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  • Trabalhos Originais

    Duration of Intraepithelial Neoplasia and Invasive Carcinoma of the Cervix in Relation to Age at Diagnosis

    Rev Bras Ginecol Obstet. 1998;20(10):565-569

    Summary

    Trabalhos Originais

    Duration of Intraepithelial Neoplasia and Invasive Carcinoma of the Cervix in Relation to Age at Diagnosis

    Rev Bras Ginecol Obstet. 1998;20(10):565-569

    DOI 10.1590/S0100-72031998001000004

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    Purpose: to estimate the duration of cervical neoplasia from human pappilomavirus (HPV) infection to advanced invasive carcinoma, using as paremeter the mean age of the women at diagnosis. Methods: this cross-sectional study included 1,177 women with HPV infection, 1,561 with cervical intraepithelial neoplasia (CIN) and 773 with invasive carcinoma. Results: the mean ages of CIN 1 and CIN 2 on diagnosis were not statistically different. The mean duration of CIN 2 was 2.2 years. The mean duration of CIN 3 was 10.3 years, with 4.1 years as severe dysplasia and 6.2 years as carcinoma in situ (CIS). The mean duration of high grade squamous intraepithelial lesions was 12.5 years. The duration means of invasive carcinoma stages Ia, Ib and II were 3.0, 2.7 and 3.7 years, respectively. Conclusions: according to the results, CIN 1 and CIN 2 may arise directly from HPV infection and most of these lesions are transient. CIS presented the longest duration and the mean asymptomatic period of cervical neoplasia is 18.2 years. These results were discussed considering the present knowledge of the natural history of cervical carcinoma and other studies on duration of this neoplasia.

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  • Original Article

    Analysis of Avoidable Mortality Among Women in Reproductive Age

    Rev Bras Ginecol Obstet. 2000;22(9):579-584

    Summary

    Original Article

    Analysis of Avoidable Mortality Among Women in Reproductive Age

    Rev Bras Ginecol Obstet. 2000;22(9):579-584

    DOI 10.1590/S0100-72032000000900007

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    Purpose: to evaluate the avoidable mortality among women in reproductive age, living in Campinas, SP, comparing two five-year periods: 1985-89 and 1990-94. Methods: death certificates of 3.086 women aged 10 to 49 years were studied, representing the total number of deaths during the period from January 1985 through December 1994. The criteria for avoidance were applied to these deaths using preventive, sanitary, early diagnosis and treatment, and mixed measures. The deaths were also classified as: with hardly avoidable causes, not well-defined causes and other causes. The specific mortality coefficient for each period of five years and the ratio between these coefficients were calculated. Results: there was a 20% increase in the avoidable mortality rate from the first to the second period. The main failure was observed among the group of avoidable causes by preventive and sanitary measures. The main increase in death causes by preventive measures resulted from AIDS. Among the causes of death avoidable by mixed measures, the increase of 50% in maternal mortality caused by abortion, as well as causes due to violence specially homicides, are emphasized. Conclusion: there was an increase in the proportion of avoidable death causes. Measures to prevent AIDS, abortion and to reduce violent deaths, specially homicides, should be political and social priorities in our Country.

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  • Original Article

    Maternal perception of fetal movements as a method to evaluate fetal condition in diabetic women

    Rev Bras Ginecol Obstet. 1999;21(10):579-584

    Summary

    Original Article

    Maternal perception of fetal movements as a method to evaluate fetal condition in diabetic women

    Rev Bras Ginecol Obstet. 1999;21(10):579-584

    DOI 10.1590/S0100-72031999001000003

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    Purpose: to evaluate the accuracy of maternal perception of fetal movements (MPFM) in diabetic pregnant women, using Apgar score at the 1st and 5th min of life, intrapartum fetal distress and neonatal hypoxia as parameters. Methods: two hundred and nine diabetic women evaluated at the High Risk Prenatal Care Clinic of the Women's Hospital (CAISM) were analyzed retrospectively between June 1988 and May 1996. All patients had MPFM records within three days before delivery, fetal heart rate recordings during labor, gestational age greater than 30 weeks and a complete neonatal evaluation. MPFM was classified as normal if seven movements were recorded in 60 min. Results: the sensitivity of the test was 23 and 29% for Apgar score <7 at the 5th min and intrapartum fetal distress, respectively, and close to 50% for neonatal hypoxia (45.5%). Specificity was near 95% for the three standards, and the negative predictive value (NPV) was 80% for fetal distress, increasing to 97 and 98% for Apgar >7 at 5 min and neonatal hypoxia. Conclusions: MPFM is a useful test to identify diabetic women needing fetal evaluation with more complex techniques, given the high NPV, that indicates the capacity to separate the cases where the fetus is in good condition.

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  • Trabalhos Originais

    Maternal mortality in Recife: causes of maternal deaths

    Rev Bras Ginecol Obstet. 1998;20(1):7-11

    Summary

    Trabalhos Originais

    Maternal mortality in Recife: causes of maternal deaths

    Rev Bras Ginecol Obstet. 1998;20(1):7-11

    DOI 10.1590/S0100-72031998000100002

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    With the purpose of identifying the causes of maternal deaths, this study evaluated all cases of deaths of 10 to 49-years-old women which occurred in Recife, Pernambuco, Brazil, during 1992 and 1993. The data were obtained from 1013 death certificates and were complemented by medical and anesthetia records forms, nursing reports, necropsies and also interviews with physicians who took care of the women, or with their relatives. The main basic causes of maternal deaths identified were arterial hypertension (23.8%), infections (19.0%), abortion (11.9%), hemorrhage (9.5%), pulmonary embolism (4.8%) and anaesthetic accident (2.4%). About 70% of maternal deaths in Recife in the studied period were due to directo obstetrical causes.

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  • Original Article

    Advantages and Disadvantages of Medical Abortion, According to Brazilian Residents in Obstetrics and Gynaecology

    Rev Bras Ginecol Obstet. 2020;42(12):793-799

    Summary

    Original Article

    Advantages and Disadvantages of Medical Abortion, According to Brazilian Residents in Obstetrics and Gynaecology

    Rev Bras Ginecol Obstet. 2020;42(12):793-799

    DOI 10.1055/s-0040-1718952

    Views3

    Abstract

    Objective

    To find out which was the opinion of residents in obstetrics and gynecology about the advantages and disadvantages of medical abortion as compared with surgical procedures.

    Method

    Cross-sectional multicenter study among residents in obstetrics and gynecology from 21 maternity hospitals located in 4 different geographical regions of Brazil, using a self-responded questionnaire with 31 questions related to their opinion and experience on providing abortion services.

    Results

    Most residents agreed that “being less invasive” (94.7%), “does not require anesthesia” (89.7%), “can be accompanied during the process” (89.1%), “prevents physical trauma” (84.4%) were the main advantages of medical abortion.

    Conclusion

    Residents perceived both clinical and personal issues as advantages of medical abortion.

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  • Original Article

    Knowledge, opinion and attitudes of Brazilian gynecologists and obstetricians regarding induction of abortion

    Rev Bras Ginecol Obstet. 2004;26(2):89-96

    Summary

    Original Article

    Knowledge, opinion and attitudes of Brazilian gynecologists and obstetricians regarding induction of abortion

    Rev Bras Ginecol Obstet. 2004;26(2):89-96

    DOI 10.1590/S0100-72032004000200002

    Views1

    PURPOSE: to evaluate knowledge, opinion and practice of gynecologists/obstetricians regarding induction of abortion. Method: a pretested, structured questionnaire was sent to gynecologists/obstetricians affiliated to FEBRASGO. They were asked to answer and return the questionnaire in a self-addressed, prepaid envelope, without identification of the respondent so as to preserve anonymity. Knowledge about the legal situation of abortion in Brazil, opinion about it and practice if confronted with abortion requests were questioned. RESULTS: approximately 90% of the respondents believed that abortion is legal for pregnancy resulting from rape or in case of risk to a woman's life and for 31.8% in case of severe fetal malformation. In their opinion abortion should be permitted in the case that pregnancy is a risk for a woman's life (79.3%), fetal malformation (77.0%) and after rape (76.6%), added to 9.9% who expressed that abortion should be permitted in all circumstances. Two thirds wrongly thought that a judicial order is required to practice a legal abortion and only 27.4% knew that a written request by the woman is required. Confronted with unwanted pregnancy, 77.6% of female gynecologists/obstetricians and 79.9% of partners of male respondents had an abortion, 40% would help a client and 48.5% a relative in the same situation. CONCLUSION: gynecologists/obstetricians lack knowledge on the legal situation of abortion although their opinion and practice are favorable.

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