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Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):228-232
The present report describes a case of complete atrioventricular block (CAVB) diagnosed at 25 weeks of gestation in a pregnant woman with Sjögren's syndrome and positive anti-Ro/SSA antibodies. Fluorinated steroids (dexamethasone and betamethasone) and terbuline were used to increase the fetal heart rate, but the fetal heart block was not reversible, and the administration of drugs was discontinued due to maternal collateral effects. Follow-up fetal echocardiograms were performed, and the fetus evolved with pericardial effusion, presence of fibroelastosis in the right ventricle, and ventricular dysfunction. Interruption of pregnancy by cesarean section was indicated at 34 weeks of gestation, and a cardiac pacemaker was implanted in the male newborn immediately after birth. Therapy for fetuses with CAVB is controversial mainly regarding the use or not of corticosteroids; however, monitoring of the atrioventricular interval by fetal echocardiography should be performed in fetuses from pregnant women with positive autoantibodies anti-Ro/SSA and/or anti-La/SSB to prevent the progression to CAVB.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):228-232
The present report describes a case of complete atrioventricular block (CAVB) diagnosed at 25 weeks of gestation in a pregnant woman with Sjögren's syndrome and positive anti-Ro/SSA antibodies. Fluorinated steroids (dexamethasone and betamethasone) and terbuline were used to increase the fetal heart rate, but the fetal heart block was not reversible, and the administration of drugs was discontinued due to maternal collateral effects. Follow-up fetal echocardiograms were performed, and the fetus evolved with pericardial effusion, presence of fibroelastosis in the right ventricle, and ventricular dysfunction. Interruption of pregnancy by cesarean section was indicated at 34 weeks of gestation, and a cardiac pacemaker was implanted in the male newborn immediately after birth. Therapy for fetuses with CAVB is controversial mainly regarding the use or not of corticosteroids; however, monitoring of the atrioventricular interval by fetal echocardiography should be performed in fetuses from pregnant women with positive autoantibodies anti-Ro/SSA and/or anti-La/SSB to prevent the progression to CAVB.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):229-233
DOI 10.1590/S0100-72032000000400007
Purpose: to evaluate the effects of hormone replacement therapy on the body mass index of postmenopausal women. Methods: for this purpose, 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM - UNICAMP, where the variations in this parameter were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through chi² test, Student's t test, and Mann-Whitney test. Results: we observed no significant variations in the body mass index, when comparing users and non-users during the three years of observation. Conclusion: hormone replacement therapy did not produce changes in this parameter in women properly assisted during its use.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):229-233
DOI 10.1590/S0100-72032000000400007
Purpose: to evaluate the effects of hormone replacement therapy on the body mass index of postmenopausal women. Methods: for this purpose, 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM - UNICAMP, where the variations in this parameter were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through chi² test, Student's t test, and Mann-Whitney test. Results: we observed no significant variations in the body mass index, when comparing users and non-users during the three years of observation. Conclusion: hormone replacement therapy did not produce changes in this parameter in women properly assisted during its use.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):229-229
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):229-229
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):229-229
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):229-229
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(4):229-235
DOI 10.1590/S0100-72032003000400002
PURPOSE: to determine the association between ultrasonographic, hysteroscopic and histopathologic findings in women with postmenopausal uterine bleeding. METHODS: a retrospective, cross-sectional study was conducted enrolling 156 women with postmenopausal bleeding attended at the Diagnostic Center - IMIP during the period of January 1995 to December 2001. According to the results of the endometrial examination (ultrasound), the patients were classified as having an abnormal or normal finding depending on the cutoffs of 4 or 5 mm. The most common histologic and hysteroscopic findings were studied and classified as premalignant/malignant lesions (hyperplasia/endometrial cancer) or benign findings. These results were compared using the kappa index, to establish the agreement between these techniques. RESULTS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. Hysteroscopic findings were atrophic endometrium in 59 (37.8%), endometrial polyp in 56 (35.9%), endometrial hyperplasia in 17 (10.9%), cancer in 16 (10.3%), still active endometrium in 1 (3,2), and other findings in 3 (1.9%). The two most frequent histopathologic findings were also atrophic endometrium (31.4%) and endometrial polyps (26,.3%), followed by scanty material (16.0%), endometrial cancer (10.9%), endometrial hyperplastic changes (9.0%), and others (6.4%). A good agreement between hysteroscopic and histopathologic findings was observed (kappa = 0.61). CONCLUSIONS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. No premalignant or malignant lesions were missed when an endometrial cutoff of 4 mm was used. The most frequent hysteroscopic and histopathologic findings were atrophic endometrium and endometrial polyps and a good agreement between these findings was encountered.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(4):229-235
DOI 10.1590/S0100-72032003000400002
PURPOSE: to determine the association between ultrasonographic, hysteroscopic and histopathologic findings in women with postmenopausal uterine bleeding. METHODS: a retrospective, cross-sectional study was conducted enrolling 156 women with postmenopausal bleeding attended at the Diagnostic Center - IMIP during the period of January 1995 to December 2001. According to the results of the endometrial examination (ultrasound), the patients were classified as having an abnormal or normal finding depending on the cutoffs of 4 or 5 mm. The most common histologic and hysteroscopic findings were studied and classified as premalignant/malignant lesions (hyperplasia/endometrial cancer) or benign findings. These results were compared using the kappa index, to establish the agreement between these techniques. RESULTS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. Hysteroscopic findings were atrophic endometrium in 59 (37.8%), endometrial polyp in 56 (35.9%), endometrial hyperplasia in 17 (10.9%), cancer in 16 (10.3%), still active endometrium in 1 (3,2), and other findings in 3 (1.9%). The two most frequent histopathologic findings were also atrophic endometrium (31.4%) and endometrial polyps (26,.3%), followed by scanty material (16.0%), endometrial cancer (10.9%), endometrial hyperplastic changes (9.0%), and others (6.4%). A good agreement between hysteroscopic and histopathologic findings was observed (kappa = 0.61). CONCLUSIONS: the frequency of endometrial thickening was 75.0 and 67.3% according to cutoffs of 4 mm and 5 mm, respectively. No premalignant or malignant lesions were missed when an endometrial cutoff of 4 mm was used. The most frequent hysteroscopic and histopathologic findings were atrophic endometrium and endometrial polyps and a good agreement between these findings was encountered.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):229-232
DOI 10.1590/SO100-720320150005295
To compare the frequency of an ASCUS Pap Smear result in pregnant and
non-pregnant women, stratified by age group.
We analyzed the results of 1,336,180 cytopathologyc exams of Pap smears performed
between 2000 and 2009 (ten years) with the purpose of screening for cervical
carcinoma. Comparisons were made between pregnant and non-pregnant women, and the
sample was stratified into three age groups (20-24, 25-29 and 30-34 years). The
χ2 test was used and the magnitude of association was determined by
the by Odds Ratio (OR) with the 95% confidence interval (95%CI).
A Total of 447,489 samples were excluded on the basis of the criteria adopted,
for a total final sample of 37,137 pregnant women and 851,554 non-pregnant women.
An ASCUS result was detected in 1.2% of cases, with a significant difference
between pregnant and non-pregnant women in the age groups of 20-24 years (OR=0.85;
95%CI 0.75-0.97) and 25-29 years (OR=0.78; 95%CI 0.63-0.96). There was no
difference in the group between 30-34 years (OR=0.76; 95%CI 0.57-1.03).
This study suggested that non-pregnant women have a higher frequency of ASCUS,
most evident in the age group of 20 to 29 years. The collection of cervical cancer
screening should not be a compulsory part of the prenatal routine.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(5):229-232
DOI 10.1590/SO100-720320150005295
To compare the frequency of an ASCUS Pap Smear result in pregnant and
non-pregnant women, stratified by age group.
We analyzed the results of 1,336,180 cytopathologyc exams of Pap smears performed
between 2000 and 2009 (ten years) with the purpose of screening for cervical
carcinoma. Comparisons were made between pregnant and non-pregnant women, and the
sample was stratified into three age groups (20-24, 25-29 and 30-34 years). The
χ2 test was used and the magnitude of association was determined by
the by Odds Ratio (OR) with the 95% confidence interval (95%CI).
A Total of 447,489 samples were excluded on the basis of the criteria adopted,
for a total final sample of 37,137 pregnant women and 851,554 non-pregnant women.
An ASCUS result was detected in 1.2% of cases, with a significant difference
between pregnant and non-pregnant women in the age groups of 20-24 years (OR=0.85;
95%CI 0.75-0.97) and 25-29 years (OR=0.78; 95%CI 0.63-0.96). There was no
difference in the group between 30-34 years (OR=0.76; 95%CI 0.57-1.03).
This study suggested that non-pregnant women have a higher frequency of ASCUS,
most evident in the age group of 20 to 29 years. The collection of cervical cancer
screening should not be a compulsory part of the prenatal routine.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):229-234
Preoperatively identification of malignancy potential of a postmenopausal adnexal masses is important.
To evaluate the effectiveness of the Risk of Malignancy Index-2 in presumably benign adnexal masses in postmenopausal women.
Retrospective, observational study.
119 women with postmenopausal adnexal masses with a preliminary diagnosis of benign tumors according to the Risk of Malignancy Index-2 were included. Age, duration of menopause, ultrasonographic findings, and serum CA-125 levels were recorded preoperatively. The definitive diagnosis was based on postoperative histopathological examination.
Of 119 adnexal mass, 10 were malignant and 109 were benign. There was no statistically significant difference with regard to age and tumor size between the groups. The two significant ultrasonographic parameter between groups were the presence of solid area in the mass and bilaterality. Moreover, if the cut off point for serum CA-125 was adjusted to 14.75 IU/mL according to ROC curve, a sensitivity value of 80% and a specificity value of 72% could be achieved to discriminate benign and malign cysts.
In the differential diagnosis of benign and malignant adnexal masses in postmenopausal women, the presence of a solid component, bilaterallity based on ultrasonography and high CA-125 values may be used as discriminative criteria. There is no direct relation between the size of the adnexal mass and malignancy potential. Therefore, in the malignancy indexes of postmenopausal women, we recommend lower cut-off values of CA-125 to increase the sensitivity of preoperative evaluation tests without having a great impact on negative predictive values.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):229-234
Preoperatively identification of malignancy potential of a postmenopausal adnexal masses is important.
To evaluate the effectiveness of the Risk of Malignancy Index-2 in presumably benign adnexal masses in postmenopausal women.
Retrospective, observational study.
119 women with postmenopausal adnexal masses with a preliminary diagnosis of benign tumors according to the Risk of Malignancy Index-2 were included. Age, duration of menopause, ultrasonographic findings, and serum CA-125 levels were recorded preoperatively. The definitive diagnosis was based on postoperative histopathological examination.
Of 119 adnexal mass, 10 were malignant and 109 were benign. There was no statistically significant difference with regard to age and tumor size between the groups. The two significant ultrasonographic parameter between groups were the presence of solid area in the mass and bilaterality. Moreover, if the cut off point for serum CA-125 was adjusted to 14.75 IU/mL according to ROC curve, a sensitivity value of 80% and a specificity value of 72% could be achieved to discriminate benign and malign cysts.
In the differential diagnosis of benign and malignant adnexal masses in postmenopausal women, the presence of a solid component, bilaterallity based on ultrasonography and high CA-125 values may be used as discriminative criteria. There is no direct relation between the size of the adnexal mass and malignancy potential. Therefore, in the malignancy indexes of postmenopausal women, we recommend lower cut-off values of CA-125 to increase the sensitivity of preoperative evaluation tests without having a great impact on negative predictive values.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(5):229-233
DOI 10.1590/S0100-72032010000500005
PURPOSE: to assess a possible association between polymorphism of the progesterone receptor gene (PROGINS) and recurrent spontaneous abortion (RSA). METHODS: in this case-control study, 85 women with at least three previous spontaneous abortions without an identifiable cause (RSA Group) and 157 women with at least two previous term pregnancies without pathologies and no previous miscarriage (Control Group) were selected. An amount of 10 mL of peripheral blood was collected by venipuncture and genomic DNA was extracted by the DTAB/CTAB method, followed by the polymerase chain reaction (PCR) under specific conditions for this polymorphism and by amplification by 2% agarose gel electrophoresis. The bands were visualized with an ultraviolet light transilluminator and the gels were photographed. Differences in the PROGINS genotype and allele frequencies between groups were analyzed by the χ2 test, with the level of significance set at p<0.05. The Odds Ratio (OR) was also used, with 95% confidence intervals 95%CI. RESULTS: PROGINS genotypic frequencies were 72.3% T1T1 and 27.7% T1T2 for the RSA group and 764% T1T1, 22.3% T1T2 and 1.3% T2T2 for the control group. There were no differecnes between groups when the genotype and allele frequencies were analyzed: respectively p=0.48 (OR: 0.8) and p=0.65 (OR: 0.9). CONCLUSIONS: our results suggest that PROGINS polymorphism is not associated with RSA.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(5):229-233
DOI 10.1590/S0100-72032010000500005
PURPOSE: to assess a possible association between polymorphism of the progesterone receptor gene (PROGINS) and recurrent spontaneous abortion (RSA). METHODS: in this case-control study, 85 women with at least three previous spontaneous abortions without an identifiable cause (RSA Group) and 157 women with at least two previous term pregnancies without pathologies and no previous miscarriage (Control Group) were selected. An amount of 10 mL of peripheral blood was collected by venipuncture and genomic DNA was extracted by the DTAB/CTAB method, followed by the polymerase chain reaction (PCR) under specific conditions for this polymorphism and by amplification by 2% agarose gel electrophoresis. The bands were visualized with an ultraviolet light transilluminator and the gels were photographed. Differences in the PROGINS genotype and allele frequencies between groups were analyzed by the χ2 test, with the level of significance set at p<0.05. The Odds Ratio (OR) was also used, with 95% confidence intervals 95%CI. RESULTS: PROGINS genotypic frequencies were 72.3% T1T1 and 27.7% T1T2 for the RSA group and 764% T1T1, 22.3% T1T2 and 1.3% T2T2 for the control group. There were no differecnes between groups when the genotype and allele frequencies were analyzed: respectively p=0.48 (OR: 0.8) and p=0.65 (OR: 0.9). CONCLUSIONS: our results suggest that PROGINS polymorphism is not associated with RSA.
