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Trabalhos Originais
Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555
04-05-1998
Views61This 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. Summary
Trabalhos OriginaisEstimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555
04-05-1998DOI 10.1590/S0100-72031998001000002
Views61See morePurpose: to assess the validity of fetal weight estimation by a method based on uterine height — Johnson’s rule. Methods: one hundred and one pregnant women and their newborn children were studied. The fetal weight was estimated using an adaptation of Johnson’s rule, which consists of the clinical application of a mathematical model to calculate the fetal weight based on the uterine height and the height of fetal presentation. The estimated weight was obtained on the day of delivery and was compared to the weight observed after birth. This, in turn, was the control of the analysis of validity of the method used. On the same date, a detailed obstetrical ultrasonography (US) was conducted which included the fetal weight, calculated by the use of Sheppard’s tables. This weight, estimated by US, was compared to the birth weight. Results: the results have proven that the clinical estimate used in this study has a similar value to that of the US calculation of birth weight. The accuracy of the clinical method, with variations of 5%, 10% and 15% between estimated and observed weights, was 55.3%, 73% and 86.7%, respectively. Those of the US were 60.7%, 75.4% and 91.1%, respectively. When comparing both sets of figures, values were not different from a statistical standpoint. Conclusion: the clinical evaluation has shown to be accurate, similarly to the US, when calculating the birth weight.
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. -
Resumos de Teses
Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
04-05-1998
Summary
Resumos de TesesIndice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
04-05-1998DOI 10.1590/S0100-72031998000800011
Views39Indice de Líquido Amniótico em Gestantes Diabéticas e a Qualidade do Controle Glicêmico na Gestação.[…]See moreThis 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. -
Resumos de Teses
Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
04-05-1998
Summary
Resumos de TesesAvaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
04-05-1998DOI 10.1590/S0100-72031998000800010
Views51Avaliação do Grau Nuclear da Célula Maligna da Mama como Parâmetro de Atividade Proliferativa Tumoral: Comparação com a Expressão do Antígeno Nuclear de Proliferação Celular (PCNA/ciclina).[…]See moreThis 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. -
Relato de Casos
Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
- Carlos Augusto Alencar Júnior,
- Francisco Edson de Lucena Feitosa,
- Mac Gontei,
- Sammya Bezerra Maia,
- Dalgimar Beserra de Meneses
04-05-1998
Views60This 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. Summary
Relato de CasosPrenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484
04-05-1998DOI 10.1590/S0100-72031998000800009
- Carlos Augusto Alencar Júnior,
- Francisco Edson de Lucena Feitosa,
- Mac Gontei,
- Sammya Bezerra Maia,
- Dalgimar Beserra de Meneses
Views60See moreArthrogryposis multiplex congenita is characterized by multiple joint contractures present at birth. Prenatal diagnosis is difficult. There are few reports in the literature. Fetal akinesia, abnormal limb position, intrauterine growth retardation, and polyhydramnios are the main findings of the ultrasonographic diagnosis. The authors describe a case of arthrogryposis multiplex congenita ultrasonographically diagnosed in the third gestational trimester. The main findings were absence of fetal movements, polyhydramnios, symmetrical and non-symmetrical fetal growth retardation with marked decrease of abdominal and thoracic circumference, low-set ears, micrognathia, continuous flexure contracture of limbs, internal rotation of the femur, and clubfoot on the right.
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. -
Trabalhos Originais
Screening of breast cancer metastasis at preoperative work-up
- Maria Bethânia da Costa Chein,
- Luciane Maria Oliveira Brito,
- Simão Rotstein,
- Luiz Henrique Gebrim,
- Aldo Franklin F Reis, [ … ],
- Luciana Dessen Padilha
04-05-1998
Views108This 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. Summary
Trabalhos OriginaisScreening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479
04-05-1998DOI 10.1590/S0100-72031998000800008
- Maria Bethânia da Costa Chein,
- Luciane Maria Oliveira Brito,
- Simão Rotstein,
- Luiz Henrique Gebrim,
- Aldo Franklin F Reis,
- Luciana Dessen Padilha
Views108See morePurpose: to analyze the frequency of preoperative bilateral synchronic cancer and occult metastases in 454 operable breast cancer patients, at Instituto Nacional de Câncer (Brazil). Methods: the preoperative evaluation consisted of mammography, bone scan with X-ray if necessary, and chest X-ray. 260 (57.3 %) of 454 patients underwent liver echography. We calculated the cost X effectiveness ratio considering only the direct costs (monetary value) and the effectiveness was analyzed based on the number of metastases identifid by the screening tests. Results: we did not find any case of bilateral synchronic cancer, and the frequency of patients with metastasis was 2% (9/454). The diagnosis of bone metastasis was 1.5 % (7/454). The percentage of lung (2/454) and liver (1/260) metastasis was the same, 0.4 %. Most of the patients with metastases were in stage IIIb (44.5 %). The results of the screening tests showed the alteration of the initial clinical stage in 9 patients only (2%). The total cost of the screening tests for the diagnosis of systemic disease in 9 patients, was US$ 131,020.00. The cost of each diagnosed metastasise, for a total of 10 (two were found in one of the patients), was US$ 29,221.85 and the cost/effectiveness ratio was 22.3%. Conclusious: the results showed that screening for metastases in the preoperative clinical staging of breast cancer should be limited to patients symptomatic for systemic disease or in clinical stage III and that the cost/effectiveness ratio of the tests demonstrated a reduced benefit in the preoperative evaluation.
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. -
Trabalhos Originais
Second-degree family history as a risk factor for breast cancer
- Rafael Marques de Souza,
- Anderson Rech Lazzaron,
- Rafael Defferrari,
- Álvaro A. Borba,
- Luciana Scherer, [ … ],
- Antônio L. Frasson
04-05-1998
Views109This 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. Summary
Trabalhos OriginaisSecond-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
04-05-1998DOI 10.1590/S0100-72031998000800007
- Rafael Marques de Souza,
- Anderson Rech Lazzaron,
- Rafael Defferrari,
- Álvaro A. Borba,
- Luciana Scherer,
- Antônio L. Frasson
Views109See morePurpose: to evaluate the association between second-degree family history of breast cancer and the risk to develop the disease. Methods: case-control study of incident cases. Sixty-six incident breast cancer cases and 198 controls were selected among women who were submitted to mammography in a private clinic between January 1994 and July 1997. Cases and controls were paired regarding age, age at menarche, at first live birth, at menopause, parity, oral contraceptives and use of hormonal replacement therapy. Results: there was no significant difference between cases and controls regarding all risk factors evaluated, besides second-degree family history. Patients with breast cancer were more likely to have second-degree relatives with breast cancer when compared to controls (OR=2.77; 95% CI, 1.03-7.38; p=0.039). Conclusions: malignant neoplasm of the breast is significantly associated with a second-degree family history of this disease.
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. -
Trabalhos Originais
Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
- Orlando José de Almeida,
- Marcelo Alvarenga,
- José Guilherme Cecatti,
- Jessé de Paula Neves Jorge,
- Júlia Kawamura Tambascia
04-05-1998
Summary
Trabalhos OriginaisFine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467
04-05-1998DOI 10.1590/S0100-72031998000800006
- Orlando José de Almeida,
- Marcelo Alvarenga,
- José Guilherme Cecatti,
- Jessé de Paula Neves Jorge,
- Júlia Kawamura Tambascia
Views42See morePurpose: to evaluate, in a prospective way, the performance of the fine needle aspiration biopsy in the differential diagnosis of palpable breast masses. Method: the sensitivity, specificity, positive and negative predictive values for this test were evaluated in 102 women with age above 30 years and a palpable breast mass, who were attended at the University of Campinas. All punctures were performed by the same examiner. Results: the procedure had a sensitivity of 97%, specificity of 87%, positive predictive value of 94% and negative predictive value of 93%. The insufficient or unsatisfactory sample rate was 16% for the first aspiration, decreasing to 2% with a new procedure. Conclusions: this test showed to be highly sensitive and specific for the differential diagnosis of palpable breast masses, reassuring its great importance for the clinical approach of palpable masses.
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. -
Trabalhos Originais
A randomized trial of misoprostol and placebo for cervical ripening and induction of labor
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):457-462
04-05-1998
Views86This 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. Summary
Trabalhos OriginaisA randomized trial of misoprostol and placebo for cervical ripening and induction of labor
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):457-462
04-05-1998DOI 10.1590/S0100-72031998000800005
Views86See moreObjective: to determine the efficacy and safety of misoprostol for cervical ripening and induction of labor in pregnant women at term when compared with placebo. Patients and Methods: fifty-one high-risk pregnant women at term, with unripe cervix, were allocated in a double-blind trial for treatment with intravaginal misoprostol (40 mg, 4/4 h) or intravaginal placebo. Results: thirty-two patients received misoprostol and 19 received placebo. The groups were homogeneous concerning maternal age, gestacional age, parity, and indication for induction (p > 0.05). In the misoprostol group the efficacy was 87.5% and in the placebo group 21.1% (p = 0.0000087). Regarding delivery, in the misoprostol group 75% had vaginal delivery and 25% abdominal delivery, and in the placebo group only 32% had vaginal delivery and 68% abdominal delivery (p = 0.0059).The Apgar score was similar. Conclusion: in this study misoprostol was effective and safe for cervical ripening and induction of labor.
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.
-
Original Article
Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital
- Marcelo Mass-Lindenbaum
,
- Diego Arévalo-Vega
,
- Isidora Aleuanlli
,
- Fernanda Santis-Moya
,
- Andrea Maluenda
,
[ … ], - Javier Pizarro-Berdichevsky
00-00-2024
Summary
Original ArticleSacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo11
00-00-2024- Marcelo Mass-Lindenbaum
,
- Diego Arévalo-Vega
,
- Isidora Aleuanlli
,
- Fernanda Santis-Moya
,
- Andrea Maluenda
,
- Eitan Dines
,
- Miriam Cohen-Vaizer
,
- Álvaro Saavedra
,
- Trinidad Raby
,
- Bernardita Blumel
,
- Rodrigo Cuevas
,
- Simone Pohlhammer
,
- Gabriela Alarcon
,
- Marco Arellano Albornoz
,
- Javier Pizarro-Berdichevsky
Views536Abstract
Objective:
To show the experience of a Latin American public hospital, with SNM in the management of either OAB, NOUR or FI, reporting feasibility, short to medium-term success rates, and complications.
Methods:
A retrospective cohort was conducted using data collected prospectively from patients with urogynecological conditions and referred from colorectal surgery and urology services between 2015 and 2022.
Results:
Advanced or basic trial phases were performed on 35 patients, 33 (94%) of which were successful and opted to move on Implantable Pulse Generator (GG) implantation. The average follow-up time after definitive implantation was 82 months (SD 59). Of the 33 patients undergoing, 27 (81%)reported an improvement of 50% or more in their symptoms at last follow-up. Moreover, 30 patients (90%) with a definitive implant reported subjective improvement, with an average PGI-I “much better” and 9 of them reporting to be “excellent” on PGI-I.
Conclusion:
SNM is a feasible and effective treatment for pelvic floor dysfunction. Its implementation requires highly trained groups and innovative leadership. At a nation-wide level, greater diffusion of this therapy among professionals is needed to achieve timely referral of patients who require it.
Key-words Electric stimulation therapyfecal incontinenceIncontinenceNon-obstructive urinary retentionoveractiveSacral neuromodulationUrinary bladderSee moreThis 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. - Marcelo Mass-Lindenbaum
-
Original Article
Real-world utilization pattern of dydrogesterone in 7287 Indian women with obstetric and gynecological conditions: data from multicentric, retrospective study
- Jaydeep Tank
,
- Sanjay Gupte
,
- Purna Chandra Mahapatra
,
- Jayanthi Reddy
,
- Pratima Mittal
,
[ … ], - Onkar Swami
00-00-2024
Views525This 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. Summary
Original ArticleReal-world utilization pattern of dydrogesterone in 7287 Indian women with obstetric and gynecological conditions: data from multicentric, retrospective study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo18
00-00-2024- Jaydeep Tank
,
- Sanjay Gupte
,
- Purna Chandra Mahapatra
,
- Jayanthi Reddy
,
- Pratima Mittal
,
- Ashish Kumar Mukhopadhyay
,
- Lila Vyas
,
- Achla Batra
,
- Mahesh Gupta
,
- Sunita Tandulwadkar
,
- Sunita Chandra
,
- Vidya Bhat
,
- Kawita Bapat
,
- Parikshit Tank
,
- Ketan Kulkarni
,
- Onkar Swami
Views525Abstract
Objective:
Despite the literature on dydrogesterone, studies on dydrogesterone utilization patterns are largely lacking in Indian patients.
Methods:
This was a multi-center, retrospective, observational, cross-sectional, and descriptive study across 817 centers in India. Data of patients who received dydrogesterone in past and provided consent for future use of their medical record for research purpose was were retrieved and analyzed.
Results:
Data of 7287 subjects (aged 29.55±4.84 years) was analyzed. Threatened abortion was the most common indication for which the subjects received dydrogesterone (46.9%) followed by recurrent pregnancy loss. Polycystic ovary syndrome (PCOS), thyroid disorders and anemia were the most common comorbid conditions and prior pregnancy loss, advanced maternal age and obesity were the most common risk factors seen in subjects who received dydrogesterone. Total 27.5% of subjects received a loading dose of dydrogesterone, and majority (64%) received 40 mg as loading dose. 10 mg dose was used as maintenance or regular dose in 81.4% of the subjects. Twice daily (BID) was the most common dosing frequency (66.6%). The most common concomitant medications being taken by the subjects on dydrogesterone included folic acid (45.1%), iron supplements (30.3%) and calcium and vitamin D3 supplements (25.5%). Another progesterone preparation (oral, injection, vaginal, tubal) other than dydrogesterone was used concurrently in 7.8% of subjects.
Conclusion:
The study helped to identify the patient population that is benefitted by dydrogesterone and the preferred indications, risk factors, comorbid conditions and concomitant medication used in this patient population at real-life scenario.
Key-words Comorbid conditionsConcomitant medicationsdydrogesteroneGynecological conditionsIndian womenRisk factorsThreatened abortionUtilization patternSee moreThis 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. - Jaydeep Tank
-
Original Article
Assessment of sexual and body esteem in postpartum women with or without perineal laceration: a cross-sectional study with cultural translation and validation of the Vaginal Changes Sexual and Body Esteem Scale
- Renata Stefânia Olah de Souza
,
- Adriana Gomes Luz
,
- Ruth Zielinski
,
- Luis Otavio Zanatta Sarian
,
- Cassia Raquel Teatin Juliato
,
[ … ], - Luiz Gustavo Oliveira Brito
04-09-2024
Summary
Original ArticleAssessment of sexual and body esteem in postpartum women with or without perineal laceration: a cross-sectional study with cultural translation and validation of the Vaginal Changes Sexual and Body Esteem Scale
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo35
04-09-2024- Renata Stefânia Olah de Souza
,
- Adriana Gomes Luz
,
- Ruth Zielinski
,
- Luis Otavio Zanatta Sarian
,
- Cassia Raquel Teatin Juliato
,
- Lucia Alves da Silva Lara
,
- Luiz Gustavo Oliveira Brito
Views518See moreObjective:
We aimed to translate and determine cultural validity of the Vaginal Changes Sexual and Body Esteem Scale (VSBE) for Brazilian Portuguese language in postpartum women who underwent vaginal delivery with or without perineal laceration and cesarean section.
Methods:
A cross-sectional study conducted virtually, with online data collection through a survey with 234 postpartum women of 975 that were invited. Clinical, sociodemographic, and psychometric variables from the VSBE questionnaire were analyzed (content validity index, internal consistency, test-retest reliability, construct/structural and discriminant validity). Multivariate analysis was performed to explore associated factors with the presence of perineal laceration.
Results:
One-hundred fifty-eight women experienced vaginal delivery, of which 24.79% had an intact perineum, 33.33% had perineal laceration, and 9.4% underwent episiotomy; and 76 participants had cesarean sections. Women with perineal laceration were older, presented dyspareunia and previous surgeries than women without perineal laceration (p<0.05). For VSBE, a high internal consistency (Cronbach's α > 0.7) was observed, but it did not correlate with Body Attractiveness Questionnaire and Female Sexual Function Index; however, it correlated with the presence of women sutured for perineal laceration. Moreover, VSBE presented good structural validity with two loading factors after exploratory factor analysis. VSBE also demonstrated discriminant validity between the presence or absence of perineal laceration. The presence of urinary incontinence (UI) (OR=2.716[1.015-4.667];p=0.046) and a higher VSBE total score (OR=1.056[1.037-1.075];p<0.001) were the only factors associated with perineal laceration.
Conclusion:
Vaginal Changes Sexual and Body Esteem Scale demonstrated appropriate translation and good internal consistency, discriminant/construct validity and reliability. Vaginal Changes Sexual and Body Esteem Scale total score and presence of UI were associated with women that underwent perineal laceration.
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. - Renata Stefânia Olah de Souza
-
Case Report
Identification of a rare copy number polymorphic gain at 3q12.2 with candidate genes for familial endometriosis
- Flávia Gaona Oliveira
,
- Júlio Cesar Rosa-e-Silva
,
- Alexandra Galvão Gomes
,
- Juliana Dourado Grzesiuk
,
- Thiago Vidotto
,
[ … ], - Lúcia Martelli
00-00-2024
Summary
Case ReportIdentification of a rare copy number polymorphic gain at 3q12.2 with candidate genes for familial endometriosis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo12
00-00-2024- Flávia Gaona Oliveira
,
- Júlio Cesar Rosa-e-Silva
,
- Alexandra Galvão Gomes
,
- Juliana Dourado Grzesiuk
,
- Thiago Vidotto
,
- Jeremy Andrew Squire
,
- Rodrigo Alexandre Panepucci
,
- Juliana Meola
,
- Lúcia Martelli
Views512Abstract
Endometriosis is a complex disease that affects 10-15% of women of reproductive age. Familial studies show that relatives of affected patients have a higher risk of developing the disease, implicating a genetic role for this disorder. Little is known about the impact of germline genomic copy number variant (CNV) polymorphisms on the heredity of the disease. In this study, we describe a rare CNV identified in two sisters with familial endometriosis, which contain genes that may increase the susceptibility and progression of this disease. We investigated the presence of CNVs from the endometrium and blood of the sisters with endometriosis and normal endometrium of five women as controls without the disease using array-CGH through the Agilent 2x400K platform. We excluded common CNVs that were present in the database of genomic variation. We identified, in both sisters, a rare CNV gain affecting 113kb at band 3q12.2 involving two candidate genes: ADGRG7 and TFG. The CNV gain was validated by qPCR. ADGRG7 is located at 3q12.2 and encodes a G protein-coupled receptor influencing the NF-kappaβ pathway. TFG participates in chromosomal translocations associated with hematologic tumor and soft tissue sarcomas, and is also involved in the NF-kappa B pathway. The CNV gain in this family provides a new candidate genetic marker for future familial endometriosis studies. Additional longitudinal studies of affected families must confirm any associations between this rare CNV gain and genes involved in the NF-kappaβ pathway in predisposition to endometriosis.
Key-words Array-CGHDNA copy number variationsEndometriosisEndometriumgeneticGenomic structural variationHeredityPolymorphismSee moreThis 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. - Flávia Gaona Oliveira
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Original Article
Fertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists
- Renata Lack Ranniger
,
- Rívia Mara Lamaita
,
- Bárbara Flecha D’Abreu
,
- Mariana Rodrigues Tolentino
,
- Eduardo Batista Cândido
,
[ … ], - Agnaldo Lopes Silva-Filho
04-09-2024
Summary
Original ArticleFertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25
04-09-2024- Renata Lack Ranniger
,
- Rívia Mara Lamaita
,
- Bárbara Flecha D’Abreu
,
- Mariana Rodrigues Tolentino
,
- Eduardo Batista Cândido
,
- Warne Pedro Andrade
,
- Angélica Nogueira-Rodrigues
,
- Agnaldo Lopes Silva-Filho
Views500Objective:
Fertility preservation is a priority in oncology for female cancer patients. However, there is a lack of communication between infertility specialists and oncologists. This study aimed to evaluate infertility specialists’ perceptions and experiences regarding fertility preservation.
Methods:
Conduct an online survey to profile infertility specialists. Participants were infertility affiliated with the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). The specialists received an online survey, which response rate were 30.9%, most of whom were in southern and southeastern. The survey consisted on 14 questions about the infertility specialists’ location, techniques in clinical practice, treatment successful rate, patients idea, etc.
Results:
The average experience in human reproduction were 15.5 ± 10.2 years (mean ± standard deviation, range 1-40). Among reproductive-aged female cancer patients recommended for fertility preservation, 60.3 ± 28.8% (range 10-100%) underwent preservation procedures. Main barriers were cost (41%), oncologists’ knowledge or acceptance (35%) and accessibility (9%). Most infertility specialists (58%) considered 40 years the limit for fertility preservation. Leukemia, lymphoma, breast and ovarian cancers were prioritized for fertility preservation, while lung, thyroid, gastric, and brain cancers were less relevant.
Conclusion:
This is the first Brazilian study about infertility specialists’ perceptions on oncology patients access to fertility preservation. These patients primarily receive treatment in the public health system, while infertility specialists mainly work in the private healthcare. This healthcare mode is currently fragmented, but integrating these experts is enhancing patient access to fertility preservation. Studies on this topic are still warranted.
Key-words attitudesFertilityFertility preservationgynecologistshealth knowledgeNeoplasmsOncologistsOocyte retrievalpracticeReproductionsurveys and questionnairesSee moreThis 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. - Renata Lack Ranniger
-
Review Article
A meta-analysis of ferric carboxymaltose versus other intravenous iron preparations for the management of iron deficiency anemia during pregnancy
- Sanjay Gupte
,
- Ashis Mukhopadhyay
,
- Manju Puri
,
- P. M. Gopinath
,
- Reena Wani
,
[ … ], - Onkar C. Swami
03-15-2024
Views483This 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. Summary
Review ArticleA meta-analysis of ferric carboxymaltose versus other intravenous iron preparations for the management of iron deficiency anemia during pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo21
03-15-2024- Sanjay Gupte
,
- Ashis Mukhopadhyay
,
- Manju Puri
,
- P. M. Gopinath
,
- Reena Wani
,
- J. B. Sharma
,
- Onkar C. Swami
Views483Abstract
Objective:
We conducted a meta-analysis of randomized clinical trials evaluating the clinical effects of ferric carboxymaltose therapy compared to other intravenous iron in improving hemoglobin and serum ferritin in pregnant women. We also assessed the safety of ferric carboxymaltose vs. other intravenous iron.
Data source:
EMBASE, PubMed, and Web of Science were searched for trials related to ferric carboxymaltose in pregnant women, published between 2005 and 2021. We also reviewed articles from google scholar. The keywords “ferric carboxymaltose,” “FCM,” “intravenous,” “randomized,” “pregnancy,” “quality of life,” and “neonatal outcomes” were used to search the literature. The search was limited to pregnant women.
Selection of studies:
Studies related to ferric carboxymaltose in pregnancy were scanned. Observational studies, review articles, and case reports were excluded. Randomized studies in pregnant women involving ferric carboxymaltose and other intravenous iron formulations were shortlisted. Of 256 studies, nine randomized control trials were selected.
Data collection:
Two reviewers independently extracted data from nine selected trials
Data synthesis:
The final effect size for increase in hemoglobin after treatment was significant for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 0.89g/dl [95% confidence interval 0.27,1.51]). The final effect size for the increase in ferritin after treatment was more for ferric carboxymaltose vs. iron sucrose/iron polymaltose (standard mean difference 22.53µg/L [-7.26, 52.33]). No serious adverse events were reported with ferric carboxymaltose or other intravenous iron.
Conclusion:
Ferric carboxymaltose demonstrated better efficacy than other intravenous iron in increasing hemoglobin and ferritin levels in treating iron deficiency anemia in pregnant women.
Key-words AnemiaFerric carboximaltoseFerric oxideferritinhemoglobinIntravenous ironIron polymaltoseIron sucroseIron-deficiency anemiaPregnancysaccharatedSee moreThis 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. - Sanjay Gupte
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Original Article
Validation of the Brazilian 10-item Cervantes Scale for the assessment of menopausal symptoms
- Mona Lúcia Dall’Agno
,
- Charles Francisco Ferreira
,
- Fernanda Vargas Ferreira
,
- Pedro do Valle Teichmann
,
- Jéssica Zandoná
,
[ … ], - Maria Celeste Osório Wender
00-00-2024
Summary
Original ArticleValidation of the Brazilian 10-item Cervantes Scale for the assessment of menopausal symptoms
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo7
00-00-2024- Mona Lúcia Dall’Agno
,
- Charles Francisco Ferreira
,
- Fernanda Vargas Ferreira
,
- Pedro do Valle Teichmann
,
- Jéssica Zandoná
,
- Faustino Ramón Pérez-López
,
- Maria Celeste Osório Wender
Views479See moreAbstract
Objective:
To validate the 10-item Cervantes Scale (CS-10) among Brazilian women.
Methods:
This is a cross-sectional observational study involving women in the community aged 40–55 years in the Southern region of Brazil. They completed a general health, habits and socio-demographic questionnaire, the CS-10 and the Women’s Health Questionnaire (WHQ). Women unable to understand the survey, not consenting to participate, or having incapacity imposing difficulties during the completion of the questionnaire were excluded. A Confirmatory Factor Analysis (CFA) was conducted with the AMOS 16.0 software. Chi-square of degrees of freedom (χ2/df), the Comparative Fit Index (CFI), the Tucker-Lewis Index (TLI) and the Root-Mean-Square Error of Approximation (RMSEA) were used as indices of goodness of fit. Cronbach’s alpha coefficient was used for internal consistency.
Results:
A total of 422 women were included (premenopausal n=35, perimenopausal n=172, postmenopausal n=215). The CFA for the CS-10 showed a good fit (χ²/df=1.454, CFI=0.989; TLI=0.985; RMSEA=0.033; CI 90%=0.002-0.052; PCLOSE=0.921; Model p=0.049). Good reliability was established in CS-10 and WHQ (Cronbach’s alpha=0.724). Postmenopausal women had higher total CS-10 scores (p≤0.0001), reflecting worse quality of life (QoL) related to menopause symptoms and confirming the greater symptomatology evaluated by high total scores for WHQ found in this population when compared to those in the premenopausal period (p=0.041).
Conclusion:
The CS-10 is a consistent tool for health-related QoL in Brazilian mid-aged women.
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. - Mona Lúcia Dall’Agno
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Review Article
Non-RhD alloimmunization in pregnancy: an updated review
- Sabrina Menes Ares
,
- Luciano Marcondes Machado Nardozza
,
- Edward Araujo Júnior
,
- Eduardo Félix Martins Santana
00-00-2024
Views474This 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. Summary
Review ArticleNon-RhD alloimmunization in pregnancy: an updated review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo22
00-00-2024- Sabrina Menes Ares
,
- Luciano Marcondes Machado Nardozza
,
- Edward Araujo Júnior
,
- Eduardo Félix Martins Santana
Views474Abstract
RhD alloimmunization in pregnancy is still the main cause of hemolytic disease of the fetus and neonate (HDFN). Nevertheless, there are other antigens that may be associated with the occurrence of this phenomenon and that have been growing in proportion, given that current prevention strategies focus only on anti-RhD antibodies. Although not widespread, the screening and diagnostic management of the disease caused by these antibodies has recommendations in the literature. For this reason, the following review was carried out with the objective of listing the main red blood cell antigen groups described — such as Rh, ABO, Kell, MNS, Duffy, Kidd, among others — addressing the clinical importance of each one, prevalence in different countries, and recommended management when detecting such antibodies during pregnancy.
Key-words Blood group antigensErythroblastosisfetalFetal diseasesNon-Rh alloimmunizationPregnancyPrevalenceRh isoimmunizationSee moreThis 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. - Sabrina Menes Ares
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Review Article
Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
- Cibele Santini de Oliveira Imakawa
,
- Mariane Nunes de Nadai
,
- Monica Reis
,
- Silvana Maria Quintana
,
- Elaine Christine Dantas Moises
06-29-2022
Views135This 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. Summary
Review ArticleIs it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):692-700
06-29-2022- Cibele Santini de Oliveira Imakawa
,
- Mariane Nunes de Nadai
,
- Monica Reis
,
- Silvana Maria Quintana
,
- Elaine Christine Dantas Moises
Views135See moreAbstract
Objective
To review concepts, definitions, and findings about fear of childbirth (FOC).
Methods
A bibliographic review was carried out through the main scientific databases in 2020.
Results
All 32 articles considered potentially relevant were analyzed. A recent study suggests that the global prevalence of FOC can reach up to 14%. Factors such as parity, gestational age, previous birth experience, age and nationality of the woman seem to influence FOC.
Conclusion
Fear of childbirth could be related to an increased risk of adverse obstetric outcomes such as maternal request for cesarean delivery, preterm birth, prolonged labor, postpartum depression, and post-traumatic stress. These evidence highlight the importance of the discussion regarding this topic.
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. - Cibele Santini de Oliveira Imakawa
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Original Article
Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
- Margot Marie Martin
,
- Roxana Knobel
,
- Vitor Nandi
,
- Jessica Goedert Pereira
,
- Alberto Trapani Junior
,
[ … ], - Carla Betina Andreucci
02-17-2022
Views44This 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. Summary
Original ArticleAdequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022- Margot Marie Martin
,
- Roxana Knobel
,
- Vitor Nandi
,
- Jessica Goedert Pereira
,
- Alberto Trapani Junior
,
- Carla Betina Andreucci
Views44See moreAbstract
Objective
The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.
Methods
Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis onmaternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.
Results
Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The followingmaternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.
Conclusion
In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.
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. - Margot Marie Martin
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Review Article
Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
- Maria Laura Costa
,
- Ricardo de Carvalho Cavalli
,
- Henri Augusto Korkes
,
- Edson Vieira da Cunha Filho
,
- José Carlos Peraçoli
04-25-2022
Views189This 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. Summary
Review ArticleDiagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
04-25-2022- Maria Laura Costa
,
- Ricardo de Carvalho Cavalli
,
- Henri Augusto Korkes
,
- Edson Vieira da Cunha Filho
,
- José Carlos Peraçoli
Views189Abstract
Objective
It is a challenge to consider preeclampsia (PE) diagnosis and management in low and middle-income settings, where it represents a major public health concern. The placenta is the underlying cause of disease, and the plasma concentrations of proangiogenic and antiangiogenic factors released by the placenta can reflect the risks of disease progression. Antiangiogenic proteins, such as soluble fms-like tyrosine kinase 1 (sFlt-1), and proangiogenic, like placental growth factors (PlGF), are directly and inversely correlated with the disease onset, respectively.
Methods
Narrative review on the use of biomarkers (sFlt-1 to PlGF ratio) with a suggested guidance protocol.
Results
Key considerations on the use of biomarkers: the sFlt-1/PlGF ratio is mainly relevant to rule out PE between 20 and 36 6/7 weeks in cases of suspected PE; however, it should not replace the routine exams for the diagnosis of PE. The sFlt-1/PlGF ratio should not be performed after confirmed PE diagnosis (only in research settings). In women with suspected PE, sFlt-1/PlGF ratio < 38 can rule out the diagnosis of PE for 1 week (VPN = 99.3) and up to 4 weeks (VPN= 94.3); sFlt-1/PlGF ratio > 38 does not confirm the diagnosis of PE; however, it can assist clinical management. In cases of severe hypertension and/or symptoms (imminent eclampsia), hospitalization is imperative, regardless of the result of the sFlt-1/PlGF ratio.
Conclusion
The use of biomarkers can help support clinical decisions on the management of suspected PE cases, especially to rule out PE diagnosis, thus avoiding unnecessary interventions, especially hospitalizations and elective prematurity
Key-words Hypertensionplacental growth factorPreeclampsiapreterm preeclampsiasoluble fms-like tyrosine kinase 1See moreThis 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. - Maria Laura Costa
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Original Article
COVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021
Views142This 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. Summary
Original ArticleCOVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021Views142See moreAbstract
Objective
To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women.
Methods
A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation.
Results
Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87±66.92 fL for the case group versus 9.84±1.2 fL for the control group; PDW: 14.82±3.18 fL for the case group versus 13.3±2.16 fL for the controls). The criterionvalue of the receiver operating characteristic (ROC) curve forPDWat a cutoffpoint of>11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of>10.17 fL showed a good diagnostic marker.
Conclusion
The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.
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. -
Short Communication
Surgical Site Infection after Cesarean Delivery in Times of COVID-19
- Vicente Sperb Antonello
,
- Jessica Dallé
,
- Ivan Carlos Ferreira Antonello
,
- Daniela Benzano
,
- Mauro Cunha Ramos
07-30-2021
Views176This 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. Summary
Short CommunicationSurgical Site Infection after Cesarean Delivery in Times of COVID-19
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):374-376
07-30-2021- Vicente Sperb Antonello
,
- Jessica Dallé
,
- Ivan Carlos Ferreira Antonello
,
- Daniela Benzano
,
- Mauro Cunha Ramos
Views176See moreAbstract
Objective
To analyze effects of the COVID-19 pandemic on the consumption of personal protective equipment and products (PPEP), as well as the frequency of surgical site infection (SSI) among non-COVID-19 patients submitted to cesarean sections.
Methods
A retrospective study was conducted in a maternity unity of a public teaching hospital which was not part of the reference service for COVID-19 treatment. It compared PPEP consumption and the occurrence of SSI after cesarean sections in monthly periods before and after the occurrence of the first case of COVID-19 in Porto Alegre, state of Rio Grande do Sul, Brazil. Personal protective equipment and products consumption was measured as units of masks, gloves, gowns, and caps, and use of alcohol-based products or soap for hand sanitation asml/patient/day. The SSI index was calculated as the proportion of cases of SSI over the number of cesarean sections performed monthly during the study period.
Results
There was an increase in all measured items of PPEP, with consumption of disposable masks with a median of 1,450 units in the pre-COVID period, and of 2550 in the post-COVID period (a 75.9% increase). A decrease of 49% in SSI was detected, with a median of 1.74 in the pre-COVID period and of 0.89 in the post-COVID period.
Conclusion
The increase in consumption of PPEP could be a result of safer practices adopted by healthcare workers with the advent of COVID-19, of which the following reduction in the occurrence of SSI could be a direct consequence. Despite the severity of the crisis, one could state that extreme situations can lead to valuable reflections and opportunities for improvement.
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. - Vicente Sperb Antonello
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Original Article
Difficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
- Lorgio Rudy Aguilera
,
- Luz Mariana Mojica-Palacios
,
- Federico Urquizu
,
- Mirko Gorena
,
- Freddy Tinajeros Guzmán
,
[ … ], - Albaro José Nieto-Calvache
04-26-2022
Views112This 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. Summary
Original ArticleDifficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
04-26-2022- Lorgio Rudy Aguilera
,
- Luz Mariana Mojica-Palacios
,
- Federico Urquizu
,
- Mirko Gorena
,
- Freddy Tinajeros Guzmán
,
- Lina María Vergara Galliadi
,
- Alejandra Hidalgo
,
- Albaro José Nieto-Calvache
Views112See moreAbstract
Objective
Placenta accreta spectrum (PAS) is a serious diseases, and the recommendation is that the treatment is conducted in centers of excellence. Such hospitals are not easy to find in low- and middle-income countries. We seek to describe the process of prenatal diagnosis, surgical management, and postnatal histological analysis in a low-income country referral hospital with limited resources.
Methods
A descriptive, retrospective study was carried out including patients with a pre- or intraoperative diagnosis of PAS. The clinical results of the patients were studied as well as the results of the prenatal ultrasound and the correlation with the postnatal pathological diagnosis.
Results
In total, 129 patients were included. Forty-eight of them had a prenatal PAS ultrasound diagnosis (37.2%). In the remaining 81 (62.8%), the diagnosis was intraoperative. Although hysterectomy was performed in all cases, one-third of the patients (31%) did not have a histological study of the uterus. In 40% of the patients who had a histological study, PAS was not reported by the pathologist.
Conclusion
The frequency of prenatal diagnosis and the availability of postnatal histological studies were very low in the studied population. Surgical skill, favored by a high flow of patients, is an important factor to avoid complications in settings with limited resources.
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. - Lorgio Rudy Aguilera
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Original Article
Adverse Events Related to COVID-19 Vaccines Reported in Pregnant Women in Brazil
- Carla Dinamerica Kobayashi
,
- Victor Bertollo Gomes Porto
,
- Martha Elizabeth Brasil da Nóbrega
,
- Cibelle Mendes Cabral
,
- Tiago Dahrug Barros
,
[ … ], - Cecília Maria Roteli Martins
09-06-2022
Views181This 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. Summary
Original ArticleAdverse Events Related to COVID-19 Vaccines Reported in Pregnant Women in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):821-829
09-06-2022- Carla Dinamerica Kobayashi
,
- Victor Bertollo Gomes Porto
,
- Martha Elizabeth Brasil da Nóbrega
,
- Cibelle Mendes Cabral
,
- Tiago Dahrug Barros
,
- Cecília Maria Roteli Martins
Views181See moreAbstract
Regulations for the vaccination of pregnant women in Brazil occurred in March 2021. Despite the absence of robust data in the literature on the coronavirus disease 2019 (COVID-19) vaccinations in pregnant women, it is understood that the benefit-risk ratio tends to be favorable when considering the pandemic and the high burden of the disease. However, it is still important to monitor for Events Supposedly Attributable to Vaccination or Immunization (ESAVI) and to draw safety profiles of the different platforms used in pregnant and postpartum women. The present study aims to describe the main characteristics of ESAVIs related to COVID-19 vaccines occurring in pregnant women in the first months of the vaccination campaign in Brazil. During the evaluation period, 1,674 notifications of ESAVIs in pregnant women were recorded, and 582 notifications were included for the analysis. Of the 582 ESAVIs identified, 481 (82%) were classified as non-serious adverse events and 101 (17%) as serious adverse events. Ten deaths were identified, including one death which was considered to be causally related to the vaccine. The other nine maternal deaths had causality C, that is, without causal relationship with the vaccine, and most were due to complications inherent to pregnancy, such as pregnancy-specific hypertensive disorder (PSHD) in 4 cases and 3 due to COVID-19. Despite some limitations in our study, we believe it brings new insights into COVID-19 vaccines in this group and will add to the available evidence.
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. - Carla Dinamerica Kobayashi
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Original Article
Association between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
- Conceição Christina Rigo Vale
,
- Nubia Karla de Oliveira Almeida
,
- Renan Moritz Varnier Rodrigues de Almeida
06-18-2021
Views149This 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. Summary
Original ArticleAssociation between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):256-263
06-18-2021- Conceição Christina Rigo Vale
,
- Nubia Karla de Oliveira Almeida
,
- Renan Moritz Varnier Rodrigues de Almeida
Views149See moreAbstract
Objective
To investigate the association between prenatal care (PNC) adequacy indexes and the low birth weigth (LBW) outcome.
Methods
A total of 368,093 live term singleton births in the state of Rio de Janeiro (Brazil) from 2015 to 2016 were investigated using data from the Brazilian Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC, in Portuguese). Seven PNC adequacy indexes were evaluated: four developed by Brazilian authors (Ciari Jr. et al., Coutinho et al., Takeda, and an index developed and used by the Brazilian Ministry of Health – MS) and three by authors from other countries (Kessner et al., the Adequacy of Prenatal Care Utilization index – APNCU, and the Graduated Prenatal Care Utilization Index – GINDEX). Adjusted odds ratios were estimated for the PNC adequacy indexes by means of multivariate logistic regression models using maternal, gestational and newborn characteristics as covariates.
Results
When the PNC is classified as “inadequate”, the adjusted odds ratios to the LBWoutcome increase between 42% and 132%, depending on which adequacy index is evaluated. Younger (15 to 17 years old) and older (35 to 45 years old) mothers, those not married, of black or brown ethnicity, with low schooling (who did not finish Elementary School), primiparous, with preterm births, as well as female newborns had increasing odds for LBW. The models presented areas under the receiver operating characteristic (ROC) curve between 80.4% and 81.0%, and sensitivity and specificity that varied, respectively, between 57.7% and 58.6% and 94.3% and 94.5%.
Conclusion
Considering all PNC adequacy indexes evaluated, the APNCU had the best discriminatory power and the best ability to predict the LBW outcome.
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. - Conceição Christina Rigo Vale
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