Articles - Revista Brasileira de Ginecologia e Obstetrícia

04-16-1998

O Respeito às Publicações
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(2):66-66

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Abstract
O Respeito às Publicações
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(2):66-66
DOI 10.1590/S0100-72031998000200001
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Editorial O Respeito às Publicações […]
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Original Article04-12-1998

A study of hormone activity in premenopausal tamoxifen-treated women
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):533-536

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Abstract
Original Article
A study of hormone activity in premenopausal tamoxifen-treated women
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):533-536
DOI 10.1590/S0100-72031998000900007
Júlio Roberto de M. Bernardes Jr,
Luiz Henrique Gebrim,
Afonso Celso Pinto Nazário,
Claúdio Kemp,
Geraldo Rodrigues de Lima,
Edmund Chada Baracat
Views154
Purpose: to evaluate the effects of tamoxifen (TAM) on plasma levels of estradiol, progesterone, prolactin, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and steroid hormone-binding globulin (SHBG) when given to premenopausal women in the doses of 10 and 20 mg/day for 22 days. Patients and Methods: a randomized double-blind study was performed with 43 premenopausal eumenorrheic women. The patients were divided into three groups: A (N = 15, placebo); B (N = 15, TAM 10 mg/day) and C (N = 13, 20 mg/day). They started taking an oral dose of TAM or placebo on the very first day of the menstrual cycle. Two hormone determinations were performed, both on the 22nd day of the menstrual cycle: the first in the cycle that preceded the use of the drug and the second, in the following cycle, after 22 days of using the medication. We used the Levine and Student tests in order to evaluate the homogeneity of the sample and the variation of the hormone determinations respectively. Results:serum levels of estradiol, progesterone and SHBG increased significantly in groups B and C. In group C, we also observed increase in serum level of FSH (p < 0.0045) and a fall in prolactin level (p < 0.0055). Conclusions: TAM promoted a significant increase in serum concentrations of estradiol, progesterone and SHBG either in the doses of 10 or 20 mg/day. However, significant increase in FSH and decrease in prolactin were obtained only with the dose of 20 mg/day.

Key-words Estradiol Progesterone Prolactin Tamoxifen
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Case Report04-12-1998

Pneumoperitoneum after cesarean section: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):289-292

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Abstract
Case Report
Pneumoperitoneum after cesarean section: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):289-292
DOI 10.1590/S0100-72031998000500009
Melania Maria Ramos de Amorim,
Fernando Antônio Campelo Spencer Netto,
Luiz Carlos Santos,
Everaldo Mascarenhas,
Leila Katz
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Pneumoperitoneum, abdominal pain and paralytic ileus in the postoperative period are usually related to perforation of the gastrointestinal tract. The authors present a case of a patient submitted to cesarean section (abruptio placentae) who had a postoperative course of abdominal distention and abdominal pain. Abdominal X-ray showed important dilatation of the colon and small bowel. Pneumoperitoneum was seen on chest X-ray. An exploratory laparotomy was performed because of suspicion of intestinal perforation. The operation showed a marked dilatation of bowel, pneumoperitoneum, and infected hemoperitoneum and subaponeurotic hematoma (Escherichia coli), without any perforation. Postoperative recovery was good and antibiotics were given for 4 days (ceftriaxone + metronidazole). The patient was diseharged from hospital on the 7th day after laparotomy. After review of the literature the authors concluded that this case of pneumoperitoneum was probably related to infection by a gas-producing bacterium in a patient with clinical findings of paralytic ileus.

Key-words Cesarean section Pneumoperitoneum Postoperative complications Puerperium
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Case Report04-12-1998

Fetal turner syndrome and tetralogy of fallot associated with elevated maternal serum alpha-fetoprotein levels
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):283-287

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Abstract
Case Report
Fetal turner syndrome and tetralogy of fallot associated with elevated maternal serum alpha-fetoprotein levels
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):283-287
DOI 10.1590/S0100-72031998000500008
Eduardo Vieira Neto,
Jaime Liberman,
Armando A. Fonseca
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Turner syndrome and its complications, hydrops and cystic hygroma, can produce alterations in maternal serum biochemical markers used in screening for Down’s syndrome and neural tube defects (NTD). The authors report the case of a 37-year-old pregnant woman, screened for Down’s syndrome and NTD in the second trimester of pregnancy. The maternal serum alpha-fetoprotein (MSAFP) level was increased and the test was considered screen positive for NTD. A three-dimensional ultrasound investigation was performed, but no fetal or placental anomalies were found, indicating a case of unexplained increased msafp. In the third trimester severe oligohydramnios and disturbances in uteroplacental arterial circulation developed, requiring corticosteroid therapy and premature cesarean section at the 34th week of gestation. The female newborn was transferred to a neonatal ICU and tetralogy of Fallot and Turner syndrome were diagnosed. This case prompted the authors to review the literature on maternal serum biochemical markers in Turner syndrome and congenital heart defects and to propose a protocol for unexplained increased MSAFP.

Key-words Alpha-fetoprotein Fetal malformations Tetralogy of Fallot Turner syndrome
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Original Article04-12-1998

Assessment of the tolerability and cycle control of two low-dose oral contraceptives: an open-label study
- Edmund C. Baracat,
- Ione C. Barbosa,
- Altamiro A. Campos,
- Sylvia B. Hyppolito,
- Nilson R. de Melo,
- Geraldez Tomaz
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):273-280

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Abstract
Original Article
Assessment of the tolerability and cycle control of two low-dose oral contraceptives: an open-label study
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):273-280
DOI 10.1590/S0100-72031998000500007
Edmund C. Baracat,
Ione C. Barbosa,
Altamiro A. Campos,
Sylvia B. Hyppolito,
Nilson R. de Melo,
Rafael Mussielo,
Rosival Nassar,
João S. Pinho-Neto,
Geraldez Tomaz
Views195
An open-label comparative study was conducted in nine centers in Brazil to evaluate the tolerability and cycle control of two low-dose oral contraceptives containing 20 mg ethynylestradiol/75 mg gestodene and 20 mg ethynylestradiol/150 mg desogestrel, during six treatment cycles. A total of 167 healthy sexually active women were enrolled (77 in the gestodene group and 90 in the desogestrel group) and 138 completed the six-cycle treatment period. A lipid and hemostatic profile was performed for a subgroup of first users. A total of 867 cycles were evaluated. Irregular bleeding did not occur in 95.4% of the cycles evaluated with gestodene and in 91.9% with desogestrel. Tolerability was good with both preparations but there was significantly more nausea in the desogestrel group. Cycle control was good with both preparations with a significantly lower incidence of irregular bleeding with gestodene when all cycles were considered. There were no clinically significant changes in the hemostatic profile. Lipid profile showed a trend to be more favorable after six cycles of treatment with both preparations. Women in the gestodene group did not present changes in the mean weight; in the desogestrel group there was a significant mean weight increase of 1 kg after six cycles of treatment. Compliance with treatment was good with both preparations. Results of this study demonstrated that low-dose preparations containing gestodene or desogestrel combined with 20 mg of ethynylestradiol are well-tolerated oral contraceptives that provide good cycle control.

Key-words Coagulation Contraception Cycle control Desogestrel Estrogen Gestodene Lipid profile Low-dose contraceptive Progesterone
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Original Article04-12-1998

Endogenous sexual steroids and gonadotrophins in women with or without endometrial carcinoma: a comparative clinical study
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):267-271

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Abstract
Original Article
Endogenous sexual steroids and gonadotrophins in women with or without endometrial carcinoma: a comparative clinical study
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):267-271
DOI 10.1590/S0100-72031998000500006
Valdir Tadini,
Sylvia M.F. Brenna,
Aarão Mendes Pinto-Neto,
Lúcia Helena Simões da Costa Paiva,
Maurício de Sena Martins,
Gustavo Antônio de Souza
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Objective:To analyze the levels of endogenous sexual steroids and gonadotrophin in women with and without endometrial cancer. Methodology:We developed a clinical comparative study on 20 postmenopausal women with endometrial cancer and 20 postmenopausal women without endometrial cancer. The age, the postmenopausal time and the index of body mass were used as matching variables. The plasma levels of the endogenous sexual steroids were measured using radioimmunoassay and immunoenzymatic methods. For the statistic analysis we used the Student’s t test. Results: The levels of androstenedione (A), total testosterone (t) and free testosterone (TL) were higher in the women with endometrial cancer, and those of the luteinic hormone (LH) were significantly lower values in these women. We also observed that the ratio (E1/A) showed significantly lower in the group of women with cancer, while the ratio (E2/E1) did not present any differences between groups. Conclusions: We emphasize the potentiality of sexual steroids and gonadotrophins in the genesis of endometrial adenocarcinoma in postmenopausal women.

Key-words Androgen Cancer Endometrium Estrogen Hormone dosage Menopause
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Original Article04-12-1998

Is the prognosis of the second twin worse ?
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):261-264

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Abstract
Original Article
Is the prognosis of the second twin worse ?
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):261-264
DOI 10.1590/S0100-72031998000500005
Hélio de L. F. F. Costa,
Ana Cecília O. Rocha,
Alessandra F. Galvão,
Juliana de A. Souza,
Ana Cláudia de O. Rigaard,
Laura O. B. F. Costa
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The disadvantages of the second twin in respect of his birth conditions are of great concern. In this study we have reviewed 90 twin births occurred at the Maternidade da Encruzilhada (CISAM) in Recife, from January/92 to December/93, in order to compare perinatal variables between the first and second twin. Fetal presentation, way of delivery, birth weight, Apgar of the 1st and 5th minutes, occurrence of perinatal complications such as hyaline membrane syndrome, transitory tachypnea, and neonatal infection and, finally, the prognosis of each of the twins were evaluated. There was no statistical difference between the incidence of non-vertex presentation, cesarean section, low birth weight, Apgar < 7 in the 1st and 5th minutes and neonatal complication cited above. There was also no difference in perinatal mortality between the first and the second twin. Our results suggest a similar birth condition for both twins of a same pregnancy, therefore, the same perinatal care must be provided for each one.

Key-words Fetal death Perinatal mortality Pregnancy outcome Twin pregnancy
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Original Article04-12-1998

Accuracy of Clements’ test for evaluation of fetal lung maturation in preeclamptic patients
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):253-260

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Abstract
Original Article
Accuracy of Clements’ test for evaluation of fetal lung maturation in preeclamptic patients
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(5):253-260
DOI 10.1590/S0100-72031998000500004
Melania Maria Ramos de Amorim,
Aníbal Faúndes,
Luiz Carlos Santos,
Elvira Azevedo
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Objectives: To determine sensitivity, specificity, positive and negative predictive values of the shake test (Clements) for evaluation of fetal lung maturation in preeclamptic patients. Methods: A prospective study for validation of a diagnostic method was conducted enrolling 163 preeclamptic patients (gestational age between 28-34 weeks) admitted at CAM-IMIP with indication for fetal maturity testing. Preeclampsia diagnosis and classification followed criteria of the National High Blood Pressure Working Group, 1990. Clements’ test was performed in three tubes and positive, negative or intermediate results were considered for analysis (related to presence or absence of fetal lung maturity). Accuracy parameters were calculated considering actual incidence of hyaline membrane disease (positive maturity = absent disease) after birth. Hyaline membrane disease was defined by criteria of CLAP, 1978. Statistical analysis was performed using c² test (Epi-Info 6.04b) with a 5% significance level. Results: Intermediate results were considered alternately as positive or negative for analysis. When considered positive, sensitivity was 87.9% and specificity 74.5% with positive and negative predictive values of 8.9.4% and 71.4% respectively – efficiency was 84%. When intermediate results were evaluated as negative, sensitivity decreased to 62% and specificity raised to 89.4% and positive and negative predictive values were 93.5% and 51.2% respectively (efficiency = 70%). False-positive results were rare and usually related to neonatal hypoxia: only 5 (6.5%) of 77 neonates with previous positive Clements had hyaline membrane disease. Nevertheless, false negatives were frequent: almost 40% for negative/intermediate results. Conclusions: Despite its limitations, Clements’ test remains a good method for investigation of fetal lung maturation in preeclamptic patients since false positive results are unusual. However sensitivity is low and results have be cautiously analyzed because of elevated rate of false negative results. A good policy is to complement fetal maturity investigation with other tests if a negative result is determined, specially in severe cases when confirmed maturity represents indication for interruption of pregnancy.

Key-words Clements' test Fetal lung maturation Hyaline membrane disease Preeclampsia
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Original Article10-01-2016

Uterine Fibroid Symptom – Quality of Life questionnaire translation and validation into Brazilian Portuguese
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):518-523

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Abstract
Original Article
Uterine Fibroid Symptom – Quality of Life questionnaire translation and validation into Brazilian Portuguese
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):518-523
DOI 10.1055/s-0036-1593833
Rita Oliveira da Silva,
Mariano Tamura Vieira Gomes,
Rodrigo de Aquino Castro,
Cláudio Emílio Bonduki,
Manoel João Batista Castello Girão
Views240
Abstract

Purpose

To translate into Portuguese, culturally adapt and validate the Uterine Fibroid Symptom – Quality of Life (UFS-QoL) questionnaire for Brazilian women with uterine leiomyoma.

Methods

Initially, the UFS-QoL questionnaire was translated into Brazilian Portuguese in accordance with international standards, with subsequent cultural, structural, conceptual and semantic adaptations, so that patients were able to properly answer the questionnaire. Fifty patients with uterine leiomyoma and 19 patients without the disease, confirmed by abdominal pelvic examination and/or transvaginal ultrasound, were selected at the outpatient clinics of the Department of Gynecology of the Universidade Federal de São Paulo (Unifesp). The UFS-QoL questionnaire was administered to all women twice on the same day, with two different interviewers, with an interval of 15 minutes between interviews. After 15 days, the questionnaire was readministered by the first interviewer. Reliability (internal consistency and test-retest), construct and discriminative validity were tested to ratify the questionnaire.

Results

The reliability of the instrument was assessed by Cronbach’s α coefficient with an overall result of 0.97, indicating high reliability. The survey results showed a high correlation (p= 0.94; p 0.001).

Conclusion

The UFS-QoL questionnaire was successfully adapted to the Brazilian Portuguese language and Brazilian culture, showing reliability and validity.

Key-words Leiomyoma Quality of life Questionnaire translation Validation studies
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Case Report03-01-2017

Limb Body Wall Complex Associated with Placenta Accreta: A Mere Coincidence or a Sign of an Etiopathogenic Link?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):142-146

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Abstract
Case Report
Limb Body Wall Complex Associated with Placenta Accreta: A Mere Coincidence or a Sign of an Etiopathogenic Link?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):142-146
DOI 10.1055/s-0037-1598607
Marcos Masaru Okido,
Aderson Tadeu Berezowski,
Sandra Regina Marques Carvalho,
Geraldo Duarte,
Ricardo de Carvalho Cavalli,
Alessandra Cristina Marcolin
Views242
Abstract

A case was reported of a fetus with the anomaly of limb body wall complex associated with placenta accreta. To date, only one account of this condition has been published in the world literature. Due to the low frequency of both complications, the hypothesis has been raised that this association may have happened not by mere coincidence, but rather by a possible common etiopathogenic mechanism. For the first time, a study proposes the existence of a possible etiopathogenic connection between the anomaly of limb body wall complex and hypoxic disorders caused by inadequate placentation in previous uterine scarring.

Key-words complex etiology limb body wall Placenta accreta prenatal diagnosis Ultrasonography
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Original Article01-01-2018

Body Mass Index Changes during Pregnancy and Perinatal Outcomes – A Cross-Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):11-19

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Abstract
Original Article
Body Mass Index Changes during Pregnancy and Perinatal Outcomes – A Cross-Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):11-19
DOI 10.1055/s-0037-1608885
Sirlei Siani Morais,
Simony Lira Nascimento,
Ana Carolina Godoy-Miranda,
Karina Tamy Kasawara,
Fernanda Garanhani Surita
Views219
Abstract

Objective

To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes.

Methods

A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequateweight, overweight, and obese. The BMIwas calculated at the first and at the last prenatal care visits, and these values were compared.

Results

An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97-2.28), fetalmacrosomia (OR 4.13-12.54) and large for gestational age newborn (OR 2.88-9.83).

Conclusion

Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.

Key-words Atalah curve Cesarean section Fetal weight Obesity Pregnancy Weight gain
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Original Article03-01-2018

Improving Perinatology Residents’ Skills in Breaking Bad News: A Randomized Intervention Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):137-146

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Abstract
Original Article
Improving Perinatology Residents’ Skills in Breaking Bad News: A Randomized Intervention Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):137-146
DOI 10.1055/s-0037-1621741
Maria Silvia Vellutini Setubal,
Maria Ângela Reis Goes Monteiro Antonio,
Eliana Martorano Amaral,
John Boulet
Views233
Abstract

Objective

Breaking bad news (BBN) is particularly difficult in perinatology. Previous research has shown that BBN skills can be learned and improved when taught and practiced. This project evaluated whether a structured training session would enhance perinatology residents’ skills in BBN.

Methods

This was a randomized controlled intervention study with year 1 to 4 Perinatology residents from a medical school in Brazil, during the 2014/15 school year. A total of 61 out of 100 (61%) eligible residents volunteered to a structured training program involving communicating a perinatal loss to a simulated patient (SP) portraying the mother followed by the SP’s immediatefeedback,bothvideo recorded. Later, residents were randomly assigned to BBN training based on a setting, perception, invitation, knowledge, emotion and summary (SPIKES) strategy with video reviews (intervention) or no training (control group). All residents returned for a second simulation with the same SP blinded to the intervention and portraying a similar case. Residents’ performances were then evaluated by the SP with a checklist. The statistical analysis included a repeated measures analysis of covariance (RM-ANCOVA). Complementarily, the residents provided their perceptions about the simulation with feedback activities.

Results

Fifty-eight residents completed the program. The simulations lasted on average 12 minutes, feedback 5 minutes and SPIKES training between 1h and 2h30m. There was no significant difference in the residents’ performances according to the SPs’ evaluations (p = 0.55). The participants rated the simulation with feedback exercises highly. These educational activities might have offset SPIKES training impact. Conclusion The SPIKES training did not significantly impact the residents’ performance. The residents endorsed the simulation with feedback as a useful training modality. Further research is needed to determine which modality is more effective.

Key-words education Health communication internship and residency medical patient simulation perinatology
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Case Report09-01-2018

Diagnosis of Atelosteogenesis Type I suggested by Fetal Ultrasonography and Atypical Paternal Phenotype with Mosaicism
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):570-575

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Abstract
Case Report
Diagnosis of Atelosteogenesis Type I suggested by Fetal Ultrasonography and Atypical Paternal Phenotype with Mosaicism
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):570-575
DOI 10.1055/s-0038-1670684
Joanna Goes Castro Meira,
Manoel Alfredo Curvelo Sarno,
Ágatha Cristhina Oliveira Faria,
Guilherme Lopes Yamamoto,
Débora Romeo Bertola,
Gabriela Gayer Scheibler,
Dione Fernandes Tavares,
Angelina Xavier Acosta
Views245
Abstract

Atelosteogenesis type I (AOI) is an autosomal dominant skeletal dysplasia caused by mutations in the filamin B (FLNB) gene with classic and well-recognizable clinical findings. However, parents affected with a mild phenotype, probably with somatic mosaicism, can generate offspring with a much more severe phenotype of AOI. In the present report, we describe a female newborn with classic AOI leading to early neonatal death, whose diagnostic was based on prenatal radiological findings and on the physical examination of the father. Since her father had limb deformities and corporal asymmetry, suggesting somatic mosaicism, his biological samples were analyzed through a gene panel for skeletal dysplasias. A missense mutation not previously described in the literature was detected in the FLNB gene, affecting ~ 20% of the evaluated cells and, therefore, confirming the diagnosis ofmosaic AOI in the father. The molecular analysis of the father was crucial to suggest the diagnosis of AOI in the newborn, since she died early and there were no biological samples available.

Key-words atelosteogenesis exome-target sequencing Fetal ultrasonography FLNB skeletal dysplasia somatic mosaicism
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Case Report01-24-2021

Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models
- Pedro Castro ,
- Heron Werner ,
- Ana Paula Matos ,
- Gerson Ribeiro ,
- Jorge Lopes ,
- Edward Araujo Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):985-987

Views233

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Abstract
Case Report
Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):985-987
DOI 10.1055/s-0041-1739297
Pedro Castro ,
Heron Werner ,
Ana Paula Matos ,
Gerson Ribeiro ,
Jorge Lopes ,
Edward Araujo Júnior
Views233
Abstract

Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. We describe the use of 3D technologies, including 3D virtual and 3D physical models on prenatal evaluation of one parapagus CT. A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. 3D images of the fetal surface were generated by the software during the examination for spatial comprehension of the relationship between the fetal parts. The pair of CTs died at the 32^nd week of gestation, a few hours after cesarean section. 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.

Key-words conjoined Twins Magnetic resonance Imaging three-dimensional models
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Original Article05-24-2021

Disease Progression and Obstetric Outcomes of Women with Multiple Sclerosis at a Reference Center in Northeastern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):165-171

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Disease Progression and Obstetric Outcomes of Women with Multiple Sclerosis at a Reference Center in Northeastern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):165-171
DOI 10.1055/s-0040-1722157
Gabrielle Maria Carvalho de Barros ,
Bianca Etelvina Santos de Oliveira ,
Gabriela Januário Oliveira ,
Rômulo Kunrath Pinto Silva ,
Thiago Nóbrega Cardoso ,
Sabina Bastos Maia
Views250
Abstract

Objective

To describe the obstetric outcomes of patients withmultiple sclerosis (MS) and the impact of pregnancy and the postpartum period on the progression of the disease.

Methods

A case series study performed between December 2019 and February 2020, reporting pregnancies occurred between 1996 and 2019. The subjects included were women with MS undergoing follow-up at an MS referral center in Northeastern Brazil, and who had at least one pregnancy after the onset of MS symptoms, or who had their first relapse in the first year after delivery.

Results

In total, 26 women and 38 pregnancies were analyzed – 32 of them resulted in delivery, and the remaining 6, in miscarriages. There was a significant increase in the prevalence of relapse during the postpartum period when compared with the gestational period. In 16 (42.1%) of the pregnancies, there was exposure to diseasemodifying therapies (DMTs) – 14 (36.8%), to interferon β, and 2 (5.3%), to fingolimod. Higher rates of abortion, prematurity and low birth weight were reported in the group was exposed to DMT when compared with the one who was not.

Conclusion

In the sample of the present study, there was a significant increase in the rate of MS relapse during the postpartum period when compared with the gestational period. Additionally, it seems that exposure to DMTs during pregnancy may affect the obstetric outcomes of the patients.

Key-words Abortion Infant multiple sclerosis Newborn Postpartum period Pregnancy
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FEBRASGO POSITION STATEMENT01-23-2022

Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):999-1009

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
FEBRASGO POSITION STATEMENT
Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):999-1009
DOI 10.1055/s-0042-1758490
Sara Toassa Gomes Solha ,
Rosiane Mattar ,
Patrícia de Fátima dos Santos Teixeira ,
Maria Izabel Chiamolera ,
Carlos Alberto Maganha ,
Alberto Carlos Moreno Zaconeta ,
Renato Teixeira Souza
Views343
Key points

Recommendations

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Original Article11-01-2018

Obstetric Outcomes among Syrian Refugees: A Comparative Study at a Tertiary Care Maternity Hospital in Turkey
- Sule Ozel,
- Selen Yaman,
- Hatice Kansu-Celik,
- Necati Hancerliogullari,
- Nurgul Balci,
- Yaprak Engin-Ustun
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):673-679

Views204

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Obstetric Outcomes among Syrian Refugees: A Comparative Study at a Tertiary Care Maternity Hospital in Turkey
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):673-679
DOI 10.1055/s-0038-1673427
Sule Ozel,
Selen Yaman,
Hatice Kansu-Celik,
Necati Hancerliogullari,
Nurgul Balci,
Yaprak Engin-Ustun
Views204
Abstract

Objective

The aim of this study was to analyze and compare obstetric and neonatal outcomes between Syrian refugees and ethnic Turkish women.

Methods

Retrospective, observational study. A total of 576 Syrian refugees and 576 ethnic Turkish women were included in this study, which was conducted between January 2015 and December 2015 at a tertiary maternity training hospital in Ankara, Turkey. The demographic characteristics, obstetric and neonatal outcomes were compared. The primary outcomes were pregnancy outcomes and cesarean rates between the groups

Results

The mean age was significantly lower in the refugee group (p< 0.001). Mean gravidity, proportion of adolescent pregnancies, proportion of pregnant women aged 12 to 19 years, and number of pregnancies at < 18 years were significantly higher among the refugee women (p< 0.001). Rates of antenatal follow-up, double testing, triple testing, gestational diabetes mellitus (GDM) screening, and iron replacement therapy were significantly lower in the refugee group (p< 0.001). The primary Cesarean section rate was significantly lower in the refugee group (p= 0.034). Pregnancies in the refugee group were more complicated, with higher rates of preterm delivery (< 37 weeks), preterm premature rupture of membranes (PPROM), and low birth weight (< 2,500 g) when compared with the control group (4.2% versus 0.7%, p< 0.001; 1.6% versus 0.2%, p= 0.011; and 12% versus 5.8%, p< 0.001, respectively). Low education level (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 0.5–0.1), and weight gain during pregnancy (OR = 1.7, 95% CI = 0.5–0.1) were found to be significant indicators for preterm birth/PPROM and low birthweight.

Conclusion

Syrian refugees had increased risks of certain adverse obstetric outcomes, including preterm delivery, PPROM, lower birth weight, and anemia. Several factors may influence these findings; thus, refugee women would benefit from more targeted care during pregnancy and childbirth.

Key-words Antenatal care immigrants neonatal outcomes obstetric outcomes Syrian Refugees
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Editorial09-01-2018

Maternal Mortality in Brazil: Proposals and Strategies for its Reduction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):501-506

Views270

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Editorial
Maternal Mortality in Brazil: Proposals and Strategies for its Reduction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):501-506
DOI 10.1055/s-0038-1672181
Rodolfo Carvalho Pacagnella,
Marcos Nakamura-Pereira,
Flavia Gomes-Sponholz,
Regina Amélia Lopes Pessoa de Aguiar,
Gláucia Virginia de Queiroz Lins Guerra,
Carmen Simone Grilo Diniz,
Brenno Belazi Nery de Souza Campos,
Eliana Martorano Amaral,
Olímpio Barbosa de Moraes Filho
Views270
Maternal mortality is one of the health indicators that most reflect the social conditions of women. The inequities observed in this indicator between high- and low-income countries and among regions in the same country are explained by differences in the provision, in the access, and in the quality of obstetric care and of family planning. […]
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Original Article06-27-2019

Quality of Life among University Students with Premenstrual Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):312-317

Views304

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Quality of Life among University Students with Premenstrual Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):312-317
DOI 10.1055/s-0039-1688709
Fernanda Figueira Victor,
Ariani Impieri Souza,
Cynthia Danúbia Tavares Barreiros,
João Lucas Nunes de Barros,
Flavia Anchielle Carvalho da Silva,
Ana Laura Carneiro Gomes Ferreira
Views304
Abstract

Objective

To evaluate the quality of life among university students with premenstrual syndrome (PMS).

Methods

The cross-sectional study was conducted at the Faculdade Pernambucana de Saúde, in Recife, Brazil, between August 2016 and July 2017. Sociodemographic, gynecological, and lifestyle variables, and PMS occurrence, were investigated among 642 students. The short form of the World Health Organization Quality of Life (WHOQOL Bref) questionnaire was used to evaluate four domains of the quality of life of the students: physical, mental, social relationships, and environmental. The American College of Obstetricians and Gynecologists’ criteria were used to define PMS.

Results

Of the 642 students, 49.9% had PMS, 23.3% had mild PMS and 26.6% had premenstrual dysphoric disorder (PMDD). Most of the students were between 18 and 24 years old, had regular menstrual cycles, and practiced physical activity. Regarding the physical and mental domains of the WHOQOL-Bref questionnaire, a statisticallysignificant difference was observed between the students who did not have and those who had mild or PMDD (p < 0.001). A difference was also found between the students who did not have PMS and those who had mild PMS in the social relationships (p = 0.001) and environmental domains (p = 0.009).

Conclusion

Mild PMS and PMDD are prevalent among university students on healthrelated courses, and the syndrome can affect the students’ self-assessment of all the domains of quality of life.

Key-words medical student Menstruation disturbances premenstrual dysphoric disorder Premenstrual syndrome Quality of life
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Review Article06-01-2016

Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations
- Mário Dias Corrêa Junior,
- Renato Passini Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(6):301-307

Views236

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(6):301-307
DOI 10.1055/s-0036-1584942
Mário Dias Corrêa Junior,
Renato Passini Júnior
Views236
Abstract

Introduction

Episiotomy is a controversial procedure, especially because the discussion that surrounds it has gone beyond the field of scientific debate, being adopted as an indicator of the “humanization of childbirth”. The scientific literature indicates that episiotomy should not be performed routinely, but selectively.

Objectives

To review the literature in order to assess whether the implementation of selective episiotomy protects against severe perineal lacerations, the indications for the procedure, and the best technique to perform it.

Methods

A literature search was performed in PubMed using the terms episiotomy or perineal lacerations, and the filter clinical trial. The articles concerning the risk of severe perineal lacerations with or without episiotomy, perineal protection, or episiotomy techniques were selected.

Results

A total of 141 articles were identified, and 24 of them were included in the review. Out of the 13 studies that evaluated the risk of severe lacerations with and without episiotomy, 5 demonstrated a protective role of selective episiotomy, and 4 showed no significant differences between the groups. Three small studies confirmed the finding that episiotomy should be performed selectively and not routinely, and one study showed that midline episiotomy increased the risk of severe lacerations. The most cited indications were primiparity, fetal weight greater than 4 kg, prolonged second stage, operative delivery, and shoulder dystocia. As for the surgical technique, episiotomies performed with wider angles (> 40°) and earlier in the second stage (before “crowning “) appeared to be more protective.

Conclusions

Selective episiotomy decreases the risk of severe lacerations when compared with the non-performance or the performance of routine episiotomy. The use of a proper surgical technique is fundamental to obtain better results, especially in relation to the angle of incision, the distance from the vaginal introitus, and the correct timing for performing the procedure. Not performing the episiotomy when indicated or not applying the correct technique may increase the risk of severe perineal lacerations.

Key-words Episiotomy obstetrical delivery perineal lacerations
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Review Article08-01-2017

Physical Activity during Pregnancy: Recommendations and Assessment Tools
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(8):424-432

Views274

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Physical Activity during Pregnancy: Recommendations and Assessment Tools
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(8):424-432
DOI 10.1055/s-0037-1604180
Cibele Santini,
Thiago dos Santos Imakawa,
Elaine Christine Dantas Moisés
Views274
Abstract

The literature that supports and recommends the practice of exercise during pregnancy is extensive.However, although a more complete research on ways to evaluate the physical activity performedby pregnant women has been perfomed, it is found that there is no gold standard and that the articles in the area are inconclusive. Thus, the objective of the present article is to review relevant aspects, such as, technique and applicability of the different methods for the assessment of physical activity during pregnancy to providemore reliable and safe information for health professionals to encourage their pregnant patients to engage in the practice of physical activity. This review concluded that all tools for the analysis of physical activity have limitations. Thus, it is necessary to establish the objectives of evaluation in an appropriate manner, as well as to determine their viability and costeffectiveness for the population under study.

Key-words Evaluation physical activity physical exercise questionnaire Pregnancy
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Original Article02-01-2017

Predictors of cesarean delivery in pregnant women with gestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):60-65

Views277

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Predictors of cesarean delivery in pregnant women with gestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):60-65
DOI 10.1055/s-0037-1598644
Carmem Luiza Lucht Gascho,
Danieli Mayumi Kimura Leandro,
Thiago Ribeiro e Silva,
Jean Carl Silva
Views277
Abstract

Purpose

The aim of this study was to evaluate which risk factors may lead patients with gestational diabetes mellitus to cesarean delivery.

Methods

This was a retrospective, descriptive study. The subjects of the study were pregnant women with gestational diabetes mellitus attending a public maternity hospital in the south of Brazil. The primary outcomes assessed were based on maternal and fetal characteristics. The data were correlated using an odds ratio (OR) with a 95% confidence interval (95%CI), calculated using multinomial logistic regression.

Results

A total of 392 patients with gestational diabetes mellitus were analyzed, and 57.4% of them had cesarean deliveries. Among the maternal characteristics, the mean age of the patients and the pregestational body mass index were greater when a cesarean delivery was performed (p = 0.029 and p < 0.01 respectively). Gestational age at birth, newborn weight, weight class according to gestational age, and Apgar score were not significant. The analysis of the OR showed that the chance of cesarean delivery was 2.25 times (95%CI = 1.49-2.39) greater if the pregnant woman was obese, 4.6 times (95%CI = 3.017-7.150) greater if she was a primigravida, and 5.2 times (95% CI = 2.702-10.003) greater if she had a previous cesarean delivery. The other parameters analyzed showed no differences.

Conclusion

The factors that led to an increase in the occurrence of cesarean deliveries included history of a prior cesarean section, first pregnancy, and obesity.

Key-words Cesarean section Gestational diabetes Risk factors
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Original Article08-21-2015

Increased oxidative stress markers may be a promising indicator of risk for primary ovarian insufficiency: a cross-sectional case control study
- Aytekin Tokmak,
- Gülçin Yıldırım,
- Esma Sarıkaya,
- Mehmet Çınar,
- Nihal Boğdaycıoğlu,
- Nafiye Yılmaz
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):411-416

Views108

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Increased oxidative stress markers may be a promising indicator of risk for primary ovarian insufficiency: a cross-sectional case control study
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):411-416
DOI 10.1590/SO100-720320150005397
Aytekin Tokmak,
Gülçin Yıldırım,
Esma Sarıkaya,
Mehmet Çınar,
Nihal Boğdaycıoğlu,
Fatma Meriç Yılmaz,
Nafiye Yılmaz
Views108
PURPOSE:

The aim of this study was to evaluate serum levels of inducible nitric oxide synthase (INOS), myeloperoxidase (MPO), total antioxidant status (TAS), and total oxidative status (TOS) in women with primary ovarian insufficiency (POI) and to compare them with healthy fertile women. We also examined the possible risk factors associated with POI.

METHODS:

This cross-sectional case control study was conducted in Zekai Tahir Burak Women’s Health Education and Research Hospital. The study population consisted of 44 women with POI (study group) and 36 healthy fertile women (control group). In all patients, serum levels of INOS, MPO, TAS, and TOS were determined. INOS and MPO levels were measured by enzyme-linked immunosorbent assay whereas colorimetric method was used for evaluating TAS and TOS levels. Age, body mass index (BMI), obstetric history, smoking status, family history, comorbidities, sonographic findings, complete blood count values, C-reactive protein and baseline hormone levels were also analyzed. Student’s t-test or Mann-Whitney U test was used to compare continuous variables between the groups; categorical data were evaluated by using Pearson χ² or Fisher exact test, when appropriate. Binary logistic regression method was used to identify risk factors for POI.

RESULTS:

We found significantly elevated levels of INOS (234.1±749.5 versus133.8±143.0; p=0.005), MPO (3,438.7±1,228.6 versus 2,481.9±1,230.1; p=0.001), and TOS (4.3±1.4 versus 3.6±1.4; p=0.02) in the sera of the study group when compared to the BMI-age matched control group. However, difference in serum levels of TAS were not significant between the 2 groups (1.7±0.2 versus 1.6±0.2; p=0.15). Logistic regression method demonstrated that BMI <25 kg/m², nulliparity, family history of POI, smoking, and elevated serum levels of INOS, MPO, and TOS were independent risk factors for POI.

CONCLUSION:

We found an increase in INOS, MPO, and TOS in women with POI. These serum markers may be promising in early diagnosis of POI. Further large-scale studies are required to determine whether oxidative stress markers have a role in diagnosing POI.

Key-words Oxidative stress Primary ovarian insufficiency Risk factors
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Editorial12-01-2015

Maternal mortality and the new objectives of sustainable development (2016-2030)
- Joao Paulo Souza
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(12):549-551

Views120

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Editorial
Maternal mortality and the new objectives of sustainable development (2016-2030)
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(12):549-551
DOI 10.1590/SO100-720320150005526
Joao Paulo Souza
Views120
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Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations

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Predictors of cesarean delivery in pregnant women with gestational diabetes mellitus

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Increased oxidative stress markers may be a promising indicator of risk for primary ovarian insufficiency: a cross-sectional case control study

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Maternal mortality and the new objectives of sustainable development (2016-2030)

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