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Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):187-192
DOI 10.1590/S0100-72032002000300007
Purpose: in order to maintain the gonadal function after oophorectomy, morphofunctional aspects of ovarian autotransplantation to the greater omentum and the best kind of implantation, intact or sliced, were investigated. Methods: forty cycling female Wistar rats were randomly divided into four groups: Group I (n = 5), control - laparotomy; Group II (n = 5), bilateral oophorectomy; Group III (n = 10), intact ovarian autotransplantation to the greater omentum; and Group IV (n = 10), sliced ovarian autotransplantation, both to the greater omentum. The estrous cycle was investigated in the third and sixth postoperative months and histological studies of the ovarian implants were carried out considering: degeneration, fibrosis, inflammatory reaction, angiogenesis, follicular cysts, follicular development and corpora lutea. Results: the animals of Group I preserved the cycling sequence. The rats of Group II remained in diestrus. In Group III, 11 rats remained in diestrus, three presented incomplete cycles and one showed normal cycle. In Group IV, three animals remained in diestrus, eight showed incomplete cycles and four showed normal cycles. The histology of the ovaries of Group III was normal in ten female rats; however, the ovaries of the other five animals presented degeneration. In Group IV, 14 female rats had ovaries with preserved morphological aspect, and signs of degeneration occurred in one. Conclusions: the ovarian autotransplantation to the greater omentum is viable and the sliced form presented better morphofunctional aspects than the intact implants.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):187-192
DOI 10.1590/S0100-72032002000300007
Purpose: in order to maintain the gonadal function after oophorectomy, morphofunctional aspects of ovarian autotransplantation to the greater omentum and the best kind of implantation, intact or sliced, were investigated. Methods: forty cycling female Wistar rats were randomly divided into four groups: Group I (n = 5), control - laparotomy; Group II (n = 5), bilateral oophorectomy; Group III (n = 10), intact ovarian autotransplantation to the greater omentum; and Group IV (n = 10), sliced ovarian autotransplantation, both to the greater omentum. The estrous cycle was investigated in the third and sixth postoperative months and histological studies of the ovarian implants were carried out considering: degeneration, fibrosis, inflammatory reaction, angiogenesis, follicular cysts, follicular development and corpora lutea. Results: the animals of Group I preserved the cycling sequence. The rats of Group II remained in diestrus. In Group III, 11 rats remained in diestrus, three presented incomplete cycles and one showed normal cycle. In Group IV, three animals remained in diestrus, eight showed incomplete cycles and four showed normal cycles. The histology of the ovaries of Group III was normal in ten female rats; however, the ovaries of the other five animals presented degeneration. In Group IV, 14 female rats had ovaries with preserved morphological aspect, and signs of degeneration occurred in one. Conclusions: the ovarian autotransplantation to the greater omentum is viable and the sliced form presented better morphofunctional aspects than the intact implants.
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):187-193
, , , , To map health evidence on the effectiveness of transcutaneous nerve electrostimulation (TENS) therapy in pain relief during delivery.
This is a scoping review in the PubMed, LILACS, Cochrane, VHL, PEDRO, and SciELO databases, through the descriptors electric stimulation, transcutaneous and labor, obstetric and their synonyms.
A total of 263 studies were identified, of which 54 duplicates were excluded. After sorting by titles and abstracts, there were 24 articles for reading, remaining 6. The six studies evaluated the reduction of pain through the visual analogue scale (VAS).
The findings indicate that the use of TENS as a nonpharmacological strategy for pain relief in labor has positive results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):187-193
, , , , To map health evidence on the effectiveness of transcutaneous nerve electrostimulation (TENS) therapy in pain relief during delivery.
This is a scoping review in the PubMed, LILACS, Cochrane, VHL, PEDRO, and SciELO databases, through the descriptors electric stimulation, transcutaneous and labor, obstetric and their synonyms.
A total of 263 studies were identified, of which 54 duplicates were excluded. After sorting by titles and abstracts, there were 24 articles for reading, remaining 6. The six studies evaluated the reduction of pain through the visual analogue scale (VAS).
The findings indicate that the use of TENS as a nonpharmacological strategy for pain relief in labor has positive results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):188-193
To evaluate the frequency of structural congenital anomalies (CAs) in the midwest of Brazil and its association with maternal risk factors.
This was a prospective, observational, case-control study based on a hospital population. Pregnant women attended at a fetal medicine service in Brazil were analyzed in the period from October 2014 to February 2016.A total of 357 pregnant women were included, 223 of whom had fetuses with structural anomalies (group case), and 134 of whom had structurally normal fetuses (control group). The clinical history was made previous to prenatal consultation, and the diagnosis of the structural CA was performed through ultrasound.
A frequency of 64.27% (n = 223) of pregnant women with fetuses with structural anomalies was observed. The most frequent structural CAs were those of the central nervous system (30.94%), followed by anomalies of the genitourinary system (23.80%), and, finally, by multiple CAs (16.60%). The background of previous children with CAs (odds ratio [OR]: 3.85; p = 0.022), family history (OR: 6.03; p = < 0.001), and consanguinity between the progenitors (OR: 4.43; p = 0.034) influenced the occurrence of structural CA.
The most frequent CAs are those of the central nervous system, followed by those of the genitourinary system, and then multiple anomalies. The maternal risk factors that may have influenced the occurrence of structural CA were previous children with CA, family history, and consanguinity among the parents.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):188-193
To evaluate the frequency of structural congenital anomalies (CAs) in the midwest of Brazil and its association with maternal risk factors.
This was a prospective, observational, case-control study based on a hospital population. Pregnant women attended at a fetal medicine service in Brazil were analyzed in the period from October 2014 to February 2016.A total of 357 pregnant women were included, 223 of whom had fetuses with structural anomalies (group case), and 134 of whom had structurally normal fetuses (control group). The clinical history was made previous to prenatal consultation, and the diagnosis of the structural CA was performed through ultrasound.
A frequency of 64.27% (n = 223) of pregnant women with fetuses with structural anomalies was observed. The most frequent structural CAs were those of the central nervous system (30.94%), followed by anomalies of the genitourinary system (23.80%), and, finally, by multiple CAs (16.60%). The background of previous children with CAs (odds ratio [OR]: 3.85; p = 0.022), family history (OR: 6.03; p = < 0.001), and consanguinity between the progenitors (OR: 4.43; p = 0.034) influenced the occurrence of structural CA.
The most frequent CAs are those of the central nervous system, followed by those of the genitourinary system, and then multiple anomalies. The maternal risk factors that may have influenced the occurrence of structural CA were previous children with CA, family history, and consanguinity among the parents.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(4):188-195
DOI 10.1590/S0100-72032011000400007
PURPOSE: to evaluate the prevalence of urinary symptoms and association between pelvic floor muscle function and urinary symptoms in primiparous women 60 days after vaginal delivery with episiotomy and cesarean section after labor. METHODS: a cross-sectional analysis was conducted on women from an out patient clinic in São Paulo state, Brazil, 60 days after delivery. Pelvic floor muscle function was assessed by surface electromyography (basal tone, maximal voluntary contraction and mean sustained contraction) and by a manual muscle test (grades 0-5). In an interview, the urinary symptoms were identified and women with difficulty to understand, with motor/neurological impairment, pelvic surgery, diabetes, restriction for vaginal palpation and practicing exercises forpelvic floor muscles were excluded. The χ2 and Fisher Exact test were used to compare proportions and the Mann-Whitney test was used to analyze mean differences. RESULTS: 46 primiparous were assessed on average 63.7 days postpartum. The most prevalent symptoms were nocturia (19.6%), urgency (13%) and increased daytime urinary frequency (8.7%). Obese and overweight women had 4.6 times more of these symptoms (PR=4.6 [95%CI; 1.2-18.6; p value=0.0194]). Stress urinary incontinence was the most prevalent incontinence (6.5%). The mean values found for the basic tone, maximal voluntary contraction and sustained contraction were: 3 µV, 14.6 µV and 10.3 µV. Most of the women (56.5%) had grade 3 muscular strength. There was no association between urinary symptoms and pelvic floor muscle function. CONCLUSION: the prevalence of urinary symptoms was low 60 days postpartum and there was no association between pelvic floor muscle function and urinary symptoms.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(4):188-195
DOI 10.1590/S0100-72032011000400007
PURPOSE: to evaluate the prevalence of urinary symptoms and association between pelvic floor muscle function and urinary symptoms in primiparous women 60 days after vaginal delivery with episiotomy and cesarean section after labor. METHODS: a cross-sectional analysis was conducted on women from an out patient clinic in São Paulo state, Brazil, 60 days after delivery. Pelvic floor muscle function was assessed by surface electromyography (basal tone, maximal voluntary contraction and mean sustained contraction) and by a manual muscle test (grades 0-5). In an interview, the urinary symptoms were identified and women with difficulty to understand, with motor/neurological impairment, pelvic surgery, diabetes, restriction for vaginal palpation and practicing exercises forpelvic floor muscles were excluded. The χ2 and Fisher Exact test were used to compare proportions and the Mann-Whitney test was used to analyze mean differences. RESULTS: 46 primiparous were assessed on average 63.7 days postpartum. The most prevalent symptoms were nocturia (19.6%), urgency (13%) and increased daytime urinary frequency (8.7%). Obese and overweight women had 4.6 times more of these symptoms (PR=4.6 [95%CI; 1.2-18.6; p value=0.0194]). Stress urinary incontinence was the most prevalent incontinence (6.5%). The mean values found for the basic tone, maximal voluntary contraction and sustained contraction were: 3 µV, 14.6 µV and 10.3 µV. Most of the women (56.5%) had grade 3 muscular strength. There was no association between urinary symptoms and pelvic floor muscle function. CONCLUSION: the prevalence of urinary symptoms was low 60 days postpartum and there was no association between pelvic floor muscle function and urinary symptoms.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):188-195
DOI 10.1590/S0100-72032011000800004
PURPOSE: To describe the epidemiological profile and nutritional status of pregnant women infected with human immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS: A retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with 95% confidence intervals (CI). RESULTS: At the beginning of pregnancy, 11.0% of the women were underweight, and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with well-nourished pregnant women (RR=3.3 95%CI 1.3-8.1) and women with no companion (RR=1.5 95%CI 1.1-2.2) having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(8):188-195
DOI 10.1590/S0100-72032011000800004
PURPOSE: To describe the epidemiological profile and nutritional status of pregnant women infected with human immunodeficiency virus (HIV) and its effect on the nutritional status of these women during pregnancy. METHODS: A retrospective cohort study was conducted on 121 pregnant women with HIV infection, single fetus pregnancies, who received prenatal care and delivered at a referral unit for HIV-infected pregnant women during the period from 1997 to 2007. Outcomes of the study were the initial and final nutritional status as measured by body mass index, weight gain, anemia (hemoglobin <11 g/dL) and low birth weight. Bivariate analysis investigated the association of these outcomes with socio-demographic, clinical-care and dietary characteristics. We estimated the relative risks (RR) with 95% confidence intervals (CI). RESULTS: At the beginning of pregnancy, 11.0% of the women were underweight, and in late pregnancy, the prevalence was 29.3%. Low educational level, urinary infection and worm infestation were associated with low gestational weight in late pregnancy. The percentage of insufficient weight gain was 47.5%, with well-nourished pregnant women (RR=3.3 95%CI 1.3-8.1) and women with no companion (RR=1.5 95%CI 1.1-2.2) having a higher risk for this outcome. The prevalences of overweight at the beginning and at the end of pregnancy were 26.8 and 29.4, respectively. There was a significant prevalence of anemia (61.0%). CONCLUSIONS: The high percentage of negative nutritional outcomes identified at this referral service with multidisciplinary care for pregnant women living with HIV reveals the need to establish more effective strategies to deal with the complex context of HIV.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(4):188-195
To analyze the association between the indirect methods of evaluating insulin resistance (IR) and blood pressure, anthropometric and biochemical parameters in a population of polycystic ovary syndrome (PCOS) patients.
Cross-sectional study performed at the Hospital Universitário de Brasília (HUB, in the Portuguese acronym) involving PCOS patients diagnosed from January 2011 to January 2013. Four indirect methods, namely, fasting blood insulin level, fasting glucose/insulin ratio (G/I), homeostatic model-assessment-insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI), were used to obtain the IR diagnosis. The data were analyzed using the test of proportions, the Chisquare test, and Fisher exact test, when indicated.
Out of the 83 patients assessed, aged 28.79 ± 5.85, IR was found in 51.81- 66.2% of them using the G/I ratio and the QUICKI, respectively. The test of proportions did not show a significant difference between the methods analyzed. The proportion of IR diagnoses was statistically higher in obese women than in women with normal body mass index (BMI). We observed a statistically significant association between all the methods for diagnosing IR and BMI, waist circumference (WC) and lipid accumulation product (LAP). With regards to arterial hypertension (AH), we observed a significant association according to three methods, with the exception of the ratio G/I.
Insulin resistance prevalence varied according to the diagnostic method employed,with no statistical difference between them. The proportion of IR diagnoses was statistically higher in obese women than in women with normal BMI.We observed a significant association between IR andWC, BMI, LAP, as well as dyslipidemia and AH in a high proportion of patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(4):188-195
To analyze the association between the indirect methods of evaluating insulin resistance (IR) and blood pressure, anthropometric and biochemical parameters in a population of polycystic ovary syndrome (PCOS) patients.
Cross-sectional study performed at the Hospital Universitário de Brasília (HUB, in the Portuguese acronym) involving PCOS patients diagnosed from January 2011 to January 2013. Four indirect methods, namely, fasting blood insulin level, fasting glucose/insulin ratio (G/I), homeostatic model-assessment-insulin resistance (HOMA-IR), and the quantitative insulin sensitivity check index (QUICKI), were used to obtain the IR diagnosis. The data were analyzed using the test of proportions, the Chisquare test, and Fisher exact test, when indicated.
Out of the 83 patients assessed, aged 28.79 ± 5.85, IR was found in 51.81- 66.2% of them using the G/I ratio and the QUICKI, respectively. The test of proportions did not show a significant difference between the methods analyzed. The proportion of IR diagnoses was statistically higher in obese women than in women with normal body mass index (BMI). We observed a statistically significant association between all the methods for diagnosing IR and BMI, waist circumference (WC) and lipid accumulation product (LAP). With regards to arterial hypertension (AH), we observed a significant association according to three methods, with the exception of the ratio G/I.
Insulin resistance prevalence varied according to the diagnostic method employed,with no statistical difference between them. The proportion of IR diagnoses was statistically higher in obese women than in women with normal BMI.We observed a significant association between IR andWC, BMI, LAP, as well as dyslipidemia and AH in a high proportion of patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(4):189-195
Previous studies have shown that low birth weight (LBW) is associated with cardiovascular risk in late adulthood. Recent studies in adolescents suggest that modifiable factors may have greater influence on increased cardiovascular risk. This study aims to investigate the association between LBW and changes in anthropometric and biochemical risk factors during adolescence in a population with low average socioeconomic status.
In a retrospective double cohort, data of birth weight were extracted from hospital records of children born on the same day between 1992 and 2002. According to the World Health Organization, we classified the children as having LBW or normal birth weight. A total of 172 subjects among children, adolescents and adults were researched. We measured anthropometric and clinical data, lipid profile and glucose after an overnight fasting. The low and normal weight groups were compared using Mann-Whitney U, Fischer exact, Chi-square (2) and Student's t tests.
Pregnant women with preeclampsia delivered more newborns with LBW (p< 0.001). Anthropometric and clinical parameters were similar between groups. No differences were found in the family history of cardiovascular diseases (p= 0.1), family incomes (p= 0.8) and maternal school education (p= 0.8) between groups.
In this study, LBW did not increase cardiovascular disease risk factors in adolescents. We observed absence of association between low birth weight and poor health outcomes among adolescents with low socioeconomic status from an urban city in the Brazilian northeast.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(4):189-195
Previous studies have shown that low birth weight (LBW) is associated with cardiovascular risk in late adulthood. Recent studies in adolescents suggest that modifiable factors may have greater influence on increased cardiovascular risk. This study aims to investigate the association between LBW and changes in anthropometric and biochemical risk factors during adolescence in a population with low average socioeconomic status.
In a retrospective double cohort, data of birth weight were extracted from hospital records of children born on the same day between 1992 and 2002. According to the World Health Organization, we classified the children as having LBW or normal birth weight. A total of 172 subjects among children, adolescents and adults were researched. We measured anthropometric and clinical data, lipid profile and glucose after an overnight fasting. The low and normal weight groups were compared using Mann-Whitney U, Fischer exact, Chi-square (2) and Student's t tests.
Pregnant women with preeclampsia delivered more newborns with LBW (p< 0.001). Anthropometric and clinical parameters were similar between groups. No differences were found in the family history of cardiovascular diseases (p= 0.1), family incomes (p= 0.8) and maternal school education (p= 0.8) between groups.
In this study, LBW did not increase cardiovascular disease risk factors in adolescents. We observed absence of association between low birth weight and poor health outcomes among adolescents with low socioeconomic status from an urban city in the Brazilian northeast.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):189-196
DOI 10.1590/S0100-72032005000400005
PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):189-196
DOI 10.1590/S0100-72032005000400005
PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.