Articles - Revista Brasileira de Ginecologia e Obstetrícia

Review Article12-04-2024

Female genital tract microbiome: the influence of probiotics on assisted reproduction
- Ana Sofia Almeida Santana ,
- Ana Margarida Póvoa
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo82

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Abstract
Review Article
Female genital tract microbiome: the influence of probiotics on assisted reproduction
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo82
DOI 10.61622/rbgo/2024rbgo82
Ana Sofia Almeida Santana ,
Ana Margarida Póvoa
Views210
Abstract

Assisted reproductive technology (ART) has been evolving since 1978, with the number of techniques performed increasing over the years. Despite continued advances, some couples continue to have difficulties getting pregnant, and it has recently been considered that the microbiome of the female genital tract (FGT) may influence embryo implantation and the establishment of pregnancy. This review aims to evaluate the role of probiotics on reproductive outcomes in infertile women on ART. A search throughout medical databases was performed, and six articles met the criteria. Five studies showed improvements in pregnancy rates, with only one demonstrating statistical significance. One article showed no improvement but reported a statistically significant reduction in the miscarriage rate in the probiotic group. Further research is needed to evaluate the true potential of probiotics, namely to assess whether they effectively modulate the FGT microbiome and if these changes are maintained over time.

Key-words Abortion, spontaneous Embryo implantation Genitalia, female Infertility, female Pregnancy outcome Pregnancy rate Probiotics Reproductive techniques, assisted, Microbiota
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Original Article12-04-2024

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

Views252

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Abstract
Original Article
Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo81
DOI 10.61622/rbgo/2024rbgo81
Maria Elisa Franciscatto ,
Juliana Bosso Taniguchi ,
Raquel Wohlenberg ,
Isadora Luísa Riedi ,
Karen Oppermann
Views252
Abstract

Objective:

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

Methods:

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

Results:

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

Conclusion:

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

Key-words Alcohol drinking Hyperandrogenism metabolic syndrome non-alcoholic fatty liver disease Obesity Polycystic ovary syndrome Waist circumference
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Review Article12-04-2024

Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo79

Views272

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Abstract
Review Article
Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo79
DOI 10.61622/rbgo/2024rbgo79
Juliana Almeida Oliveira ,
Karine Eskandar ,
Marcos Aurélio Araújo Freitas ,
Chris Elizabeth Philip
Views272
Abstract

Objective:

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

Methods:

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

Results:

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

Conclusion:

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

Key-words Major depressive disorder postpartum depression Synthetic neurosteroid Zuranolone
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Review Article12-04-2024

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

Views244

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Self-medication among pregnant women in comparison to the general population: a scoping review of the main characteristics
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo77
DOI 10.61622/rbgo/2024rbgo77
Gabriela Pereira ,
Cinthia Madeira de Souza ,
Amanda Canato Ferracini ,
Fernanda Garanhani Surita ,
Sherif Eltonsy ,
Priscila Gava Mazzola
Views244
Abstract

Objective:

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

Methods:

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

Results:

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

Conclusions:

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

Key-words drug-related side effects and adverse reactions Medication use Pregnant women Self-medication
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FEBRASGO POSITION STATEMENT11-25-2024

Nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS11

Views171

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Abstract
FEBRASGO POSITION STATEMENT
Nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS11
DOI 10.61622/rbgo/2024FPS11
Andrea Prestes Nácul ,
Ana Carolina Japur Sá Rosa e Silva ,
Daniela Angerame Yela ,
Sebastião Freitas de Medeiros ,
José Maria Soares Júnior ,
Gabriela Pravatta Rezende Antoniassi ,
Lia Cruz da Costa Damásio ,
Técia Maria de Oliveira Maranhão ,
Gustavo Arantes Rosa Maciel ,
Cristina Laguna Benetti-Pinto
Views171
Key points[…]
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FEBRASGO POSITION STATEMENT11-14-2024

Challenges and strategies in adolescent vaccination: Number 12 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS12

Views164

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
FEBRASGO POSITION STATEMENT
Challenges and strategies in adolescent vaccination: Number 12 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS12
DOI 10.61622/rbgo/2024FPS12
Cecília Maria Roteli-Martins ,
Renato de Ávila Kfouri ,
André Luís Ferreira Santos
Views164
Key points[…]
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Letter to the Editor10-23-2024

The gynecologist and cancer in women
- Iolanda Matias Gomes
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo92

Views136

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Abstract
Letter to the Editor
The gynecologist and cancer in women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo92
DOI 10.61622/rbgo/2024rbgo92
Iolanda Matias Gomes
Views136
Cervical cancer continues to claim an alarming number of victims around the world, especially among poor women. In Brazil, in 2022, an incidence of 16.3/100,000 women was recorded,() with a projection for 2023 of 17,010 new cases, corresponding to a rate of 15.38/100,000, representing 7% of tumors in women.In the Brazilian reality, where there is […]
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Original Article10-23-2024

Nipple-sparing mastectomy in young versus elderly patients
- Antônio Luiz Frasson ,
- Isabela Miranda ,
- Betina Vollbrecht ,
- Carolina Malhone ,
- Ana Beatriz Falcone ,
- Martina Lichtenfels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo90

Views160

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Abstract
Original Article
Nipple-sparing mastectomy in young versus elderly patients
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo90
DOI 10.61622/rbgo/2024rbgo90
Antônio Luiz Frasson ,
Isabela Miranda ,
Betina Vollbrecht ,
Carolina Malhone ,
Ana Beatriz Falcone ,
Fernanda Barbosa ,
Francisco Pimentel Cavalcante ,
Martina Lichtenfels
Views160
Abstract

Objective:

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

Methods:

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

Results:

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

Conclusion:

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

Key-words Age factors Breast neoplasm Breast neoplasms Mastectomy Nipples subcutaneous Young adult
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Editorial00-00-2024

RBGO – A journal to support gynecology and obstetrics research in Latin America
- Marcos Felipe Silva de Sá
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgoedt1

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Abstract
Editorial
RBGO – A journal to support gynecology and obstetrics research in Latin America
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgoedt1
DOI 10.61622/rbgo/2024EDT01
Marcos Felipe Silva de Sá
Views430
In 2016, the Brazilian Federation of the Gynecology and Obstetrics Associations – FEBRASGO began a major restructuring process of the RBGO – Revista Brasileira de Ginecologia e Obstetrícia with significant changes in its editorial policy. Since that date, after the editorial board was reformulated, the articles began to be published in English with absolute regularity […]
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Original Article00-00-2024

Vascular contraction of umbilical arteries of pregnant women with preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo2

Views423

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Vascular contraction of umbilical arteries of pregnant women with preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo2
DOI 10.61622/rbgo/2024AO02
Gabriela Morelli Zampieri ,
Priscila Rezeck Nunes ,
Joelcio Francisco Abbade ,
Carlos Alan Dias Junior ,
Valeria Cristina Sandrim
Views423
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 Article00-00-2024

Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo9

Views416

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo9
DOI 10.61622/rbgo/2024AO09
Thaís Loureiro Felipe ,
Patrícia Paula da Fonseca Grili ,
Camila Vilarinho Vidigal ,
Ben-Hur Albergaria ,
Geise Ferreira da Cruz ,
José Luiz Marques-Rocha ,
Valdete Regina Guandalini
Views416
Abstract

Objective:

To analyze the amount of muscle and the presence of sarcopenia in postmenopausal women using different methods, verifying the agreement between them as to skeletal muscle mass (SMM).

Methods:

This cross-sectional observational study was conducted with postmenopausal women aged ≥ 50 years. SMM was obtained from a predictive equation, Bioelectrical Impedance (BIA), and Dual Energy X-Ray Absorptiometry (DXA). The skeletal muscle mass index (SMI) and the appendicular skeletal muscle mass index (ASMI) were calculated. The cut-off point of SMI was determined for the population itself. The agreement between the SMI obtained using the different methods was verified. Sarcopenia was diagnosed according to the criteria proposed by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). The significance level adopted for all tests was 5.0%.

Results:

A total of 112 women were evaluated, with an average age of 66.1 ± 5.65 years. Among them, 51.8% were sufficiently active and 43.8% were overweight and obese. The SMI cut-offs were 6.46 kg/m² for the predictive equation and 7.66 kg/m² for BIA, with high sensitivity and specificity. There was an excellent agreement in the identification of SMM by the predictive equation (0.89 [0.824-0.917], p < 0.001) and BIA (0.92 [0.883-0.945], p < 0.001), in reference to DXA. The prevalence of sarcopenia was 0.9%, 1.8%, and 2.7% according to BIA, DXA, and the predictive equation, respectively.

Conclusion:

The predictive equation showed the expected agreement in estimating skeletal muscle mass in postmenopausal women, offering a viable and accurate alternative.

Key-words Anthropometry Bioelectrical impedance Body composition Muscle mass Obesity Overweight Postmenopause sarcopenia Skeletal Muscle
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Original Article00-00-2024

Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study
- Ênio Luis Damaso ,
- Heloisa Bettiol ,
- Viviane Cunha Cardoso ,
- Mariane Nunes de Nadai ,
- Elaine Christine Dantas Moisés ,
- Ricardo Carvalho Cavalli
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo8

Views412

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo8
DOI 10.61622/rbgo/2024AO08
Ênio Luis Damaso ,
Heloisa Bettiol ,
Viviane Cunha Cardoso ,
Mariane Nunes de Nadai ,
Elaine Christine Dantas Moisés ,
Carolina Sales Vieira ,
Ricardo Carvalho Cavalli
Views412
Abstract

Objective:

To identify sociodemographic and reproductive risk factors associated with MetS in women in their fourth decade of life.

Methods:

Cohort study conducted on women born from June 1978 to May 1979 in Ribeirão Preto, Brazil. Sociodemographic, clinical, and obstetric data were collected by interview and clinical evaluation. Univariable and multivariable binomial logistic regression models were constructed to identify the risk factors of metabolic syndrome and the adjusted relative risk (RR) was calculated.

Results:

The cohort included 916 women, and 286 (31.2%) of them have metabolic syndrome. MetS was associated with lack of paid work (RR 1.49; 95% CI 1.14-1.95), marital status of without a partner (RR 1.33; 95% CI 1.03-1.72), low educational level (less than 8 years of schooling [RR 1.72; 95% CI 1.23-2.41], 8 to 12 years of schooling [RR 1.37; 95% CI 1.06-1.76], when compared with more than 12 years of schooling), and teenage pregnancy (RR 2.00; 95% CI 1.45-2.77). There was no association between MetS, and the other covariates studied.

Conclusion:

Metabolic syndrome in a population of women in the fourth decade of life was associated with lack of employment, lack of a partner, low educational level, and teenage pregnancy.

Key-words cohort study metabolic syndrome Obesity Risk factors
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Original Article03-04-2022

Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):452-457

Views411

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Abstract
Original Article
Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):452-457
DOI 10.1055/s-0042-1743095
Tenilson Amaral Oliveira ,
Guilherme Guarany Cardoso Magalhães Luzetti ,
Márcia Maria Auxiliadora Rosalém ,
Corintio Mariani Neto
Views411
Abstract

Objective

To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).

Methods

Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12.

Results

The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis.

Conclusion

There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.

Key-words Depression Postpartum period Pregnancy Prenatal care Risk factors
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Original Article04-09-2024

Impact of doula’s continuous support on serotonin release in parturients: a pilot randomized clinical trial
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo27

Views408

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Impact of doula’s continuous support on serotonin release in parturients: a pilot randomized clinical trial
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo27
DOI 10.61622/rbgo/2024rbgo27
Eleonora de Deus Vieira de Moraes ,
Mayara Segundo Ribeiro ,
Cíntia Erbert ,
Caio Antonio de Campos Prado ,
Elaine Christine Dantas Moisés
Views408
Abstract

Objective:

To evaluate whether the continuous support provided by doulas influences the endogenous release of serotonin in parturients.

Methods:

This pilot study included 24 primigravidae at term. Of these, 12 women received continuous doula support (Experimental Group), whereas the other 12 received the usual assistance without doula support (Control Group). Blood samples were collected from all the women at the active and expulsion stages of labor and at the fourth period of labor (Greenberg period) for evaluation of their serotonin levels using high-performance liquid chromatography.

Results:

The average serotonin concentrations in the control and experimental groups were respectively 159.33 and 150.02 ng/mL at the active stage, 179.13 and 162.65 ng/mL at the expulsion stage, and 198.94 and 221.21 ng/mL at the Greenberg period. There were no statistically significant differences in serotonin concentrations between the two groups at the active and expulsion stages of labor. By contrast, within the experimental group, a significant increase in serotonin concentration was observed in the Greenberg period compared with the levels in the active and expulsion stages (p < 0.05).

Conclusion:

The novelty of this study relies on the ability to correlate the influence of the continuous support offered by doulas with the release of serotonin in parturients, with the results suggesting that the assistance received during labor can modulate the levels of hormone release in the Greenberg period.

Brazilian Registry of Clinical Trials:

RBR-4zjjm4h

Key-words Doulas Humanized delivery Labor Pregnant women Serotonin
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Review Article07-30-2021

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):395-402

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.
Abstract
Review Article
The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):395-402
DOI 10.1055/s-0041-1730289
Alexandra Ruivo Coelho ,
Gonçalo Cardoso ,
Marta Espanhol Brito ,
Inês Neves Gomes ,
Maria João Cascais
Views406
Abstract

In a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, andmenstrual cycle.Onthe other hand, an imbalance causedby low energy availability dueto a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of themost recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote theacquisition ofmore consolidated knowledgeon an undervaluedtheme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.

Key-words Amenorrhea bone health female athlete low energy availability menstrual dysfunction
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Original Article00-00-2024

Outcomes after elevation of serratus anterior fascia flap versus serratus muscle flap in direct-to-implant breast reconstruction following mastectomy: a prospective study
- Lilian de Sá Paz Ramos ,
- Jorge Villanova Biazús
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo13

Views396

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Outcomes after elevation of serratus anterior fascia flap versus serratus muscle flap in direct-to-implant breast reconstruction following mastectomy: a prospective study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo13
DOI 10.61622/rbgo/2024AO13
Lilian de Sá Paz Ramos ,
Jorge Villanova Biazús
Views396
Abstract

Objective:

The purpose of this study was to compare postoperative pain between SF flap and serratus anterior muscle (SM) in direct-to-implant breast reconstruction.

Methods:

This is a prospective cohort study that included 53 women diagnosed with breast cancer who underwent mastectomy and one-stage implant-based breast reconstruction from January 2020 to March 2021. Twenty-nine patients (54.7%) had SF elevation, and 24 patients (45.3%) underwent SM elevation. We evaluated patient-reported early postoperative pain on the first day after surgery. Also, it was reported that all surgical complications in the first month and patient reported outcomes (PROs) were measured with the BRECON 23 questionnaire.

Results:

The serratus fascia group used implants with larger volumes, 407.6 ± 98.9 cc (p < 0.01). There was no significant difference between the fascial and muscular groups regarding the postoperative pain score reported by the patients (2 versus 3; p = 0.30). Also, there was no difference between the groups regarding early surgical complications and PROs after breast reconstruction.

Conclusion:

The use of SF seems to cause less morbidity, which makes the technique an alternative to be considered in breast reconstruction. Although there was no statistical difference in postoperative pain scores between the fascia and serratus muscle groups.

Key-words Breast implants Breast neoplasms breast reconstruction Fascia Mastectomy Pain Postoperative period
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Review Article03-24-2022

Commercial Surrogacy: An Overview
- Pedro Brandão ,
- Nicolás Garrido
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1141-1158

Views355

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Commercial Surrogacy: An Overview
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1141-1158
DOI 10.1055/s-0042-1759774
Pedro Brandão ,
Nicolás Garrido
Views355
Abstract

Objective

Surrogacy is the process in which a woman carries and delivers a baby to other person or couple, known as intended parents. When carriers are paid for surrogacy, this is known as commercial surrogacy. The objective of the present work is to review the legal, ethical, social, and cultural aspects of commercial surrogacy, as well as the current panorama worldwide.

Methods

This is a review of the literature published in the 21^st century on commercial surrogacy.

Results

A total of 248 articles were included as the core of the present review. The demand for surrogate treatments by women without uterus or with important uterine disorders, single men and same-sex male couples is constantly increasing worldwide. This reproductive treatment has important ethical dilemmas. In addition, legislation defers widely worldwide and is in constant change. Therefore, patients look more and more for treatments abroad, which can lead to important legal problems between countries with different laws. Commercial surrogacy is practiced in several countries, in most of which there is no specific legislation. Some countries have taken restrictive measures against this technique because of reports of exploitation of carriers.

Conclusion

Commercial surrogacy is a common practice, despite important ethical and legal dilemmas. As a consequence of diverse national legislations, patients frequently resort to international commercial surrogacy programs. As of today, there is no standard international legal context, and this practice remains largely unregulated.

Key-words Bioethics Fertilization in vitro legislation medical medical tourism surrogacy
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Review Article07-30-2021

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):395-402

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.
Abstract
Review Article
The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):395-402
DOI 10.1055/s-0041-1730289
Alexandra Ruivo Coelho ,
Gonçalo Cardoso ,
Marta Espanhol Brito ,
Inês Neves Gomes ,
Maria João Cascais
Views406
Abstract

In a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, andmenstrual cycle.Onthe other hand, an imbalance causedby low energy availability dueto a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of themost recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote theacquisition ofmore consolidated knowledgeon an undervaluedtheme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.

Key-words Amenorrhea bone health female athlete low energy availability menstrual dysfunction
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Original Article03-04-2022

Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):452-457

Views411

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):452-457
DOI 10.1055/s-0042-1743095
Tenilson Amaral Oliveira ,
Guilherme Guarany Cardoso Magalhães Luzetti ,
Márcia Maria Auxiliadora Rosalém ,
Corintio Mariani Neto
Views411
Abstract

Objective

To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).

Methods

Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12.

Results

The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis.

Conclusion

There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.

Key-words Depression Postpartum period Pregnancy Prenatal care Risk factors
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Original Article04-08-2022

Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil
- Ana Paula Rodrigues Rezende ,
- Fernanda Rassi Alvarenga ,
- Marcelo Ramos ,
- Débora Luiza Franken ,
- Juvenal Soares Dias da Costa ,
- Vera Maria Vieira Paniz
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141

Views312

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141
DOI 10.1055/s-0041-1741456
Ana Paula Rodrigues Rezende ,
Fernanda Rassi Alvarenga ,
Marcelo Ramos ,
Débora Luiza Franken ,
Juvenal Soares Dias da Costa ,
Marcos Pascoal Pattussi ,
Vera Maria Vieira Paniz
Views312
Abstract

Objective

To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in university students, the factors associated with PMS, the most prevalent symptoms, and the interference of symptoms in academic, family, social, and work activities.

Methods

This cross-sectional study included 1,115 university students aged ≥ 18 years from the University of Rio Verde, Goiás. Premenstrual syndrome and PMDD were identified using the Premenstrual Symptoms Screening Tool. Associations with sociodemographic, behavioral, reproductive, nutritional, and health factors were investigated using the Poisson regression.

Results

The prevalence of PMS was 46.9% (95% confidence interval [CI] 44.0-49.8), and of PMDD, 11.1% (95% CI 9.3-13.0). The most prevalent symptoms were physical, such as breast tenderness, bloating, e weight gain (73%); followed by psychological ones such as overeating/food cravings, tearful/more sensitive to rejection (> 60%). More than 30% of the patients reported that the symptoms interfered in a moderate-tosevere way in their social and academic activities. After adjusted analysis, PMS was more prevalent in those who were attending the 1st/2nd semester of college (prevalence ratio [PR] 1.44; 95% CI 1.14-1.80), those who consumed alcohol in the last 30 days (PR 1.23; 95% CI 1.04-1.47), and those who had depression (PR 1.49; 95% CI 1.30-1.71).

Conclusion

Almost half of the university students had PMS and ~ 11%, PMDD. Physical symptoms were themost common and interfered in amoderate-to-severe way in various aspects of life. Attending the first semesters, consuming alcohol, and having depression were risk factors for PMS. The identification of risk factors for PMS is essential to prevent symptoms and reduce the impact of the syndrome.

Key-words Cross-sectional studies premenstrual dysphoric disorder Premenstrual syndrome Risk factors Students
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Review Article07-30-2021

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

Views369

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Interventions among Pregnant Women in the Field of Music Therapy: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):403-413
DOI 10.1055/s-0041-1731924
Bruna Mayumi Omori Shimada ,
Magda da Silva Oliveira Menezes dos Santos ,
Mayara Alvares Cabral ,
Vanessa Oliveira Silva ,
Gislaine Cristina Vagetti
Views369
Abstract

Objective

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

Data Sources

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

Study Selection

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

Data Collectio

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

Summary of the Data

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

Conclusion

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

Key-words music music therapy Pregnancy Women's health
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Review Article06-27-2022

Cognitive Behavioral Therapy in Endometriosis, Psychological Based Intervention: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):295-303

Views324

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Cognitive Behavioral Therapy in Endometriosis, Psychological Based Intervention: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):295-303
DOI 10.1055/s-0042-1742406
Lilian Donatti ,
Helena Malvezzi ,
Bruna Cestari de Azevedo ,
Edmund Chada Baracat ,
Sergio Podgaec
Views324
Abstract

Introduction

Endometriosis is an inflammatory disease that affects women of reproductive age, causing pain and the possibility of infertility. Endometriosis was associated to low life quality and research shows the impact of endometriosis in several areas of life, justifying how these patients are more likely to develop depression, anxiety, and stress.

Objective

The aim of the present systematic review was to explore the field of psychology in endometriosis, identifying studies that used the cognitive behavioral therapy technique as a treatment for endometriosis and chronic pelvic pain.

Methods

The keywords used were Endometriosis and Behavioral Therapy; Behavioral Disciplines and Activities; Cognitive Behavioral Therapy; Mental Health; Psychological Techniques; Psychology; Psychotherapy; Mental Health Services; and the search was performed in the following databases: PubMed/Medline, Scielo, Lilacs, and Capes. The study followed the PRISMA guidelines and all studies whose intervention strategy used was related to cognitive-behavioral therapy were considered.

Results

Of the 129 articles found, only 5 were selected, and it was possible to identify that the psychological intervention whose approach brought cognitive-behavioral therapy techniques promoted a decrease in the sensation of pain, improvements in the scores of depression and stress, and significant changes in aspects of quality of life such as vitality, physical and social functioning, emotional well-being, control, and autonomy.

Conclusion

Cognitive-behavioral therapy can be very promising to take care of the emotional side of those who have endometriosis However, the present systematic review highlights the need to develop more structured studies with consistent, clear and replicablemethods to reach a psychological intervention protocol for patients who live with this gynecological-physical-emotional condition.

Key-words Chronic pelvic pain cognitive behavioral therapy Endometriosis psychological intervention Quality of life systematic reviews
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Review Article08-15-2022

The Correlation between Chlamydia Trachomatis and Female Infertility: A Systematic Review
- Laura Gazal Passos ,
- Paula Terraciano ,
- Nicole Wolf ,
- Fernanda dos Santos de Oliveira ,
- Isabel de Almeida ,
- Eduardo Pandolfi Passos
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):614-620

Views370

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
The Correlation between Chlamydia Trachomatis and Female Infertility: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(6):614-620
DOI 10.1055/s-0042-1748023
Laura Gazal Passos ,
Paula Terraciano ,
Nicole Wolf ,
Fernanda dos Santos de Oliveira ,
Isabel de Almeida ,
Eduardo Pandolfi Passos
Views370
Abstract

The impact of Chlamydia trachomatis (CT) infection on female’s fertility is not completely established yet, since the level of evidence associating these factors is still weak. Hence, the goal of the present review is to contribute to a better elucidation of this matter. The electronic database chosen was the Medline/PubMed, with the last survey on May 11, 2021. Publication date was used as a filter, with the previous 5 years having been selected. The following describers were used: chlamydia trachomatis AND infertility; chlamydia trachomatis AND tubal alteration AND infertility; chlamydia AND low pregnancy rates. From the 322 studies screened, 293 that failed to meet our eligibility criteria were excluded. Subsequently, we removed seven studies for not having the possible correlation between CT infections and female infertility as its main focus, and three for being about sexually transmitted infections (STIs) in general. Moreover, two studies designed as reviews were also excluded. Ergo, we included 17 studies in our qualitative analysis. The authors conducted research individually and analyzed carefully the studies selected. As we retrieved the information needed for our study through reading the texts, no contact was made with the authors of the studies selected. This systematic review corroborates the hypothesis that CT infection potentiates female infertility, as 76.47% of the included studies found a positive correlation between them. We conclude that there is an important association between CT infection and female infertility. Ergo, making CT screening part of the infertility investigation routine is relevant and has a reasonable justification.

Key-words Chlamydia trachomatis human reproduction Infertility Sexually transmitted diseases tubal factor infertility
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Review Article06-27-2022

Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management
- Mariana Enxuto Santos Manique ,
- Ana Margarida Antunes Póvoa Ferreira
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433

Views336

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433
DOI 10.1055/s-0042-1742292
Mariana Enxuto Santos Manique ,
Ana Margarida Antunes Póvoa Ferreira
Views336
Abstract

Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarianmorphology ought not to be used as a diagnostic criterion. Treatment should targetmanifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes.

Key-words Adolescence Diagnosis management Polycystic ovary syndrome
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Articles - Revista Brasileira de Ginecologia e Obstetrícia

Female genital tract microbiome: the influence of probiotics on assisted reproduction

Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome

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

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

Challenges and strategies in adolescent vaccination: Number 12 – 2024

The gynecologist and cancer in women

Nipple-sparing mastectomy in young versus elderly patients

RBGO – A journal to support gynecology and obstetrics research in Latin America

Vascular contraction of umbilical arteries of pregnant women with preeclampsia

Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women

Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study

Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale

Impact of doula’s continuous support on serotonin release in parturients: a pilot randomized clinical trial

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)

Outcomes after elevation of serratus anterior fascia flap versus serratus muscle flap in direct-to-implant breast reconstruction following mastectomy: a prospective study

Commercial Surrogacy: An Overview

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)

Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale

Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

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

Cognitive Behavioral Therapy in Endometriosis, Psychological Based Intervention: A Systematic Review

The Correlation between Chlamydia Trachomatis and Female Infertility: A Systematic Review

Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

Tag Cloud

Female genital tract microbiome: the influence of probiotics on assisted reproduction

Abstract

Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Results:

Conclusion:

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

Abstract

Objective:

Methods:

Results:

Conclusions:

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

Challenges and strategies in adolescent vaccination: Number 12 – 2024

The gynecologist and cancer in women

Nipple-sparing mastectomy in young versus elderly patients

Abstract

Objective:

Methods:

Results:

Conclusion:

RBGO – A journal to support gynecology and obstetrics research in Latin America

Vascular contraction of umbilical arteries of pregnant women with preeclampsia

Abstract

Objective:

Methods:

Results:

Conclusion:

Skeletal muscle mass obtained by anthropometric equation and presence of sarcopenia in postmenopausal women

Abstract

Objective:

Methods:

Results:

Conclusion:

Sociodemographic and reproductive risk factors associated with metabolic syndrome in a population of Brazilian women from the city of Ribeirão Preto: a cross-sectional study

Abstract

Objective:

Methods:

Results:

Conclusion:

Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale

Abstract

Objective

Methods

Results

Conclusion

Impact of doula’s continuous support on serotonin release in parturients: a pilot randomized clinical trial

Abstract

Objective:

Methods:

Results:

Conclusion:

Brazilian Registry of Clinical Trials:

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)

Abstract

Outcomes after elevation of serratus anterior fascia flap versus serratus muscle flap in direct-to-implant breast reconstruction following mastectomy: a prospective study

Abstract

Objective:

Methods:

Results:

Conclusion:

Commercial Surrogacy: An Overview

Abstract

Objective

Methods

Results

Conclusion

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)

Abstract

Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale

Abstract

Objective