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  • Review Article

    Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):560-569

    Summary

    Review Article

    Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):560-569

    DOI 10.1055/s-0041-1730292

    Views15

    Abstract

    Introduction

    Preeclampsia (PE) is a pregnancy complication associated with increased maternal and perinatal morbidity and mortality. The disease presents with recent onset hypertension (after 20 weeks of gestation) and proteinuria, and can progress to multiple organ dysfunction, with worse outcomes among early onset preeclampsia (EOP) cases (<34 weeks). The placenta is considered the root cause of PE; it represents the interface between the mother and the fetus, and acts as a macromembrane between the two circulations, due to its villous and vascular structures. Therefore, in pathological conditions, macroscopic and microscopic evaluation can provide clinically useful information that can confirm diagnosis and enlighten about outcomes and future therapeutic benefit.

    Objective

    To perform an integrative review of the literature on pathological placental findings associated to preeclampsia (comparing EOP and late onset preeclampsia [LOP]) and its impacts on clinical manifestations.

    Results:

    Cases of EOP presented worse maternal and perinatal outcomes, and pathophysiological and anatomopathological findings were different between EOP and LOP placentas, with less placental perfusion, greater placental pathological changes with less villous volume (villous hypoplasia), greater amount of trophoblastic debris, syncytial nodules, microcalcification, villous infarcts, decidual arteriolopathy in EOP placentas when compared with LOP placentas. Clinically, the use of low doses of aspirin has been shown to be effective in preventing PE, as well asmagnesium sulfate in preventing seizures in cases of severe features.

    Conclusion

    The anatomopathological characteristics between EOP and LOP are significantly different, with large morphological changes in cases of EOP, such as

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    Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature
  • Review Article

    Acute Onset Neurological Disorders during Pregnancy: A Literature Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):560-568

    Summary

    Review Article

    Acute Onset Neurological Disorders during Pregnancy: A Literature Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):560-568

    DOI 10.1055/s-0037-1604058

    Views7

    Abstract

    Objectives

    To characterize the most common peripheral and central neurological disorders during pregnancy.

    Methods

    Original research and review of the literature on neurological complications during pregnancy. We searched for keywords related to the topic on different databases.

    Results

    Pregnancy involves physiological changes that can trigger peripheral neurological and/or central nervous system pathologies, which can sometimes be associated with hypertensive disorders. A definitive diagnosis of neurological disorders can be made according to the trimester of pregnancy and the clinical findings. Carpal tunnel syndrome and peripheral facial palsy are common peripheral neurological disorders, more frequent in the second half of pregnancy. Central nervous disorders are more complex and a precise diagnosis must be made in order to improve perinatal outcomes, provide correct management and treatment and to prevent acute and long-term complications.

    Conclusions

    It is possible to achieve a precise diagnosis,management and treatment of neurological disorders during pregnancy, but these require a multidisciplinary approach, crucial to improve perinatal outcomes.

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    Acute Onset Neurological Disorders during Pregnancy: A Literature Review
  • Original Article

    Support Systems and Limitations in Therapeutic Abortion Care by the Gynecologist-Obstetrician of Public Hospitals in Peru

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):560-566

    Summary

    Original Article

    Support Systems and Limitations in Therapeutic Abortion Care by the Gynecologist-Obstetrician of Public Hospitals in Peru

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):560-566

    DOI 10.1055/s-0042-1746198

    Views5

    Abstract

    Objective

    To identify the barriers to provide to women and adequately train physicians on therapeutic abortions in public hospitals in Peru.

    Methods

    Descriptive cross-sectional survey-based study. We invited 400 obstetrics and gynecology specialists from 7 academic public hospitals in Lima and 8 from other regions of Peru. Expert judges validated the survey.

    Results

    We collected survey results from 160 participants that met the inclusion criteria. Of those, 63.7% stated that the hospital where they work does not offer abortion training. Most of the participants consider that the position of the Peruvian government regarding therapeutic abortion is indifferent or deficient. The major limitations to provide therapeutic abortions included Peruvian law (53.8%), hospital policies (18.8%), and lack of experts (10.6%).

    Conclusion

    Most surveyed physicians supported therapeutic abortions and showed interest in improving their skills. However, not all hospitals offer training and education. The limited knowledge of the physicians regarding the law and institutional policies, as well as fear of ethical, legal, and religious repercussions, were the main barriers for providing abortions.

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    Support Systems and Limitations in Therapeutic Abortion Care by the Gynecologist-Obstetrician of Public Hospitals in Peru
  • Resumos de Teses

    Impacto do Hipotireoidismo entre Mulheres Climatéricas

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):560-560

    Summary

    Resumos de Teses

    Impacto do Hipotireoidismo entre Mulheres Climatéricas

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):560-560

    DOI 10.1590/S0100-72031999000900010

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    Impacto do Hipotireoidismo entre Mulheres Climatéricas […]
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  • Resumos de Teses

    Fatores Prognósticos em Câncer de Mama em Mulheres Pré e Pós-Menopausa

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):560-561

    Summary

    Resumos de Teses

    Fatores Prognósticos em Câncer de Mama em Mulheres Pré e Pós-Menopausa

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):560-561

    DOI 10.1590/S0100-72031999000900011

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    Fatores Prognósticos em Câncer de Mama em Mulheres Pré e Pós-Menopausa […]
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  • Trabalhos Originais

    Prenatal Diagnosis of Lip and Palate Cleft: Experience of 40 Cases

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):561-566

    Summary

    Trabalhos Originais

    Prenatal Diagnosis of Lip and Palate Cleft: Experience of 40 Cases

    Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(9):561-566

    DOI 10.1590/S0100-72032001000900003

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    Purpose: to evaluate fetuses with facial cleft as to type of lesion, associated malformations and aneuploidies. Method: the following parameters were evaluated: maternal age and previous history, gestational age at diagnosis, lesion side, type of lesion, presence of associated malformations and aneuploidies, mortality rate and postnatal follow-up. Results: forty fetuses had facial cleft, 18 (45%) cases had cleft lip, 19 (47.5%) had cleft lip and palate, and 3 (7.5%) cases presented with cleft palate. Isolated facial cleft was observed in 10 fetuses (25%), all of them unilaterally located. Aneuploidies were identified in 10/30 (33.33%) of the patients with associated malformations. Cleft lip and palate was more often seen in this group (18/30 - 60%), followed by bilateral lesion (8/30 - 26.7%) and median cleft (10/30 - 33.3%). Conclusion: facial clefts are considered excellent signs for the presence of associated malformations and fetal aneuploidies. Fetuses with facial cleft must be referred to specialized centers in order to have specialized ultrasound and genetic analysis which can provide the best prenatal counseling for these cases. Isolated facial cleft was associated with very good prognosis.

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    Prenatal Diagnosis of Lip and Palate Cleft: Experience of 40 Cases
  • Resumos de Teses

    Ultra-sonografia Transretal Contribuição ao Estadiamento do Câncer do Colo Uterino

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):561-561

    Summary

    Resumos de Teses

    Ultra-sonografia Transretal Contribuição ao Estadiamento do Câncer do Colo Uterino

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):561-561

    DOI 10.1590/S0100-72031999000900012

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    Ultra-sonografia Transretal Contribuição ao Estadiamento do Câncer do Colo Uterino […]
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  • Resumos de Teses

    Estudo Descritivo da Mini-Laparoscopia em Pacientes com Algia Pélvica

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):561-561

    Summary

    Resumos de Teses

    Estudo Descritivo da Mini-Laparoscopia em Pacientes com Algia Pélvica

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(9):561-561

    DOI 10.1590/S0100-72031999000900013

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    Estudo Descritivo da Mini-Laparoscopia em Pacientes com Algia Pélvica […]
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