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  • Resumos de Teses

    Estudo Prospectivo, Comparativo da Isradipina e Atenolol no Tratamento de Gestantes Hipertensas

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):578-578

    Summary

    Resumos de Teses

    Estudo Prospectivo, Comparativo da Isradipina e Atenolol no Tratamento de Gestantes Hipertensas

    Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):578-578

    DOI 10.1590/S0100-72031998001000008

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    Estudo Prospectivo, Comparativo da Isradipina e Atenolol no Tratamento de Gestantes Hipertensas […]
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  • Original Article

    One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):578-585

    Summary

    Original Article

    One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):578-585

    DOI 10.1055/s-0042-1743096

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    Abstract

    Objective

    It is known that the single embryo transfer (SET) is the best choice to reduce multiples and associated risks. The practice of cryopreserving all embryos for posterior transfer has been increasingly performed for in vitro fertilization (IVF) patients at the risk of ovarian hyperstimulation syndrome or preimplantation genetic testing for aneuploidy. However, its widespread practice is still controverse. The aim of this study was to evaluate how effective is the transfer of two sequential SET procedures compared with a double embryo transfer (DET) in freeze-only cycles.

    Methods

    This retrospective study reviewed 5,156 IVF cycles performed between 2011 and 2019, and 506 cycles using own oocytes and freeze-only policy with subsequent elective frozen-thawed embryo transfers (eFET) were selected for this study. Cycles having elective SET (eSET, n = 209) comprised our study group and as control group we included cycles performed with elective DET (eDET, n = 291). In the eSET group, 57 couples who had failed in the 1st eSET had a 2nd eFET, and the estimated cumulative ongoing pregnancy rate was calculated and compared with eDET.

    Results

    After the 1st eFET, the ongoing pregnancy rates were similar between groups (eSET: 35.4% versus eDET: 38.5%; p =0.497), but the estimated cumulative ongoing pregnancy rate after a 2nd eFET in the eSET group (eSET + SET) was significantly higher (48.8%) than in the eDET group (p < 0.001). Additionally, the eSET +SET group had a 2.7% rate of multiple gestations, which is significantly lower than the eDET group, with a 30.4% rate (p < 0.001).

    Conclusion

    Our study showed the association of freeze-only strategy with until up to two consecutive frozen-thawed eSETs resulted in higher success rates than a frozenthawed DET, while drastically reducing the rate of multiple pregnancies.

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    One Plus One is Better than Two: An Approach Towards a Single Blastocyst Transfer Policy for All IVF Patients
  • Artigos Originais

    Severe malaria in pregnant women

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(12):579-583

    Summary

    Artigos Originais

    Severe malaria in pregnant women

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(12):579-583

    DOI 10.1590/S0100-72032010001200003

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    PURPOSE: to analyze the clinical course of three pregnant patients with severe malaria admitted to the intensive care unit of a hospital in Porto Velho (RO), Brazil. METHODS: a descriptive study was conducted on three pregnant women infected with Plasmodium falciparum malaria, admitted to the intensive care unit of a hospital in Porto Velho from 2005 to 2006. Categorical variables used were the classification criteria of the World Health Organization which ranks severe malaria and the Acute Physiology and Chronic Health Disease Classification System II (APACHE II) and Sepsis Related Organ Failure Assessment (SOFA) predictors of morbidity and severity of intensive care unit diseases. RESULTS: the malaria acquired by the pregnant subjects characterized by infection with Plasmodium falciparum in its most serious form resulted in death for all three patients and their fetuses. CONCLUSIONS: although the sample of this study was small it reflects the important impact of severe malaria on pregnant women as well as the need for a more judicious and attentive prenatal care to identify the disease in its early stages and its first complications in pregnant women.

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    Severe malaria in pregnant women
  • Trabalhos Originais

    Analysis of Avoidable Mortality Among Women in Reproductive Age

    Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(9):579-584

    Summary

    Trabalhos Originais

    Analysis of Avoidable Mortality Among Women in Reproductive Age

    Revista Brasileira de Ginecologia e Obstetrícia. 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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  • Editorial

    ‘Missing Adenocarcinomas’: Are They a Real Problem in Cervical Cancer Screening in Brazil?

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(10):579-580

    Summary

    Editorial

    ‘Missing Adenocarcinomas’: Are They a Real Problem in Cervical Cancer Screening in Brazil?

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(10):579-580

    DOI 10.1055/s-0039-1698772

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    Screening and human papillomavirus (HPV) vaccine are the most critical strategies for cervical cancer control. The impact of vaccine programs has not been fully demonstrated yet due to the long natural history of the neoplasia. Regions that have implemented organized screening had efficiently reduced their incidence and mortality rates. Even in Brazil, where screening is […]
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  • Trabalhos Originais

    Accuracy of Clinical and Ecographic Methods in the Diagnosis of Adenomyosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(9):579-584

    Summary

    Trabalhos Originais

    Accuracy of Clinical and Ecographic Methods in the Diagnosis of Adenomyosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(9):579-584

    DOI 10.1590/S0100-72032002000900003

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    Purpose: to evaluate the sensitivity, specificity, positive and negative predictive values of a clinical and an ecographic method for adenomyosis diagnosis. Methods: a transversal study of validation of the diagnostic method was done, including 95 women in menacme submitted to hysterectomy for various causes. Adenomyosis was diagnosed through a clinical method in women aged 40 years or older, with 2 or more deliveries, increased menstrual bleeding associated with dysmenorrhea. The ecographic diagnosis was established if at least one myometrial ill defined area of abnormal ecotexture was found, which could be hypoechoic, hyperchoic, heterogeneous or cystic. Gold standard was histopathology, defined as the finding of endometrial glands or stroma more than 2.5 cm above the endomiometrial junction. Results: the clinical method had 68.2% sensitivity, 78.1% specificity, 48.4% positive predictive value and 89.1% negative predictive value. For the echographic method this figures were, respectively, 45.5%, 84.9%, 47.6% and 83.8%. Likelihood ratio was 3.11 for the clinical and 3.03 for the echographic method. Considering only those simultaneously positive cases by both methods, sensitivity was below 30% and specificity was near 100%. Considering all positive cases by one or the other method or concomitanty by both, the sensitivity reached 86% and specificity was 60%. Conclusion: the echographic method was not better than the clinical for the diagnosis of adenomyosis.

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    Accuracy of Clinical and Ecographic Methods in the Diagnosis of Adenomyosis
  • Trabalhos Originais

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

    Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(10):579-584

    Summary

    Trabalhos Originais

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

    Revista Brasileira de Ginecologia e Obstetrícia. 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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  • Febrasgo Position Statement

    Contraceptive counseling during the pandemic: practical guidelines

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):579-584

    Summary

    Febrasgo Position Statement

    Contraceptive counseling during the pandemic: practical guidelines

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):579-584

    DOI 10.1055/s-0041-1735185

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    Key-points: […]
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