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  • Técnica e Equipamentos

    Endometrial Ablation Using a Thermal Balloon: Preliminary Results

    Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):235-238

    Summary

    Técnica e Equipamentos

    Endometrial Ablation Using a Thermal Balloon: Preliminary Results

    Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):235-238

    DOI 10.1590/S0100-72032000000400008

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    Purpose: to evaluate thermal balloon endometrial ablation in the management of menorrhagia. Study design: twenty patients were submitted to endometrial ablation using the thermal balloon device, between June 1996 and June 1997. Local anesthesia was used in 16 patients. The device was introduced into the uterine cavity. The duration of the procedure was 8 minutes and 30 seconds. Results: two patients (10%) did not show improvement of the symptons. Eighteen patients (90%) referred improvement of symptoms. There was no complication during and after the procedure. Conclusions: The thermal balloon seems to be safe and efficient in the management of menorrhagia.

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  • Case Report

    Intestinal Perforation due to Deep Infiltrating Endometriosis during Pregnancy: Case Report

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(4):235-238

    Summary

    Case Report

    Intestinal Perforation due to Deep Infiltrating Endometriosis during Pregnancy: Case Report

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(4):235-238

    DOI 10.1055/s-0038-1624579

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    Abstract

    We report the case of a 33 year-old woman who complained of severe dysmenorrhea since menarche. From 2003 to 2009, she underwent 4 laparoscopies for the treatment of pain associated with endometriosis. After all four interventions, the pain recurred despite the use of gonadotropin-releasing hormone (GnRH) analogues and the insertion of a levonorgestrel intrauterine system (LNG-IUS). Finally, a colonoscopy performed in 2010 revealed rectosigmoid stenosis probably due to extrinsic compression. The patient was advised to get pregnant before treating the intestinal lesion. Spontaneous pregnancy occurred soon after LNG-IUS removal in 2011. In the 33rd week of pregnancy, the patient started to feel severe abdominal pain. No fever or sings of pelviperitonitis were present, but as the pain worsened, a cesarean section was performed, with the delivery of a premature healthy male, and an intestinal rupturewas identified. Severe peritoneal infection and sepsis ensued. A colostomy was performed, and the patient recovered after eight days in intensive care. Three months later, the colostomy was closed, and a new LNG-IUS was inserted. The patient then came to be treated by our multidisciplinary endometriosis team. The diagnostic evaluation revealed the presence of intestinal lesions with extrinsic compression of the rectum. She then underwent a laparoscopic excision of the endometriotic lesions, including an ovarian endometrioma, adhesiolysis and segmental colectomy in 2014. She is now fully recovered and planning a new pregnancy. A transvaginal ultrasound (TVUS) performed six months after surgery showed signs of pelvic adhesions, but no endometriotic lesions.

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    Intestinal Perforation due to Deep Infiltrating Endometriosis during Pregnancy: Case Report
  • Systematic Review

    Zika Virus Infection in Pregnant Women and Microcephaly

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):235-248

    Summary

    Systematic Review

    Zika Virus Infection in Pregnant Women and Microcephaly

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):235-248

    DOI 10.1055/s-0037-1603450

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    Abstract

    From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damagetothe central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection’s devastating process on the central nervous system of embryos and fetuses. As a result of central nervous system aggression by the ZIKV, this infection brings the possibility of arthrogryposis, dysphagia, deafness and visual impairment. All of these changes of varying severity directly or indirectly compromise the future life of these children, and are already considered a congenital syndrome linked to the ZIKV. Diagnosis is one of the main difficulties in the approach of this infection. Considering the clinical part, it has manifestations common to infections by the dengue virus and the chikungunya fever, varying only in subjective intensities. The most frequent clinical variables are rash, febrile state, non-purulent conjunctivitis and arthralgia, among others. In terms of laboratory resources, there are also limitations to the subsidiary diagnosis. Molecular biology tests are based on polymerase chain reaction (PCR)with reverse transcriptase (RT) action, since the ZIKV is a ribonucleic acid (RNA) virus. The RT-PCR shows serum or plasma positivity for a short period of time, no more than five days after the onset of the signs and symptoms. The ZIKVurine test is positive for a longer period, up to 14 days. There are still no reliable techniques for the serological diagnosis of this infection. If there are no complications (meningoencephalitis or Guillain-Barré syndrome), further examination is unnecessary to assess systemic impairment. However, evidence is needed to rule out other infections that also cause rashes, such as dengue, chikungunya, syphilis, toxoplasmosis, cytomegalovirus, rubella, and herpes. There is no specific antiviral therapy against ZIKV, and the therapeutic approach to infected pregnant women is limited to the use of antipyretics and analgesics. Anti-inflammatory drugs should be avoided until the diagnosis of dengue is discarded. There is no need to modify the schedule of prenatal visits for pregnant women infected by ZIKV, but it is necessary to guarantee three ultrasound examinations during pregnancy for low-risk pregnancies, and monthly for pregnant women with confirmed ZIKV infection. Vaginal delivery and natural breastfeeding are advised.

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    Zika Virus Infection in Pregnant Women and Microcephaly
  • Artigos Originais

    Prevalence of thrombophilic factors in infertile women

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240

    Summary

    Artigos Originais

    Prevalence of thrombophilic factors in infertile women

    Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):235-240

    DOI 10.1590/S0100-72032007000500003

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    PURPOSE: to establish the prevalence of thrombophilic factors in infertile women. METHODS: a cross-sectional study was performed, in which infertile women, seen in a private clinic with investigation for thrombophilia were included, according to the protocol of the clinic, between March 2003 and March 2005, after the approval of the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). One hundred and forty-four infertile women without any liver disease were evaluated. Infertility is defined as one year of unprotected sexual intercourse without conception. The acquired and/or inherited thrombophilic factors investigated were: anticardiolipin antibody (aCL), lupus anticoagulant (LA), protein C deficiency (PCD), protein S deficiency (PSD), antithrombin III deficiency (ATD), presence of the factor V Leiden, mutation G20 210A in the prothrombin gene, and C677T mutation of methylene tetrahydrofolate reductase (MTHFR). RESULTS: the prevalence values obtained for aCL and LA were 2%. The prevalence of the hereditary thrombophilic factors were: PCD=4%, PSD=6%, ATD=5%, factor V Leiden=3%, prothrombin mutation=3%, MTHFR mutation=57%. Conclusions: of the 144 patients selected, 105 women (72.9%) presented at least one thrombophilic factor. This reinforces the importance and justifies the need of investigation in this group.

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  • Trabalhos Originais

    Proposal of a New Uterine Height Growth Curve for Pregnancies between 20 and 42 Weeks

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(4):235-241

    Summary

    Trabalhos Originais

    Proposal of a New Uterine Height Growth Curve for Pregnancies between 20 and 42 Weeks

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(4):235-241

    DOI 10.1590/S0100-72032001000400006

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    Purpose: to create a uterine height growth curve, according to gestational age, to verify differences among the existing curves and to evaluate the influence of color, parity and maternal weight on the variation of uterine height. Methods: during the period from July 1997 to July 1999, 100 normal pregnant women were submitted to uterine height measurements between the 20th and 42nd week of gestation. All the pregnant women had ultrasonically confirmed gestational age. A total of 726 measurements of uterine height were carried out by the same examiner, using a metric tape from the upper border of the symphysis pubis to the fundus uteri. Results: curves and tables of uterine height according to gestational age were obtained. The average uterine height growth was 0.7 cm/week. The study revealed different average uterine height values in relation to other uterine height growth curves. No statistically significant variations were found between the distributions of uterine heights according to color, parity and weight. Conclusion: the construction of a methodologically accepted uterine height growth curve aimed to detect, as a clinical method, the fetal growth disturbances. This should be analyzed in a posterior study.

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    Proposal of a New Uterine Height Growth Curve for Pregnancies between 20 and 42 Weeks
  • Relato de Caso

    Fetal triploidy associated with low levels of unconjugated estriol and beta-subunit in maternal serum

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(4):235-238

    Summary

    Relato de Caso

    Fetal triploidy associated with low levels of unconjugated estriol and beta-subunit in maternal serum

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(4):235-238

    DOI 10.1590/S0100-72031999000400009

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    We report a case of nonmolar fetal triploidy detected by fetal blood sampling at 20 weeks of gestation, performed as an investigation of intrauterine growth retardation and severe oligohydramnios found by ultrasound scan. At 19 weeks of gestation very low levels of maternal free serum beta-subunit of human chorionic gonadotropin and unconjugated estriol, and normal levels of alpha-fetoprotein were found, which were interpreted as a high risk of fetal Edwards syndrome. Fetal death supervened the day after fetal blood sampling, and the pregnancy was terminated by vaginal delivery induced by misoprostol and oxytocin, under epidural anesthesia. Chromosome study of the fetal blood cells showed a 69,XXX karyotype. The severe intrauterine growth retardation and macrocephaly noted on pathological review plus the very low levels of hCG and unconjugated estriol suggest a fetal gynoid triploidy case, caused by the fertilization of a diploid egg by a haploid sperm.

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  • Editorial

    RBGO: presente e futuro

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):235-235

    Summary

    Editorial

    RBGO: presente e futuro

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):235-235

    DOI 10.1590/S0100-72031998000500001

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    RBGO – presente e futuro […]
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  • Editorial

    The search for the breast cancer cure: shall we start all over again?

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):235-236

    Summary

    Editorial

    The search for the breast cancer cure: shall we start all over again?

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):235-236

    DOI 10.1590/S0100-720320140005043

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