Home - Revista Brasileira de Ginecologia e Obstetrícia

  • Review Article

    Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo37

    Summary

    Review Article

    Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo37

    DOI 10.61622/rbgo/2024rbgo37

    Views50

    Abstract

    Objective

    To identify the impact of redox imbalance on the clinical evolution of patients with polycystic ovary syndrome and carry out a qualitative and quantitative projection of the benefits of vitamin D supplementation.

    Data sources

    Combinations of the keywords polycystic ovary syndrome, vitamin D, oxidative stress, reactive oxygen species, antioxidant, and free radicals were used in PubMed, Cochrane Library, LILACS, EMBASE, and Web of Science databases. The last search was conducted on August 22, 2023.Selection of studies: Based on the inclusion and exclusion criteria, studies were selected considering a low risk of bias, published in the last 5 years in English, which investigated the effects of vitamin D supplementation in women with PCOS, focusing on oxidative stress markers. Of the 136 articles retrieved, 6 intervention studies (445 women) were included.

    Data collection

    The risk of bias in included studies was assessed using the Jadad scale, and analysis and visualization of continuous data were performed using Review Manager 5.4.1, summarized as standardized mean differences (SMD) with confidence intervals (CI) of 95%.

    Data synthesis

    Vitamin D effectively reduced malondialdehyde (P=0.002) and total testosterone (P=0.0004) levels and increased total antioxidant capacity levels (P=0.01). Although possible improvements in the modified Ferriman–Gallwey hirsutism score, levels of sex hormone-binding globulin, and free androgen index were identified and the results were not statistically significant.

    Conclusion

    Vitamin D is a promising alternative for the treatment of PCOS with a positive influence on the oxidative, metabolic, and endocrine disorders of this syndrome.

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    Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study
  • Original Article

    The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo42

    Summary

    Original Article

    The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo42

    DOI 10.61622/rbgo/2024rbgo42

    Views26

    Abstract

    Objective

    To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.

    Methods

    Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza – Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.

    Results

    Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).

    Conclusion

    Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.

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  • Original Article

    The profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo47

    Summary

    Original Article

    The profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo47

    DOI 10.61622/rbgo/2024rbgo47

    Views63

    Abstract

    Objective

    In Brazil, postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. Data on the profile of women and risk factors associated with PPH are sparse. This study aimed to describe the profile and management of patients with PPH, and the association of risk factors for PPH with severe maternal outcomes (SMO).

    Methods

    A cross-sectional study was conducted in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) obstetric intensive care unit (ICU) between January 2012 and March 2020, including patients who gave birth at the hospital and that were admitted with PPH to the ICU.

    Results

    The study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.

    Conclusion

    The principal factors associated with poor maternal outcome were being multiparous and placental abruption.

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    The profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study
  • Original Article

    Prevalence of macrosomic newborn and maternal and neonatal complications in a high-risk maternity

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo48

    Summary

    Original Article

    Prevalence of macrosomic newborn and maternal and neonatal complications in a high-risk maternity

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo48

    DOI 10.61622/rbgo/2024rbgo48

    Views29

    Abstract

    Objective

    Evaluate the prevalence of macrosomic newborns (birth weight above 4000 grams) in a high-risk maternity from 2014 to 2019, as well as the maternal characteristics involved, risk factors, mode of delivery and associated outcomes, comparing newborns weighing 4000-4500 grams and those weighing above 4500 grams.

    Methods

    This is an observational study, case-control type, carried out by searching for data in hospital’s own system and clinical records. The criteria for inclusion in the study were all patients monitored at the service who had newborns with birth weight equal than or greater than 4000 grams in the period from January 2014 to December 2019, being subsequently divided into two subgroups (newborns with 4000 to 4500 grams and newborns above 4500 grams). After being collected, the variables were transcribed into a database, arranged in frequency tables. For treatment and statistical analysis of the data, Excel and R software were used. This tool was used to create graphs and tables that helped in the interpretation of the results. The statistical analysis of the variables collected included both simple descriptive analyzes as well as inferential statistics, with univariate, bivariate and multivariate analysis.

    Results

    From 2014 to 2019, 3.3% of deliveries were macrosomic newborns. The average gestational age in the birth was 39.4 weeks. The most common mode of delivery (65%) was cesarean section. Diabetes mellitus was present in 30% of the deliveries studied and glycemic control was absent in most patients. Among the vaginal deliveries, only 6% were instrumented and there was shoulder dystocia in 21% of the cases. The majority (62%) of newborns had some complication, with jaundice (35%) being the most common.

    Conclusion

    Birth weight above 4000 grams had a statistically significant impact on the occurrence of neonatal complications, such as hypoglycemia, respiratory distress and 5th minute APGAR less than 7, especially if birth weight was above 4500 grams. Gestational age was also shown to be statistically significant associated with neonatal complications, the lower, the greater the risk. Thus, macrosomia is strongly linked to complications, especially neonatal complications.

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    Prevalence of macrosomic newborn and maternal and neonatal complications in a high-risk maternity
  • Original Article

    Prevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo51

    Summary

    Original Article

    Prevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo51

    DOI 10.61622/rbgo/2024rbgo51

    Views21

    Abstract

    Objective

    To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.

    Methods

    We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.

    Results

    Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.

    Conclusion

    The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.

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  • Original Article

    Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo52

    Summary

    Original Article

    Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo52

    DOI 10.61622/rbgo/2024rbgo52

    Views17

    Abstract

    Objective

    To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.

    Methods

    This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.

    Results

    A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).

    Conclusion

    The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.

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  • Original Article

    Risk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo53

    Summary

    Original Article

    Risk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo53

    DOI 10.61622/rbgo/2024rbgo53

    Views18

    Abstract

    Objective

    To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.

    Methods

    We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.

    Results

    There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).

    Conclusion

    Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.

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    Risk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
  • Review Article

    Monkeypox infection and pregnancy in lower and middle-income countries: Precautions & recommendations

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo54

    Summary

    Review Article

    Monkeypox infection and pregnancy in lower and middle-income countries: Precautions & recommendations

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo54

    DOI 10.61622/rbgo/2024rbgo54

    Views34

    Abstract

    Monkeypox (MPX), an orthopoxviral disease endemic in Africa, is now a public health emergency of international concern (PHEIC) as declared by the World Health Organization in July 2023. Although it is generally mild, the overall case fatality rate was reported to be 3%, and the basic reproduction number (R0) is > 1 in men who have sex with men (MSM, i.e., Portugal (1.4), the United Kingdom (1.6), and Spain (1.8)). However, R0 is < 1 in other settings. In concordance with the smallpox virus, it is also expected to increase the risk of adverse outcomes for both the mother and the fetus. The outcomes of the disease in an immunocompromised state of pregnancy are scary, showing high mortality and morbidity of both mother and fetus, with up to a 75% risk of fetal side effects and a 25% risk of severe maternal diseases. Therefore, it warrants timely diagnosis and intervention. The reverse transcription polymerase chain reaction (RT PCR) test is the standard approach to diagnosis. We summarized the recent findings of MPX on pregnancy, and the associated risk factors. We also give recommendations for active fetal surveillance, perinatal care, and good reporting to improve outcomes. The available vaccines have shown promise for primary disease prevention.

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    Monkeypox infection and pregnancy in lower and middle-income countries: Precautions & recommendations
  • Review Article

    Breastfeeding and the Benefits of Lactation for Women’s Health

    Rev Bras Ginecol Obstet. 2018;40(6):354-359

    Summary

    Review Article

    Breastfeeding and the Benefits of Lactation for Women’s Health

    Rev Bras Ginecol Obstet. 2018;40(6):354-359

    DOI 10.1055/s-0038-1657766

    Views6

    Abstract

    The offer of the maternal breast to the baby is an unquestionable right of mothers and their children, and all efforts should bemade to promote, follow and maintain exclusive breastfeeding for up to 6months and supplement it until the child completes 2 years of age. Many publications are available in the literature about the qualities of breast milk, its benefits and health repercussions, stimulating the practice of breastfeeding and supporting campaigns for its implementation. However, although it is widely known that breastfeeding is an important step in the reproductive process of women and its practice offers benefits to both mother and child, most of the available information highlights the benefits of breast milk for children, while mention of the effects of breastfeeding on the health of the mother is usually neglected. Thus, the objective of the present study is to highlight the multiple benefits of breastfeeding for the physical and emotional health of the nursing mother. The authors consulted articles published in the databases PubMed, Virtual Health Library andWeb of Science using the keywords breastfeeding, breast milk, lactation and maternal health.

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  • Original Article

    Translation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index

    Rev Bras Ginecol Obstet. 2008;30(10):504-510

    Summary

    Original Article

    Translation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index

    Rev Bras Ginecol Obstet. 2008;30(10):504-510

    DOI 10.1590/S0100-72032008001000005

    Views16

    PURPOSE: to translate from English into Portuguese, adapt culturally and validate the Female Sexual Function Index (FSFI). METHODS: knowing the objectives of this research, two Brazilian translators have prepared a version each from the FSFI into Portuguese. Both versions have then been retro-translated into English by two English translators. After harmonizing the differences, they have been pre-tested in a pilot study. The final versions from the FSFI and from another questionnaire, the Short-Form Health Survey, which had already been translated and published in Portuguese, have then been simultaneously administered to one hundred patients, to test the FSFI psychometric proprieties concerning reliability (internal consistency and testing-retesting) and construct validity. Retesting was done after four weeks from the first interview. RESULTS: the process of cultural adaptation has not altered the Portuguese version of the FSFI, as compared to the original. The FSFI standardized Cronbach alpha was 0.96, and the evaluation by domains has varied from 0.31 to 0.97. As a measure of test-retest confidentiality, it was applied the intra-class coefficient, which has been considered strong and identical (1.0). Pearson’s correlation coefficient between the FSFI and the Short-Form Health Survey was positive, but weak in most of the interrelated domains, varying from 0.017 to 0.036. CONCLUSIONS: the FSFI English version has been translated into Portuguese and culturally adapted, being reliable to evaluate the sexual response of Brazilian women.

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  • Review Article

    Preeclampsia

    Rev Bras Ginecol Obstet. 2017;39(9):496-512

    Summary

    Review Article

    Preeclampsia

    Rev Bras Ginecol Obstet. 2017;39(9):496-512

    DOI 10.1055/s-0037-1604471

    Views19

    Abstract

    The authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia. The early treatment of acute hypertension, use of magnesium sulfate and early hospitalization in cases of preeclampsia are concepts to pursue the reduction of our pregnant women’s mortality.

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    Preeclampsia
  • Review Article

    Primary Dysmenorrhea: Assessment and Treatment

    Rev Bras Ginecol Obstet. 2020;42(8):501-507

    Summary

    Review Article

    Primary Dysmenorrhea: Assessment and Treatment

    Rev Bras Ginecol Obstet. 2020;42(8):501-507

    DOI 10.1055/s-0040-1712131

    Views5

    Abstract

    Primary dysmenorrhea is defined asmenstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of themenstrual cycle. It hasmajor implications for quality of life, such as limitation of daily activities and psychological stress, being one of themain causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, nonpharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments’ contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.

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    Primary Dysmenorrhea: Assessment and Treatment
  • Original Article

    Coverage of the Pap smear in Brazil and its determining factors: a systematic literature review

    Rev Bras Ginecol Obstet. 2005;27(8):485-492

    Summary

    Original Article

    Coverage of the Pap smear in Brazil and its determining factors: a systematic literature review

    Rev Bras Ginecol Obstet. 2005;27(8):485-492

    DOI 10.1590/S0100-72032005000800009

    Views1

    PURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE – 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women’s failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women’s failure to submit to the Pap smear.

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    Coverage of the Pap smear in Brazil and its determining factors: a systematic literature review
  • Original Article

    Pré-natal Care Profile among Public Health Service (“Sistema Único de Saúde”) Users from Caxias do Sul

    Rev Bras Ginecol Obstet. 2002;24(5):293-299

    Summary

    Original Article

    Pré-natal Care Profile among Public Health Service (“Sistema Único de Saúde”) Users from Caxias do Sul

    Rev Bras Ginecol Obstet. 2002;24(5):293-299

    DOI 10.1590/S0100-72032002000500002

    Views6

    Purpose: to study the prenatal care among Public Health Service (“Sistema Único de Saúde”) users from Caxias do Sul – RS. Methods: a transversal study of 702 pregnancies attended at the Hospital Geral -Universidade de Caxias do Sul from March 2000 to March 2001 based on the criteria set by the “Programa Nacional de Humanização do Pré-natal e Nascimento (PNHPN)” of the Brazilian Ministry of Health. Results: the observed prenatal coverage was 95.4%, whereas the average of visits was 6.2. The main reported reason for not following prenatal care was the lack of information about its importance (65.6%). In 51.5% of the cases, prenatal care started in the third month of pregnancy, whereas 44.3% of the pregnant women carried out all the proposed complementary tests. Prenatal care was considered inappropriate in 64.8% and appropriate in 35.2% of the cases. The quality of prenatal attention was significantly associated with the mother’s education, as well as with the number of previous deliveries. The higher the educational level, the better the quality of observed prenatal care (p=0.0148). In addition, the higher number of previous deliveries showed to be associated with a later beginning of prenatal care and a lower number of visits (p=0.0008). Conclusions: the prenatal care available at Caxias do Sul in spite of its good coverage, should be reviewed in terms of quality. Special attention should be given to education in health along the prenatal assistance.

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  • Original Article

    Validation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence

    Rev Bras Ginecol Obstet. 2005;27(5):235-242

    Summary

    Original Article

    Validation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence

    Rev Bras Ginecol Obstet. 2005;27(5):235-242

    DOI 10.1590/S0100-72032005000500002

    Views3

    PURPOSE: the proposal of the present study was to translate and to validate King’s Health Questionnaire (KHQ) for Brazilian women with urinary incontinence. METHODS: a hundred and thirty-four patients with urinary incontinence, confirmed by urodynamic study, were enrolled from the outpatient clinic of Uroginecology. Initially, we translated the KHQ into the Brazilian Portuguese language in agreement with international criteria. Due to language and cultural differences we performed a cultural, structural, conceptual, and semantic adaptation of the KHQ, in order to make sure that patients were able to fully understand the questions. All patients answered the KHQ twice on the same day, within an interval of 30 min, applied by two different interviewers. After 7 to 14 days, on a second visit, the questionnaire was applied again. Reliability (intra- and interobserver internal consistency), construct and discriminative validity were tested. RESULTS: several cultural adaptations were necessary until we reached the final version. The intra-observer internal consistency (alpha of Cronbach) of the several dimensions varied from moderate to high (0.77-0.90), and the interobserver internal consistency varied from 0.66 to 0.94. Moderate to strong correlation was detected among the specific KHQ urinary incontinence dominions and clinical urinary incontinence manifestations known to affect the quality of life of these patients. CONCLUSION: KHQ was adapted to the Portuguese language and to the Brazilian culture, showing great reliability and validity. It should be included and used in any Brazilian urinary incontinence clinical trial.

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    Validation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence
  • Review Article

    Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity

    Rev Bras Ginecol Obstet. 2018;40(9):554-562

    Summary

    Review Article

    Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity

    Rev Bras Ginecol Obstet. 2018;40(9):554-562

    DOI 10.1055/s-0038-1668117

    Views4

    Abstract

    Twin pregnancy accounts for 2 to 4% of total births, with a prevalence ranging from 0.9 to 2.4% in Brazil. It is associated with worse maternal and perinatal outcomes. Many conditions, such as severe maternal morbidity (SMM) (potentially life-threatening conditions and maternal near-miss) and neonatal near-miss (NNM) still have not been properly investigated in the literature. The difficulty in determining the conditions associated with twin pregnancy probably lies in its relatively low occurrence and the need for larger population studies. The use of the whole population and of databases from large multicenter studies, therefore, may provide unprecedented results. Since it is a rare condition, it ismore easily evaluated using vital statistics from birth e-registries. Therefore, we have performed a literature review to identify the characteristics of twin pregnancy in Brazil and worldwide. Twin pregnancy has consistently been associated with SMM, maternal near-miss (MNM) and perinatal morbidity, with still worse results for the second twin, possibly due to some characteristics of the delivery, including safety and availability of appropriate obstetric care to women at a high risk of perinatal complications.

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    Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity

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2003; v.25
2002; v.24
2001; v.23
2000; v.22
1999; v.21
1998; v.20
ISSUE

Aims and Vision

The Brazilian Journal of Gynecology and Obstetrics (RBGO) aims to publish basic and clinical research in gynecology, obstetrics and other related specialties and   be a reference to support and promote professional education for residents, researchers and university teachers. As a vision, RBGO aims to become an internationally recognized reference among the main world’s journals in Gynecology and Obstetrics.

Indexers

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