Articles - Revista Brasileira de Ginecologia e Obstetrícia

Trabalhos Originais
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
04-05-1998

Views61

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
Trabalhos Originais
Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555
04-05-1998
DOI 10.1590/S0100-72031998001000002
Alexandre Faisal Cury,
Sidney A. L. Garcia
Views61
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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Resumos de Teses
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
04-05-1998

Views39

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
Resumos de Teses
Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
04-05-1998
DOI 10.1590/S0100-72031998000800011
Fábio Sgarbosa
Views39
Indice de Líquido Amniótico em Gestantes Diabéticas e a Qualidade do Controle Glicêmico na Gestação.[…]
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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.
Resumos de Teses
Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
- Luiz Ayrton Santos Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
04-05-1998

Views51

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
Resumos de Teses
Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
04-05-1998
DOI 10.1590/S0100-72031998000800010
Luiz Ayrton Santos Júnior
Views51
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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Relato de Casos
Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484
04-05-1998

Views60

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
Relato de Casos
Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484
04-05-1998
DOI 10.1590/S0100-72031998000800009
Carlos Augusto Alencar Júnior,
Francisco Edson de Lucena Feitosa,
Mac Gontei,
Sammya Bezerra Maia,
Dalgimar Beserra de Meneses
Views60
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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Trabalhos Originais
Screening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479
04-05-1998

Views108

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Summary
Trabalhos Originais
Screening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479
04-05-1998
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
Views108
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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Trabalhos Originais
Second-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
04-05-1998

Views109

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
Trabalhos Originais
Second-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
04-05-1998
DOI 10.1590/S0100-72031998000800007
Rafael Marques de Souza,
Anderson Rech Lazzaron,
Rafael Defferrari,
Álvaro A. Borba,
Luciana Scherer,
Antônio L. Frasson
Views109
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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Trabalhos Originais
Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467
04-05-1998

Views42

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
Trabalhos Originais
Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467
04-05-1998
DOI 10.1590/S0100-72031998000800006
Orlando José de Almeida,
Marcelo Alvarenga,
José Guilherme Cecatti,
Jessé de Paula Neves Jorge,
Júlia Kawamura Tambascia
Views42
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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Trabalhos Originais
A randomized trial of misoprostol and placebo for cervical ripening and induction of labor
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):457-462
04-05-1998

Views86

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
Trabalhos Originais
A randomized trial of misoprostol and placebo for cervical ripening and induction of labor
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):457-462
04-05-1998
DOI 10.1590/S0100-72031998000800005
Renata Murad Macedo,
Ivete de Ávila,
Manuel Maurício Gonçalves
Views86
Objective: to determine the efficacy and safety of misoprostol for cervical ripening and induction of labor in pregnant women at term when compared with placebo. Patients and Methods: fifty-one high-risk pregnant women at term, with unripe cervix, were allocated in a double-blind trial for treatment with intravaginal misoprostol (40 mg, 4/4 h) or intravaginal placebo. Results: thirty-two patients received misoprostol and 19 received placebo. The groups were homogeneous concerning maternal age, gestacional age, parity, and indication for induction (p > 0.05). In the misoprostol group the efficacy was 87.5% and in the placebo group 21.1% (p = 0.0000087). Regarding delivery, in the misoprostol group 75% had vaginal delivery and 25% abdominal delivery, and in the placebo group only 32% had vaginal delivery and 68% abdominal delivery (p = 0.0059).The Apgar score was similar. Conclusion: in this study misoprostol was effective and safe for cervical ripening and induction of labor.

Key-words Cervical ripening High risk pregnancy Induction of labor Pregnancy interruption Prostaglandin
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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

Views467

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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
Views467
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

Views452

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
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
Views452
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

Views440

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
Views440
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
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

Views435

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
Views435
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
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

Views434

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
Views434
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
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

Views420

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
Views420
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

Views413

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
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
Views413
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

Views406

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
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
Views406
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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Review Article
Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):692-700
06-29-2022

Views135

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
Review Article
Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):692-700
06-29-2022
DOI 10.1055/s-0042-1751062
Cibele Santini de Oliveira Imakawa ,
Mariane Nunes de Nadai ,
Monica Reis ,
Silvana Maria Quintana ,
Elaine Christine Dantas Moises
Views135
Abstract

Objective

To review concepts, definitions, and findings about fear of childbirth (FOC).

Methods

A bibliographic review was carried out through the main scientific databases in 2020.

Results

All 32 articles considered potentially relevant were analyzed. A recent study suggests that the global prevalence of FOC can reach up to 14%. Factors such as parity, gestational age, previous birth experience, age and nationality of the woman seem to influence FOC.

Conclusion

Fear of childbirth could be related to an increased risk of adverse obstetric outcomes such as maternal request for cesarean delivery, preterm birth, prolonged labor, postpartum depression, and post-traumatic stress. These evidence highlight the importance of the discussion regarding this topic.

Key-words childbirth Delivery Fear Obstetric labor pregnant
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Original Article
Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
- Margot Marie Martin ,
- Roxana Knobel ,
- Vitor Nandi ,
- Jessica Goedert Pereira ,
- Alberto Trapani Junior ,
- Carla Betina Andreucci
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022

Views44

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Summary
Original Article
Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022
DOI 10.1055/s-0041-1741450
Margot Marie Martin ,
Roxana Knobel ,
Vitor Nandi ,
Jessica Goedert Pereira ,
Alberto Trapani Junior ,
Carla Betina Andreucci
Views44
Abstract

Objective

The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.

Methods

Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis onmaternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.

Results

Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The followingmaternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.

Conclusion

In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.

Key-words access to health services COVID-19 Prenatal care Primary health care
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Review Article
Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
04-25-2022

Views189

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
Review Article
Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
04-25-2022
DOI 10.1055/s-0042-1744286
Maria Laura Costa ,
Ricardo de Carvalho Cavalli ,
Henri Augusto Korkes ,
Edson Vieira da Cunha Filho ,
José Carlos Peraçoli
Views189
Abstract

Objective

It is a challenge to consider preeclampsia (PE) diagnosis and management in low and middle-income settings, where it represents a major public health concern. The placenta is the underlying cause of disease, and the plasma concentrations of proangiogenic and antiangiogenic factors released by the placenta can reflect the risks of disease progression. Antiangiogenic proteins, such as soluble fms-like tyrosine kinase 1 (sFlt-1), and proangiogenic, like placental growth factors (PlGF), are directly and inversely correlated with the disease onset, respectively.

Methods

Narrative review on the use of biomarkers (sFlt-1 to PlGF ratio) with a suggested guidance protocol.

Results

Key considerations on the use of biomarkers: the sFlt-1/PlGF ratio is mainly relevant to rule out PE between 20 and 36 6/7 weeks in cases of suspected PE; however, it should not replace the routine exams for the diagnosis of PE. The sFlt-1/PlGF ratio should not be performed after confirmed PE diagnosis (only in research settings). In women with suspected PE, sFlt-1/PlGF ratio < 38 can rule out the diagnosis of PE for 1 week (VPN = 99.3) and up to 4 weeks (VPN= 94.3); sFlt-1/PlGF ratio > 38 does not confirm the diagnosis of PE; however, it can assist clinical management. In cases of severe hypertension and/or symptoms (imminent eclampsia), hospitalization is imperative, regardless of the result of the sFlt-1/PlGF ratio.

Conclusion

The use of biomarkers can help support clinical decisions on the management of suspected PE cases, especially to rule out PE diagnosis, thus avoiding unnecessary interventions, especially hospitalizations and elective prematurity

Key-words Hypertension placental growth factor Preeclampsia preterm preeclampsia soluble fms-like tyrosine kinase 1
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Original Article
COVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021

Views142

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Summary
Original Article
COVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021
DOI 10.1055/s-0041-1733912
Wassan Nori ,
Ban Hadi Hameed ,
Asmaa Rajih Thamir ,
Amenah Fadhil
Views142
Abstract

Objective

To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women.

Methods

A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation.

Results

Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87±66.92 fL for the case group versus 9.84±1.2 fL for the control group; PDW: 14.82±3.18 fL for the case group versus 13.3±2.16 fL for the controls). The criterionvalue of the receiver operating characteristic (ROC) curve forPDWat a cutoffpoint of>11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of>10.17 fL showed a good diagnostic marker.

Conclusion

The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.

Key-words COVID-19 Mean platelet volume platelet distribution width platelet indices Pregnancy
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Short Communication
Surgical Site Infection after Cesarean Delivery in Times of COVID-19
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):374-376
07-30-2021

Views176

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
Short Communication
Surgical Site Infection after Cesarean Delivery in Times of COVID-19
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):374-376
07-30-2021
DOI 10.1055/s-0041-1729144
Vicente Sperb Antonello ,
Jessica Dallé ,
Ivan Carlos Ferreira Antonello ,
Daniela Benzano ,
Mauro Cunha Ramos
Views176
Abstract

Objective

To analyze effects of the COVID-19 pandemic on the consumption of personal protective equipment and products (PPEP), as well as the frequency of surgical site infection (SSI) among non-COVID-19 patients submitted to cesarean sections.

Methods

A retrospective study was conducted in a maternity unity of a public teaching hospital which was not part of the reference service for COVID-19 treatment. It compared PPEP consumption and the occurrence of SSI after cesarean sections in monthly periods before and after the occurrence of the first case of COVID-19 in Porto Alegre, state of Rio Grande do Sul, Brazil. Personal protective equipment and products consumption was measured as units of masks, gloves, gowns, and caps, and use of alcohol-based products or soap for hand sanitation asml/patient/day. The SSI index was calculated as the proportion of cases of SSI over the number of cesarean sections performed monthly during the study period.

Results

There was an increase in all measured items of PPEP, with consumption of disposable masks with a median of 1,450 units in the pre-COVID period, and of 2550 in the post-COVID period (a 75.9% increase). A decrease of 49% in SSI was detected, with a median of 1.74 in the pre-COVID period and of 0.89 in the post-COVID period.

Conclusion

The increase in consumption of PPEP could be a result of safer practices adopted by healthcare workers with the advent of COVID-19, of which the following reduction in the occurrence of SSI could be a direct consequence. Despite the severity of the crisis, one could state that extreme situations can lead to valuable reflections and opportunities for improvement.

Key-words Cesarean section coronavirus personal protective equipment Surgical wound infection
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Original Article
Difficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
- Lorgio Rudy Aguilera ,
- Luz Mariana Mojica-Palacios ,
- Federico Urquizu ,
- Mirko Gorena ,
- Freddy Tinajeros Guzmán ,
- Albaro José Nieto-Calvache
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
04-26-2022

Views112

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Summary
Original Article
Difficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
04-26-2022
DOI 10.1055/s-0042-1742408
Lorgio Rudy Aguilera ,
Luz Mariana Mojica-Palacios ,
Federico Urquizu ,
Mirko Gorena ,
Freddy Tinajeros Guzmán ,
Lina María Vergara Galliadi ,
Alejandra Hidalgo ,
Albaro José Nieto-Calvache
Views112
Abstract

Objective

Placenta accreta spectrum (PAS) is a serious diseases, and the recommendation is that the treatment is conducted in centers of excellence. Such hospitals are not easy to find in low- and middle-income countries. We seek to describe the process of prenatal diagnosis, surgical management, and postnatal histological analysis in a low-income country referral hospital with limited resources.

Methods

A descriptive, retrospective study was carried out including patients with a pre- or intraoperative diagnosis of PAS. The clinical results of the patients were studied as well as the results of the prenatal ultrasound and the correlation with the postnatal pathological diagnosis.

Results

In total, 129 patients were included. Forty-eight of them had a prenatal PAS ultrasound diagnosis (37.2%). In the remaining 81 (62.8%), the diagnosis was intraoperative. Although hysterectomy was performed in all cases, one-third of the patients (31%) did not have a histological study of the uterus. In 40% of the patients who had a histological study, PAS was not reported by the pathologist.

Conclusion

The frequency of prenatal diagnosis and the availability of postnatal histological studies were very low in the studied population. Surgical skill, favored by a high flow of patients, is an important factor to avoid complications in settings with limited resources.

Key-words developing countries Latin America Placenta accreta
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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

Views181

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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
Views181
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
Association between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):256-263
06-18-2021

Views149

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 between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):256-263
06-18-2021
DOI 10.1055/s-0041-1728779
Conceição Christina Rigo Vale ,
Nubia Karla de Oliveira Almeida ,
Renan Moritz Varnier Rodrigues de Almeida
Views149
Abstract

Objective

To investigate the association between prenatal care (PNC) adequacy indexes and the low birth weigth (LBW) outcome.

Methods

A total of 368,093 live term singleton births in the state of Rio de Janeiro (Brazil) from 2015 to 2016 were investigated using data from the Brazilian Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC, in Portuguese). Seven PNC adequacy indexes were evaluated: four developed by Brazilian authors (Ciari Jr. et al., Coutinho et al., Takeda, and an index developed and used by the Brazilian Ministry of Health – MS) and three by authors from other countries (Kessner et al., the Adequacy of Prenatal Care Utilization index – APNCU, and the Graduated Prenatal Care Utilization Index – GINDEX). Adjusted odds ratios were estimated for the PNC adequacy indexes by means of multivariate logistic regression models using maternal, gestational and newborn characteristics as covariates.

Results

When the PNC is classified as “inadequate”, the adjusted odds ratios to the LBWoutcome increase between 42% and 132%, depending on which adequacy index is evaluated. Younger (15 to 17 years old) and older (35 to 45 years old) mothers, those not married, of black or brown ethnicity, with low schooling (who did not finish Elementary School), primiparous, with preterm births, as well as female newborns had increasing odds for LBW. The models presented areas under the receiver operating characteristic (ROC) curve between 80.4% and 81.0%, and sensitivity and specificity that varied, respectively, between 57.7% and 58.6% and 94.3% and 94.5%.

Conclusion

Considering all PNC adequacy indexes evaluated, the APNCU had the best discriminatory power and the best ability to predict the LBW outcome.

Key-words Low birth weight maternal and newborn health perinatal epidemiology Prenatal care
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ISSUE

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

Screening of breast cancer metastasis at preoperative work-up

Second-degree family history as a risk factor for breast cancer

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

A randomized trial of misoprostol and placebo for cervical ripening and induction of labor

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

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Result:

Conclusion:

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

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Results:

Conclusion:

Vascular contraction of umbilical arteries of pregnant women with preeclampsia

Abstract

Objective:

Methods:

Results:

Conclusion:

Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review

Abstract

Objective

Methods

Results

Conclusion

Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women

Abstract

Objective

Methods

Results

Conclusion

Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers

Abstract

Objective

Methods

Results

Conclusion

COVID-19 in Pregnancy: Implication on Platelets and Blood Indices

Abstract

Objective

Methods

Results

Conclusion