Articles - Revista Brasileira de Ginecologia e Obstetrícia

  • Thesis Abstract09-02-2004

    Effect of levonorgestrel-releasing intrauterine system on the reduction of CA-125 Levels in patients with endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):496-496

    Abstract

    Thesis Abstract

    Effect of levonorgestrel-releasing intrauterine system on the reduction of CA-125 Levels in patients with endometriosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):496-496

    DOI 10.1590/S0100-72032004000600014

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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.
  • Thesis Abstract09-02-2004

    Association between viral load and T CD4 lymphocytes and cervical intraepithelial lesions in women infected with human immunodeficiency virus

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):495-496

    Abstract

    Thesis Abstract

    Association between viral load and T CD4 lymphocytes and cervical intraepithelial lesions in women infected with human immunodeficiency virus

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):495-496

    DOI 10.1590/S0100-72032004000600013

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  • Thesis Abstract09-02-2004

    Development of an experimental model of endometriosis in rabbits

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):495-495

    Abstract

    Thesis Abstract

    Development of an experimental model of endometriosis in rabbits

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):495-495

    DOI 10.1590/S0100-72032004000600012

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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.
  • Case Report09-02-2004

    Umbilical artery occlusion as a therapeutic option in pregnancy with acardiac twin

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):489-494

    Abstract

    Case Report

    Umbilical artery occlusion as a therapeutic option in pregnancy with acardiac twin

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):489-494

    DOI 10.1590/S0100-72032004000600011

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    Twin pregnancy with an acardiac twin is a rare event characterized by the presence of a placentary arterial anastomosis between the pump twin, morfologically normal, and the acardiac twin, causing a reverse circulation in one of the twins. The major complications are associated with cardiac failure in the normal twin, which is due to circulatory overload and prematurity. Many therapeutic options have been proposed, but there is no consensus about which one is the best therapy. However, intrafetal ablation of the umbilical artery of the acardiac fetus proved to be an inexpensive method that is easy to perform and highly efficient in controlling circulatory overload. We presented two cases of intra-fetal ablation and good evolution. A triplet pregnancy in which the intra-fetal ablation was done in a 29-week-old fetus that evolved to premature delivery of a healthy baby, and a twin pregnancy in which intra-fetal ablation was done in a 31-week-old fetus that evolved to premature rupture of membranes and the premature delivery of a healthy baby.

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  • Original Article09-02-2004

    The changing clinical presentation of molar pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):483-488

    Abstract

    Original Article

    The changing clinical presentation of molar pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):483-488

    DOI 10.1590/S0100-72032004000600010

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    OBJECTIVE: to determine whether the clinical presentation of hydatidiform mole has changed in the recent years (1992-1998) when compared with historic controls (1960-1981). METHODS: medical records of 80 patients with hydatidiform mole attended in the 1960-1981 period (Group I) were reviewed and compared to data from 801 patients followed in the 1992-1998 period (Group II). The clinical signals and symptoms analyzed were: age distribution, number of pregnancies, vaginal bleeding, hyperemesis, edema, hypertension, large uterus for gestation date and theca lutein cysts of the ovaries. Statistical analyses employed chi-square tests and odds ratio (OR) estimate with the confidence interval (CI) of 95%. RESULTS: concerning age, the disease occurred more frequently in group II than in group I, in patients under 15 and over 40 years old. As to the number of pregnancies, there was no statistical difference only in those patients who were in their third or fourth pregnancies. Arterial hypertension was the only symptom that occurred with similar frequency in both groups. Enlarged uterus was more frequent in group II (41.4 X 31.2% – p <0.05; OR: 1.5; IC: 1.0-2.3). Bleeding remained the most common symptom, occurring in 76.9% of patients (Group II), although it has occurred in 98.7% of the historic controls (p<0.05; OR: 0.04; IC: 0.03 0.04). The following symptoms were also less frequent in group II as compared to group I: hyperemesis (36.5% X 45% - p<0.05; OR: 0.7; IC: 0.4 0.9), edema (12.7% X 20% - p<0.05, OR: 0.5, IC: 0.3 0.8), enlarged uterus for gestational age (41.4% x 31.2% - p<0.05; OR: 1.5; IC: 1.0 2.3) and theca lutein cysts (16.4% X 41.2% - p<0.05; OR: 0.3; IC: 0.2 0.4). Ultrasound has become the commonest method of diagnosis (89.2% - p<0.05), allowing early detection of hydatidiform moles. CONCLUSION: there was a decrease of the traditional symptoms in current patients with hydatidiform mole as compared to historic controls, due to early diagnosis through ultrasonography.

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  • Original Article09-02-2004

    Neonatal morbity and mortality related to pregnant women at the age of 35 and older, according to parity

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):477-482

    Abstract

    Original Article

    Neonatal morbity and mortality related to pregnant women at the age of 35 and older, according to parity

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):477-482

    DOI 10.1590/S0100-72032004000600009

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    OBJECTIVE: to evaluate the neonatal morbidity and mortality related to mothers at the age of 35 or older than that. METHODS: in 2377 births in a year, 316 newborns (13.26%) from mothers at the age of 35 or more were selected for the study. These women were compared to pregnant controls aged 20 to 29, randomly selected among the 1170 women in the same age group (49,2%). For the inclusion criteria, pregnancies should have been over 22 weeks and the newborns should have weighted 500g or more at birth. Fourteen twin cases were excluded. To evaluate mortality and morbidity the following variables were considered: Apgar Index, birth weight, newborn health conditions, fetal malformations and neonatal mortality until hospital discharge. RESULTS: when analyzed as a whole, nulliparous and multiparous women showed significantly less favorable perinatal results for the selected group of women at 35 or more years old as compared with pregnant controls, what was not sustained when the nulliparous were excluded. Multiparous at the age of 35 or over presented a higher rate of low Apgar index in the 1st minute: 21.3 and 13.1%: (p<0,0033); small NB for the gestational age: 15.2% and 6.7% (p<0,02); big NB for the gestational age: 5.7 and 0.0% (p<0,02); low weight at birth: 23.8 and 14,5% (p<0,01), and prematurity, 16,7 and 6,7%, (p<0,005). Significant differences were not found for the Apgar index in the 5th minute, fetal malformations, newborn health conditions at hospital discharge and neonatal mortality. CONCLUSIONS: Neonatal morbidity increased among pregnant women at the age of 35 and older, but not the neonatal mortality.

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  • Original Article09-02-2004

    Relationship between endometrial thickness and beta-HCG levels in the response to treatment of ectopic pregnancy with methotrexate

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):471-475

    Abstract

    Original Article

    Relationship between endometrial thickness and beta-HCG levels in the response to treatment of ectopic pregnancy with methotrexate

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):471-475

    DOI 10.1590/S0100-72032004000600008

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    OBJECTIVE: to evaluate the correlation between the beta-human chorionic gonadotropin (beta-hCG) serum levels and the measurement of the endometrial thickness, in patients under treatment of ectopic pregnancy with methotrexate. METHODS: a prospective study in which the levels of beta-hCG as well as the largest measurement of the endometrial thickness on the uterine longitudinal axis through transvaginal ultrasound were evaluated at 24-48 h intervals in thirty-eight patients with hemodynamic stability, ectopic pregnancy, diameter <3.5 cm, and increased beta-hCG levels. All the patients got methotrexate in a single-dose therapy (50 mg/m² im). We compared the mean values of beta-hCG and endometrial thickness of cases that evolved successfully versus the poor responders using the Student t-test. Afterwards we analyzed the difference of the beta-hCG mean serum values related to the endometrial thickness(<10.0 mm and >10.0 mm) independently of the response to treatment employing the Student t-test. RESULTS: the mean values of beta-hCG and endometrial thickness in patients with successful treatment (28 cases) were 1936.2 mIU/ml and 6.4 mm, respectively, significanlty lower than the mean values for insuccessful cases: 6831.3 mIU/ml and 11.7 mm, respectively (p<0.05). The mean values of beta-hCG in women with endometrial thickness <10.0 mm were 2008.7 mIU/ml, significantly lower than the ones with endometrium >10.0 mm, whose mean values were 6925.9 mIU/ml (<0.05). CONCLUSIONS: the measurement of the endometrial thickness through ultrasound is under the beta-hCG serum values influence, and it showed to be a valuable additional factor to suggest medical treatment with methotrexate in the non-disrupted ectopic pregnancy.

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  • Original Article09-02-2004

    Evaluation of neuroendocrine axis inhibition with a low-dose oral contraceptive

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):463-469

    Abstract

    Original Article

    Evaluation of neuroendocrine axis inhibition with a low-dose oral contraceptive

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(6):463-469

    DOI 10.1590/S0100-72032004000600007

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    OBJECTIVE: to evaluate serum levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the pill-free interval of a combined oral contraceptive containing 20 mg of ethynylestradiol and 75 mg of gestodene. METHODS: thirty-one women from 17 to 36 years old, mean age of 24.5 years old, 19% adolescents, were included. FSH, LH, prolactin (PRL) and estradiol (E2) levels were measured by immunochemoluminescence. Both FSH and LH levels were measured within the last four days of pill intake and on the 7th day of the pill-free interval between two cycles. Hormonal levels were compared by the Student t-test. Comparisons between hormonal and anthropometric data were made by linear regression; values of p < 0.05 were taken as significant. RESULTS: seventy-one percent of women were using the pill for the first time. FSH levels increased from 1.3 to 5.7 mIU/ml between the end of the blister pack and the 7th day of the pill-free interval. LH increased from 0.8 to 4.3 mIU/ml. E2 levels changed from 20.2 to 28.0 pg/ml. The levels of PRL decreased from 12.4 to 10.2 ng/ml. There was no correlation between the changes in gonadotrophin levels and most of the anthropometric parameters in these women, with body mass index < 25 kg/m². CONCLUSION: the gonadotrophin levels detected on the last four days of pill intake were greatly suppressed, recovery of three to four times in amount occurring on the 7th day of the pill-free interval.

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