management Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Review Article

    The Effect of Neuromodulatory Drugs on the Intensity of Chronic Pelvic Pain in Women: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(9):891-898

    Summary

    Review Article

    The Effect of Neuromodulatory Drugs on the Intensity of Chronic Pelvic Pain in Women: A Systematic Review

    Rev Bras Ginecol Obstet. 2022;44(9):891-898

    DOI 10.1055/s-0042-1755459

    Views1

    Abstract

    Objective:

    To evaluate the effect of neuromodulatory drugs on the intensity of chronic pelvic pain (CPP) in women.

    Data sources:

    Searches were carried out in the PubMed, Cochrane Central, Embase, Lilacs, OpenGrey, and Clinical Trials databases.

    Selection of studies:

    The searches were carried out by two of the authors, not delimiting publication date or original language. The following descriptors were used: chronic pelvic pain in women OR endometriosis, associated with MESH/ENTREE/DeCS: gabapentinoids, gabapentin, amitriptyline, antidepressant, pregabalin, anticonvulsant, sertraline, duloxetine, nortriptyline, citalopram, imipramine, venlafaxine, neuromodulation drugs, acyclic pelvic pain, serotonin, noradrenaline reuptake inhibitors, and tricyclic antidepressants, with the Boolean operator OR. Case reports and systematic reviews were excluded.

    Data collection:

    The following data were extracted: author, year of publication, setting, type of study, sample size, intervention details, follow-up time, and results.

    Data synthesis:

    A total of 218 articles were found, with 79 being excluded because they were repeated, leaving 139 articles for analysis: 90 were excluded in the analysis of the titles, 37 after reading the abstract, and 4 after reading the articles in full, and 1 could not be found, therefore, leaving 7 articles that were included in the review.

    Conclusion:

    Most of the studies analyzed have shown pain improvement with the help of neuromodulators for chronic pain. However, no improvement was found in the study with the highest statistical power. There is still not enough evidence that neuromodulatory drugs reduce the intensity of pain in women with CPP.

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    The Effect of Neuromodulatory Drugs on the Intensity of Chronic Pelvic Pain in Women: A Systematic Review
  • Review Article

    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

    Rev Bras Ginecol Obstet. 2022;44(4):425-433

    Summary

    Review Article

    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

    Rev Bras Ginecol Obstet. 2022;44(4):425-433

    DOI 10.1055/s-0042-1742292

    Views9

    Abstract

    Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarianmorphology ought not to be used as a diagnostic criterion. Treatment should targetmanifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes.

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    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management
  • Review Article

    Acute Onset Neurological Disorders during Pregnancy: A Literature Review

    Rev Bras Ginecol Obstet. 2017;39(10):560-568

    Summary

    Review Article

    Acute Onset Neurological Disorders during Pregnancy: A Literature Review

    Rev Bras Ginecol Obstet. 2017;39(10):560-568

    DOI 10.1055/s-0037-1604058

    Views0

    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

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