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Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):619-626
DOI 10.1590/S0100-72032005001000009
PURPOSE: to evaluate the prevalence of cytologic, colposcopic and histopathologic alterations observed in the uterine cervix of adolescents with suspected cervical neoplasia and to compare it with young adult women. METHODS: a cross-sectional, retrospective study that analyzed 366 medical records of females referred to clarify diagnosis of the suspected cervical neoplasia. The patients had been classified into two groups defined by age. The Adolescent group was composed of 129 females between 13 and 19 years and the Adult group was composed of 237 females between 20 and 24 years. Data were analyzed statistically by the prevalence ratio (PR), respective confidence intervals (CI) at 95% for each variable, chi2 test, or Fisher exact test used to compare proportion. RESULTS: the first sexual intercourse coitarche occurred on average at 15.0 years in the Adolescent group and 16.6 years in the Adult group. The possibility of diagnosis of cytological alterations in the first Papanicolaou smears (PR=2.61; CI 95%: 2.0-3,4), the condition of non-clarified cervical intraepithelial neoplasia (CIN) (PR=1.78; CI 95%: 1.26-2,52), and the colposcopic impressions of low grade (PR=1.42; CI 95%: 1.08-1.86) were statistically significant in the Adolescent group. The histopathologic analysis did not show differences at any grade of CIN. However, two cases of microinvasive carcinoma, one in each group, and three cases of clinical invasive carcinoma in the Adult group were identified. CONCLUSION: our study suggests that cervical cancer is rare among adolescents, but we verified that alterations associated with it occurred even in younger women. The evaluation of cervical intraepithelial neoplasia with the careful application of the same tools used for adult women was appropriate also in adolescence.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(10):619-626
DOI 10.1590/S0100-72032005001000009
PURPOSE: to evaluate the prevalence of cytologic, colposcopic and histopathologic alterations observed in the uterine cervix of adolescents with suspected cervical neoplasia and to compare it with young adult women. METHODS: a cross-sectional, retrospective study that analyzed 366 medical records of females referred to clarify diagnosis of the suspected cervical neoplasia. The patients had been classified into two groups defined by age. The Adolescent group was composed of 129 females between 13 and 19 years and the Adult group was composed of 237 females between 20 and 24 years. Data were analyzed statistically by the prevalence ratio (PR), respective confidence intervals (CI) at 95% for each variable, chi2 test, or Fisher exact test used to compare proportion. RESULTS: the first sexual intercourse coitarche occurred on average at 15.0 years in the Adolescent group and 16.6 years in the Adult group. The possibility of diagnosis of cytological alterations in the first Papanicolaou smears (PR=2.61; CI 95%: 2.0-3,4), the condition of non-clarified cervical intraepithelial neoplasia (CIN) (PR=1.78; CI 95%: 1.26-2,52), and the colposcopic impressions of low grade (PR=1.42; CI 95%: 1.08-1.86) were statistically significant in the Adolescent group. The histopathologic analysis did not show differences at any grade of CIN. However, two cases of microinvasive carcinoma, one in each group, and three cases of clinical invasive carcinoma in the Adult group were identified. CONCLUSION: our study suggests that cervical cancer is rare among adolescents, but we verified that alterations associated with it occurred even in younger women. The evaluation of cervical intraepithelial neoplasia with the careful application of the same tools used for adult women was appropriate also in adolescence.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):619-624
DOI 10.1590/S0100-72032004000800005
PURPOSE: to analyze the relationship of the imune system with preeclamptic pregnancies, comparing lymphocyte and lymphocyte subset analyses of normal pregnant women to pregnancy-induced hypertensive women. To evaluate this immunological function, 40 pregnant women were studied at the "Irmandade da Santa Casa Hospital" of São Paulo: 20 women with normal pregnancies and 20 women with pregnancy-induced hypertension. From all these pregnant women peripheral blood samples were obtained and submitted to the following tests: lymphocyte and lymphocyte subsets analyses (CD4+, CD8+, CD4+/CD8 +CD3+, CD19+). Statistical analysis was performed by the Mann-Whitney test. RESULTS: the serum lymphocyte counts were decreased in women with preeclampsia (preeclamptic group 2295.10±1328.16; control group 3892.80±1430.85, p<0,05); and so were CD4+ (preeclamptic group 1188.80±625.61, control group; 1742.25±628.40, p<0.05); CD8+ (preeclamptic group: 774.00±371.31, control group 1175.70±517.72, p<0,05) and CD3+ (preeclamptic group 1958.65±983.78, control group 2916.95±1117.88, p<0,05). The other tests showed no significant differences between groups. CONCLUSION: the findings indicated a decreased number of lymphocytes, CD4+, CD8+ and CD3+ in preeclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):619-624
DOI 10.1590/S0100-72032004000800005
PURPOSE: to analyze the relationship of the imune system with preeclamptic pregnancies, comparing lymphocyte and lymphocyte subset analyses of normal pregnant women to pregnancy-induced hypertensive women. To evaluate this immunological function, 40 pregnant women were studied at the "Irmandade da Santa Casa Hospital" of São Paulo: 20 women with normal pregnancies and 20 women with pregnancy-induced hypertension. From all these pregnant women peripheral blood samples were obtained and submitted to the following tests: lymphocyte and lymphocyte subsets analyses (CD4+, CD8+, CD4+/CD8 +CD3+, CD19+). Statistical analysis was performed by the Mann-Whitney test. RESULTS: the serum lymphocyte counts were decreased in women with preeclampsia (preeclamptic group 2295.10±1328.16; control group 3892.80±1430.85, p<0,05); and so were CD4+ (preeclamptic group 1188.80±625.61, control group; 1742.25±628.40, p<0.05); CD8+ (preeclamptic group: 774.00±371.31, control group 1175.70±517.72, p<0,05) and CD3+ (preeclamptic group 1958.65±983.78, control group 2916.95±1117.88, p<0,05). The other tests showed no significant differences between groups. CONCLUSION: the findings indicated a decreased number of lymphocytes, CD4+, CD8+ and CD3+ in preeclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(12):619-624
DOI 10.1590/S0100-72032007001200004
PURPOSE: to evaluate the results of neovaginoplasty with the use of a human amniotic graft in patients with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. METHODS: the study was a retrospective analysis of a series of 28 patients with the MRKH syndrome conducted from 1990 to 2003. The patients were attended and treated at the Ambulatório de Ginecologia Infanto-Puberal (AGIP) of the Hospital Universitário of the Faculdade de Medicina de Ribeirão Preto of the Universidade de São Paulo (FMRP-USP), being submitted to neovaginoplasty by the technique of McIndoe and Bannister, modified by the use of a human amniotic membrane graft. Epithelization, amplitude and depth of the neovaginas were evaluated 7 and 40 days after the procedure. Patient satisfaction was determined during the late postoperative period in terms of the presence of discomfort and dyspareunia during sexual relations. RESULTS: postoperatively, seven patients (25%) presented vaginal stenosis and six of them were submitted to a new surgical intervention, one had shortening of the neovagina, corrected with the use of exercises with a vaginal mold, three (10.7%) developed a rectovaginal fistula, one (3.6%) a uterovesical fistula, and one (3.6%) excess skin in the vaginal introitus - all successfully corrected with surgery. Four patients (14.3%) presented urinary tract infection. Two months after surgery, 11/19 patients (57.8%) presented satisfactory sexual activity and 42% dyspareunia, and within a maximum period of four years, 20/21 patients (95.2%) had satisfactory sexual activity and 4.8% dyspareunia. CONCLUSIONS: an amniotic membrane graft is a good option for the treatment of vaginal agenesis. Perioperative follow-up involves educational guidance regarding the use of the mold and regarding patient sexuality in order to reduce the complaints of dysfunctional coitus in the presence of a favorable surgical evolution and a neovagina of adequate aspect.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(12):619-624
DOI 10.1590/S0100-72032007001200004
PURPOSE: to evaluate the results of neovaginoplasty with the use of a human amniotic graft in patients with the Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. METHODS: the study was a retrospective analysis of a series of 28 patients with the MRKH syndrome conducted from 1990 to 2003. The patients were attended and treated at the Ambulatório de Ginecologia Infanto-Puberal (AGIP) of the Hospital Universitário of the Faculdade de Medicina de Ribeirão Preto of the Universidade de São Paulo (FMRP-USP), being submitted to neovaginoplasty by the technique of McIndoe and Bannister, modified by the use of a human amniotic membrane graft. Epithelization, amplitude and depth of the neovaginas were evaluated 7 and 40 days after the procedure. Patient satisfaction was determined during the late postoperative period in terms of the presence of discomfort and dyspareunia during sexual relations. RESULTS: postoperatively, seven patients (25%) presented vaginal stenosis and six of them were submitted to a new surgical intervention, one had shortening of the neovagina, corrected with the use of exercises with a vaginal mold, three (10.7%) developed a rectovaginal fistula, one (3.6%) a uterovesical fistula, and one (3.6%) excess skin in the vaginal introitus - all successfully corrected with surgery. Four patients (14.3%) presented urinary tract infection. Two months after surgery, 11/19 patients (57.8%) presented satisfactory sexual activity and 42% dyspareunia, and within a maximum period of four years, 20/21 patients (95.2%) had satisfactory sexual activity and 4.8% dyspareunia. CONCLUSIONS: an amniotic membrane graft is a good option for the treatment of vaginal agenesis. Perioperative follow-up involves educational guidance regarding the use of the mold and regarding patient sexuality in order to reduce the complaints of dysfunctional coitus in the presence of a favorable surgical evolution and a neovagina of adequate aspect.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):619-625
DOI 10.1590/S0100-72032000001000004
Purpose: to compare the methods used to investigate the endouterine cavity by testing the sensitivity and specificity of X-ray hysterography and sonohysterography compared with hysteroscopy (gold standard). Methods: we carried out a prospective study with 18 patients who, due to symptoms such as irregular menstrual cycles, unexplained postmenopausal uterine bleeding and ultrasound disturbance, were candidates for uterine cavity investigation by X-ray hysterography, sonohysterography and hysteroscopy. Results: sonohysterography sensitivity and specificity were 90 and 87.5%, respectively. Positive and negative predictive values were 90 and 87.5%. For X-ray hysterography, sensitivity, specificity, positive and negative predictive values were 70, 75, 77.7 and 75%, respectively. Conclusion: the use of saline instilation into the endometrial cavity in order to enhance the acuracy of the vaginal ultrasonography seems reliable as a mean to distinguish lesions in the uterine cavity, thereby facilitating the identification of candidates for diagnostic or operative hysteroscopy. X-ray hysterography produces results inferior to hysterosonography.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):619-625
DOI 10.1590/S0100-72032000001000004
Purpose: to compare the methods used to investigate the endouterine cavity by testing the sensitivity and specificity of X-ray hysterography and sonohysterography compared with hysteroscopy (gold standard). Methods: we carried out a prospective study with 18 patients who, due to symptoms such as irregular menstrual cycles, unexplained postmenopausal uterine bleeding and ultrasound disturbance, were candidates for uterine cavity investigation by X-ray hysterography, sonohysterography and hysteroscopy. Results: sonohysterography sensitivity and specificity were 90 and 87.5%, respectively. Positive and negative predictive values were 90 and 87.5%. For X-ray hysterography, sensitivity, specificity, positive and negative predictive values were 70, 75, 77.7 and 75%, respectively. Conclusion: the use of saline instilation into the endometrial cavity in order to enhance the acuracy of the vaginal ultrasonography seems reliable as a mean to distinguish lesions in the uterine cavity, thereby facilitating the identification of candidates for diagnostic or operative hysteroscopy. X-ray hysterography produces results inferior to hysterosonography.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):619-619
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):619-619
, Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):62-64
, Renal artery aneurysms (RAAs) are rare and usually asymptomatic; ~ 90% of them are unilateral. Once diagnosed during pregnancy, they may rupture, presenting a high maternal-fetal risk. The present study reports the case of a 32-year-old pregnant woman with a 30-week gestational age and a ruptured unilateral RAA.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):62-64
, Renal artery aneurysms (RAAs) are rare and usually asymptomatic; ~ 90% of them are unilateral. Once diagnosed during pregnancy, they may rupture, presenting a high maternal-fetal risk. The present study reports the case of a 32-year-old pregnant woman with a 30-week gestational age and a ruptured unilateral RAA.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(10):620-624
Epidemiological studies have shown evidence of the effect of genetic variations in the pathogenesis of breast cancer and have suggested a relationship of the disease with genetic polymorphisms. Matrix metallopeptidase 9 (MMP-9) is a collagenase responsible for the degradation of type IV collagen, the major component of the basement membrane, and other essential extra cellular matrix components, being involved in the tumor cell invasion and metastasis. Our objective was to evaluate the relationship between the MMP-9-1562 C/T polymorphism (rs 3918242) and the risk of developing breast cancer.
In this case-control study, the frequency of the MMP-9-1562 C/T polymorphism (rs 3918242) was determined in 148 women with breast cancer and 245 women without the disease. The DNA was extracted from plasma samples, and the gene was amplified by polymerase chain reaction (PCR); the presence of the polymorphism was determined using restriction enzymes.
After adjusting for confounding variables, we found that the polymorphism was not associated with the occurrence of breast cancer (odds ratio [OR] = 1.159, 95% confidence interval [CI]: 0.6625-1.997, p = 0.5964). We also found no association with more advanced disease, the presence of hormone receptors, human epidermal growth factor receptor 2 (HER2) overexpression, or rate of tumor cell proliferation.
We did not observe a relationship between MMP-9-1562 C/T polymorphism (rs 3918242) and the occurrence of breast cancer.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(10):620-624
Epidemiological studies have shown evidence of the effect of genetic variations in the pathogenesis of breast cancer and have suggested a relationship of the disease with genetic polymorphisms. Matrix metallopeptidase 9 (MMP-9) is a collagenase responsible for the degradation of type IV collagen, the major component of the basement membrane, and other essential extra cellular matrix components, being involved in the tumor cell invasion and metastasis. Our objective was to evaluate the relationship between the MMP-9-1562 C/T polymorphism (rs 3918242) and the risk of developing breast cancer.
In this case-control study, the frequency of the MMP-9-1562 C/T polymorphism (rs 3918242) was determined in 148 women with breast cancer and 245 women without the disease. The DNA was extracted from plasma samples, and the gene was amplified by polymerase chain reaction (PCR); the presence of the polymorphism was determined using restriction enzymes.
After adjusting for confounding variables, we found that the polymorphism was not associated with the occurrence of breast cancer (odds ratio [OR] = 1.159, 95% confidence interval [CI]: 0.6625-1.997, p = 0.5964). We also found no association with more advanced disease, the presence of hormone receptors, human epidermal growth factor receptor 2 (HER2) overexpression, or rate of tumor cell proliferation.
We did not observe a relationship between MMP-9-1562 C/T polymorphism (rs 3918242) and the occurrence of breast cancer.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(12):620-625
DOI 10.1590/S0100-72032008001200006
PURPOSE: to compare delivery and pregnancy follow-up among adolescent and non-adolescent pregnant women whose delivery occurred in a tertiary hospital from Região de Lisboa (Portugal). METHODS: retrospective study with 10,656 deliveries. Pregnancy follow-up, delivery type, need of episiotomy and severe lacerations, Apgar index at the fifth minute and the delivery weight have been evaluated. The pregnant women were divided into two groups, over and under 20 years old. The group with women under 20 was further subdivided in pregnant women under or over 16. The χ2 test has been used for statistical analysis. RESULTS: adolescents presented worse follow-up: first appointment after 12 weeks (46.4 versus 26.3%) and less than four appointments (8.1 versus 3.1%), less dystocia (21.5 versus 35.1%), less caesarian sections (10.6 versus 20.7%), and lower need for inducing labor (16.5 versus 26.5%). There was no significant difference concerning gestational age at delivery and ratio of low weight newborns. Among adolescents, the ones under 16 had more low weight newborns (12 versus 7.4%) and more deliveries between 34 and 37 weeks (10.8 versus 4.2%). CONCLUSIONS: in a hospital attending adolescents with social and psychological support, the fact of them having had a worse follow-up in the pre-natal phase, their performance has not been worse. Nevertheless, special attention might be given to pregnant women under 16.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(12):620-625
DOI 10.1590/S0100-72032008001200006
PURPOSE: to compare delivery and pregnancy follow-up among adolescent and non-adolescent pregnant women whose delivery occurred in a tertiary hospital from Região de Lisboa (Portugal). METHODS: retrospective study with 10,656 deliveries. Pregnancy follow-up, delivery type, need of episiotomy and severe lacerations, Apgar index at the fifth minute and the delivery weight have been evaluated. The pregnant women were divided into two groups, over and under 20 years old. The group with women under 20 was further subdivided in pregnant women under or over 16. The χ2 test has been used for statistical analysis. RESULTS: adolescents presented worse follow-up: first appointment after 12 weeks (46.4 versus 26.3%) and less than four appointments (8.1 versus 3.1%), less dystocia (21.5 versus 35.1%), less caesarian sections (10.6 versus 20.7%), and lower need for inducing labor (16.5 versus 26.5%). There was no significant difference concerning gestational age at delivery and ratio of low weight newborns. Among adolescents, the ones under 16 had more low weight newborns (12 versus 7.4%) and more deliveries between 34 and 37 weeks (10.8 versus 4.2%). CONCLUSIONS: in a hospital attending adolescents with social and psychological support, the fact of them having had a worse follow-up in the pre-natal phase, their performance has not been worse. Nevertheless, special attention might be given to pregnant women under 16.