Articles - Revista Brasileira de Ginecologia e Obstetrícia

Editorial
Ética em pesquisa
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):494-494
04-09-1998

Views45

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Summary
Editorial
Ética em pesquisa
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):494-494
04-09-1998
DOI 10.1590/S0100-72031998000900001
Views45
Ética em Pesquisa […]
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Resumos de Teses
Estudo Controlado e Randomizado para Prevenção de Infecção Pós-Cesárea com Penicilina e Cefalotina
- Moisés Mendonça Neto
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):424-424
04-09-1998

Views40

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
Estudo Controlado e Randomizado para Prevenção de Infecção Pós-Cesárea com Penicilina e Cefalotina
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):424-424
04-09-1998
DOI 10.1590/S0100-72031998000700011
Moisés Mendonça Neto
Views40
Estudo Controlado e Randomizado para Prevenção de Infecção Pós-Cesárea com Penicilina e Cefalotina […]
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Resumos de Teses
Estudo Morfológico e Morfométrico do Endométrio de Mulheres na Pós-Menopausa Durante Terapêutica Estrogênica Contínua, Associada ao Acetato de Medroxiprogesterona a Cada Dois, Três e Quatro Meses
- Cláudia de Carvalho Ramos Bortoletto
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-423
04-09-1998

Views35

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
Estudo Morfológico e Morfométrico do Endométrio de Mulheres na Pós-Menopausa Durante Terapêutica Estrogênica Contínua, Associada ao Acetato de Medroxiprogesterona a Cada Dois, Três e Quatro Meses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-423
04-09-1998
DOI 10.1590/S0100-72031998000700009
Cláudia de Carvalho Ramos Bortoletto
Views35
Estudo Morfológico e Morfométrico do Endométrio de Mulheres na Pós-Menopausa Durante Terapêutica Estrogênica Contínua, Associada ao Acetato de Medroxiprogesterona a Cada Dois, Três e Quatro Meses[…]
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Resumos de Teses
Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada – Recife (PE)
- Welkovic Stefan
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-424
04-09-1998

Views38

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Summary
Resumos de Teses
Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada – Recife (PE)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-424
04-09-1998
DOI 10.1590/S0100-72031998000700010
Welkovic Stefan
Views38
Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada Recife (PE) […]
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Relato de Caso
Complete Mole in Twin Pregnancy: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):415-419
04-09-1998

Views72

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Summary
Relato de Caso
Complete Mole in Twin Pregnancy: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):415-419
04-09-1998
DOI 10.1590/S0100-72031998000700008
Izildinha Maestá,
Iracema M.P. Calderon,
Marilza V.C. Rudge,
Magaly M. Sales,
Fabiano P. Saggioro,
José Carlos Peraçoli
Views72
Twin pregnancy in which a normal fetus and a complete mole develop at the same time is a rare event. Clinical complications and malignancy are frequent in this type of disease.This report is about a case of a late diagnosis due to the presence of the fetus. The diagnosis was made when the pregnancy was interrupted and then confirmed by histopathological study and flow cytometry. The pregnancy was terminated transpelvically due to massive uterine hemorrhage. The post-molar follow-up showed the persistence of high levels of bhCG. The patient’s complete recovery was achieved after the administration of methotrexate. The diagnosis, natural history, and procedures for this rare disease are discussed in view of this case.

Key-words Chemotherapy Complete hydatidiform mole Gestational trophoblastic disease Hemorrhage Pregnancy complications Twin pregnancy Ultrasonography
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Relato de Caso
Clear Cell Adenocarcinoma of the Endocervix in a 7-year-old Child
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):411-414
04-09-1998

Views86

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Summary
Relato de Caso
Clear Cell Adenocarcinoma of the Endocervix in a 7-year-old Child
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):411-414
04-09-1998
DOI 10.1590/S0100-72031998000700007
Marta Francis Benevides Rehme,
Mauro Fernando Kürten Ihlenfeld,
Ana Carolina Silva Chuery
Views86
Clear cell adenocarcinoma of the vagina and cervix is a rare disease associated commonly with the use of diethylstilbestrol (DES) during pregnancy. The most commom complaint is irregular vaginal bleeding, which could be confused with vaginitis in children and abnormalities in the hypothalamic-pituitary axis in adolescents. We report a case of clear cell adenocarcinoma of the endocervix in a 7-year-old child who was attended at the Children and Adolescent Gynecology Sector, and we call attention to the diagnosis of genital cancer which, in spite of its rarity at this age, must be considered in children with genital bleeding.

Key-words Carcinoma Childhood and adolescence Uterine cervix Vaginal cancer
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Equipamentos e Métodos
Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):405-410
04-09-1998

Views78

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
Equipamentos e Métodos
Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):405-410
04-09-1998
DOI 10.1590/S0100-72031998000700006
Caio Parente Barbosa,
Marcelo Ettruri Santos,
Ana Cristina Napolitano,
Paula Harue Tamanaka,
Emerson Barchi Cordts
Views78
Objective: to demonstrate the effectiveness of video-hysteroscopic endometrial resection in the treatment of abnormal uterine bleeding. Patients and method: The authors studied 60 records of patients with abnormal uterine bleeding who did not respond to clinical treatment. Results: eighty-eight percent of the patients had adequate response to the treatment (53% oligomenorrhea and 35% amenorrhea). The complication rate was 8.3% (5 uterine perforations). Conclusion: video-hysteroscopic endometrial resection is an effective technique to treat abnormal uterine bleeding which failed to respond to clinical management. The intra and postoperative complication rates are low.

Key-words Endometrial hyperplanaresection Hysteroscopy
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Trabalhos Originais
Maternal Mortality in São Paulo City in 1996
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403
04-09-1998

Views103

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Summary
Trabalhos Originais
Maternal Mortality in São Paulo City in 1996
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403
04-09-1998
DOI 10.1590/S0100-72031998000700005
Luis Carlos Pazero,
Paulo Afonso Ferrigno Marcus,
Carlos Eduardo Pereira Vega,
Krikor Boyaciyan,
Sônia Antonini Barbosa
Views103
Purpose: to establish a list of diseases promoting maternal death according to frequency. Methods: In 1996, 65,406 deaths were recorded in the City of São Paulo, 26,778 of which were of women. Of these, 4591 were within the 10-49 year age bracket. We analyzed the latter group, regarding at the field “Cause of Death” in the Death Certificate, trying to establish some correlation between the described pathology, and the pregnancy-puerperium cycle. We separated for a further study 293 Death Certificates, from which we selected, after hospital survey and/or home visits, a total of 119 positive cases for maternal death. The positive cases for maternal death were then tabulated, grouped and analyzed according to age and pathology, using the great medical care groups. Results: as regards the 119 positive cases for maternal death, we did not find any reference to the pregnancy-puerperium state in 53 of them (that is, 40.54% subnotifying). The cases were grouped according to pathology, where we found a predominance of eclampsia/pre-eclampsia cases (18.02%), followed by cases resulting from hemorrhagic complications in the third quarter and puerperium (12.61%), abortion complications (12.61%), puerperal infection (9.91%) and cardiopathies (9.91%). Conclusions: for the first time, we are publishing the Late Maternal Mortality Coefficient for the City of São Paulo, which was 51.33/100,000 born alive. However, we used for the official publication the Maternal Mortality Coefficient for death within up to 42 days of puerperium, which was, 48.03/100,000 born alive for the city of São Paulo. We should bear in mind that no correction factor should be applied to these figures since we have made an active search of cases.

Key-words Cardiopathy in pregnancy Eclampsia Hemorrhagic complications in pregnancy Maternal mortality Maternal mortality coefficient Pregnancy complications
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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

Views460

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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
Views460
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

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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

Views447

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
Views447
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

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
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
Views434
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

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
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

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
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
Comparison of Automated Breast Ultrasound and Hand-Held Breast Ultrasound in the Screening of Dense Breasts
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):190-199
05-24-2021

Views229

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
Comparison of Automated Breast Ultrasound and Hand-Held Breast Ultrasound in the Screening of Dense Breasts
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):190-199
05-24-2021
DOI 10.1055/s-0040-1722156
Fernanda Philadelpho ,
Maria Julia Gregorio Calas ,
Gracy de Almeida Coutinho Carneiro ,
Isabela Cunha Silveira ,
Andréia Brandão Ribeiro Vaz ,
Adriana Maria Coelho Nogueira ,
Anke Bergmann ,
Flávia Paiva Proença Lobo Lopes
Views229
Abstract

Objective

To compare hand-held breast ultrasound (HHBUS) and automated breast ultrasound (ABUS) as screening tool for cancer.

Methods

A cross-sectional study in patients with mammographically dense breasts was conducted, and both HHBUS and ABUS were performed. Hand-held breast ultrasound was acquired by radiologists and ABUS by mammography technicians and analyzed by breast radiologists. We evaluated the Breast Imaging Reporting and

Data System

(BI-RADS) classification of the exam and of the lesion, as well as the amount of time required to perform and read each exam. The statistical analysis employed was measures of central tendency and dispersion, frequencies, Student t test, and a univariate logistic regression, through the odds ratio and its respective 95% confidence interval, and with p<0.05 considered of statistical significance.

Results

Atotal of 440 patientswere evaluated. Regarding lesions,HHBUS detected 15 (7.7%) BI-RADS 2, 175 (89.3%) BI-RADS 3, and 6 (3%) BI-RADS 4, with 3 being confirmed by biopsy as invasive ductal carcinomas (IDCs), and 3 false-positives. Automated breast ultrasound identified 12 (12.9%) BI-RADS 2, 75 (80.7%) BI-RADS 3, and 6 (6.4%) BI-RADS 4, including 3 lesions detected by HHBUS and confirmed as IDCs, in addition to 1 invasive lobular carcinoma and 2 high-risk lesions not detected by HHBUS. The amount of time required for the radiologist to read the ABUS was statistically inferior compared with the time required to read the HHBUS (p<0.001). The overall concordance was 80.9%. A total of 219 lesions were detected, from those 70 lesions by both methods, 126 only by HHBUS (84.9% not suspicious by ABUS) and 23 only by ABUS.

Conclusion

Compared with HHBUS, ABUS allowed adequate sonographic study in supplemental screening for breast cancer in heterogeneously dense and extremely dense breasts.

Key-words automated breast ultrasound Breast cancer dense breast hand-held breast ultrasound Screening
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Review Article
Main Complications during Pregnancy and Recommendations for Adequate Antenatal Care in Sickle Cell Disease: A Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):593-601
02-09-2022

Views246

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
Main Complications during Pregnancy and Recommendations for Adequate Antenatal Care in Sickle Cell Disease: A Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):593-601
02-09-2022
DOI 10.1055/s-0042-1742314
Camilla Olivares Figueira ,
Fernanda Garanhani Surita ,
Kleber Fertrin ,
Guilherme de Moraes Nobrega ,
Maria Laura Costa
Views246
Abstract

Sickle cell disease (SCD) is the most common monogenic disease worldwide, with a variable prevalence in each continent. A single nucleotide substitution leads to an amino-acid change in the β-globin chain, altering the normal structure of hemoglobin, which is then called hemoglobin S inherited in homozygosity (HbSS) or double heterozygosity (HbSC, HbSβ), and leads to chronic hemolysis, vaso-occlusion, inflammation, and endothelium activation. Pregnant women with SCD are at a higher risk of developing maternal and perinatal complications. We performed a narrative review of the literature considering SCD and pregnancy, the main clinical and obstetrical complications, the specific antenatal care, and the follow-up for maternal and fetal surveillance. Pregnant women with SCD are at a higher risk of developing clinical and obstetric complications such as pain episodes, pulmonary complications, infections, thromboembolic events, preeclampsia, and maternal death. Their newborns are also at an increased risk of developing neonatal complications: fetal growth restriction, preterm birth, stillbirth. Severe complications can occur in patients of any genotype. We concluded that SCD is a high-risk condition that increases maternal and perinatal morbidity and mortality. A multidisciplinary approach during pregnancy and the postpartum period is key to adequately diagnose and treat complications.

Key-words Maternal morbidity Maternal mortality Pregnancy sickle cell disease
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Original Article
Postplacental Placement of Intrauterine Devices: Acceptability, Reasons for Refusal and Proposals to Increase its Use
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):172-177
05-24-2021

Views203

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Summary
Original Article
Postplacental Placement of Intrauterine Devices: Acceptability, Reasons for Refusal and Proposals to Increase its Use
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):172-177
05-24-2021
DOI 10.1055/s-0041-1725053
Maria Beatriz de Paula Leite Kraft ,
Mariana Miadaira ,
Marcos Marangoni Júnior ,
Cássia Raquel Teatin Juliato ,
Fernanda Garanhani Surita
Views203
Abstract

Objective

To evaluate the acceptability of postplacental placement of intrauterine devices (PPIUD), reasons for refusal and suggested policies to increase its use.

Methods

Cross-sectional study conducted at the Women Hospital of the Universidade de Campinas, Campinas, SP, Brazil. Postplacental placement of intrauterine devices was offered to women admitted in labor who did not present infections, uterinemalformation, twin pregnancy, preterm birth, and were at least 18 years old. In case of refusal, the parturient was asked to give their reasons and the answers were classified as misinformation about contraception or other reasons. The following were considered misinformation: fear of pain, bleeding, contraception failure and future infertility. Bivariate analysis was performed.

Results

Amongst 241 invited women, the refusal rate was of 41.9%. Misinformation corresponded to 50.5% of all refusals, and the reasons were: fear of pain (39.9%); fear of contraception failure (4.9%); fear of bleeding (3.9%); fear of future infertility (1.9%); other reasons for refusal were 49.5%. Parturients aged between 18 and 27 years old refused the PPIUD more frequently due to misinformation (67.4%), and older parturients (between 28 and 43 years old) refused frequently due to other reasons (63.6%) (p=0.002). Themean age of those who declined the PPIUD due to misinformation was 27.3 ± 6.4 years old, while those who declined for other reasons had a mean age of 29.9 ± 5.9 years old (p=0.017).

Conclusion

The refusal of the PPIUD was high, especially amongst young women and due to misinformation. It is necessary to develop educative measures during antenatal care to counsel women about contraception, reproductive health and consequences of unintended pregnancy.

Key-words Contraception Health education Intrauterine device Postpartum
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Original Article
Understanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):648-654
11-29-2021

Views172

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Summary
Original Article
Understanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):648-654
11-29-2021
DOI 10.1055/s-0041-1733997
Silvana Ferreira Bento ,
Anderson Borovac-Pinheiro ,
Erika Zambrano Tanaka ,
Carla Silveira ,
Rodolfo Carvalho Pacagnella
Views172
Abstract

Objective

To identify how health providers recognize postpartum hemorrhage early and the difficulties involved in it.

Methods

An exploratory, descriptive study using a qualitative approach through a semi-structured interview technique. In total, 27 health professionals (nursing tech nicians, nurses, medical residents in Gynecology and Obstetrics, hired medical doctors, and medicine professors) working in a tertiary-level hospital of reference in women’s health care in the State of São Paulo, Brazil, participated in the study through an invitation. After they accepted the invitation, they signed the free and informed consent form. All interviews were recorded and transcribed, and a thematic analysis was conducted. We found three analysis categories: a) perception of the severity: “there is something wrong with the women”; b) difficulties in the early diagnosis of postpartum hemorrhage; and c) the process to improve obstetrical care.

Results

Caregivers believe teamwork and communication should be improved. Besides the visual estimation of blood loss, the nursing team is attentive to behavioral symptoms like irritability, while the medical staff follow protocols and look for objective signs, such as altered vital signs.

Conclusion

Besides the objective evaluations, the subjective perceptions of the providers are involved in the clinical judgement regarding the diagnosis of postpartum hemorrhage, and this should be included in a broader diagnosis strategy.

Key-words clinical judgment Diagnosis health professionals Postpartum hemorrhage qualitative research
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Original Article
Cervical Cancer Screening with HPV Testing: Updates on the Recommendation
- Carla Fabrine Carvalho ,
- Julio Cesar Teixeira ,
- Joana Froes Bragança ,
- Sophie Derchain ,
- Luiz Carlos Zeferino ,
- Diama Bhadra Vale
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):264-271
02-15-2022

Views271

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Summary
Original Article
Cervical Cancer Screening with HPV Testing: Updates on the Recommendation
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):264-271
02-15-2022
DOI 10.1055/s-0041-1739314
Carla Fabrine Carvalho ,
Julio Cesar Teixeira ,
Joana Froes Bragança ,
Sophie Derchain ,
Luiz Carlos Zeferino ,
Diama Bhadra Vale
Views271
Abstract

The present update is a reassessment of the 2018 ‘Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil’ (Zeferino et al.)9, according to the changes observed in new international guidelines and knowledge updates. The most relevant and recent guidelines were assessed. Questions regarding the clinical practice were formulated, and the answers considered the perspective of the public and private sectors of the Brazilian health system. The review addressed risk-based strategies regarding age to start and stop screening, the use of cytology and colposcopy to support management decisions, treatment, follow-up strategies, and screening in specific groups, including vaccinated women. The update aims to improve the prevention of cervical cancer and to reduce overtreatment and the misuse of HPV testing.

Key-words accessibility of health services early detection of cancer human papillomavirus DNA tests Mass screening Uterine cervical neoplasms
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Original Article
Concordance Between Clinical and Laboratory Diagnosis of Abnormal Vaginal Discharge in Chilean Women
- Angélica Melo ,
- Ximena Ossa ,
- Giselle Fetis ,
- Lorena Lazo ,
- Luis Bustos ,
- Flery Fonseca-Salamanca
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):600-607
11-15-2021

Views175

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
Concordance Between Clinical and Laboratory Diagnosis of Abnormal Vaginal Discharge in Chilean Women
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):600-607
11-15-2021
DOI 10.1055/s-0041-1735299
Angélica Melo ,
Ximena Ossa ,
Giselle Fetis ,
Lorena Lazo ,
Luis Bustos ,
Flery Fonseca-Salamanca
Views175
Abstract

Objective

To determine the concordance between the clinical diagnosis of women with abnormal vaginal discharge (AVD) and laboratory results using molecular detection and observation of the vaginal microbiota.

Methods

Cross-sectional study conducted in 2018 in Temuco, Chile. A total of 25 midwives from 12 health centers participated. A total of 125 women>18 years old, volunteers, were recruited. The sample of the posterior vaginal fornix was obtained by speculoscopy. Characteristics of the discharge and of the external and internal genitalia were observed. Gram staining was used to observe vaginal microbiota, blastoconidia and pseudohyphae, and polymerase chain reaction was used for the detection of Trichomonas vaginalis and Candida albicans. The Cohen kappa coefficient was used in the concordance analysis.

Results

Out of a total of 125 women with AVD, 85.6% consulted spontaneously and 14.4% were diagnosed clinically during a routine check-up. Absolute concordance was significant (p=0.0012), with an agreement of 13.6%. The relative concordance was significant, but fair for bacterial vaginosis (Kappa=0.21; p=0.003) and candidiasis (Kappa=0.22; p=0.001), and slight for trichomoniasis (Kappa=0.14; p=0.009). The percentage of coincidence of the diagnoses (single or mixed) by laboratory and midwives was: bacterial vaginosis 63.2% (12/19), candidiasis 36.5% (27/74), and trichomoniasis 12.5% (4/32). There was 20% coinfection. A total of 36% of the clinical diagnoses of AVD had negative laboratory tests.

Conclusion

The vulvovaginitis conditions candidiasis and trichomoniasis appear to be overdiagnosed, and bacterial vaginosis appears to be underdiagnosed by the clinical diagnosis when compared with the laboratory diagnosis. The low concordance obtained shows the importance of complementing the clinical diagnosis with a laboratory study of AVD, particularly in women with failed treatments and/or coinfections with unspecific and varying signs and symptoms.

Key-words Bacterial vaginosis Candidiasis laboratory diagnosis trichomonas vaginalis Vaginal discharge
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Original Article
Postoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo ,
- Omar Féres
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1040-1046
01-23-2022

Views113

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Summary
Original Article
Postoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1040-1046
01-23-2022
DOI 10.1055/s-0042-1756212
Rogério Serafim Parra ,
Fernando Passador Valério ,
José Vitor Cabral Zanardi ,
Marley Ribeiro Feitosa ,
Hugo Parra Camargo ,
Omar Féres
Views113
Abstract

Objective

The purpose was to assess the rates of postoperative complications and the need of temporary stoma of laparoscopic surgical treatment for bowel endometriosis in a referral center.

Methods

The surgical indication, type of operation, operative time, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, postoperative complications were evaluated.

Results

One-hundred and fifty patients were included. The average duration of surgery was significantly longer for segmental resection (151 minutes) than for disc excision (111.5 minutes, p < 0.001) and shaving (96.8 minutes, p < 0.001). Patients with segmental resection had longer postoperative lengths of hospital stay (1.87 days) compared with patients with disc excision (1.43 days, p < 0.001) and shaving (1.03 days, p < 0.001). A temporary stoma was performed in 2.7% of patients. Grade II and III postoperative complications occurred in 6.7% and 4.7% patients, respectively.

Conclusion

Laparoscopic intestinal resection has an acceptable postoperative complication rate and a low need for a temporary stoma.

Key-words colorectal surgery Endometriosis Laparoscopy Postoperative complications surgical stomas
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Review Article
The Effect of Neuromodulatory Drugs on the Intensity of Chronic Pelvic Pain in Women: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):891-898
08-31-2022

Views145

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
The Effect of Neuromodulatory Drugs on the Intensity of Chronic Pelvic Pain in Women: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):891-898
08-31-2022
DOI 10.1055/s-0042-1755459
Marcela Almeida Andrade ,
Leila Cristina Soares ,
Marco Aurélio Pinho de Oliveira
Views145
Abstract

Objective:

To evaluate the effect of neuromodulatory drugs on the intensity of chronic pelvic pain (CPP) in women.

Data sources:

Searches were carried out in the PubMed, Cochrane Central, Embase, Lilacs, OpenGrey, and Clinical Trials databases.

Selection of studies:

The searches were carried out by two of the authors, not delimiting publication date or original language. The following descriptors were used: chronic pelvic pain in women OR endometriosis, associated with MESH/ENTREE/DeCS: gabapentinoids, gabapentin, amitriptyline, antidepressant, pregabalin, anticonvulsant, sertraline, duloxetine, nortriptyline, citalopram, imipramine, venlafaxine, neuromodulation drugs, acyclic pelvic pain, serotonin, noradrenaline reuptake inhibitors, and tricyclic antidepressants, with the Boolean operator OR. Case reports and systematic reviews were excluded.

Data collection:

The following data were extracted: author, year of publication, setting, type of study, sample size, intervention details, follow-up time, and results.

Data synthesis:

A total of 218 articles were found, with 79 being excluded because they were repeated, leaving 139 articles for analysis: 90 were excluded in the analysis of the titles, 37 after reading the abstract, and 4 after reading the articles in full, and 1 could not be found, therefore, leaving 7 articles that were included in the review.

Conclusion:

Most of the studies analyzed have shown pain improvement with the help of neuromodulators for chronic pain. However, no improvement was found in the study with the highest statistical power. There is still not enough evidence that neuromodulatory drugs reduce the intensity of pain in women with CPP.

Key-words Chronic pelvic pain gabapentin management neuromodulations drugs sertraline
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Estudo Controlado e Randomizado para Prevenção de Infecção Pós-Cesárea com Penicilina e Cefalotina

Estudo Morfológico e Morfométrico do Endométrio de Mulheres na Pós-Menopausa Durante Terapêutica Estrogênica Contínua, Associada ao Acetato de Medroxiprogesterona a Cada Dois, Três e Quatro Meses

Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada – Recife (PE)

Complete Mole in Twin Pregnancy: a Case Report

Clear Cell Adenocarcinoma of the Endocervix in a 7-year-old Child

Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital

Maternal Mortality in São Paulo City in 1996

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

Abstract

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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:

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

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Result:

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:

Comparison of Automated Breast Ultrasound and Hand-Held Breast Ultrasound in the Screening of Dense Breasts

Abstract

Objective

Methods

Data System

Results

Conclusion

Main Complications during Pregnancy and Recommendations for Adequate Antenatal Care in Sickle Cell Disease: A Literature Review

Abstract

Postplacental Placement of Intrauterine Devices: Acceptability, Reasons for Refusal and Proposals to Increase its Use

Abstract

Objective

Methods

Results

Conclusion

Understanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study

Abstract

Objective

Methods

Results

Conclusion

Cervical Cancer Screening with HPV Testing: Updates on the Recommendation

Abstract

Concordance Between Clinical and Laboratory Diagnosis of Abnormal Vaginal Discharge in Chilean Women