-
Original Article08-07-1999
Massive hemorrhage in gynecologic cancer surgery: the use of hemostatic pack
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):415-418
Abstract
Original ArticleMassive hemorrhage in gynecologic cancer surgery: the use of hemostatic pack
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):415-418
DOI 10.1590/S0100-72031999000700008
Views125See morePurpose: to introduce the use of the hemostatic pack, a tampon consisting of compresses tied to the bleeding surface and left in place for 48 to 72 h and which is one of the therapeutic alternatives to be used in this situation. Patients and Methods: we evaluated 3 cases of massive bleeding during surgery, with the exchange, on average, of 1.4 blood volumes (1.2-2.4), in terms of hemostatic effectiveness of the pack and of some patient parameters such as age and amount and type of volume infused. Results: the mean age of the patients was 57 years (51, 56 and 64). Only one had been previously irradiated. The bleeding was of venous origin, from the fossa of the obturator nerve, the iliac plexus and the presacral plexus. The volume expander most often used was 0.9% physiological saline solution, followed by blood derivatives and by Ringer lactate. Two patients were submitted to ligation of the hypogastric vein during surgery, with no improvement. The use of hemostatic synthetic material was inefficient in all three cases. In one of the patients, the use of nonabsorbable sutures to close the bleeding area led to a considerable reduction of bleeding, but did not eliminate it completely. One patient died before 24 h had elapsed, with signs and symptoms of heart failure. The other two patients developed acute renal failure and one of them developed aspirative pneumonia during surgical reexploration. Conclusion: massive bleeding is related to high morbidity and mortality. Among the emergency measures used for hemostasis, the pack seems to be the most adequate.
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. -
Original Article08-07-1999
Human embryo coculture in vero cells and blastocyst stage transfer
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):409-414
Abstract
Original ArticleHuman embryo coculture in vero cells and blastocyst stage transfer
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):409-414
DOI 10.1590/S0100-72031999000700007
Views65See morePurpose: to determine whether the transfer day or the stage that the embryo is transferred interferes in pregnancy and implantation rates. Methods: oocytes we recovered from 107 patients and submitted to in vitro fertilization. The embryos were cocultured on Vero cells and transferred on day 3 or day 5 post-fertilization, after morphological assessment. Results: the implantation rate of the transferred embryos on day 5 was significantly higher than when the embryos were transferred on day 3, but the pregnacy rates did not change. However, a significant difference was observed in the pregnancy rates for embryos transferred at the expanded blastocyst stage (70.6% of pregnancy) when compared to 20.0% and 10.5% at the earlier blastocyst and morula stages, respectively. Conclusions: the implantation and pregnancy rates were significantly increased when the embryos were transferred at the expanded blastocyst stage, but the culture media and culture conditions now available are not able to provide a satisfactory rate at this stage.
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. -
Original Article08-07-1999
Use of the cotton swab in cervical cytology
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):401-405
Abstract
Original ArticleUse of the cotton swab in cervical cytology
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):401-405
DOI 10.1590/S0100-72031999000700006
Views65See morePurpose: to investigate if the addition of a cotton “swab” to the Ayre spatula and its previous moistening with physiologic saline solution increase the obtention of endocervical cells in colpocytologic smears. Methods: a random and single-blind diagnostic study was performed, involving three techniques of collection (Ayre spatula, combination of Ayre-dry cotton swab spatula and combination of Ayre-moist cotton swab spatula). A total of 307 smears prepared by Medicine students and residents of Gynecology and Obstetrics were evaluated. Results: there was no significant increase in the number of endocervical cells (columnar and/or metaplastic), obtained with the addition of dry swab (p = 0.2) or with the addition of a moistened swab (p = 0.8). Conclusions: the author concluded that mainly when the collections were performed by trainee professionals and in the absence of other more effective endocervical collecting device, it is more economical to use only the Ayre spatula to prepare the smear.
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. -
Original Article08-07-1999
The use of sulfonylureas by pregnant diabetic women and fetal malformations
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):393-397
Abstract
Original ArticleThe use of sulfonylureas by pregnant diabetic women and fetal malformations
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):393-397
DOI 10.1590/S0100-72031999000700005
Views68Purpose: to evaluate a possible relationship between fetal malformations (FM) and the use of sulfonylureas (SF) by diabetic pregnant women. Methods: we retrospectively studied 35 type 2 diabetic pregnant women followed at the Pathological Prenatal Care Outpatient Clinic of the University Hospital, Faculty of Medicine of Ribeirão Preto, from 1993 to 1995. Twenty-two of these women had been inadvertently using sulfonylureas during the 1st trimester of gestation (SF group). We determined their prevalence of FM and compared it to that observed for pregnant diabetic women who were only on diet or insulin therapy (group C). We also analyzed other variables such as time of disease, age, metabolic control, and prenatal care. Results: there was no significant difference between groups in terms of age range, duration of diabetes, glycemic control, or early start of prenatal care, with the prevalence of FM being similar for the two groups (8.3% in group C and 13.6% in group SF). The malformations observed in group SF were: renal agenesis, pulmonary hypoplasia and ribbon gonads (patient 1); short limbs and abnormally implanted toes (patient 2); cleft palate, low implanted ears, neck webbing and saddle nose (patient 3), and micrognathia, dysplastic ears, imperforate anus, hypospadia, polydactily, ventricular septal defect and atrial septal defect (patient 4) in group C. Conclusions: these data do not allow us to attribute the malformations detected in group SF to the use of sulfonylureas, although not usually described alterations in diabetic embryopathy occurred in this group.
Key-words Diabetes mellitusFetal malformationsSee moreThis 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. -
Original Article08-07-1999
Amnioinfusion during labor with meconium-stained amniotic fluid
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):389-392
Abstract
Original ArticleAmnioinfusion during labor with meconium-stained amniotic fluid
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):389-392
DOI 10.1590/S0100-72031999000700004
Views68See morePurpose: to report the personal experience with the use of the amnioinfusion technique in patients in labor presenting meconial amniotic fluid, and the incidence of complications, the meconium aspiration syndrome and of cesarean sections. Method: twenty patients at term and in labor with meconial amniotic fluid were evaluated retrospectively, at the delivery ward at two public institutions of Rio Grande do Sul. An initial infusion of 1.000 ml of normal saline solution at room temperature, at an infusion rate of 20-30 ml per minute was initiated and then reduced to 3 ml per minute. The liquid was drained by elevating the cephalic pole. Results: the procedure was feasible when a nasogastric catheter was used. None of the patients presented major complications related to the procedure. None of the neonates presented meconium below their vocal cords. The cesarean section rate was 3/20 (15%). Conclusion: the amnioinfusion is a low-cost and feasible technique that did not show any complication in this study.
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. -
Original Article08-07-1999
Fetal pulse oximetry: relationship between oxygen saturation at second stage of labor and the umbilical artery pH at birth
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):381-384
Abstract
Original ArticleFetal pulse oximetry: relationship between oxygen saturation at second stage of labor and the umbilical artery pH at birth
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):381-384
DOI 10.1590/S0100-72031999000700003
Views64See morePurpose: to study the correlation between fetal oxygen saturation measured by pulse oximetry during second stage of labor and umbilical artery pH at birth. Patients and Methods: fetal oxygen saturation (FSpO2) was monitored by pulse oximetry during the second stage of labor in 64 singleton pregnancies at term, with vertex presentation. Umbilical blood was sampled immediately after delivery for subsequent measurement of venous and arterial blood gases and pH. All fetuses maintained FSpO2 > or = 30% through the first stage of labor, until the start of second stage. Results: the mean FSpO2 at the second stage of labor correlated significantly with umbilical artery pH at birth (n = 64, r = 0.79, p <0.001). There was no significant corre-lation between FSpO2 at the second stage of labor and umbilical artery oxygen saturation at birth. Conclusion: fetal oxygen saturation measured by pulse oximetry during second stage of labor has a good correlation with umbilical artery pH at birth.
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. -
Original Article08-07-1999
Reverse blood flow in ductus venosus: new perspective in detection of chromosomal abnormalities
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):371-376
Abstract
Original ArticleReverse blood flow in ductus venosus: new perspective in detection of chromosomal abnormalities
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):371-376
DOI 10.1590/S0100-72031999000700002
Views119See morePurpose: to evaluate the possible value of pulsed and color Doppler of ductus venosus blood flow in the screening for chromosomal abnormalities at 10-14 weeks of gestation. Methods: the ductus venosus flow velocity waveforms and the nuchal translucency (NT) thickness were obtained immediately before the chorionic villus sample in 26 pregnancies. We employed the following criteria for the suspicion of chromosomal defects: reverse or absent flow during atrial contraction and NT greater or equal to 3 mm. We calculated the sensitivity, the specificity, the negative and positive predictive value for each of the above items. Results: there were 9 chromosomal abnormalities (3 cases of trisomy 21, 2 cases of trisomy 13, 1 case of trisomy 9, 1 case of trisomy 22, 1 triploidy and 1 monosomy X). Abnormal ductus venosus flow was observed in all cases (sensitivity of 100%). In the normal fetuses (17 cases) only 1 had abnormal flow (specificity of 94%). Concerning NT, the sensitivity and the specificity were 88% and 76%, respectively. Conclusion: our preliminary results suggest that the presence of chromosomal abnormalities may be strongly suspected when an increased NT thickness is associated with an absent or reverse flow in the ductus venosus. We speculated that both methods are valid in the screening of chromosomal defects.
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. -
As sociedades científicas, sua proliferação e a ética
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):370-370
Abstract
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.
Search
Search in:
Tag Cloud
Pregnancy (252)Breast neoplasms (104)Pregnancy complications (104)Risk factors (103)Menopause (88)Ultrasonography (83)Cesarean section (78)Prenatal care (71)Endometriosis (70)Obesity (61)Infertility (57)Quality of life (55)prenatal diagnosis (51)Women's health (48)Postpartum period (46)Maternal mortality (45)Pregnant women (45)Breast (44)Prevalence (43)Uterine cervical neoplasms (43)