Você pesquisou por y - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):253-260
DOI 10.1590/S0100-72031998000500004
Objectives: To determine sensitivity, specificity, positive and negative predictive values of the shake test (Clements) for evaluation of fetal lung maturation in preeclamptic patients. Methods: A prospective study for validation of a diagnostic method was conducted enrolling 163 preeclamptic patients (gestational age between 28-34 weeks) admitted at CAM-IMIP with indication for fetal maturity testing. Preeclampsia diagnosis and classification followed criteria of the National High Blood Pressure Working Group, 1990. Clements' test was performed in three tubes and positive, negative or intermediate results were considered for analysis (related to presence or absence of fetal lung maturity). Accuracy parameters were calculated considering actual incidence of hyaline membrane disease (positive maturity = absent disease) after birth. Hyaline membrane disease was defined by criteria of CLAP, 1978. Statistical analysis was performed using c² test (Epi-Info 6.04b) with a 5% significance level. Results: Intermediate results were considered alternately as positive or negative for analysis. When considered positive, sensitivity was 87.9% and specificity 74.5% with positive and negative predictive values of 8.9.4% and 71.4% respectively - efficiency was 84%. When intermediate results were evaluated as negative, sensitivity decreased to 62% and specificity raised to 89.4% and positive and negative predictive values were 93.5% and 51.2% respectively (efficiency = 70%). False-positive results were rare and usually related to neonatal hypoxia: only 5 (6.5%) of 77 neonates with previous positive Clements had hyaline membrane disease. Nevertheless, false negatives were frequent: almost 40% for negative/intermediate results. Conclusions: Despite its limitations, Clements' test remains a good method for investigation of fetal lung maturation in preeclamptic patients since false positive results are unusual. However sensitivity is low and results have be cautiously analyzed because of elevated rate of false negative results. A good policy is to complement fetal maturity investigation with other tests if a negative result is determined, specially in severe cases when confirmed maturity represents indication for interruption of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):253-260
DOI 10.1590/S0100-72031998000500004
Objectives: To determine sensitivity, specificity, positive and negative predictive values of the shake test (Clements) for evaluation of fetal lung maturation in preeclamptic patients. Methods: A prospective study for validation of a diagnostic method was conducted enrolling 163 preeclamptic patients (gestational age between 28-34 weeks) admitted at CAM-IMIP with indication for fetal maturity testing. Preeclampsia diagnosis and classification followed criteria of the National High Blood Pressure Working Group, 1990. Clements' test was performed in three tubes and positive, negative or intermediate results were considered for analysis (related to presence or absence of fetal lung maturity). Accuracy parameters were calculated considering actual incidence of hyaline membrane disease (positive maturity = absent disease) after birth. Hyaline membrane disease was defined by criteria of CLAP, 1978. Statistical analysis was performed using c² test (Epi-Info 6.04b) with a 5% significance level. Results: Intermediate results were considered alternately as positive or negative for analysis. When considered positive, sensitivity was 87.9% and specificity 74.5% with positive and negative predictive values of 8.9.4% and 71.4% respectively - efficiency was 84%. When intermediate results were evaluated as negative, sensitivity decreased to 62% and specificity raised to 89.4% and positive and negative predictive values were 93.5% and 51.2% respectively (efficiency = 70%). False-positive results were rare and usually related to neonatal hypoxia: only 5 (6.5%) of 77 neonates with previous positive Clements had hyaline membrane disease. Nevertheless, false negatives were frequent: almost 40% for negative/intermediate results. Conclusions: Despite its limitations, Clements' test remains a good method for investigation of fetal lung maturation in preeclamptic patients since false positive results are unusual. However sensitivity is low and results have be cautiously analyzed because of elevated rate of false negative results. A good policy is to complement fetal maturity investigation with other tests if a negative result is determined, specially in severe cases when confirmed maturity represents indication for interruption of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(6):254-258
DOI 10.1590/S0100-72032012000600003
PURPOSE: To determine the frequency of hydatiform mole in tissues obtained by curettage. METHODS: A cross-sectional, prospective and descriptive conducted on patients who underwent curretage due to a diagnosis of abortion or hydatiform mole whose material was sent for pathological examination. We excluded women who did not accept to participate and refused to sign the free informed consent form. We studied the following variables: pathological findings, age, race, number of pregnancies and previous abortions, gestational age at diagnosis, quantitative serum beta fraction of human chorionic gonadotropin and ultrasound findings. The data were compared to the to histological diagnosis, considered to be the gold standard. Data were stored and analyzed in Microsoft Excel® software and the Epi-Info program, version 6.0 (STATCALC) and the results are presented as frequency (percentage) or mean±standard deviation. The χ2 test was used to determine the association between qualitative variables and the level of significance was set at p<0.005. RESULTS: A total of 515 curettage procedures were performed, 446 of which comprised the sample. The frequency of hydatiform mole was 2.2% (ten cases). The mean age of the patients with a mole was 31±10 years, most patients were white and multiparous and had no history of previous abortions, but there was no significant association between these variables. The pregnancy loss occurred early in patients with and without a mole and the most common complaints in both groups were vaginal bleeding and cramps in the lower abdomen. Quantitative determination of human chorionic gonadotropin was performed in 422 cases (413 with and 9 without a hydatiform mole). The levels of the hormone were higher than 100,000 mIU/mL in 1.9% of the patients without a hydatiform mole and in 44.45% of the patients with the disease (p=0.00004). All patients with this hormonal level had an ultrasound suspicion of hydatiform mole and one of them also had a clinical suspicion. A total of 333 patients underwent ultrasound examination. Of the patients with sonographic findings suggestive of molar pregnancy, there was confirmation in five (41.7%) cases. The other seven (58.3%) were false positives. A significant association was found between ultrasound suspected molar pregnancy and disease confirmation by histopathological analysis (p=0.0001). In 50% of cases of hydatiform mole there was no suspicion of the disease according to clinical signs and symptoms, levels of beta fraction of human chorionic gonadotropin or sonographic findings. CONCLUSIONS: The frequency of hydatidiform mole is low and the disease may not be suspected by clinical examination, ultrasonography or the serum level of the beta fraction of human chorionic gonadotropin, requiring pathological examination of tissue obtained by uterine evacuation for diagnosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(6):254-258
DOI 10.1590/S0100-72032012000600003
PURPOSE: To determine the frequency of hydatiform mole in tissues obtained by curettage. METHODS: A cross-sectional, prospective and descriptive conducted on patients who underwent curretage due to a diagnosis of abortion or hydatiform mole whose material was sent for pathological examination. We excluded women who did not accept to participate and refused to sign the free informed consent form. We studied the following variables: pathological findings, age, race, number of pregnancies and previous abortions, gestational age at diagnosis, quantitative serum beta fraction of human chorionic gonadotropin and ultrasound findings. The data were compared to the to histological diagnosis, considered to be the gold standard. Data were stored and analyzed in Microsoft Excel® software and the Epi-Info program, version 6.0 (STATCALC) and the results are presented as frequency (percentage) or mean±standard deviation. The χ2 test was used to determine the association between qualitative variables and the level of significance was set at p<0.005. RESULTS: A total of 515 curettage procedures were performed, 446 of which comprised the sample. The frequency of hydatiform mole was 2.2% (ten cases). The mean age of the patients with a mole was 31±10 years, most patients were white and multiparous and had no history of previous abortions, but there was no significant association between these variables. The pregnancy loss occurred early in patients with and without a mole and the most common complaints in both groups were vaginal bleeding and cramps in the lower abdomen. Quantitative determination of human chorionic gonadotropin was performed in 422 cases (413 with and 9 without a hydatiform mole). The levels of the hormone were higher than 100,000 mIU/mL in 1.9% of the patients without a hydatiform mole and in 44.45% of the patients with the disease (p=0.00004). All patients with this hormonal level had an ultrasound suspicion of hydatiform mole and one of them also had a clinical suspicion. A total of 333 patients underwent ultrasound examination. Of the patients with sonographic findings suggestive of molar pregnancy, there was confirmation in five (41.7%) cases. The other seven (58.3%) were false positives. A significant association was found between ultrasound suspected molar pregnancy and disease confirmation by histopathological analysis (p=0.0001). In 50% of cases of hydatiform mole there was no suspicion of the disease according to clinical signs and symptoms, levels of beta fraction of human chorionic gonadotropin or sonographic findings. CONCLUSIONS: The frequency of hydatidiform mole is low and the disease may not be suspected by clinical examination, ultrasonography or the serum level of the beta fraction of human chorionic gonadotropin, requiring pathological examination of tissue obtained by uterine evacuation for diagnosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):254-261
DOI 10.1590/S0100-72032009000500009
It is believed that estrogen deficiency, lipid profile alterations, body weight gain, and sedentary lifestyle are strongly associated with the increased incidence of arterial hypertension in postmenopausal women. In an attempting to reduce the incidence of arterial hypertension in this population, a variety of approaches has been used, but the results are conflicting and the changing in lifestyle has been proposed and an important preventive action to control the arterial hypertension and associated risk factors in this women age - mainly practice of physical exercise. Continuous exercise has been used as an important approach in management cardiovascular disease and endocrine-metabolic disorders. Continuous exercise prescription is characterized by, at least, 30 minutes of moderate-intensity physical activity (60 to 70% of maximum heart rate), three days of the week. Intermittent exercise is characterized by low intensity exercise periods, alternating with high-intensity exercise periods, ranging of 50 to 85% of the maximum heart rate, during ten minutes. Intermittent exercise has been employed as training program in weight loss therapy and personal training because previous studies have shown similar metabolic adaptations and aerobic capacity after continuous or intermittent exercise. This review focused on the relevance of continuous and intermittent exercise on the blood pressure control, discussion of the data found in experimental model of menopause and in women and the relationship between incidence of arterial hypertension and its genesis in postmenopausal women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(5):254-261
DOI 10.1590/S0100-72032009000500009
It is believed that estrogen deficiency, lipid profile alterations, body weight gain, and sedentary lifestyle are strongly associated with the increased incidence of arterial hypertension in postmenopausal women. In an attempting to reduce the incidence of arterial hypertension in this population, a variety of approaches has been used, but the results are conflicting and the changing in lifestyle has been proposed and an important preventive action to control the arterial hypertension and associated risk factors in this women age - mainly practice of physical exercise. Continuous exercise has been used as an important approach in management cardiovascular disease and endocrine-metabolic disorders. Continuous exercise prescription is characterized by, at least, 30 minutes of moderate-intensity physical activity (60 to 70% of maximum heart rate), three days of the week. Intermittent exercise is characterized by low intensity exercise periods, alternating with high-intensity exercise periods, ranging of 50 to 85% of the maximum heart rate, during ten minutes. Intermittent exercise has been employed as training program in weight loss therapy and personal training because previous studies have shown similar metabolic adaptations and aerobic capacity after continuous or intermittent exercise. This review focused on the relevance of continuous and intermittent exercise on the blood pressure control, discussion of the data found in experimental model of menopause and in women and the relationship between incidence of arterial hypertension and its genesis in postmenopausal women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):254-254
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):254-254
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):255-255
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):255-255
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):255-255
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):255-255
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):255-261
DOI 10.1590/S0100-72032013000600004
PURPOSE: To evaluate the level of stress in men and women seeking treatment for infertility and to identify the associated variables. METHODS: A cross-sectional study with 101 men and 101 women consulting for the first time at the Human Reproduction Unit. Participants completed the Brazilian version of the Fertility Problem Inventory (FPI) based on four domains: "social relationships", "life without children"; "marital relationship/sexual" and "maternity/paternity" and a structured questionnaire with socioeconomic and reproductive variables. Bivariate analysis was performed using the Chi-square and Fisher exact tests, considering p<0.05. Afterwards the multivariate correspondence analysis was done with variables with p<0.20. RESULTS: Overall, the participants presented a high level of stress in all domains, except in the "life without children" domain. Multivariate analysis of correspondence showed that variables associated with a high level of stress in the "social relationships" domains were: to be a woman, to have the infertility problem, and to consider the quality of the marital relationship to be regular. In the "life without children" domain the variables that approached the high stress were: to be woman, age between 18 and 24 years, and to have the infertility problem. To be a man, to consider adoption, parents/in-laws and other people knowing about the difficulty to become pregnant, and to consider the quality of the marital relationship to be excellent were the variables associated with high level of stress in "marital/sexual relationship" domain. For "maternity/paternity" domain the variables associated were to be women, consider marital relationship quality regular, age between 25 and 35 years, be evangelical or protestant were the variables associated with a high level of stress. CONCLUSION:Men and women seeking treatment for infertility present a high level of stress and it can be suggested that psychosocial support is important and should be different for men and women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):255-261
DOI 10.1590/S0100-72032013000600004
PURPOSE: To evaluate the level of stress in men and women seeking treatment for infertility and to identify the associated variables. METHODS: A cross-sectional study with 101 men and 101 women consulting for the first time at the Human Reproduction Unit. Participants completed the Brazilian version of the Fertility Problem Inventory (FPI) based on four domains: "social relationships", "life without children"; "marital relationship/sexual" and "maternity/paternity" and a structured questionnaire with socioeconomic and reproductive variables. Bivariate analysis was performed using the Chi-square and Fisher exact tests, considering p<0.05. Afterwards the multivariate correspondence analysis was done with variables with p<0.20. RESULTS: Overall, the participants presented a high level of stress in all domains, except in the "life without children" domain. Multivariate analysis of correspondence showed that variables associated with a high level of stress in the "social relationships" domains were: to be a woman, to have the infertility problem, and to consider the quality of the marital relationship to be regular. In the "life without children" domain the variables that approached the high stress were: to be woman, age between 18 and 24 years, and to have the infertility problem. To be a man, to consider adoption, parents/in-laws and other people knowing about the difficulty to become pregnant, and to consider the quality of the marital relationship to be excellent were the variables associated with high level of stress in "marital/sexual relationship" domain. For "maternity/paternity" domain the variables associated were to be women, consider marital relationship quality regular, age between 25 and 35 years, be evangelical or protestant were the variables associated with a high level of stress. CONCLUSION:Men and women seeking treatment for infertility present a high level of stress and it can be suggested that psychosocial support is important and should be different for men and women.
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Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(5):255-265
, , , , , , The optimal use of contraceptive methods requires that women participate in targeted choice of methods that meet their individual needs and expectations. The Thinking About Needs in Contraception (TANCO) study is a quantitative online survey of the views of health professionals and women on aspects of contraceptive counseling and contraceptive use.
Physicians and women attending clinics for contraception were invited to complete online questionnaires. The research explored the knowledge and use of contraceptive methods, satisfaction with the current method and interest in receiving more information on all methods. Aspects related to contraceptive practice among physicians were gathered in parallel. The results obtained in the Brazilian research were compared with those of the European research, which involved 11 countries.
There was a high prevalence of contraceptive use and general satisfaction with the current method. A total of 63% of the women were using short-acting contraceptive (SAC) methods, and 9% were using a long-acting reversible contraceptive (LARC). Sixty-six percent of women were interested in receiving more information on all methods; 69% of women said they would consider LARC if they received more comprehensive information about it. Health professionals tend to underestimate the interest of women in receiving information about contraception in general, and more specifically about LARCs.
Despite the high levels of use and satisfaction with the current methods, women were interested in receiving more information on all contraceptive methods. Structured contraceptive counseling based on individual needs and expectations may lead to greater knowledge and a greater likelihood of proper contraceptive choice.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(5):255-265
, , , , , , The optimal use of contraceptive methods requires that women participate in targeted choice of methods that meet their individual needs and expectations. The Thinking About Needs in Contraception (TANCO) study is a quantitative online survey of the views of health professionals and women on aspects of contraceptive counseling and contraceptive use.
Physicians and women attending clinics for contraception were invited to complete online questionnaires. The research explored the knowledge and use of contraceptive methods, satisfaction with the current method and interest in receiving more information on all methods. Aspects related to contraceptive practice among physicians were gathered in parallel. The results obtained in the Brazilian research were compared with those of the European research, which involved 11 countries.
There was a high prevalence of contraceptive use and general satisfaction with the current method. A total of 63% of the women were using short-acting contraceptive (SAC) methods, and 9% were using a long-acting reversible contraceptive (LARC). Sixty-six percent of women were interested in receiving more information on all methods; 69% of women said they would consider LARC if they received more comprehensive information about it. Health professionals tend to underestimate the interest of women in receiving information about contraception in general, and more specifically about LARCs.
Despite the high levels of use and satisfaction with the current methods, women were interested in receiving more information on all contraceptive methods. Structured contraceptive counseling based on individual needs and expectations may lead to greater knowledge and a greater likelihood of proper contraceptive choice.
