Articles - Revista Brasileira de Ginecologia e Obstetrícia

Original Article04-09-1998

Clinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):371-376
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Abstract
Original Article
Clinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):371-376
DOI 10.1590/S0100-72031998000700001
Luiz Antonio Verdiani,
Cássia Raquel Teatin Juliato,
Sophie F. Mauricette Derchain,
Júlio Eduardo Ferro
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The purpose of the present study was to evaluate some epidemiological, clinical and pathological characteristics of the different grades of vulvar intraepithelial neoplasia (VIN), and its relation with the presence of human papillomavirus (HPV). The charts of 46 women with VIN, examined from 1986 through 1997, were reviewed. For statistical analysis the chi² with yates correction when appropriate, and Fisher’s exact tests were used. Regarding the grade of VIN, six women presented VIN 1, six others had VIN 2 and the remaining 34 presented VIN 3. All women presented similar characteristics such as age, menstrual status and age at first sexual intercourse. Women with more than one lifetime sexual partner had a tendency to show more VIN 3 (p = 0.090). Cigarette smoking was significantly associated with the severity of the vulvar lesion (p = 0.031). HPV was significantly more frequent in women younger than 35 years of age (p = 0.005) and in women with multiple lesions (p = 0.089). Although the number of lesions were not related to the severity of VIN (p = 0.703), lesions with extensions greater than 2 cm were significantly associated with VIN 3 (p = 0.009). The treatment of choice for VIN 3 was surgery, including local resection and simple vulvectomy. Eight women relapsed, and only one had VIN 2. We concluded that among women with VIN, cigarette smoking and more than one lifetime sexual partner were associated with high-grade lesions. HPV was more frequent among patients younger than 35 years of age presenting multiple lesions. Women with VIN 3 presented lesions bigger than 2 cm and a high relapse rate, despite the type of treatment applied.

Key-words HPV Smoking VIN Vulvar intraepithelial neoplasia
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Original Article04-05-1998

Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
- Alexandre Faisal Cury,
- Sidney A. L. Garcia
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555

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Abstract
Original Article
Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555
DOI 10.1590/S0100-72031998001000002
Alexandre Faisal Cury,
Sidney A. L. Garcia
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Purpose: 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.

Key-words Fetal weight Normal pregnancy Ultrasonography
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04-05-1998

Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
- Fábio Sgarbosa
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
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Abstract
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
DOI 10.1590/S0100-72031998000800011
Fábio Sgarbosa
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Indice de Líquido Amniótico em Gestantes Diabéticas e a Qualidade do Controle Glicêmico na Gestação.[…]
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04-05-1998

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)
- Luiz Ayrton Santos Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485

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Abstract
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
DOI 10.1590/S0100-72031998000800010
Luiz Ayrton Santos Júnior
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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).[…]
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Case Report04-05-1998

Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484

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Abstract
Case Report
Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484
DOI 10.1590/S0100-72031998000800009
Carlos Augusto Alencar Júnior,
Francisco Edson de Lucena Feitosa,
Mac Gontei,
Sammya Bezerra Maia,
Dalgimar Beserra de Meneses
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Arthrogryposis 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.

Key-words Fetal malformation prenatal diagnosis Ultrasonography
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Original Article04-05-1998

Screening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479

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Abstract
Original Article
Screening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479
DOI 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
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Purpose: 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.

Key-words Breast cancer Health care costs Metastasis Ultrasonography
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Original Article04-05-1998

Second-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473

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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
Second-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
DOI 10.1590/S0100-72031998000800007
Rafael Marques de Souza,
Anderson Rech Lazzaron,
Rafael Defferrari,
Álvaro A. Borba,
Luciana Scherer,
Antônio L. Frasson
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Purpose: 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.

Key-words Breast neoplasms Heredity Risk factors
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Original Article04-05-1998

Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467

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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
Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467
DOI 10.1590/S0100-72031998000800006
Orlando José de Almeida,
Marcelo Alvarenga,
José Guilherme Cecatti,
Jessé de Paula Neves Jorge,
Júlia Kawamura Tambascia
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Purpose: 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.

Key-words Breast cancer Fine needle aspiration biopsy
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Original Article03-01-2018

The Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):106-114

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Abstract
Original Article
The Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):106-114
DOI 10.1055/s-0038-1623511
Jessica Fernandes Cirelli,
Fernanda Garanhani Surita,
Maria Laura Costa,
Mary Angela Parpinelli,
Samira Maerrawi Haddad,
José Guilherme Cecatti
Views214
Abstract

Objective

The aim of this study is to evaluate the burden of indirect causes of maternal morbidity/mortality in Brazil.

Methods

Secondary analysis of a multicenter cross-sectional study conducted in 27 referral obstetric units within the Brazilian Network for Surveillance of Severe Maternal Morbidity.

Results

A total of 82,388 women were surveilled: 9,555 women with severe maternal morbidity were included, and 942 (9.9%) of them had indirect causes of morbidity/ mortality. There was an increased risk of higher severity among the indirect causes group, which presented 7.56 times increased risk of maternal death (prevalence ratio [PR]: 7.56; 95% confidence interval [95%CI]: 4.99-11.45). The main indirect causes of maternal death were H1N1 influenza, sepsis, cancer and cardiovascular disease. Non-public antenatal care (PR: 2.52; 95%CI: 1.70-3.74), diabetes (PR: 1.90; 95%CI: 1.24-2.90), neoplasia (PR: 1.98; 95%CI: 1.25-3.14), kidney diseases (PR: 1.99; 95%CI: 1.14-3.49), sickle cell anemia (PR: 2.50; 95%CI: 1.16-5.41) and drug addiction (PR: 1.98; 95%CI: 1.03-3.80) were independentlyassociatedwithworseresultsintheindirectcausesgroup.Someprocedures for the management of severity were more common for the indirect causes group.

Conclusion

Indirect causes were present in less than 10% of the overall cases, but they represented over 40% of maternal deaths in the current study. Indirect causes of maternal morbidity/mortality were also responsible for an increased risk of higher severity, and they were associated with worse maternal and perinatal outcomes. In middle-income countries there is a mix of indirect causes of maternal morbidity/ mortality that points to some advances in the scale of obstetric transition, but also reveals the fragility of health systems.

Key-words indirect causes Maternal death maternal near miss Reproductive health
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Case Report06-19-2019

Spontaneous Heterotopic Triplet Pregnancy with a Two Viable Intrauterine Embryos and an Ectopic One with Right Tubal Rupture
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):268-272

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Abstract
Case Report
Spontaneous Heterotopic Triplet Pregnancy with a Two Viable Intrauterine Embryos and an Ectopic One with Right Tubal Rupture
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):268-272
DOI 10.1055/s-0039-1683910
Adriano Carvalho Guimarães ,
Luciano Dias de Oliveira Reis,
Fabio Chaves Leite,
Cassiana Franco Dias dos Reis,
Alex Paula Costa,
Walter Junior Boim de Araujo
Views213
Abstract

Heterotopic pregnancy (HP) is defined as the simultaneous development of an intra- and an extra uterine gestation. The occurrence of a spontaneous triplet HP is an exceptionally rare medical condition. We report the case of a young woman with spontaneous heterotopic triplets at 8weeks of gestation, with amisdiagnosis of topic twins and acute appendicitis. The ectopic tubal pregnancy was ruptured and a salpingectomy was performed by laparotomy. The intrauterine pregnancy progressed uneventfully. The two healthy babies were delivery by cesarean section at 36 ± 2 weeks of gestation. Heterotopic triplets with ruptured tubal ectopic pregnancy represent a special diagnostic and therapeutic challenge for the obstetrician. A high rate of clinical suspicion and timely treatment by laparotomy or laparoscopy can preserve the intrauterine gestation with a successful outcome of the pregnancy.

Key-words heterotopic pregnancy Multiple pregnancy obstetrical surgery Pregnancy complications tubal pregnancy
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Original Article08-26-2020

Maternal and Sociodemographic Factors Influence the Consumption of Ultraprocessed and Minimally-Processed Foods in Pregnant Women
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):380-389

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Abstract
Original Article
Maternal and Sociodemographic Factors Influence the Consumption of Ultraprocessed and Minimally-Processed Foods in Pregnant Women
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):380-389
DOI 10.1055/s-0040-1712996
Monique Tavares Pereira ,
Monica Cattafesta ,
Edson Theodoro dos Santos Neto ,
Luciane Bresciani Salaroli
Views197
Abstract

Objective

To analyze the consumption of minimally-processed and ultraprocessed foods in relation with sociodemographic variables, maternal habits, educational activity received during prenatal care and clinical history.

Methods

A cross-sectional, analytical and descriptive study with 1,035 pregnant women who lives in the municipalities of the metropolitan region of Grande Vitória, Espírito Santo, Brazil (RMGV-ES), and who were hospitalized in establishments of the Unified Health System (SUS) due to childbirth (April-September 2010). The food frequency questionnaire, pregnant woman’s card and information from the medical records of the health facility unit were analyzed. The Chi-square test and the binary logistic regression model were used to investigate the association between the independent variables and the consumption of ultraprocessed foods.

Results

It was identified that pregnant women ≤ 19 years of agewere 2.9 timesmore likely to consume ultraprocessed foods (confidence interval [CI] 95% 1.683-5.168, p< 0.001), while those ≥ 35 years old were less likely to consume them (odds ratio [OR] 0.265, 95% CI 0.105-0.666, p= 0.005). Maternal smoking increased the odds of consumption of ultraprocessed foods by 2.2 times (95% CI 1.202-4.199, p= 0.011) and pregnant womenwho did not obtain information on healthy food during prenatal care presented 54.1% less chances of consuming minimally-processed foods (OR 0.459, 95% CI 0.307-0.687, p< 0.001).

Conclusion

Smoking during the gestational period and being a teenager are factors that influence the consumption of ultraprocessed foods of pregnant women. Race/ color, head of household, age group, receiving of information about feeding in the prenatal period and not having smoked in gestation determined the consumption of minimally-processed foods.

Key-words dietary habits Feeding behavior Maternal nutrition pregnant ultraprocessed foods
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Original Article01-12-2021

Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(11):834-839

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Abstract
Original Article
Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(11):834-839
DOI 10.1055/s-0041-1739464
Christiane Ricaldoni Giviziez ,
Eliane Gouveia de Morais Sanchez ,
Yanna Andressa Ramos de Lima ,
Mário Silva Approbato
Views202
Abstract

Objective

It has been suggested that excess body weight could represent a risk factor for infertility outcomes. The present study aimed to evaluate the association of overweight and anovulation among infertile women with regular menstrual cycles.

Methods

We conducted a retrospective case-control study with consistently anovulatory patients undergoing assisted reproduction treatment. The patients were stratified into normal weight (body mass index [BMI]: 18.5-24.9kg/m2) and overweight (BMI: 25.0- 29.9kg/m2).Those with polycystic ovary syndrome or obesity were excluded. The groups were matched for age, duration of infertility, prolactin, follicle stimulating hormone (FSH), thydroid stimulating hormone (TSH), luteinizing hormone (LH), and estradiol levels.

Results

Overweight was significantly associated with anovulation, when using the World Health Organization (WHO) criteria for anovulation: progesterone levels>5.65 ng/ml and ultrasonography evidence of follicle collapse (odds ratio [OR]: 2.69; 95% confidence interval [CI95%]: 1.04-6.98).

Conclusion

Body mass index above the normal range jeopardizes ovulation among non-obese infertile women with regular menstrual cycles.

Key-words Anovulation Assisted reproductive techniques female infertility Overweight
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Original Article03-11-2022

Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):385-390

Views200

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Abstract
Original Article
Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):385-390
DOI 10.1055/s-0042-1743102
Fernanda Villar Fonseca ,
Maria Victória Gutierrez Cordeiro ,
Ariadne Cristine Pozza ,
Carlos Afonso Maestri
Views200
Abstract

Objective

To evaluate the role of cervical cytology (Pap smear) in the diagnosis of cervical intraepithelial neoplasia 2 or greater (CIN2+), presented exclusively in the endocervical canal, the clinical-epidemiological characteristics of this lesion, the necessary length of canal to be removed to treat, and the rate of invasive lesion hidden in the endocervical canal.

Methods

Cross-sectional study, by database analysis, of patients with abnormal cytology (high-grade squamous intraepithelial lesion [HSIL]), without visible colposcopy lesion, submitted to loop electrosurgical procedure (LEEP) to evaluate the association of cytology results with the histological product of the conization, to identify the epidemiological characteristics of endocervical lesion and clinical evolution, using a pvalue< 0.05 and 95% CI.

Results

In 444 cases, the Pap smear sensitivity for CIN2+ diagnosis was 75% (95% CI: 69.8-79.7), specificity was 40% (95% CI: 30.2-49.5), and the prevalence rate of histological lesion was 73% (95% CI: 70.1-78.7). There was a higher prevalence of CIN2+ in women over 42 years old and invasive cancer in those over 56 years old (p<0.001), and it was necessary to remove 2.6 cm in length of the canal to reduce the chance of recurrence (p<0.006). The rate of invasive cancer was 2.7%.

Conclusion

Cytology was related to a high prevalence to histological lesion (73%) in the diagnosis of CIN2+ in the endocervical disease; older patients presented a higher relationship with histological lesions in the canal disease, and it was necessary to remove an average of 2.6 cm in length of the endocervical canal to avoid the persistence and progression of CIN. The rate of occult neoplasia in the endocervical canal was 2.7%.

Key-words Cervical intraepithelial neoplasia CIN oncotic cytology
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Review Article12-11-2023

Prognostic Impact of AGR3 Protein Expression in Breast Cancer: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(10):609-619

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Abstract
Review Article
Prognostic Impact of AGR3 Protein Expression in Breast Cancer: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(10):609-619
DOI 10.1055/s-0043-1772183
Carolina Leão de Moraes ,
Carolina Rodrigues Mendonça ,
Natália Cruz e Melo ,
Fernanda Sardinha de Abreu Tacon ,
Jair Pereira de Melo Junior ,
Waldemar Naves do Amaral
Views201
Abstract

Objective

To investigate the clinicopathological significance and prognosis of the expression of the anterior gradient 3 (AGR3) protein in women with breast cancer.

Data Sources

The PubMed, CINAHL, EMBASE, Scopus, and Web of Science databases were searched for studies published in English and without restrictions regarding the year of publication. The search terms were: breast cancer AND anterior gradient 3 OR AGR3 expression.

Study Selection

We included observational or interventional studies, studies on AGR3 protein expression by immunohistochemistry, and studies on invasive breast cancer. Case reports, studies with animals, and reviews were excluded. In total, 4 studies were included, containing 713 cases of breast cancer.

Data Collection

Data were extracted on clinicopathological characteristics and survival. A meta-analysis of the prevalence of AGR3 expression was performed according to the clinicopathological characteristics, hazard ratios (HRs), and overall survival and disease-free survival.

Data Synthesis

The expression of AGR3 was found in 62% of the cases, and it was associated with histological grade II, positivity of estrogen and progesterone receptors, low expression of ki67, recurrence or distant metastasis, and lumen subtypes. In patients with low and intermediate histological grades, AGR3 expression was associated with worse overall survival (HR: 2.39; 95% confidence interval [95%CI]: 0.628–4.159; p = 0.008) and worse disease-free survival (HR: 3.856; 95%CI: 1.026–6.686; p = 0.008).

Conclusion

The AGR3 protein may be a biomarker for the early detection of breast cancer and predict prognosis in luminal subtypes. In addition, in patients with low and intermediate histological grades, AGR3 protein expression may indicate an unfavorable prognosis in relation to survival.

Key-words Breast neoplasms human AGR3 protein Immunohistochemistry Prognosis survival
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Original Article10-01-2017

Clinical Characteristics in a Sample of Transsexual People
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):545-551

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Abstract
Original Article
Clinical Characteristics in a Sample of Transsexual People
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):545-551
DOI 10.1055/s-0037-1604134
Maria Rita Lerri,
Adriana Peterson Mariano Salata Romão,
Manoel Antônio dos Santos,
Alain Giami,
Rui Alberto Ferriani,
Lúcia Alves da Silva Lara
Views208
Abstract

Purpose

To assess the clinical characteristics of subjects with gender dysphoria (GD).

Method

A cross-sectional study of adults with GD. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Sociodemographic data, clinical data and life habits were recorded.

Results

Total of 44 subjects participated in the study: 36 (82%) trans women and 8 (18%) trans men. Forty-three (98%) of the GD patients had anxiety (36 [100%] trans women and 7 [87.5%] trans men), and 36 (82%) had depression (29 [80.5%] trans women and 7 [87.5%] trans men). Suicide had been attempted by 32 (73%) subjects. The rates of depression were lower among the subjects living with partners, parents, or other people than among those living alone (p = 0.03), and it was also lower among the subjects who were married compared to those who were dating or single (p = 0.03).

Conclusion

Improving the relationship status may reduce the prevalence of depressive symptoms in GD patients. There was a high rate of attempted suicide in this sample.

Key-words Anxiety Depression gender dysphoria sex reassignment surgery transsexual
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Review Article09-18-2024

Immunosuppressants in women with repeated implantation failure in assisted reproductive techniques: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo70

Views307

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
Immunosuppressants in women with repeated implantation failure in assisted reproductive techniques: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo70
DOI 10.61622/rbgo/2024rbgo70
Ana Clara Felix de Farias Santos ,
Fernanda Valeriano Zamora ,
Lubna Al-Sharif ,
Kush Sehgal ,
Deyvid Vieira Silva Cavalcante ,
Sarah Hasimyan Ferreira ,
Pedro Henrique Costa Matos da Silva
Views307
Abstract

Objective

To compare outcomes in patients with repeated implantation failure undergoing Intracytoplasmic Sperm Injection/In vitro fertilization (IVF/ICSI) plus immunosuppressants such as prednisolone, prednisone, or cyclosporine A versus the use of IVF/ICSI alone.

Data source

Databases were systematically searched in PubMed, Cochrane, and Embase databases in September 2023.

Study Selection

Randomized clinical trials and observational studies with the outcomes of interest were included.

Data collect

We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Heterogeneity was assessed using I² statistics. Data were analyzed using Review Manager 5.4.The main outcomes were live birth, miscarriage, implantation rate, clinical pregnancy, and biochemical pregnancy.

Data synthesis

Seven studies with 2,829 patients were included. Immunosuppressive treatments were used in 1,312 (46.37%). Cyclosporine A improved implantation rate (OR 1.48; 95% CI 1.01-2.18) and clinical pregnancy (1.89, 95% CI 1.14-3.14). Compared to non-immunosuppressive treatment, prednisolone and prednisone did not improve live birth (OR 1.13, 95% CI 0.88-1.46) and miscarriage (OR 1.49, 95% CI 1.07-2.09). Prednisolone showed no significant effect in patients undergoing IVF/ICSI, clinical pregnancy (OR 1.34; 95% CI 0.76-2.36), or implantation rate (OR 1.36; 95% CI 0.76-2.42).

Conclusion

Cyclosporine A may promote implantation and clinical pregnancy rates. However, given the limited sample size, it is important to approach these findings with caution. Our results indicate that prednisolone and prednisone do not have any beneficial effects on clinical outcomes of IVF/ICSI patients with repeated implantation failure.

PROSPERO

CRD42023449655

Key-words Cyclosporine A Prednisolone Immunosupressive agents Prednisone Repeated implantation failure Reproduction Reproductive techniques, assisted
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Original Article03-01-2018

The Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):106-114

Views214

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Abstract
Original Article
The Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):106-114
DOI 10.1055/s-0038-1623511
Jessica Fernandes Cirelli,
Fernanda Garanhani Surita,
Maria Laura Costa,
Mary Angela Parpinelli,
Samira Maerrawi Haddad,
José Guilherme Cecatti
Views214
Abstract

Objective

The aim of this study is to evaluate the burden of indirect causes of maternal morbidity/mortality in Brazil.

Methods

Secondary analysis of a multicenter cross-sectional study conducted in 27 referral obstetric units within the Brazilian Network for Surveillance of Severe Maternal Morbidity.

Results

A total of 82,388 women were surveilled: 9,555 women with severe maternal morbidity were included, and 942 (9.9%) of them had indirect causes of morbidity/ mortality. There was an increased risk of higher severity among the indirect causes group, which presented 7.56 times increased risk of maternal death (prevalence ratio [PR]: 7.56; 95% confidence interval [95%CI]: 4.99-11.45). The main indirect causes of maternal death were H1N1 influenza, sepsis, cancer and cardiovascular disease. Non-public antenatal care (PR: 2.52; 95%CI: 1.70-3.74), diabetes (PR: 1.90; 95%CI: 1.24-2.90), neoplasia (PR: 1.98; 95%CI: 1.25-3.14), kidney diseases (PR: 1.99; 95%CI: 1.14-3.49), sickle cell anemia (PR: 2.50; 95%CI: 1.16-5.41) and drug addiction (PR: 1.98; 95%CI: 1.03-3.80) were independentlyassociatedwithworseresultsintheindirectcausesgroup.Someprocedures for the management of severity were more common for the indirect causes group.

Conclusion

Indirect causes were present in less than 10% of the overall cases, but they represented over 40% of maternal deaths in the current study. Indirect causes of maternal morbidity/mortality were also responsible for an increased risk of higher severity, and they were associated with worse maternal and perinatal outcomes. In middle-income countries there is a mix of indirect causes of maternal morbidity/ mortality that points to some advances in the scale of obstetric transition, but also reveals the fragility of health systems.

Key-words indirect causes Maternal death maternal near miss Reproductive health
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Original Article01-01-2017

Perineal Massage Improves the Dyspareunia Caused by Tenderness of the Pelvic Floor Muscles
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(1):26-30

Views337

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Abstract
Original Article
Perineal Massage Improves the Dyspareunia Caused by Tenderness of the Pelvic Floor Muscles
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(1):26-30
DOI 10.1055/s-0036-1597651
Ana Paula Moreira da Silva,
Mary Lourdes Montenegro,
Maria Beatriz Ferreira Gurian,
Andreia Moreira de Souza Mitidieri,
Lucia Alves da Silva Lara,
Omero Benedicto Poli Neto,
Julio Cesar Rosa e Silva
Views337
ABSTRACT

Aim:

To evaluate the long-term effectiveness of perineal Thiele massage in the treatment of women with dyspareunia caused by tenderness of the pelvic floor muscles.

Methods:

A total of 18 women with diagnoses of dyspareunia caused by tenderness of the pelvic floor muscles were included in the study. The women were divided in two groups: the dyspareunia (D) group – 8 women with dyspareunia caused by tenderness of the pelvic floor muscles; and the chronic pelvic pain group (CPP) group – 10 women with dyspareunia caused by tenderness of the pelvic floor muscles associated with CPP. Each patient filled out the Visual Analogue Scale (VAS), the McGill Pain Index, the Female Sexual Function Index (FSFI) and the Hospital Anxiety and Depression Scale (HADS). After an evaluation, the women underwent transvaginal massage using the Thiele technique over a period of 5 minutes, once a week for 4 weeks.

Results:

All women had significant improvements in their dyspareunia according the VAS and the McGill Pain Index (p < 0,001), but the HADS scores did not show significant differences. Regarding sexual function, the D group showed improvements on all aspects of sexual function, while the CPP group showed differences only in the pain domain.

Conclusion:

Thiele massage is effective in the treatment of dyspareunia caused by tenderness of the pelvic floor muscles with a long-term pain relief.

Key-words Dyspareunia Pelvic floor Pelvic pain physical therapy Women's health
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Review Article07-30-2021

Interventions among Pregnant Women in the Field of Music Therapy: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):403-413

Views443

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
Interventions among Pregnant Women in the Field of Music Therapy: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):403-413
DOI 10.1055/s-0041-1731924
Bruna Mayumi Omori Shimada ,
Magda da Silva Oliveira Menezes dos Santos ,
Mayara Alvares Cabral ,
Vanessa Oliveira Silva ,
Gislaine Cristina Vagetti
Views443
Abstract

Objective

To investigate in the literature the studies on the benefits ofmusic therapy interventions among pregnant women in the prenatal, delivery and postpartum periods.

Data Sources

The search for articles was carried out in the following electronic databases: VHL, LILACS, SciELO, Portal CAPES, PsycINFO, ERIC, PubMed/Medline, and journals specialized in this field: Revista Brasileira de Musicoterapia (“Brazilian Journal of Music Therapy”) and Voices.

Study Selection

Descriptors in Portuguese (musicoterapia, gravidez, gestantes, revisão), English (music therapy, pregnancy, pregnant women, review) and Spanish (musicoterapia, embarazo, mujeres embarazadas, revisión) were used. The search was delimited between January 2009 and June 2019. The process of selection and evaluation of the articles was performed through peer review.

Data Collectio

n The following data were extracted: article title, year of publication, journal, author(s), database, country and date of collection, purpose of the study, sample size, type of care, intervention, instruments used, results, and conclusion. The data were organized in chronological order based on the year of publication of thestudy.

Summary of the Data

In total, 146 articles were identified, and only 23 studies were included in this systematic review. The articles found indicate among their results relaxation, decreased levels of anxiety, psychosocial stress and depression, decreased pain, increase in the maternal bond, improvement in the quality of sleep, control of the fetal heart rate and maternal blood pressure, and decreased intake of drugs in the postoperative period.

Conclusion

Music therapy during the prenatal, delivery and postpartum periods can provide benefits to pregnant women and newborns, thus justifying its importance in this field.

Key-words music music therapy Pregnancy Women's health
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Editorial09-01-2016

Syphilis in Pregnancy and Congenital Syphilis: Why Can We not yet Face This Problem?
- Helaine Milanez
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):425-427

Views139

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Abstract
Editorial
Syphilis in Pregnancy and Congenital Syphilis: Why Can We not yet Face This Problem?
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(9):425-427
DOI 10.1055/s-0036-1593603
Helaine Milanez
Views139
The increased occurrence of syphilis during pregnancy, and its severe repercussions to the fetal environment, has been a cause for concern among health care professionals. It is hard to comprehend why congenital syphilis has not yet been controlled, since its agent, the spirochaete Treponema pallidum, is well known and is highly susceptible to penicillin, a […]
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Original Article07-01-2017

Effect of Obesity on Gestational and Perinatal Outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):330-336

Views135

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Abstract
Original Article
Effect of Obesity on Gestational and Perinatal Outcomes
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):330-336
DOI 10.1055/s-0037-1603826
Sônia Regina Cabral Madi,
Rosa Maria Rahmi Garcia,
Vandrea Carla de Souza,
Renato Luís Rombaldi,
Breno Fauth de Araújo,
José Mauro Madi
Views135
Abstract

Purpose

To assess the impact of pre-pregnancy obesity (body mass index [BMI] ≥30 kg/m²) on the gestational and perinatal outcomes.

Methods

Retrospective cohort study of 731 pregnant women with a BMI ≥30 kg/m² at the first prenatal care visit, comparing them with 3,161 women with a BMI between 18.5 kg/m² and 24.9 kg/m². Maternal and neonatal variables were assessed. Statistical analyses reporting the demographic features of the pregnant women (obese and normal) were performed with descriptive statistics followed by two-sided independent Student’s t tests for the continuous variables, and the chi-squared (χ²) test, or Fisher’s exact test, for the categorical variables. We performed a multiple linear regression analysis of newborn body weight based on the mother’s BMI, adjusted by maternal age, hyperglycemic disorders, hypertensive disorders, and cesarean deliveries to analyze the relationships among these variables. All analyses were performed with the R (R Foundation for Statistical Computing, Vienna, Austria) for Windows software, version 3.1.0. A value of p < 0.05 was considered statistically significant.

Results

Obesity was associated with older age [OR 9.8 (7.8-12.2); p < 0.01], hyperglycemic disorders [OR 6.5 (4.8-8.9); p < 0.01], hypertensive disorders [OR 7.6 (6.1-9.5); p < 0.01], caesarean deliveries [OR 2.5 (2.1-3.0); p < 0.01], fetal macrosomia [OR 2.9 (2.3-3.6); p < 0.01] and umbilical cord pH [OR 2.1 (1.4-2.9); p < 0.01). Conversely, no association was observed with the duration of labor, bleeding during labor, Apgar scores at 1 and 5 minutes after birth, gestational age, stillbirth and early neonatal mortality, congenital malformations, and maternal and fetal injury.

Conclusion

We observed that pre-pregnancy obesity was associated with maternal age, hyperglycemic disorders, hypertension syndrome, cesarean deliveries, fetal macrosomia, and fetal acidosis.

Key-words Body mass index neonatal outcomes Obesity pregnancy outcomes
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Original Article12-01-2017

Mandibular Inferior Cortex Erosion on Dental Panoramic Radiograph as a Sign of Low BoneMineral Density in Postmenopausal Women
- Juliana Zigart Brum Carmo,
- Sebastião Freitas de Medeiros
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):663-669

Views185

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Abstract
Original Article
Mandibular Inferior Cortex Erosion on Dental Panoramic Radiograph as a Sign of Low BoneMineral Density in Postmenopausal Women
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):663-669
DOI 10.1055/s-0037-1606622
Juliana Zigart Brum Carmo,
Sebastião Freitas de Medeiros
Views185
Abstract

Objective

To examine the role of the panoramic mandibular radiograph in the diagnosis of low bone mineral density (BMD) in postmenopausal women.

Methods

A cross-sectional study including volunteer women aged over 40 years in amenorrhea due to ovarian failure for at least 12 months, who were cared for at the climacteric outpatient clinic of a university hospital in the city of Cuiabá, in the state of Mato Grosso, Brazil. The panoramic radiographs were evaluated using a specific software. Two aspects were analyzed in the mandibular panoramic radiograph: a qualitative aspect regarding the shape of the mandibular cortical bone, and a quantitative aspect regarding thewidth of themandibular cortical bone. Themorphology of themandibular cortical bone in the digital panoramic radiograph was determined bilaterally by the observation of the bone structure between the mental foramen and the base of the jaw. The mandibular cortical bonewas categorized into three groups. Themental index (MI)was used to evaluate the thickness of themandibular cortical bone through a perpendicular line drawn fromthe base of the mandible at the height of the center of the mental foramen, with another line drawn tangent to the inferior border of the mandible, and a third line parallel to the line at the superior border of themandible. The MI data are expressed in millimeters, with a normal value of 3.0 mm. The densities of the lumbar spine and femur, expressed in g/cm2, were categorized as normal, osteopenia or osteoporosis.

Results

The agreement index between the MI and the BMD of the lumbar spine was good (Kappa = 0.718), but the same index between the MI and the BMD of the femoral neck was poor (Kappa = 0.443). An excellent agreement occurred when the mandibular cortical index (MCI) was compared with the BMD of the lumbar spine (Kappa = 0.912). The agreement between MCI and the BMD in the femur was moderated (Kappa = 0.579).

Conclusion

The radiomorphometric indices evaluated in the mandibular panoramic radiograph are capable of identifying postmenopausal women with low mineral density in the mandible, and the results can be used to refer these women to appropriate medical investigation and/or treatment.

Key-words Climacteric mandible Menopause Osteoporosis panoramic radiograph
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Editorial02-01-2017

Pregnancy in Adolescence – A Challenge Beyond Public Health Policies
- João Luiz Pinto e Silva,
- Fernanda Garanhani Surita
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):41-43

Views171

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
Pregnancy in Adolescence – A Challenge Beyond Public Health Policies
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):41-43
DOI 10.1055/s-0037-1600899
João Luiz Pinto e Silva,
Fernanda Garanhani Surita
Views171
Recent Sustainable Development Goals were established by the United Nations (2015–2030), including the broad goal of “good health and wellbeing” for all. Good health and wellbeing (item 3), quality education (item 4), gender equality (item 5) and reduced inequalities (item 10) are among the 17 items of the list. These four cited goals are directly […]
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Original Article10-01-2017

Breaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):552-559

Views211

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Abstract
Original Article
Breaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):552-559
DOI 10.1055/s-0037-1604490
Maria Silvia Vellutini Setubal,
Andrea Vasconcelos Gonçalves,
Sheyla Ribeiro Rocha,
Eliana Martorano Amaral
Views211
Abstract

Objective

Resident doctors usually face the task to communicate bad news in perinatology without any formal training. The impact on parents can be disastrous. The objective of this paper is to analyze the perception of residents regarding a training program in communicating bad news in perinatology based on video reviews and setting, perception, invitation, knowledge, emotion, and summary (SPIKES) strategy.

Methods

We performed the analysis of complementary data collected from participants in a randomized controlled intervention study to evaluate the efficacy of a training program on improving residents’ skills to communicate bad news. Data were collected using a Likert scale. Through a thematic content analysis we tried to to apprehend the meanings, feelings and experiences expressed by resident doctors in their comments as a response to an open-ended question. Half of the group received training, consisting of discussions of video reviews of participants’ simulated encounters communicating a perinatal loss to a “mother” based on the SPIKES strategy. We also offered training sessions to the control group after they completed participation. Twenty-eight residents who were randomized to intervention and 16 from the control group received training. Twenty written comments were analyzed.

Results

The majority of the residents evaluated training highly as an education activity to help increase knowledge, ability and understanding about breaking bad news in perinatology. Three big categories emerged fromresidents’ comments: SPIKES training effects; bad news communication in medical training; and doctors’ feelings and relationship with patients.

Conclusions

Residents took SPIKES training as a guide to systematize the communication of bad news and to amplify perceptions of the emotional needs of the patients. They suggested the insertion of a similar training in their residency programs curricula.

Key-words Health communication Program evaluation qualitative analysis simulation training
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Clinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases

Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography

Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação

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)

Prenatal diagnosis of arthrogryposis multiplex congenita: a case report

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Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses

The Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study

Abstract

Objective

Methods

Results

Conclusion

Spontaneous Heterotopic Triplet Pregnancy with a Two Viable Intrauterine Embryos and an Ectopic One with Right Tubal Rupture

Abstract

Maternal and Sociodemographic Factors Influence the Consumption of Ultraprocessed and Minimally-Processed Foods in Pregnant Women

Abstract

Objective

Methods

Results

Conclusion

Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study

Abstract

Objective

Methods

Results

Conclusion

Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal

Abstract

Objective

Methods

Results

Conclusion

Prognostic Impact of AGR3 Protein Expression in Breast Cancer: A Systematic Review and Meta-analysis

Abstract

Objective

Data Sources

Study Selection

Data Collection

Data Synthesis

Conclusion

Clinical Characteristics in a Sample of Transsexual People

Abstract

Purpose

Method

Results

Conclusion

Immunosuppressants in women with repeated implantation failure in assisted reproductive techniques: a systematic review and meta-analysis

Abstract

Objective

Data source

Study Selection

Data collect

Data synthesis

Conclusion

PROSPERO

The Burden of Indirect Causes of Maternal Morbidity and Mortality in the Processof Obstetric Transition: A Cross-Sectional Multicenter Study

Abstract

Objective

Methods

Results

Conclusion

Perineal Massage Improves the Dyspareunia Caused by Tenderness of the Pelvic Floor Muscles

ABSTRACT

Aim:

Methods:

Results:

Conclusion:

Interventions among Pregnant Women in the Field of Music Therapy: A Systematic Review

Abstract

Objective

Data Sources

Study Selection

Data Collectio

Summary of the Data

Conclusion

Syphilis in Pregnancy and Congenital Syphilis: Why Can We not yet Face This Problem?

Effect of Obesity on Gestational and Perinatal Outcomes

Abstract