to identify the causes associated with prematurity in the city of Sobral. It is a study of case-control, documentary based on data from SINASC and Strategy Database "Trevo de Quatro Folhas" in Sobral. The cases were all premature infants residents in Sobral. Controls were randomly selected among non premature infants born in Sobral. There were 169 cases and 170 controls born between the months of August to December 2015. The upshot variable was the premature birth. The independent variables were divided into five blocks: Identification and socioeconomic characteristics; maternal reproductive history; mother's characteristics in pregnancy; prenatal care and complications; childbirth and newborn conditions. For univariate analysis was performed χ2 test (chisquare) and Fisher's exact test, considered significant association when the p value was less than 0.05. For the multivariate analysis was used logistic regression, the variables being selected whose p value was less than 0.20. The technique used was the model of hierarchical causal effect. The method of inputs variable was the stepwise forward, in which, in each stage, remained in the model variables with p <0.05. Univariate and multivariate analyzes were performed using SPSS version 20.0. The level of significance was 5%. The study followed Resolution 466/12 with a favorable opinion of the Ethics Committee of t he State University of Vale do Acaraú (No. 1.590.501). At the end of multivariate analysis remained as causes associated with prematurity in Sobral insufficient number of consultations in prenatal care (p = 0.01 OR 2.9) and hospitalization during pregnancy (p = 0.01, OR 3.0). The variable hospitalization during pregnancy expressed biological conditions, while the number of consultation reflects the social conditions of the women. This result was similar to that was observed in other Brazilian studies in dif ferent social contexts, despite the various socio-economic realities and the use of different variables. / A prematuridade é a principal causa de morte nas primeiras 24 horas de vida, sendo uma grande preocupação para gestores e profissionais de saúde em todo o mundo, por constituir-se um dos maiores desafios para a redução da mortalidade infantil. Além disso, o parto pré-termo está associado à sequelas que podem ser graves e penosas, tanto para o bebê quanto para a família, contribuindo significativamente para o aumento da morbidade neurológica, pulmonar e oftalmológica. Dessa forma, o conhecimento sobre a complexidade da relação entre a prematuridade e seus determinantes, é fundamental para que se possa planejar intervenções que sejam efetivas para reduzir a prematuridade e principalmente, o óbito de recém-nascidos pré-termo. Esse estudo objetiva identificar as causas associadas à prematuridade no município de Sobral. Trata-se de um estudo do tipo caso-controle, documental com base em dados do SINASC e do Banco de Dados da Estratégia Trevo de Quatro Folhas de Sobral. Os casos foram todos os recém-nascidos prematuros residentes em Sobral. Os controles foram selecionados aleatoriamente entre os RN não prematuros nascidos em Sobral. Foram 169 casos e 170 controles nascidos entre os meses de agosto a dezembro de 2015. A variável desfecho foi o nascimento prematuro. As variáveis independentes foram divididas em cinco blocos:Identificação e características socioeconômicas; história reprodutiva materna; características da mãe na gravidez; assistência pré-natal e intercorrências; condições do parto e do RN. Para a análise univariada foi realizado o teste de χ (Quiquadrado) e Teste Exato de Fisher, sendo considerada associação significativa quando o valor de p foi menor que 0,05. Para a análise múltipla foi utilizada a técnica de regressão logística, sendo selecionadas as variáveis cujo valor de p foi menor que 0,20. A técnica utilizada foi o modelo de efeito causal hierarquizado. O método de entradas das variáveis foi o stepwise forward, no qual, em cada etapa, permaneciam no modelo as variáveis que apresentavam p < 0,05. As análises univariadas e múltiplas foram realizadas utilizando o programa SPSS versão 20.0. O nível de significância utilizado foi de 5%. O estudo obedeceu a Resolução 466/12 com parecer favorável do Comitê de Ética da Universidade Estadual Vale do Acaraú (nº 1.590.501). No final da análise multivariada permaneceram como causas associadas à prematuridade em Sobral o número insuficiente de consultas no prénatal (p= 0,01 OR 2,9) e a internação durante a gravidez (p= 0,01 OR 3,0). É possível pensar que a variável internação durante a gravidez esteja expressando condições biológicas na gestação, enquanto o número de consulta reflete as condições sociais das gestantes. Esse resultado foi semelhante ao observado em outros estudos brasileiros em diferentes contextos sociais, apesar das realidades socioeconômicas diversas e da utilização de variáveis diferentes.

Em ratos a mãe é indispensável para a sobrevivência dos filhotes durante as duas primeiras semanas de vida. O comportamento maternal despendido pelas fêmeas tem grande importância para o desenvolvimento adequado dos filhotes. Assim, eventos estressores durante o período perinatal capazes de desencadear perturbações nessa relação podem levar a alterações comportamentais e neuroendócrinas duradouras nesses filhotes. Nesse trabalho avaliamos o efeito do estresse perinatal sobre a formação do vínculo entre mãe-filhotes e sobre os níveis dos hormônios relacionados com as respostas ao estresse, para tanto, os filhotes foram submetidos à coleta de plasma sanguíneo para a dosagem de hormônios relacionados ao estresse (corticosterona e prolactina) e foram submetidos ao Teste de Preferência Olfatória (teste comportamental) e à dosagem de ocitocina central para avaliar a formação do vínculo mãe-filhote. O estresse perinatal aqui empregado foi subdividido em estresse pré-natal e estresse pós-natal. No primeiro, a fêmea prenha foi submetida à restrição de maravalha ao longo da última semana de gestação – do 14º ao 21º dia gestacional – e no segundo a ninhada inteira (mãe e filhotes) foi exposta à presença de um predador (gato) no 1º dia pós-parto. Levando em consideração a presença ou ausência desses estressores os filhotes foram divididos em quatro grupos experimentais: Controle, Estresse Pré, Estresse Pós e Estresse Pré+Pós. Em nossos animais, o estresse perinatal, tanto o pré como o pós-natal, foi capaz de desencadear alterações no Teste de Preferência Olfatória no nono dia de vida, alterações estas que podem ser traduzidas como uma perda na capacidade desses animais se direcionarem ao cheiro da mãe. No entanto, a ocitocina central (coletada no primeiro dia pós-parto) que é fortemente relacionada à formação do vínculo mãe-filhote não foi alterada pelo estresse. Além da alteração no teste comportamental, o estresse perinatal foi capaz de desencadear alterações nos hormônios de estresse (corticosterona e prolactina) em filhotes muito jovens (primeiro dia pós-natal) e, portanto, ainda dentro do período hiporresponsivo ao estresse no qual as respostas ao estresse, assim como todo o eixo Hipotálamo-Pituitária-Adrenal (HPA) estão inibidos. No entanto, os efeitos observados nem sempre foram de aumento desses hormônios e nem sempre foram homogêneos entre os gêneros. Em conclusão, os resultados dessa dissertação apontam para a validade do modelo de estresse perinatal aqui empregado para provocar perturbações no desenvolvimento adequado dos filhotes a ele submetidos, pois ambos os protocolos de estresse empregados (restrição de maravalha e exposição ao predador) mostraram-se eficazes em gerar mudanças tanto na relação mãe-filhotes como nos principais hormônios relacionados com a resposta ao estresse desses filhotes. E as consequências desse modelo de estresse abrangem tanto os filhotes fêmeas como os filhotes machos, embora nem sempre os gêneros tenham respondido da mesma forma aos estresses, o que demonstra que mesmo ainda muito jovens esses animais já podem apresentar respostas diferentes a mesmas situações e estímulos. O curioso desse modelo é que embora o estresse pré-natal tenha tido uma duração mais longa, o estresse pós-natal (estresse agudo) parece ter sido mais eficiente em provocar alterações nesses filhotes, o que demonstra tanto a importância do período pós-parto imediato para o desenvolvimento desses animais como o forte efeito do predador sobre a presa. / In rats, the mother plays an essential role in offspring survival during the first two weeks of life. Mother behavior is very important for appropriate offspring development. In this sense, stress events during the perinatal period may disturb the relationship between mother and offspring, leading to enduring behavioral and endocrine changes in the newly born rats. The present study evaluates the effect of perinatal stress on the establishment of a bond between mother and offspring and on hormone levels associated with response to stress. With that aim, levels of hormones associated with stress (corticosterone and prolactin) were analyzed using blood plasma collected from offspring. Also, the olfactory preference test (behavioral test) was conducted and central oxytocin levels were evaluated to test the mother-to-offspring bond. Perinatal stress challenge was divided into two stages, pre-natal and post-natal stress. In the first, pregnant females were kept in cages without sawdust during the last week of pregnancy (14th to 21st day), while in the second the whole litter (mother and offspring) were exposed to a predator (cat) on the first post-partum day. Considering exposure to stress, four experimental groups were formed: pre-natal stress, post-natal stress, pre- and post-natal stress, control (no exposure to stress factors). Perinatal stress (pre- and post-natal) influenced the results of the olfactory preference test on the 9th day of life of offspring. These changes manifested as the loss of the ability to detect the mother’s smell. However, central oxytocin levels, which are strongly associated to the establishment of a mother-to-offspring bond and was collected on the first day post-partum, remained unaltered during stress challenge. Apart from the changes observed in the behavioral test, perinatal stress altered corticosterone and prolactin levels in very young offspring (one day old), within the hyporesponsive period, when responses to stress and the hypothalamic-pituitary-adrenal (HPA) axis are inhibited. Nevertheless, the effects observed were not uniform across genders and were not restricted to increased corticosterone and prolactin levels. In conclusion, the results obtained point to the legitimacy of the perinatal stress model tested to trigger changes in appropriate offspring development of rats. Both stress protocols (absence of sawdust and exposure to a predator) were efficient in altering the mother-to-offspring bond and influencing the main hormones associated with response to stress by this offspring. The model tested affected both male and female offspring, though genders not always responded uniformly to stresses, demonstrating that even at a very tender age these animals may already exhibit different responses to different stimuli. The interesting point in this model is that, though pre-natal stress lasted longer, post-natal stress (acute stress) seemed to have been more efficient in triggering changes, showing the importance of immediate post-partum period in the development of these animals and the strong effect a predator has on its prey.

MARTINS NETO, Manoel. Fatores prognósticos para o óbito neonatal em gestações com diástole zero ou reserva na dopplervelocimetria das artérias umbilicais. 2009. 87 f. Dissertação (Mestrado em Tocoginecologia) - Universidade Federal do Ceará. Faculdade de Medicina, Fortaleza, 2009. / Submitted by denise santos (denise.santos@ufc.br) on 2013-12-23T17:46:06Z No. of bitstreams: 1 2009_dis_mmartinsneto.pdf: 474196 bytes, checksum: e235f8add5c02c395b78131baaa8ad4b (MD5) / Approved for entry into archive by denise santos(denise.santos@ufc.br) on 2013-12-23T17:47:10Z (GMT) No. of bitstreams: 1 2009_dis_mmartinsneto.pdf: 474196 bytes, checksum: e235f8add5c02c395b78131baaa8ad4b (MD5) / Made available in DSpace on 2013-12-23T17:47:10Z (GMT). No. of bitstreams: 1 2009_dis_mmartinsneto.pdf: 474196 bytes, checksum: e235f8add5c02c395b78131baaa8ad4b (MD5) Previous issue date: 2009 / Objectives: evaluate the perinatal results in pregnancies with fetal brain sparing on the Doppler velocimetric study and identify the main prognostic factors associated with neonatal death. Methods: it is a transverse study from the charts of pregnant wowen with diagnosis of brain sparing, absent or reversed end-diastolic flow in the umbilical artery, followed at the Service of Maternal-Fetal Medicine of Maternidade-Escola Assis Chateaubrind – Universidade Federal do Ceará. There were analyzed 143 patients with single pregnancies, without structural or chromosomal anomalies, presenting gestacional age above 22 weeks and fetal weight equal or above 500 grams. ROC curve was constructed for gestacional age and weight at birth (independent variables) and neonatal death (dependent variable). The perinatal results were evaluated on the general population and on each group (brain sparing, absent and reversed end-diastolic flow), later compared with each other. For the statistical analisys it was utilized the tests: Shapiro-Wilk, Levene, t Studente, Mann-Whitney, ANOVA, Kruskal Wallis, Fisher. Chi-square, Logistical and Multinomial Regression. All were considered statistically significant when p < 0.05. Results: the majority of pregnante wowen (78.3%) presented some hypertensive disturb associated to the pregnancy. The pregnancy was resolved in the first 24 hours after Doppler velocimetric diagnosis on most cases (74.8%), being the abdominal acess utilized in 96.5% of the times. At the moment of delivers, the average gestational age was 33.6 weeks and the weight was 1684g. The newborns were classified as small for gestational age in 69.6% and needed ICU admission in 63% of the cases. The indexes of perinatal mortality for brain sparing, absent and reversed end-diastolic flow were respectively 11.1, 31.1 and 70.6%. The weight of the newborn (area bellow the ROC curve 0.934, p=0.000 and gestational age at birth (area 0.909, p=0.000) have shown to be good predictors of neonatal death. The cutoff point calculated for the weight was 1010g and for the gestational age as 32.5 weeks. The incidence of diminished amniotic fluid indez (AFI) in the pregnancies with lethal perinatal outcome was 41.2% and in those without lethality was 41.3%. Conclusions: fetuses with diagnosis of brain sparing, absent and reversed end-diastolic flow presented progressively worse and statistically different with each other prognosis. The gestational age and weight at birth showed excellent correlation with neonatal mortality. The AFI did not demonstrate association with lethality rate. / Objetivos. Avaliar os fatores prognósticos para o óbito neonatal em gestações com diástole zero ou reversa na dopplervelocimetria da artéria umbilical Métodos. Estudo transversal a partir dos prontuários das gestantes com diagnóstico de diástole zero (DZ) ou reversa (DR) em artéria umbilical acompanhadas no Serviço de Medicina Materno Fetal da Maternidade-Escola Assis Chateaubriand – Universidade Federal do Ceará. Foram analisadas 48 pacientes com gestação única, sem anomalias estruturais ou cromossômicas, apresentando idade gestacional superior a 22 semanas e menor do que 34 semanas. Para a avaliação estatística, foram empregados os testes: t Student, Exato de Fisher, Qui-quadrado de Pearson e Regressão Logística e Multinomial. Todos foram considerados estatisticamente significantes quando p<0,05. Resultados. As síndromes hipertensivas foram observadas na maioria (78,3 %) das gestantes. A maioria (52,1%) das gestações foi resolvida nas primeiras 24 horas após o diagnóstico dopplervelocimétrico. Em uma semana, 81,3% dos casos tinham terminado em parto, preferencialmente (85,4%) pela via abdominal. Os maiores percentuais da idade gestacional no momento do diagnóstico dopplervelocimétrico concentraram-se na faixa de 25 e 27 semanas. Os pesos do RN variaram entre 550g e 2600g, com média de 1021,7g. Os recém-nascidos foram classificados como pequenos para idade gestacional em 79,1% dos casos. Ao primeiro minuto de vida, 24 (57,1%) RN apresentaram índices de Apgar menores do que 7. Ocorreram 26 óbitos neonatais. Do estudo estatístico univariado dos fatores de risco antenatais, a idade gestacional no momento do diagnóstico dopplervelocimétrico revelou-se variável significativamente relacionada com o óbito neonatal (RR; 2,1, 95% CI 1.152 – 4.008, p = 0.011). Do estudo estatístico univariado dos fatores de risco pós-natais peso do RN (RR; 2,6, 95% CI 1.329 - 5.238, p = 0.001) e Apgar ao primeiro minuto (RR; 1,9, 95% CI 1.03 – 3.588,p = 0.027) revelaram-se variáveis significativamente relacionadas com o óbito neonatal, com peso do RN apresentando sensibilidade de 76,9%, especificidade de 73,6%, valor preditivo positivo de 80,0% e valor preditivo negativo de 30%, e Apgar ao primeiro minuto apresentando sensibilidade de 61,5%, especificidade de 61,1%, valor preditivo positivo de 69,5% e valor preditivo negativo de 47,6%. Conclusões. Diástole zero ou reversa estão relacionadas com resultados perinatais adversos, cujo risco para óbito neonatal está relacionado com a idade gestacional no momento do diagnóstico dopplervelocimétrico e com o peso do RN e com Apgar ao primeiro minuto.