Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):343-343
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):343-351
To evaluate the emotional and clinical aspects observed in women with gestational trophoblastic disease (GTD) followed-up in a reference center (RC) by a multidisciplinary team.
Retrospective cohort study of the clinical records of 186 women with GTD and of the emotional aspects (EA) observed in these women by a teamof psychologists and reported by the 389 support groups conducted from 2014 to 2018.
The women were young (mean age: 31.2 years), 47% had no living child, 60% had planned the pregnancy, and 50% participated in two or more SG. Most women (n=137; 73.6%) reached spontaneous remission ofmolar gestation in a median time of 10 weeks and had a total follow-up time of seven months. In the group of 49 women (26.3%) who progressed to gestational trophoblastic neoplasia (GTN), time to remission after chemotherapy was 18 weeks, and total follow-up time was 36 months. EA included different levels of anxiety and depression,more evident in 9.1% of the women; these symptoms tended to occur more frequently in women older than 40 years (p=0.067), less educated (p=0.054), and whose disease progressed to GTN (p=0.018), as well as in those who had to undergo multi-agent chemotherapy (p=0.028) or hysterectomy (p=0.001) adjuvant to clinical treatment.
This study found several EA in association with all types of GTD. It also highlights the importance of specialized care only found in a RC, essential to support the recovery of the mental health of these women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(5):343-346
DOI 10.1590/S0100-72032002000500009
Aplastic anemia is characterized by a circulating pancytopenia, hypocellularity, and fatty replacement of cellular marrow elements, without evidence of malignant transformation or myeloproliferative disease. It usually affects young and senior adults, without any sexual preference. Most cases of aplastic anemia are acquired, but the disease may also be inherited due to a molecular disorder (Fanconi's anemia). Aplastic anemia in pregnancy is an extremely rare condition with high maternal and fetal morbidity and mortality rates. The authors describe a case of a patient with previously diagnosed aplastic anemia, whose pregnancy was complicated with urinary tract infection, preeclampsia and fetal growth restriction, with elective preterm birth. In spite of the adverse conditions in pregnancy and delivery, mother and newborn had a satisfactory clinical evolution.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):344-344
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):344-349
To evaluate the trends in definitive contraception in a ten-year interval comprising the years 2002 and 2012.
Retrospective analysis of the tubal sterilization performed in our service in 2002 and2012,analyzingthedemographiccharacteristics,personalhistory,previouscontraceptive method, definite contraception technique, effectiveness and complications.
Definitive contraception was performed in 112 women in 2002 (group 1) and in 60 women in 2012 (group 2). The groups were homogeneous regarding age, parity, educational level and personal history. The number of women older than 40 years choosing a definitive method was more frequent in group 1, 49.1% (n = 55); for group 2, the rate was 34.8% (n = 23) (p = 0.04). The time between the last delivery and the procedure was 11.6±6.2 and 7.9±6.4 years (p = 0.014) in 2002 against 2012 respectively. In 2002, all patients performed tubal ligation by laparoscopic inpatient regime. In 2012, the bilateral placement of the Essure (Bayer Corporation, Whippany, NJ, US) device was suggested to 56.1% (n = 37) of the patients, while laparoscopy was suggested to 43.9% (n = 29) of them. All women who underwent laparoscopic sterilization had the procedure successfully completed using silastic rings. The overall bilateral device placement rate for the Essure was 91.6%, with only one complication reported. All Essure procedures were performed in an outpatient setting; for the laparoscopy, this rate was 79% (n = 15). No intentional pregnancies occurred until this date.
There is a trend in the decrease in definitive contraception over the years in our institution, maybe as a result of the development of long-acting reversible contraceptives. The hysteroscopic procedure has become a frequent option, as it is performed in an office setting without anesthesia, being a well-tolerated, minimal invasive method.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(5):345-351
DOI 10.1590/S0100-72032003000500007
PURPOSE: to estimate the sensitivity, specificity and accuracy of patient age, ultrasound result and CA-125 marker variables for the differential diagnosis between malignant and benign ovarian tumors. In addition, to establish a risk of malignancy index (RMI) incorporating these three variables and to estimate its sensitivity, specificity and accuracy for the differential diagnosis. METHODS: one hundred patients with ovarian tumors with surgical indication were included. The age, ultrasonographic findings and CA-125 level variables were evaluated separately and later on together as the RMI. The study was performed based on the evaluation of the sensitivity, specificity and diagnostic accuracy and the use of the measurements: likelihood ratio, odds ratio, and the Student's t test, chi², and logistic regression with univariate and multivariate analysis. RESULTS: for the age variable, sensitivity, specificity and diagnostic accuracy were 58.8, 68.2 and 65.0%, respectively. For ultrasound, 88.2, 77.3 and 81.0%. For CA-125 dosage, the values were 64.7, 74.2 and 71.0%. When the three variables were put together, as the RMI, a sensitivity of 76.5%, a specificity of 87.9% and a diagnostic accuracy of 84.0% were observed. CONCLUSIONS: RMI, made up of the association of patient age, ultrasound results and CA-125 dosage variables is a valuable indicator to distinguish between malignant and benign ovarian tumor, especially in regard to its specificity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(8):345-346
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(6):345-351
DOI 10.1590/S0100-72032006000600005
PURPOSE: to evaluate association between CD4+ cell count and cervical intraepithelial lesion severity in HIV-infected women. METHODS: cross-sectional study of 87 HIV-infected patients which were confirmed by previous serologic examinations. All had cervical HPV diagnosed by polymerase chain reaction (PCR). All patients underwent anamnesis, physical examinations and colposcopy. Cervix biopsy was performed when indicated by colposcopical examination. Histopathological results followed Richart's classification, adapted by Wright, and CD4+ cell count and cervical intraepithelial lesion severity association was analysed by comparison of means using analysis using analysis of variance (ANOVA). RESULTS: among 60 biopsied women 24 were found (40.0%) with CIN I, eight (13.3%) with CIN II, three (5%) with CIN III, 14 (23.3%) with chronic cervicitis and 11 with cytopathic effect of HPV, without cell polarity loss. This corresponds to 35 (58.3%) women with intraepithelial lesion of low grade (CIN I + HPV) and 11 (18.3%) with intraepithelial lesion of high grade (CIN II + CIN III). There was no significant association between CD4+ cell count mean and cervical intraepithelial lesion severity (p=0.901). CONCLUSIONS: there was no association between CD4+ cell count and cervical intraepithelial lesion severity diagnosed by histopathological examination.