Articles - Revista Brasileira de Ginecologia e Obstetrícia

Original Article
Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo81
12-04-2024

Views240

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Summary
Original Article
Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo81
12-04-2024
DOI 10.61622/rbgo/2024rbgo81
Maria Elisa Franciscatto ,
Juliana Bosso Taniguchi ,
Raquel Wohlenberg ,
Isadora Luísa Riedi ,
Karen Oppermann
Views240
Abstract

Objective:

To verify the prevalence and factors associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among women with Polycystic Ovary Syndrome (PCOS).

Methods:

A cross-sectional study was conducted with 53 patients with PCOS. The diagnosis of PCOS followed the Rotterdam criteria. The diagnosis of NAFLD was made through US showing hepatic steatosis, excluding significant alcohol consumption and chronic liver disease. The following variables were compared between the groups of women with and without NAFLD: age, race, anthropometric data, blood pressure levels, liver enzymes, glycemic and lipid profiles, total testosterone, presence of hirsutism, and metabolic syndrome (MS). Variables were compared between the groups using T-test, Mann-Whitney, and Chi-square tests.

Results:

Among 53 patients with PCOS, 50.9% had NAFLD. The NAFLD group had higher weight (p=0.003), BMI (p=0.001), waist circumference (p≤0.001), fasting glucose (p=0.021), HbA1C% (p=0.028), triglycerides (p=0.023), AST (p=0.004), ALT (p=0.001), higher prevalence of MS (p=0.004), and lower levels of HDL cholesterol (p=0.043). The other variables did not differ between the groups. Both groups were predominantly of caucasian race, and there was no significant difference in age.

Conclusion:

The prevalence of NAFLD among patients with PCOS was 50.9%. Metabolic and hepatic enzyme abnormalities were more prevalent in this group compared to the group without the disease. Obesity tripled the prevalence of NAFLD.

Key-words Alcohol drinking Hyperandrogenism metabolic syndrome non-alcoholic fatty liver disease Obesity Polycystic ovary syndrome Waist circumference
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Review Article
Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo79
12-04-2024

Views254

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Summary
Review Article
Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo79
12-04-2024
DOI 10.61622/rbgo/2024rbgo79
Juliana Almeida Oliveira ,
Karine Eskandar ,
Marcos Aurélio Araújo Freitas ,
Chris Elizabeth Philip
Views254
Abstract

Objective:

To evaluate the maternal outcomes in women with postpartum depression using zuranolone, the first oral medication indicated to treat postpartum depression.

Methods:

We conducted a systematic search in September 2023, on Pubmed, Embase and Cochrane Trials. We included randomized controlled trials comparing the effectiveness and safety of zuranolone versus placebo in women with postpartum depression. No time or language restrictions were applied. 297 results were retrieved, of which 11 papers were selected and fully reviewed by two authors. Review Manager 5 was used for statistical analysis and Cochrane Risk-of-bias tool for randomized trials was applied for quality assessment.

Results:

We included 2 studies, with 346 women, of whom 174 (50.2%) were treated with zuranolone. Zuranolone was significantly associated to an improvement of Clinical Global Impression response rate; Hamilton Depression Rating Scale 15 days and 45-day remission, 3-day, 15-day, and 45-day symptom remission, and reduction in the dose of antidepressants. As for safety outcomes, it was noticed that zuranolone increases sedation risk, which can be dose related. No significant differences were found for other adverse events.

Conclusion:

These findings suggest that zuranolone might present a safe and effective medication for out-of-hospital treatment of PPD. Sedation effects need to be further assessed.

Key-words Major depressive disorder postpartum depression Synthetic neurosteroid Zuranolone
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Review Article
Self-medication among pregnant women in comparison to the general population: a scoping review of the main characteristics
- Gabriela Pereira ,
- Cinthia Madeira de Souza ,
- Amanda Canato Ferracini ,
- Fernanda Garanhani Surita ,
- Sherif Eltonsy ,
- Priscila Gava Mazzola
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo77
12-04-2024

Views226

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Summary
Review Article
Self-medication among pregnant women in comparison to the general population: a scoping review of the main characteristics
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo77
12-04-2024
DOI 10.61622/rbgo/2024rbgo77
Gabriela Pereira ,
Cinthia Madeira de Souza ,
Amanda Canato Ferracini ,
Fernanda Garanhani Surita ,
Sherif Eltonsy ,
Priscila Gava Mazzola
Views226
Abstract

Objective:

An in-depth evaluation of the published evidence is needed on self-medication, specifically the evidence focusing on vulnerable groups, such as pregnant women. This scoping review aims to provide an overview of the differences in self-medication prevalence and study characteristics among different groups, while identifying gaps in the literature.

Methods:

A literature search was performed in PubMed and Web of Science, including articles published in the last 10 years for the pregnant women group (PWG) and the general population group (GPG). Data on study design, self-medication prevalence, medications used, and other variables were collected, tabulated, and summarized.

Results:

From 2888 screened articles, 75 were considered including 108,559 individuals. The self-medication (SM) in the PWG ranged from 2.6 to 72.4% and most studies had an SM prevalence between 21 and 50% and in the GPG, 32 from 50 studies had a SM prevalence higher than 50%. The reviewed studies varied considerably in methodology, requiring careful interpretation. While most of the studies assessed self-medication during the entire pregnancy, self-medication definition was often inconsistent between studies. Acetaminophen was the most used medication and headache was the most frequent symptom leading to self-medication initiation in the PWG.

Conclusions:

Self-medication among pregnant women showed a lower prevalence when compared to the general population. The medications used and symptoms reported were similar between groups. However, methodological differences must be carefully considered. Pregnant women should carefully follow their physicians’ advice before initiating self-medication to avoid preventable maternal and fetal adverse effects.

Key-words drug-related side effects and adverse reactions Medication use Pregnant women Self-medication
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FEBRASGO POSITION STATEMENT
Nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS11
11-25-2024

Views162

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Summary
FEBRASGO POSITION STATEMENT
Nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS11
11-25-2024
DOI 10.61622/rbgo/2024FPS11
Andrea Prestes Nácul ,
Ana Carolina Japur Sá Rosa e Silva ,
Daniela Angerame Yela ,
Sebastião Freitas de Medeiros ,
José Maria Soares Júnior ,
Gabriela Pravatta Rezende Antoniassi ,
Lia Cruz da Costa Damásio ,
Técia Maria de Oliveira Maranhão ,
Gustavo Arantes Rosa Maciel ,
Cristina Laguna Benetti-Pinto
Views162
Key points[…]
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FEBRASGO POSITION STATEMENT
Challenges and strategies in adolescent vaccination: Number 12 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS12
11-14-2024

Views153

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.
Summary
FEBRASGO POSITION STATEMENT
Challenges and strategies in adolescent vaccination: Number 12 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS12
11-14-2024
DOI 10.61622/rbgo/2024FPS12
Cecília Maria Roteli-Martins ,
Renato de Ávila Kfouri ,
André Luís Ferreira Santos
Views153
Key points[…]
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Letter to the Editor
The gynecologist and cancer in women
- Iolanda Matias Gomes
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo92
10-23-2024

Views122

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Summary
Letter to the Editor
The gynecologist and cancer in women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo92
10-23-2024
DOI 10.61622/rbgo/2024rbgo92
Iolanda Matias Gomes
Views122
Cervical cancer continues to claim an alarming number of victims around the world, especially among poor women. In Brazil, in 2022, an incidence of 16.3/100,000 women was recorded,() with a projection for 2023 of 17,010 new cases, corresponding to a rate of 15.38/100,000, representing 7% of tumors in women.In the Brazilian reality, where there is […]
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Original Article
Nipple-sparing mastectomy in young versus elderly patients
- Antônio Luiz Frasson ,
- Isabela Miranda ,
- Betina Vollbrecht ,
- Carolina Malhone ,
- Ana Beatriz Falcone ,
- Martina Lichtenfels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo90
10-23-2024

Views146

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Summary
Original Article
Nipple-sparing mastectomy in young versus elderly patients
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo90
10-23-2024
DOI 10.61622/rbgo/2024rbgo90
Antônio Luiz Frasson ,
Isabela Miranda ,
Betina Vollbrecht ,
Carolina Malhone ,
Ana Beatriz Falcone ,
Fernanda Barbosa ,
Francisco Pimentel Cavalcante ,
Martina Lichtenfels
Views146
Abstract

Objective:

In this study, we compared indications and outcomes of 115 young (< 40 years) versus 40 elderly (> 60 years) patients undergoing nipple-sparing mastectomy (NSM) as risk-reducing surgery or for breast cancer (BC) treatment.

Methods:

Between January 2004 and December 2018, young and elderly patients undergoing NSM with complete data from at least 6 months of follow-up were included.

Results:

BC treatment was the main indication for NSM, observed in 85(73.9%) young versus 33(82.5%) elderly patients, followed by risk-reducing surgery in 30(26.1%) young versus 7(17.5%) elderly patients. Complication rates did not differ between the age groups. At a median follow-up of 43 months, the overall recurrence rate was higher in the younger cohort (p = 0.04). However, when stratified into local, locoregional, contralateral, and distant metastasis, no statistical difference was observed. During the follow-up, only 2(1.7%) young patients died.

Conclusion:

Our findings elucidate a higher recurrence rate of breast cancer in younger patients undergoing NSM, which may correlate with the fact that age is an independent prognostic factor. High overall survival and low complication rates were evidenced in the two groups showing the safety of NSM for young and elderly patients.

Key-words Age factors Breast neoplasm Breast neoplasms Mastectomy Nipples subcutaneous Young adult
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Original Article
Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
- Nicole Zazula Beatrici ,
- Roxana Knobel ,
- Mariana Schmidt Vieira ,
- Iago Felipe Alexandrini ,
- Alberto Trapani Júnior ,
- Carla Betina Andreucci
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024

Views180

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Summary
Original Article
Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024
DOI 10.61622/rbgo/2024rbgo87
Nicole Zazula Beatrici ,
Roxana Knobel ,
Mariana Schmidt Vieira ,
Iago Felipe Alexandrini ,
Alberto Trapani Júnior ,
Carla Betina Andreucci
Views180
Abstract

Objective:

To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.

Methods:

Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.

Results:

395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.

Conclusion:

The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.

Key-words COVID-19 Delivery of health care Diabetes Gestational pandemics Postpartum period Pregnancy Prenatal care surveys and questionnaires Vaccination
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Original Article
Screening and prevention of preterm birth: how is it done in clinical practice?
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
04-09-2024

Views485

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Summary
Original Article
Screening and prevention of preterm birth: how is it done in clinical practice?
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
04-09-2024
DOI 10.61622/rbgo/2024rbgo32
Roberta Bulsing dos Santos ,
Janete Vettorazzi ,
Marcos Wengrover Rosa ,
Ellen Machado Arlindo ,
Edimárlei Gonsales Valério
Views485
Abstract

Objective:

To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country.

Methods:

Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices.

Results:

The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix.

Conclusion:

In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.

Key-words attitudes, practice Cervical length measurement gynecologists health knowledge Infant, premature obstetricians Preterm birth Prevention Screening surveys and questionnaires
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Original Article
Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo31
04-09-2024

Views459

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Summary
Original Article
Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo31
04-09-2024
DOI 10.61622/rbgo/2024rbgo31
Andreia Jacobo ,
Renata Fogaça Borges ,
Carlos Augusto Bastos de Souza ,
Vanessa Krebs Genro ,
João Sabino Cunha-Filho
Views459
Abstract

Objective:

To compare Transforming growth factor beta-1 (TGF-β1) expression in patients with and without adenomyosis.

Methods:

A prospective design was performed including 49 patients submitted to hysterectomy. Immunohistochemistry was performed on anatomopathological samples staged in paraffin blocks from patients with and without adenomyosis. The sample contained 28 adenomyosis cases and 21 controls. Student’s t-test and multivariate logistic regression tests were used for statistical analysis. Associations were considered significant at p < 0.05.

Results:

We found no significant association between adenomyosis and: smoking (p = 0.75), miscarriage (p = 0.29), number of previous pregnancies (p = 0.85), curettage (p = 0.81), pelvic pain (p = 0.72) and myoma (p = 0.15). However, we did find a relationship between adenomyosis and abnormal uterine bleeding (AUB) (p = 0.02) and previous cesarean section (p = 0.02). The mean TGF-β1 intensity (mean ± SD) in the ectopic endometrium of women with adenomyosis showed no significant association (184.17 ± 9.4 vs.184.66 ± 16.08, p = 0.86) from the topic endometrium of women without adenomyosis.

Conclusion:

TGF-β1 expression was not increased in the ectopic endometrium of women with adenomyosis.

Key-words Adenomyosis Etiopathogenesis Immunohistochemistry Transforming growth factor β1
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Original Article
Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo17
00-00-2024

Views457

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.
Summary
Original Article
Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo17
00-00-2024
DOI 10.61622/rbgo/2024AO17
Maria Luiza de Castro Amaral ,
Isabela Michel da Silva ,
Alexandre Ferreira Bello ,
Franciele Cascaes da Silva ,
Gustavo Salata Romão ,
Alberto Trapani Júnior
Views457
Abstract

Objective:

To determine the prevalence of anxiety, depression and burnout in residents of Gynecology and Obstetrics during COVID-19 pandemic in Brazil and its associated factors.

Methods:

Cross-sectional study involving all regions of Brazil, through the application of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the Maslach Burnout Inventory (MBI-HSS) instrument. Multivariate analysis was performed after adjusting the Poisson model.

Results:

Among the 719 participating medical residents, screening was positive for anxiety in 75.7% and for depression in 49.8% of cases. Burnout syndrome was evidenced in 41.3% of the physicians studied. Those with depression are more likely to have anxiety (OR 0.797; 95%CI 0.687 – 0.925) and burnout syndrome (OR 0.847 95%CI 0.74 – 0.97). Residents with anxiety (OR 0.805; 95%CI 0.699 – 0.928) and burnout (OR 0.841; 95%CI 0.734 – 0.963) are more likely to have depression.

Conclusion:

High prevalence of anxiety, depression and burnout were found in residents of Gynecology and Obstetrics in Brazil, in addition to important correlations between anxiety-depression and depression-burnout.

Key-words Anxiety Brazil Burnout, psychological COVID-19 Depression Gynecology internship and residency medical residency Mental health Obstetrics pandemics
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Original Article
Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo33
04-09-2024

Views455

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.
Summary
Original Article
Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo33
04-09-2024
DOI 10.61622/rbgo/2024rbgo33
Lina Rigodanzo Marins ,
Tiago Elias Rosito ,
Lucia Maria Kliemann ,
Edson Capp ,
Helena von Eye Corleta
Views455
Abstract

Objective:

Evaluate histological changes in testicular parameters after hormone treatment in transgender women.

Methods:

Cross-section study with patients who underwent gonadectomy at Hospital de Clínicas de Porto Alegre from 2011 to 2019. Hormone treatment type, route of administration, age at initiation and duration were recorded. Atrophy parameters were observed: testicular volume, tubular diameter, basal membrane length, presence of spermatogonia and spermatids (diploid and haploid spermatozoid precursors).

Results:

Eighty-six patients were included. Duration of hormone treatment is associated with testicular atrophy and spermatogenesis arrest. Other characteristics of hormone treatment such as age of initiation, route of administration and type of treatment were not associated with testicular histological changes. Testicular volume may predict spermatogenesis arrest. Basal membrane length and tubular diameter ratio is an interesting predictor of germ cell presence.

Conclusion:

Cross-sex hormone treatment affects testicular germ cell presence. Basal membrane length and tubular diameter ratio reduces inter variability of measurements and better exemplify how atrophic seminiferous tubules are. Fertility preservation should be addressed by healthcare providers in order to recognize gender affirming treatment impact on transgender health.

Key-words Fertility Fertility preservation Gonadal steroid hormones Hormone treatment Spermatogenesis Transgender persons Transgender women
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Original Article
Association of placental histopathological findings with COVID-19 and its predictive factors
- Zeena Helmi ,
- Hadeel Al-badri
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3
00-00-2024

Views446

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.
Summary
Original Article
Association of placental histopathological findings with COVID-19 and its predictive factors
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3
00-00-2024
DOI 10.61622/rbgo/2024AO03
Zeena Helmi ,
Hadeel Al-badri
Views446
Abstract

Objective:

The aims of the study are to describe the association of coronavirus disease (COVID-19) with the abnormal histopathological findings in human placenta and to highlight the potential predictors of these histopathological findings.

Methods:

A retrospective cohort study, held in two obstetric units from January 2021- 2022, 34 patients who were confirmed cases of COVID- 19 were followed up till the time of delivery as their placenta were sent for histopathology. Patients diagnosed with other viral infections, chorioamnionitis, or were known case of as pre-term or term pre labour rupture of membrans (PROM) were excluded as well as pre exisiting diabetes mellitus or pre-eclampsia. Data analysis were performed using STATA software version 16.

Result:

Specific histopatological findings (fetal vascular malperfusion, maternal vascular malperfusion, inflammatory pathology and thrombotic finding) were significantly high among 13 (38.2%) of the study group who got infected earlier in pregnancy (P<0.001). The period between the diagnosis of COVID-19 and the delivery significantly increases the odds of the presence of pathological findings by 2.75 times for each week the patients getting infected earlier.

Conclusion:

Association of abnormal placental histopathological findings with COVID-19 infection in pregnancy and the potential predictor for the occurrence of placental findings is the longer duration between the diagnosis of the infection and the delivery.

Key-words coronavirus infections COVID-19 Histopathology Placenta
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Original Article
Translation, cross-cultural adaptation to Brazilian Portuguese and measurement properties of the WaLIDD score
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo16
00-00-2024

Views432

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.
Summary
Original Article
Translation, cross-cultural adaptation to Brazilian Portuguese and measurement properties of the WaLIDD score
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo16
00-00-2024
DOI 10.61622/rbgo/2024AO16
Mariana Arias Avila ,
Guilherme Tavares de Arruda ,
Amanda Garcia de Godoy ,
Patricia Driusso
Views432
Abstract

Objective:

Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was created. The purpose of this work was to culturally adapt and assess the measurement properties of the WaLIDD score for dysmenorrhea in Brazilian women.

Methods:

In this cross-sectional online study, we evaluated women with and without dysmenorrhea. Criterion validity and construct validity were assessed, respectively, by the Receiver Operator Characteristic (ROC) curve and correlations with the bodily pain and social functioning domains of medical outcomes study 36-item short-form health survey (SF-36), self-report of absenteeism and Stanford Presenteeism Scale for presenteeism. Test-retest reliability and measurement errors were assessed, respectively, by intraclass correlation coefficient (ICC) and Bland and Altman Graph.

Results:

430 women completed the test, 238 (55.4%) women had dysmenorrhea, and 199 (46.3%) answered the questionnaire twice for the retest. The cutoff points ≥4, ≥5, and ≥5 could discriminate between women with and without dysmenorrhea, absenteeism, and presenteeism related to dysmenorrhea, respectively. Correlations between SF-36 – pain and social functioning domains and WaLIDD score were weak to strong and negative. For WaLIDD total Score, ICC was 0.95 and the limits of agreement were −1.54 and 1.62.

Conclusion:

WaLIDD score is a short, valid and reliable instrument to screen and predict dysmenorrhea and could predict absenteeism and presenteeism related to dysmenorrhea in Brazilian women.

Key-words Dysmenorrhea Pain surveys and questionnaires Women's health
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Original Article
Postpartum hemorrhage in electronic health records: risk factors at admission and in-hospital occurrence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo14
00-00-2024

Views429

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Summary
Original Article
Postpartum hemorrhage in electronic health records: risk factors at admission and in-hospital occurrence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo14
00-00-2024
DOI 10.61622/rbgo/2024AO14
Raíssa Isabelle Leão Martins ,
Jussara de Souza Mayrink Novais ,
Zilma Silveira Nogueira Reis
Views429
Abstract

Objective:

Postpartum hemorrhage (PPH) is the leading cause of maternal death globally. Therefore, prevention strategies have been created. The study aimed to evaluate the occurrence of PPH and its risk factors after implementing a risk stratification at admission in a teaching hospital.

Methods:

A retrospective cohort involving a database of SISMATER® electronic medical record. Classification in low, medium, or high risk for PPH was performed through data filled out by the obstetrician-assistant. PPH frequency was calculated, compared among these groups and associated with the risk factors.

Results:

The prevalence of PPH was 6.8%, 131 among 1,936 women. Sixty-eight (51.9%) of them occurred in the high-risk group, 30 (22.9%) in the medium-risk and 33 (25.2%) in the low-risk group. The adjusted-odds ratio (OR) for PPH were analyzed using a confidence interval (95% CI) and was significantly higher in who presented multiple pregnancy (OR 2.88, 95% CI 1.28 to 6.49), active bleeding on admission (OR 6.12, 95% CI 1.20 to 4.65), non-cephalic presentation (OR 2.36, 95% CI 1.20 to 4.65), retained placenta (OR 9.39, 95% CI 2.90 to 30.46) and placental abruption (OR 6.95, 95% CI 2.06 to 23.48). Vaginal delivery figured out as a protective factor (OR 0.58, 95% CI 0.34 to 0.98).

Conclusion:

Prediction of PPH is still a challenge since its unpredictable factor arrangements. The fact that the analysis did not demonstrate a relationship between risk category and frequency of PPH could be attributable to the efficacy of the strategy: Women classified as “high-risk” received adequate medical care, consequently.

Key-words Electronic health records Maternal mortality Postpartum hemorrhage Puerperal disorders Risk factors
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Original Article
Vascular contraction of umbilical arteries of pregnant women with preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo2
00-00-2024

Views413

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Summary
Original Article
Vascular contraction of umbilical arteries of pregnant women with preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo2
00-00-2024
DOI 10.61622/rbgo/2024AO02
Gabriela Morelli Zampieri ,
Priscila Rezeck Nunes ,
Joelcio Francisco Abbade ,
Carlos Alan Dias Junior ,
Valeria Cristina Sandrim
Views413
Abstract

Objective:

Potassium channels have an important role in the vascular adaptation during pregnancy and a reduction in the expression of adenosine triphosphate-sensitive potassium channels (Katp) has been linked to preeclampsia. Activation of Katp induces vasodilation; however, no previous study has been conducted to evaluate the effects of the inhibition of these channels in the contractility of preeclamptic arteries. Glibenclamide is an oral antihyperglycemic agent that inhibits Katp and has been widely used in vascular studies.

Methods:

To investigate the effects of the inhibition of K_atp, umbilical arteries of preeclamptic women and women with healthy pregnancies were assessed by vascular contractility experiments, in the presence or absence of glibenclamide. The umbilical arteries were challenged with cumulative concentrations of potassium chloride (KCl) and serotonin.

Results:

There were no differences between the groups concerning the maternal age and gestational age of the patients. The percentage of smokers, caucasians and primiparae per group was also similar. On the other hand, blood pressure parameters were elevated in the preeclamptic group. In addition, the preeclamptic group presented a significantly higher body mass index. The newborns of both groups presented similar APGAR scores and weights.

Conclusion:

In the presence of glibenclamide, there was an increase in the KCl-induced contractions only in vessels from the PE group, showing a possible involvement of these channels in the disorder.

Key-words Glibenclamide Preeclampsia Umbilical arteries Vascular contractility
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Original Article
School-based HPV Vaccination: The Challenges in a Brazilian Initiative
- Julio Cesar Teixeira ,
- Mariana Silva Castro Vianna ,
- Diama Bhadra Vale ,
- Daniella Moretti Arbore ,
- Thais Helena Wilmers Perini ,
- Luiz Carlos Zeferino
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):926-931
01-24-2021

Views239

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Summary
Original Article
School-based HPV Vaccination: The Challenges in a Brazilian Initiative
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):926-931
01-24-2021
DOI 10.1055/s-0041-1740279
Julio Cesar Teixeira ,
Mariana Silva Castro Vianna ,
Diama Bhadra Vale ,
Daniella Moretti Arbore ,
Thais Helena Wilmers Perini ,
Tulio Jose Tomass Couto ,
Jose Pedroso Neto ,
Luiz Carlos Zeferino
Views239
Abstract

Objective

The present study assesses the implementation and the impact after 2 years of a school-based human papillomavirus (HPV) vaccination program in a Brazilian city.

Methods

A prospective study assessing the implementation of the program, offering quadrivalent HPV vaccine in two annual doses to girls and boys aged from 9 to 10 years old. The program was started in the city of Indaiatuba, state of São Paulo, Brazil, in 2018, and had authorization from the National Immunization Program. The number of HPV vaccine first doses applied and the coverage in 2018 was calculated and compared to the year 2017. There were described events that have influenced the results.

Results

The program invited 4,878 children through schools (87.1% of the target population), and 7.5% refused vaccination. Several concurrent events required or competed for health professionals of the vaccination teams. The coverage of the first dose (between 9 and 10 years old) was 16.1% in 2017 and increased to 50.5% in 2018 (p < 0.0001). The first dose in all ages increased 78% in 2018 compared with 2017 (6,636/3,733). Competing demands over the program continued in 2019, and the first dose coverage dropped (26.9%). For 2020, a municipal law instituted school-based vaccination and the creation of dedicated teams for vaccination, and these strategies are waiting to be tested.

Conclusion

School-based annual HPV vaccination in children between 9 and 10 years old was feasible and increased vaccination coverage, regardless of gender, although the program was vulnerable to competing events.

Key-words Adolescents HPV vaccine Human papillomavirus schools Vaccination
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Case Report
Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):414-416
07-30-2021

Views200

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Summary
Case Report
Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):414-416
07-30-2021
DOI 10.1055/s-0041-1729147
Daniela Alexandra Gonçalves Pereira ,
Eliana Patrícia Pereira Teixeira ,
Ana Cláudia Martins Lopes ,
Ricardo José Pina Sarmento ,
Ana Paula Calado Lopes
Views200
Abstract

The diagnosis of genital ulcers remains a challenge in clinical practice. Lipschütz ulcer is a non-sexually transmitted rare and, probably, underdiagnosed condition, characterized by the sudden onset of vulvar edema along with painful necrotic ulcerations. Despite its unknown incidence, this seems to be an uncommon entity, with sparse cases reported in the literature. We report the case of an 11-year-old girl who presented at the emergency department with vulvar ulcers. She denied any sexual intercourse. The investigation excluded sexually transmitted infections, so, knowledge of different etiologies of non-venereal ulcers became essential. The differential diagnoses are extensive and include inflammatory processes, drug reactions, trauma, and malignant tumors. Lipschütz ulcer is a diagnosis of exclusion. With the presentation of this case report, the authors aim to describe the etiology, clinical course, and outcomes of this rare disease, to allow differential diagnosis of genital ulceration.

Key-words Adolescent non-venereal lesions vulvar ulcer
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Original Article
Maternal Deaths from COVID-19 in Brazil: Increase during the Second Wave of the Pandemic
- Carlos André Scheler ,
- Michelle Garcia Discacciati ,
- Diama Bhadra Vale ,
- Giuliane Jesus Lajos ,
- Fernanda Garanhani Surita ,
- Julio Cesar Teixeira
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):567-572
06-01-2022

Views192

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.
Summary
Original Article
Maternal Deaths from COVID-19 in Brazil: Increase during the Second Wave of the Pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):567-572
06-01-2022
DOI 10.1055/s-0042-1748975
Carlos André Scheler ,
Michelle Garcia Discacciati ,
Diama Bhadra Vale ,
Giuliane Jesus Lajos ,
Fernanda Garanhani Surita ,
Julio Cesar Teixeira
Views192
Abstract

Objective

To compare death rates by COVID-19 between pregnant or postpartum and nonpregnant women during the first and second waves of the Brazilian pandemic.

Methods

In the present population-based evaluation data from the Sistema de Informação da Vigilância Epidemiológica da Gripe (SIVEP-Gripe, in the Portuguese acronym), we included women with c (ARDS) by COVID-19: 47,768 in 2020 (4,853 obstetric versus 42,915 nonobstetric) and 66,689 in 2021 (5,208 obstetric versus 61,481 nonobstetric) and estimated the frequency of in-hospital death.

Results

We identified 377 maternal deaths in 2020 (first wave) and 804 in 2021 (second wave). The death rate increased 2.0-fold for the obstetric (7.7 to 15.4%) and 1.6-fold for the nonobstetric groups (13.9 to 22.9%) from 2020 to 2021 (odds ratio [OR]: 0.52; 95% confidence interval [CI]: 0.47–0.58 in 2020 and OR: 0.61; 95%CI: 0.56– 0.66 in 2021; p < 0.05). In women with comorbidities, the death rate increased 1.7-fold (13.3 to 23.3%) and 1.4-fold (22.8 to 31.4%) in the obstetric and nonobstetric groups, respectively (OR: 0.52; 95%CI: 0.44–0.61 in 2020 to OR: 0.66; 95%CI: 0.59–0.73 in 2021; p <0.05). In women without comorbidities, the mortality rate was higher for nonobstetric (2.4 times; 6.6 to 15.7%) than for obstetric women (1.8 times; 5.5 to 10.1%; OR: 0.81; 95%CI: 0.69–0.95 in 2020 and OR: 0.60; 95%CI: 0.58–0.68 in 2021; p <0.05).

Conclusion

There was an increase in maternal deaths from COVID-19 in 2021 compared with 2020, especially in patients with comorbidities. Death rates were even higher in nonpregnant women, with or without comorbidities.

Key-words acute respiratory distress syndrome case-fatality coronavirus COVID-19 Maternal death Maternal mortality mortality rate Pregnancy SARS-CoV-2
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Review
Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):540-547
04-28-2022

Views224

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Summary
Review
Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):540-547
04-28-2022
DOI 10.1055/s-0042-1744290
Larissa Bueno Ferreira ,
Cecília Viana Lobo ,
Aline Elizabeth da Silva Miranda ,
Brenda da Cunha Carvalho ,
Luana Caroline dos Santos
Views224
Abstract

The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.

Key-words diets gestational dietary patterns Pregnancy Pregnant women Weight gain
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Original Article
Risk Factors for Intrapartum Cesarean Section Delivery in Low-risk Multiparous Women Following at Least a Prior Vaginal Birth (Robson Classification 3 and 4)
- Gul Nihal Buyuk ,
- Hatice Kansu-Celik ,
- Zeynep Asli Oskovi Kaplan ,
- Burcu Kisa ,
- Sule Ozel ,
- Yaprak Engin-Ustun
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(6):436-441
07-27-2021

Views141

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Summary
Original Article
Risk Factors for Intrapartum Cesarean Section Delivery in Low-risk Multiparous Women Following at Least a Prior Vaginal Birth (Robson Classification 3 and 4)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(6):436-441
07-27-2021
DOI 10.1055/s-0041-1731378
Gul Nihal Buyuk ,
Hatice Kansu-Celik ,
Zeynep Asli Oskovi Kaplan ,
Burcu Kisa ,
Sule Ozel ,
Yaprak Engin-Ustun
Views141
Abstract

Objective

The aim of the present study was to evaluate the risk factors for cesarean section (C-section) in low-risk multiparous women with a history of vaginal birth.

Methods

The present retrospective study included low-risk multiparous women with a history of vaginal birth who gave birth at between 37 and 42 gestational weeks. The subjects were divided into 2 groups according to the mode of delivery, as C-section Group and vaginal delivery Group. Risk factors for C-section such as demographic characteristics, ultrasonographic measurements, smoking, weight gain during pregnancy (WGDP), interval time between prior birth, history of macrosomic birth, and cervical dilatation at the admission to the hospital were obtained fromthe charts of the patients. Obstetric and neonatal outcomes were compared between groups.

Results

The most common C-section indications were fetal distress and macrosomia (33.9% [n=77 and 20.7% [n=47] respectively). A bivariate correlation analysis demonstrated that mothers aged>30 years old (odds ratio [OR]: 2.09; 95% confidence interval [CI]: 1.30-3.34; p=0.002), parity >1 (OR: 1.81; 95%CI: 1.18-2.71; p=0.006), fetal abdominal circumference (FAC) measurement>360mm (OR: 34.20; 95%CI: 8.04 -145.56; p<0.001)) and<345mm (OR: 3.06; 95%CI: 1.88-5; p<0.001), presence of large for gestational age (LGA) fetus (OR: 5.09; 95%CI: 1.35-19.21; p=0.016), premature rupture of membranes (PROM) (OR: 1.52; 95%CI: 1-2.33; p=0.041), and cervical dilatation<5cm at admission (OR: 2.12; 95%CI: 1.34-3.34; p=0.001) were associated with the group requiring a C-section.

Conclusion

This is the first study evaluating the risk factors for C-section in low-risk multiparous women with a history of vaginal birth according to the Robson classification 3 and 4. Fetal distress and suspected fetal macrosomia constituted most of the Csection indications.

Key-words cervical dilatation Cesarean section fetal abdominal circumference Risk factors Vaginal delivery
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Original Article
Adverse 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

Views192

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Summary
Original Article
Adverse 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
DOI 10.1055/s-0042-1755461
Carla Dinamerica Kobayashi ,
Victor Bertollo Gomes Porto ,
Martha Elizabeth Brasil da Nóbrega ,
Cibelle Mendes Cabral ,
Tiago Dahrug Barros ,
Cecília Maria Roteli Martins
Views192
Abstract

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.

Key-words adverse event Brazil COVID-19 vaccines Pregnant women vaccine-preventable diseases
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Original Article
The Impact of the COVID-19 Pandemic on Depression and Sexual Function: Are Pregnant Women Affected More Adversely?
- Ramazan Denizli ,
- Önder Sakin ,
- Kazibe Koyuncu ,
- Nayif Çiçekli ,
- Nihat Farisoğulları ,
- Mikail Özdemir
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):765-774
12-17-2021

Views165

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Summary
Original Article
The Impact of the COVID-19 Pandemic on Depression and Sexual Function: Are Pregnant Women Affected More Adversely?
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):765-774
12-17-2021
DOI 10.1055/s-0041-1736174
Ramazan Denizli ,
Önder Sakin ,
Kazibe Koyuncu ,
Nayif Çiçekli ,
Nihat Farisoğulları ,
Mikail Özdemir
Views165
Abstract

Objective

To investigate depression and sexual function among pregnant and nonpregnant women throughout the COVID-19 pandemic.

Methods

A total of 188 women, 96 pregnant and 92 non-pregnant were included. The Beck Depression Inventory (BDI) and the Arizona Sexual Experience Scale (ASEX) were applied to the participants after obtaining sociodemographic data.

Results

The depression scores of pregnant and non-pregnant women were similar (p = 0.846). We found that the depression scores were significantly higher among the group of participants who have lower economic status (p = 0.046). Moreover, the depression score was significantly higher among women who lost their income during the pandemic (p = 0.027). The score on the ASEX was significantly higher, and sexual dysfunction was more prevalent among women who have lower levels of schooling and income (p < 0.05). Likewise, the ASEX scores were significantly higher (p = 0.019) among the group who experienced greater income loss throughout the pandemic. Upon comparing the pregnant and non-pregnant groups, we detected that sexual dysfunction had a significantly higher rate among pregnant women (p < 0.001).

Conclusion

In times of global crisis, such as the current pandemic, low-income families have an increased risk of experiencing depression and sexual dysfunction. When we compared pregnant women with non-pregnant women, depression scores were similar, but pregnant women were at a 6.2 times higher risk of developing sexual dysfunction.

Key-words COVID-19 Depression pandemic pregnant sexual function
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Original Article
Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):360-368
03-11-2022

Views232

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Summary
Original Article
Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):360-368
03-11-2022
DOI 10.1055/s-0042-1743099
Larissa Antunes Miranda ,
Anna Caroline Ribeiro de Moura ,
Karina Tamy Kasawara ,
Fernanda Garanhani Surita ,
Mayle Andrade Moreira ,
Simony Lira do Nascimento
Views232
Abstract

Objective

To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women.

Methods

A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study’s participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%.

Results

Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81±81.84 METs), followed by work-related activities (40.77±84.71 METs). Only 19.3% women exercised during pregnancy (4.76±12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR=29.8; 95% CI 4.9-117.8). Nulliparity (OR=3.1; 95% CI 1.0-9.1), low levels of anxiety (OR=3.6; 95% CI 1.2-10.7), and unemployment (OR=4.8; 95% CI 1.1-19.6) were associated with the practice of exercise during pregnancy.

Conclusion

Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.

Key-words Exercise High-risk pregnancies Motor activity Pregnancy sedentary behavior
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Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome

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Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies

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Self-medication among pregnant women in comparison to the general population: a scoping review of the main characteristics

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Nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 – 2024

Challenges and strategies in adolescent vaccination: Number 12 – 2024

The gynecologist and cancer in women

Nipple-sparing mastectomy in young versus elderly patients

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Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic

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Screening and prevention of preterm birth: how is it done in clinical practice?

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Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis

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Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic

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Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence

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Association of placental histopathological findings with COVID-19 and its predictive factors

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Translation, cross-cultural adaptation to Brazilian Portuguese and measurement properties of the WaLIDD score

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Postpartum hemorrhage in electronic health records: risk factors at admission and in-hospital occurrence

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Vascular contraction of umbilical arteries of pregnant women with preeclampsia

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