Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(5):275-279
DOI 10.1590/S0100-72032000000500004
Objective: to evaluate ultrasound findings in pregnant women with threatened abortion in the first trimester of pregnancy. Methods: transabdominal and transvaginal ultrasound scans were performed in patients with vaginal bleeding with previous positive pregnancy test. Patients with 6-14-week gestation (by the last menstrual period or ultrasound scan), with closed cervix on clinical evaluation were included. Multiple pregnancies and those patients who have tried abortion by using abortive drugs or manipulation were excluded. Results: in 132 of 247 (53.4%) the pregnancy was viable and in 46.6% (115/247) the pregnancy was nonviable. Incomplete miscarriage was found in 19% (47/247), complete miscarriage in 8.5% (21/247), missed abortion in 7.7% (19/247), anembryonic pregnancy in 6.1% (15/247), ectopic pregnancy in 4.5% (11/247) and hydatidiform mole in 0.8% (2/247). Conclusion: almost half (46.6%) of the pregnancies with threatened abortion in the first trimester were diagnosed as a nonviable pregnancy. The ultrasound scan can help to define this condition and the management of the pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):275-280
Gender incongruence is defined as a condition in which an individual self-identifies and desires to have physical characteristics and social roles that connote the opposite biological sex. Gender dysphoria is when an individual displays the anxiety and/or depression disorders that result from the incongruity between the gender identity and the biological sex. The gender affirmation process must be performed by a multidisciplinary team. The main goal of the hormone treatment is to start the development of male physical characteristics by means of testosterone administration that may be offered to transgender men who are 18 years old or over. The use of testosterone is usually well tolerated and improves the quality of life. However, there is still lack of evidence regarding the effects and risks of the long-term use of this hormone. Many different pharmacological formulations have been used in the transsexualization process. The most commonly used formulation is the intramuscular testosterone esters in a short-term release injection, followed by testosterone cypionate or testosterone enanthate. In the majority of testosterone therapy protocols, the male physical characteristics can be seen in almost all users after 6 months of therapy, and themaximum virilization effects are usually achieved after 3 to 5 years of regular use of the hormone. To minimize risks, plasmatic testosterone levels should be kept within male physiological ranges (300 to 1,000 ng/dl) during hormonal treatment. It is recommended that transgender men under androgen therapy be monitored every 3 months during the 1st year of treatment and then, every 6 to 12 months.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(5):275-282
DOI 10.1590/S0100-72032005000500008
PURPOSE: to evaluate the effectiveness of the "global active stretching" (GAS) method and the routine medical recommendations for lumbar and/or posterior pelvic pain in pregnancy. METHODS: sixty-nine pregnant women who experienced lumbar or posterior pelvic pain were selected and identified through a randomized controlled clinical trial and were randomly divided into two groups. One group practiced GAS-oriented exercises and the other followed the routine medical recommendations. The pregnant women were followed up for eight weeks. The severity of pain was estimated by the visual analog scale and posterior pelvic pain and lumbar back pain were confirmed by provocation tests. RESULTS: after treatment, 61% (p<0.01) of the women of the GAS group reported no pain at the lumbar/or posterior pelvic area compared with 11% (p=0.50) of the group who followed routine medical recommendations. CONCLUSIONS: the GAS method relieved and diminished the intensity of lumbar and/or pelvic pains more effectively than routine medical recommendations.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(6):276-280
DOI 10.1590/S0100-72032011000600003
PURPOSE: To evaluate the effectiveness of misoprostol administered vaginally for uterine evacuation in interrupted early pregnancies and the time between the administration and emptying correlated with gestational age. METHODS: Clinical trial with 41 patients with pregnancies interrupted between the 7th and the 12th gestational weeks. The mean age was 27.3 (±6.1) years. Mean parity was 2.2 (±1.2) deliveries. The average number of previous abortions was 0.2 (± 0.5). Misoprostol was administered vaginally in a single 800 µg dose and transvaginal ultrasound was performed after 24 hours. Abortion was considered complete when the anteroposterior diameter of the endometrial cavity measured <15 mm. Patients whose diameter remained was larger than 15 mm underwent uterine curettage. Two groups (<8 and >8 weeks of gestational age) were compared using the binomial test and Student's t test regarding outcome: frequency of complete abortion and the interval between administration of misoprostol and abortion (in minutes). The level of significance was 5%. RESULTS: The mean gestational age at diagnosis was 8.5 weeks (SD=1.5). The intervals between administration of misoprostol and uterine contractions and between the administration and abortion were 322.5±97.0 minutes and 772.5±201.0 minutes, respectively. There was complete abortion in 80.3%. The success rate was 96.2% for the first group and 53.3% for the second (p<0.01). We observed a statistically significant difference in time between administration and uterine evacuation (676.2±178.9 vs. 939.5±105.7 minutes, p<0.01). The side effects observed were hyperthermia (12.1%), nausea (7.3%), diarrhea or breast pain (2.4%). No case of genital infection was observed. CONCLUSIONS: The use of vaginal misoprostol is a safe and effective alternative to curettage for interrupted early pregnancies, being better in pregnancies up to the 8th week. The time interval until emptying was lower in pregnancies that were interrupted earlier.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(6):276-280
DOI 10.1590/S0100-720320140004827
Schistosomiasis mansoni is found in different endemic areas of Brazil. It is a serious public health problem in Brazil and worldwide. Ectopic forms of the disease may affect the female reproductive system, representing a rare type of Schistosoma mansoni infection. A 26-year-old patient complained of vaginal discharge, dyspareunia and pain on palpation of the hypogastrium. Gynecological examination revealed an endocervical polyp. A biopsy was performed. Under microscopy, several granulomas surrounding degenerate and viable eggs of Schistosoma mansoni were seen. Treated with praziquantel, she was asymptomatic after four weeks of treatment. Vaginal discharge and dyspareunia may be secondary causes of cervicitis caused by Schistosoma mansoni. The search for eggs in routine vaginal smear or histological examination should be part of the gynecologic evaluation of patients from endemic areas, with the purpose of tracking ectopic schistosomiasis of the female genital tract.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):276-276
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):276-276
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):277-287
DOI 10.1590/S0100-72032004000400003
OBJECTIVE: to compare the prevalence of DNA of human papillomavirus (HPV), in samples of normal endometrial tissue, and tissue with endometrial carcinoma of women submitted to surgical treatment (hysterectomy), or between endometrial carcinoma and benign disease, through the PCR technique. METHODS: this is an observational control-case study where 100 women (50 with endometrial carcinoma and 50 with normal endometrial tissue) were analyzed for the detection of HPV DNA in samples of endometrial tissue kept in paraffin blocks by the PCR technique. The cases of endometrial carcinoma with uncertain primary site of the lesion as well as the cases with previous or current history of pre-neoplasic lesions or carcinoma of the lower genital tract were excluded. Variables as age, smoking habit, endometrial trophism, squamous differentiation and degree of tumor differentiation were also evaluated. RESULTS: the estimated relative risk of the presence of HPV in the endometrial carcinoma and in the normal endometrial tissue was the same. HPV was detected in 8% of the cases of carcinoma and 10% in the normal endometrial tissue. In spite of HPV having been 3.5 times more detected in women with smoking habit in the group without carcinoma, there was no statistical difference. The presence of HPV was also not correlated with the women's age, endometrial trophism, squamous differentiation and degree of tumor differentiation. The HPV types 16 (5 cases) and 18 (4 cases) were the viruses most frequently found both in the normal endometrial tissue or in the tissue with carcinoma. No oncogenic low risk virus was detected in the samples. CONCLUSION: The same proportion of HPV is present in the endometrial tissue of women with endometrial cancer and with normal endometrium. It could not be demonstrated a possible correlation of DNA of HPV with the development of endometrial carcinoma.