Articles - Revista Brasileira de Ginecologia e Obstetrícia

10-18-2000

Defesa Profissional, a FEBRASGO e a Nova Tabela de Honorários
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(3):127-127

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Abstract
Defesa Profissional, a FEBRASGO e a Nova Tabela de Honorários
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(3):127-127
DOI 10.1590/S0100-72032000000300001
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Defesa Profissional, a FEBRASGO e a Nova Tabela de Honorários […]
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Equipments and Methods10-17-2000

Endometrial Ablation Using a Thermal Balloon: Preliminary Results
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):235-238

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Abstract
Equipments and Methods
Endometrial Ablation Using a Thermal Balloon: Preliminary Results
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):235-238
DOI 10.1590/S0100-72032000000400008
Francesco Viscomi,
João Alfredo Martins,
Marilice Pastore,
Rogério Dias,
Laurival DeLuca
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Purpose: to evaluate thermal balloon endometrial ablation in the management of menorrhagia. Study design: twenty patients were submitted to endometrial ablation using the thermal balloon device, between June 1996 and June 1997. Local anesthesia was used in 16 patients. The device was introduced into the uterine cavity. The duration of the procedure was 8 minutes and 30 seconds. Results: two patients (10%) did not show improvement of the symptons. Eighteen patients (90%) referred improvement of symptoms. There was no complication during and after the procedure. Conclusions: The thermal balloon seems to be safe and efficient in the management of menorrhagia.

Key-words abnormal Endometrial ablation Hysteroscopy Thermal balloon Uterine bleeding
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Original Article10-17-2000

Recurrent Spontaneous Abortion–associated Factors
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):217-223

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Abstract
Original Article
Recurrent Spontaneous Abortion–associated Factors
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):217-223
DOI 10.1590/S0100-72032000000400005
Ricardo Barini,
Egle Couto,
Marcos Matias Mota,
Carolina Taddeo M. dos Santos,
Sofia Rocha Leiber,
Simone Cotes Batista
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Purpose: to identify recurrent spontaneous abortion- associated factors. Subjects: one hundred seventy-five outpatients were investigated from March 1993 to March 1997 at the “Ambulatório de Aborto Recorrente CAISM/UNICAMP”. All of them had had three or more consecutive spontaneous abortions and/or two abortions and were 35 years or more old. Methods: the investigation protocol included: couple’s karyotype; hysterosalpingography, serial plasma progesterone levels and/or endometrial biopsy; toxoplasmosis, listeriosis, brucelosis, lues and cytomegalovirus serum tests; Chlamydia trachomatis and Mycoplasma hominis cultures of cervical discharge; TSH and thyroid hormone levels; fasting glucose; autoantibody panel, anti-HLA antibody search by microlymphocytotoxicity crossmatch and one-way mixed lymphocyte culture with inhibitor factor detection. Husband’s evaluation included: physical evaluation, lues, Chagas’ disease, B and C hepatitis and AIDS serum tests, microlymphocytotoxicity crossmatch and one-way mixed lymphocyte culture with inhibitor factor detection. Results: alloimmune etiology was the most frequently found factor (86.3% of studied patients), represented by negative crossmatch and one-way mixed lymphocyte culture with inhibitor factor below 50%. The second most frequently found factor was cervical incompetence (22.8%), followed by hormonal factor (21.2%), mainly represented by luteal insufficiency. Some patients were found to have more than one etiologic factor. Conclusion: the investigation of recurrent spontaneous abortion-associated factors must include alloimmune etiology. Most cases will remain unexplained without this investigation.

Key-words Abortion Antiphospholipid antibodies Cervical incompetence Lymphocyte
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Original Article10-17-2000

Fetal Biophysical Profile in Premature Rupture of the Membranes
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):201-208

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Abstract
Original Article
Fetal Biophysical Profile in Premature Rupture of the Membranes
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):201-208
DOI 10.1590/S0100-72032000000400003
Vardeli Alves de Moraes,
Luis Kulay Jr.,
Anna Maria Bertini
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Purpose: to evaluate the modifications due to premature rupture of the membranes of variables of the fetal biophysical profile, comparing them to the ones found in pregnant women with intact membranes. In the group with premature rupture of the membranes, the association of biophysical variables with the Apgar score at the first and fifth minutes and with the occurrence or not of clinical chorioamnionitis and neonatal infection was analyzed. Patients and Methods: in a prospective study, 112 fetal biophysical profiles were established in 60 pregnant women with premature rupture of the membranes at a period between the 28th and the 40th week of pregnancy, and only the last fetal biophysical profile was analyzed and compared to other 60 fetal biophysical profiles of pregnant women with gestational ages identical to the group of study and with intact membranes. Results: statistical analysis of the results revealed that the premature rupture of the membranes diminished the reactivity, not interfering with the body movements of the fetus. It also diminished the frequency of the respiratory movements of the fetus, not determining modifications of the fetal tonus, and considerably decreasing the amniotic fluid index. In terms of prediction of chorioamnionitis and neonatal infection, the fetal biophysical profile did not show any significant statistic validity; however, when the biophysical variables were present, the correlation with the absence of chorioamnionitis and neonatal infection was clearly shown. The result of the last fetal biophysical profile was strongly associated with the Apgar score at the 5th minute. Conclusion: the fetal biophysical profile should be used routinely in pregnant women with premature rupture of the membranes with the purpose of evaluating fetal vitality, and in order to detect those fetuses at a higher risk of infection, specially those with gestational ages of less than 34 weeks. Regarding those fetuses it is best to use a conservative approach.

Key-words Fetal biophysical profile Fetal vitality Premature rupture of the membranes
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Original Article10-17-2000

Gastroschisis: Prenatal Diagnosis x Neonatal Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):191-199

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Abstract
Original Article
Gastroschisis: Prenatal Diagnosis x Neonatal Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):191-199
DOI 10.1590/S0100-72032000000400002
Melania Maria Ramos de Amorim,
Paulo Carvalho Vilela,
Luiz Carlos Santos,
Gilliatt Hanois Falbo Neto,
Luiz André Marinho Lippo,
Marcelo Marques
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Purpose: to determine the frequency of prenatal diagnosis in newborns with gastroschisis operated at the Instituto Materno-Infantil de Pernambuco (IMIP) and to analyze its repercussions on neonatal prognosis. Patients and Methods: a cross-sectional study was carried out, including 31 cases of gastroschisis submitted to surgical correction in our service from 1995 to 1999. Prevalence risk (PR) of neonatal death and its 95% confidence interval were calculated for the presence of prenatal diagnosis and other perinatal and surgical variables. Multiple logistic regression analysis was carried out to determine the adjusted risk of neonatal death. Results: only 10 of 31 cases of gastroschisis (32.3%) had prenatal diagnosis and all were delivered at IMIP. No newborn with prenatal diagnosis was preterm but 43% of those without prenatal diagnosis were premature (p < 0,05). Birth-to-surgery interval was significantly greater in the absence of prenatal diagnosis (7.7 versus 3.8 hours). The type of surgery, need of mechanical ventilation and frequency of postoperative infection were not different between the groups. Neonatal death was more frequent in the group without prenatal diagnosis (67%) than in the group with prenatal diagnosis (20%). The main factors associated with increased risk of neonatal death were gestational age <37 weeks, absence of prenatal diagnosis, delivery in other hospitals, birth-to-surgery interval > 4 hours, staged silo surgery, need of mechanical ventilation and postoperative infection. Conclusions: prenatal diagnosis was infrequent among infants with gastroschisis and neonatal death was extremely high in its absence. It is necessary to achieve greater rates of prenatal diagnosis and to improve perinatal care in order to reduce this increased mortality.

Key-words Fetal malformations Gastroschisis Neonatal outcome Prematurity prenatal diagnosis
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10-17-2000

2001 Uma Odisséia no Universo Científico Feminino
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):190-190

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Abstract
2001 Uma Odisséia no Universo Científico Feminino
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):190-190
DOI 10.1590/S0100-72032000000400001
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2001 Uma Odisséia no Universo Científico Feminino […]
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Original Article10-17-2000

Methods of treatment of genuine stress incontinence: a comparative study between a pelvic floor exercise program and a pelvic floor electrical stimulation
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):49-54

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Methods of treatment of genuine stress incontinence: a comparative study between a pelvic floor exercise program and a pelvic floor electrical stimulation
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):49-54
DOI 10.1590/S0100-72032000000100009
Nicole O. Bernardes,
Flávia R. Péres,
Elza L.B.L. Souza,
Oswaldo L. Souza
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Purpose: to compare patients with genuine stress incontinence (GSI) who were submitted to a pelvic floor exercise program (PFEP) with those who were submitted to a pelvic floor electrical stimulation (PFES). Methods: fourteen GSI patients, with age between 31-64 years, participated in the study. They were divided into two groups of 7 each. PFEP or PFES was performed for 10 days. The women were evaluated at the first consultation and reevaluated after the ten-day treatment by only one physical therapist. For the statistical analysis nonparametric tests were used. Results: all had a partial or a total improvement of the GSI after the treatment, considering the subjective and objective analysis of the research. Conclusion: both PFEP and PFES showed to be effective to treat GSI, although PFEP showed a tendency to be the better treatment.

Key-words Genuine stress incontinence Pelvic floor electrical stimulation program Pelvic floor exercise program
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Original Article10-17-2000

Comparison of the results of the treatment of stress urinary incontinence with three different surgical procedures
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):43-48

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Abstract
Original Article
Comparison of the results of the treatment of stress urinary incontinence with three different surgical procedures
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):43-48
DOI 10.1590/S0100-72032000000100008
José Geraldo Lopes Ramos,
Nilton Leite Xavier,
Andrea Prestes Nácul,
Ângela Erguy Zucatto,
Eduardo Lange Hentschel
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Purpose: to analyze the prevalence of genuine urinary incontinence (GUI) recurrence, after at least two years of follow-up, in different surgical techniques used for its correction. Patients and Methods: fifty-five patients with diagnosis of GUI, submitted to surgery for its repair at the Serviço de Ginecologia e Obstetrícia do Hospital de Clínicas de Porto Alegre from 1992 to 1996 and whose post-surgical follow-up was superior to 2 years were divided into three groups according to the surgical approach: Kelly-Kennedy (n = 24), Burch (n = 23) and Marshall-Marchetti-Krantz (n = 8). Results: there were no differences regarding recurrence rate, age at surgery and at recurrence time, estrogen therapy, number of pregnancies and vaginal delivery (p>0.05). Although posterior perineoplasty was more prevalent in the Kelly-Kennedy group, it did not influence the recurrence rate. The group submitted to the Burch approach had more years of menopause at the time of surgery. Conclusion: the recurrence rates of urinary incontinence comparing the three different techniques (Kelly-Kennedy, Burch and Marshall-Marchetti-Krantz) were, respectively, 29.2, 39.1 and 50%, which did not differ statistically. Considering the potential confusional bias for urinary stress incontinence, they did not differ among the groups. Nevertheless, we noticed that all women who had previous surgery presented recurrence of incontinence.

Key-words Hormonal replacement therapy Stress urinary incontinence Vaginal surgery
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FEBRASGO POSITION STATEMENT03-01-2019

Increasing the Chances of Natural Conception: Opinion Statement from the the Brazilian Federation of Gynecology and Obstetrics Associations – FEBRASGO Committee of Gynecological Endocrinology
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):183-190

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Abstract
FEBRASGO POSITION STATEMENT
Increasing the Chances of Natural Conception: Opinion Statement from the the Brazilian Federation of Gynecology and Obstetrics Associations – FEBRASGO Committee of Gynecological Endocrinology
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):183-190
DOI 10.1055/s-0039-1677838
Bruno Ramalho de Carvalho ,
Ionara Diniz Evangelista Santos Barcelos,
Sebastião Freitas de Medeiros,
Cristina Laguna Benetti-Pinto,
Daniela Angerame Yela,
Andrea Prestes Nácul,
Gustavo Arantes Rosa Maciel,
José Maria Soares Júnior,
Ana Carolina Japur de Sá Rosa e Silva,
Laura Olinda Bregieiro Fernandes Costa
Views467
Abstract

Considering that myths and misconceptions regarding natural procreation spread rapidly in the era of easy access to information and to social networks, adequate counseling about natural fertility and spontaneous conception should be encouraged in any kind of health assistance. Despite the fact that there is no strong-powered evidence about any of the aspects related to natural fertility, literature on how to increase the chances of a spontaneous pregnancy is available. In the present article, the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO, in the Portuguese acronym) Committee on Endocrine Gynecology provides suggestions to optimize counseling for non-infertile people attempting spontaneous conception.

Key-words fecundability fertility determinants natural fertility preconception care reproductive period
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Original Article11-01-2018

Do Food Intake and Food Cravings Change during the Menstrual Cycle of Young Women?
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):686-692

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Abstract
Original Article
Do Food Intake and Food Cravings Change during the Menstrual Cycle of Young Women?
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):686-692
DOI 10.1055/s-0038-1675831
Luciana Bronzi de Souza,
Karine Anusca Martins,
Mariana Morais Cordeiro,
Ymárdila de Souza Rodrigues,
Bruna Paola Murino Rafacho,
Rafael Aiello Bomfim
Views434
Abstract

Objective

The aim of the present study was to assess the anthropometric measures, food intake and food cravings during the menstrual cycle of undergraduate students of the faculty of nutrition.

Methods

A cross-sectional study was performed with 27 students from a public university in the state of Mato Grosso do Sul, Brazil, who had their food intake evaluated through a 24-hour food recall, their nutritional status evaluated based on anthropometric measures, and food cravings evaluated using the Food Desire Questionnaire. Data were collected during an evaluation in the follicular phase (between the 5^th and the 9^th day of the menstrual cycle) and another in the luteal phase (LP) (between the 20^th and the 25^th day of the menstrual cycle). For food intake variables, the analysis of variance (ANOVA) test was used, followed by the Tukey test. The Mann-Whitney test was used for the analysis of food cravings, considering a significance level of 5% (p< 0.05).

Results

The desire for foods rich in sugar, salt, and fat, such as chocolate, pastries, snacks and desserts were higher (p< 0.05) during the premenstrual period, although it did not reflect neither a higher energy intake nor an alteration in the distribution of macronutrients. A higher intake of carbohydrates, proteins, fibers, and calcium was observed during the LP; however, without statistical difference between the groups. There were no differences either in the intake of any food group or in the anthropometric measurements (p> 0.05).

Conclusion

Food cravings of nutrition students differed between the phases of the menstrual cycle; however, with no difference in food intake and in anthropometric measures.

Key-words Feeding behavior follicular phase food intake luteal phase Menstrual cycle Nutrition assessment
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Review Article01-11-2023

Efficacy, Safety, and Acceptability of Misoprostol in the Treatment of Incomplete Miscarriage: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):808-817

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Abstract
Review Article
Efficacy, Safety, and Acceptability of Misoprostol in the Treatment of Incomplete Miscarriage: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):808-817
DOI 10.1055/s-0043-1776029
Thiago Menezes da Silva ,
Moema Alves Guerra de Araujo ,
Ana Carolina Zimmermann Simões ,
Ronnier de Oliveira ,
Kleyton Santos de Medeiros ,
Ayane Cristine Sarmento ,
Robinson Dias de Medeiros ,
Ana Paula Ferreira Costa ,
Ana Katherine Gonçalves
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Abstract

Objective

To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage.

Data sources

The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied.

Selection of studies

Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened.

Data collection

Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I² statistic.

Data synthesis

When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07–0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96–4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52–0.80). No statistically significant differences were observed in the general acceptability of the treatments.

Conclusion

Misoprostol has been determined as a safe option with good acceptance by patients.

Key-words Abortion Curettage Miscarriage Misoprostol
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Review Article02-28-2022

Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis
- Claudia López-Ruiz ,
- Jerutsa Catalina Orjuela ,
- Diego Fernando Rojas-Gualdrón ,
- Marcela Jimenez-Arango ,
- José Fernando de los Ríos ,
- Claudia Vargas
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):55-66

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):55-66
DOI 10.1055/s-0041-1740595
Claudia López-Ruiz ,
Jerutsa Catalina Orjuela ,
Diego Fernando Rojas-Gualdrón ,
Marcela Jimenez-Arango ,
José Fernando de los Ríos ,
Elsa Maria Vásquez-Trespalacios ,
Claudia Vargas
Views448
Abstract

Objective

To summarize the available evidence of TAP Block in efficacy in laparoscopic or robotic hysterectomy.

Data Sources

We searched databases and gray literature for randomized controlled trials in which transversus abdominis plane (TAP) block was compared with placebo or with no treatment in patients who underwent laparoscopic or robot-assisted hysterectomy.

Method of Study

Selection Two researchers independently evaluated the eligibility of the selected articles. Tabulation, Integration, and Results Seven studies were selected, involving 518 patients. Early postoperative pain showed a difference in the mean mean difference (MD): – 1.17 (95% confidence interval [CI]: – 1.87-0.46) in pain scale scores (I2=68%), which was statistically significant in favor of using TAP block, but without clinical relevance; late postoperative pain: DM 0.001 (95%CI: – 0.43-0.44; I2=69%); opioid requirement: DM 0.36 (95%CI: – 0.94-1.68; I2=80%); and incidence of nausea and vomiting with a difference of 95%CI=- 0.11 (- 0.215-0.006) in favor of TAP.

Conclusion

With moderate strength of evidence, due to the high heterogeneity and imbalance in baseline characteristics among studies, the results indicate that TAP block should not be considered as a clinically relevant analgesic technique to improve postoperative pain in laparoscopic or robotic hysterectomy, despite statistical significance in early postoperative pain scale scores.

Key-words laparoscopic hysterectomy Opioid Pain robotic-assisted hysterectomy transversus abdominis plane block
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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

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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
Views425
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 Article08-26-2020

Tribulus Terrestris for Female Sexual Dysfunction: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):427-435

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Abstract
Review Article
Tribulus Terrestris for Female Sexual Dysfunction: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):427-435
DOI 10.1055/s-0040-1712123
Ana Luiza Cabrera Martimbianco ,
Rafael Leite Pacheco ,
Fábia Lima Vilarino ,
Carolina de Oliveira Cruz Latorraca ,
Maria Regina Torloni ,
Rachel Riera
Views421
Abstract

Objective

We performed a systematic review to assess the effectiveness and safety of Tribulus terrestris to treat female sexual dysfunction (FSD).

Data sources

We performed unrestricted electronic searches in the MEDLINE, CENTRAL, EMBASE, LILACS, CINAHL, PsycINFO,WHO-ICTR, Clinicaltrials.gov and OpenGrey databases. Selection of studies We included any randomized controlled trials (RCTs) that compared T. terrestris versus inactive/active interventions. After the selection process, conducted by two reviewers, 5 RCTs (n = 279 participants) were included.

Data collection

Data extraction was performed by two reviewers with a preestablished data collection formulary.

Data synthesis

Due to lack of data and clinical heterogeneity, we could not perform meta-analyses. The risk of bias was assessed by the Cochrane Risk of Bias (RoB) tool, and the certainty of evidence was assessed with Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

Results

After 1 to 3 months of treatment, premenopausal and postmenopausal women randomized to T. terrestris had a significant increase in sexual function scores. Three months of treatment with T. terrestris showed a significant increase in the serum testosterone levels of premenopausal women. There was no report of serious adverse events, and none of the studies assessed health-related quality of life. The certainty of the evidence was very low, whichmeans that we have very little confidence in the effect estimates, and future studies are likely to change these estimates.

Conclusion

MoreRCTs are needed to supportor refute the use of T. terrestris. The decision to use this intervention should be shared with the patients, and the uncertainties around its effects should be discussed in the clinical decision-making process. Number of Protocol registration in PROSPERO database: CRD42019121130

Key-words Evidence-based medicine review Sexual dysfunction tribulus
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Review Article06-01-2018

Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):360-368

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Abstract
Review Article
Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):360-368
DOI 10.1055/s-0038-1657754
Luiz Carlos Zeferino,
Joana Bragança Bastos,
Diama Bhadra Andrade Peixoto do Vale,
Rita Maria Zanine,
Yara Lucia Mendes Furtado de Melo,
Walquíria Quida Salles Pereira Primo,
Flávia de Miranda Corrêa,
Isabel Cristina Chulvis do Val,
Fábio Russomano
Views399
Abstract

Evidence-based clinical guidelines ensure best practice protocols are available in health care. There is a widespread use of human papillomavirus deoxyribonucleic acid (HPVDNA) tests in Brazil, regardless of the lack of official guidelines. On behalf of the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym), a team of reviewers searched for published evidence and developed a set of recommendations for the use of HPV-DNA tests in cervical cancer screening in Brazil. The product of this process was debated and consensus was sought by the participants. One concern of the authors was the inclusion of these tests in the assessment of women with cytologic atypia and women treated for cervical intraepithelial neoplasia (CIN). Testing for HPV is recommended in an organized screening scenario to identify women with precursor lesions or asymptomatic cervical cancer older than 30 years of age, and it can be performed every 5 years. It also has value after the cytology showing atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSILs) as a triage test for colposcopy, in the investigation of other cytological alterations when no abnormal findings are observed at colposcopy, seeking to exclude disease, or, further, after treatment of high-grade cervical intraepithelial neoplasia, to rule out residual disease.

Key-words Cervical intraepithelial neoplasia cervical neoplasms Cytology DNA-HPV probes Screening
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Original Article03-27-2020

Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):12-18

Views368

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
Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):12-18
DOI 10.1055/s-0039-1700797
Pâmela Antoniazzi dos Santos ,
José Mauro Madi ,
Emerson Rodrigues da Silva ,
Daiane de Oliveira Pereira Vergani ,
Breno Fauth de Araújo ,
Rosa Maria Rahmi Garcia
Views368
Abstract

Objective

To assess the prevalence of gestational diabetes mellitus and the main associated risk factors in the population served by the Brazilian Unified Health System in the city of Caxias do Sul, state of Rio Grande do Sul.

Materials and Methods

A descriptive, cross-sectional and retrospective study was conducted. Maternal variables were collected from the medical records of all pregnant women treated at the basic health units in 2016. Hyperglycemia during pregnancy (pregestational diabetes, overt diabetes and gestational diabetes mellitus) was identified by analyzing the results of a 75-g oral glucose tolerance test, as recommended by the Brazilian Ministry of Health. Based on the data, the women were allocated into two groups: the gestational diabetes group and the no gestational diabetes group.

Results

The estimated prevalence of gestational diabetes among 2,313 pregnant women was of 5.4% (95% confidence interval [95%CI]: 4.56-6.45). Pregnant women with 3 or more pregnancies had twice the odds of having gestational diabetes compared with primiparous women (odds ratio [OR]=2.19; 95%CI: 1.42-3.37; p<0.001). Pregnant women aged 35 years or older had three times the odds of having gestational diabetes when compared with younger women (OR=3.01; 95%CI: 1.97-4.61; p<0.001). Overweight pregnant women were 84% more likely to develop gestational diabetes than those with a body mass index lower than 25 kg/m2 (OR =1.84; 95%CI: 1.25-2.71; p=0.002). A multivariable regression analysis showed that being overweight and being 35 years old or older were independent variables.

Conclusion

In this population, the prevalence of gestational diabetes mellitus was of 5.4%. Age and being overweight were predictive factors for gestational diabetes.

Key-words Gestational diabetes maternal health Prevalence Public health
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Review Article06-01-2018

Breastfeeding and the Benefits of Lactation for Women’s Health
- Luiz Antonio Del Ciampo,
- Ieda Regina Lopes Del Ciampo
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):354-359

Views570

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
Breastfeeding and the Benefits of Lactation for Women’s Health
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):354-359
DOI 10.1055/s-0038-1657766
Luiz Antonio Del Ciampo,
Ieda Regina Lopes Del Ciampo
Views570
Abstract

The offer of the maternal breast to the baby is an unquestionable right of mothers and their children, and all efforts should bemade to promote, follow and maintain exclusive breastfeeding for up to 6months and supplement it until the child completes 2 years of age. Many publications are available in the literature about the qualities of breast milk, its benefits and health repercussions, stimulating the practice of breastfeeding and supporting campaigns for its implementation. However, although it is widely known that breastfeeding is an important step in the reproductive process of women and its practice offers benefits to both mother and child, most of the available information highlights the benefits of breast milk for children, while mention of the effects of breastfeeding on the health of the mother is usually neglected. Thus, the objective of the present study is to highlight the multiple benefits of breastfeeding for the physical and emotional health of the nursing mother. The authors consulted articles published in the databases PubMed, Virtual Health Library andWeb of Science using the keywords breastfeeding, breast milk, lactation and maternal health.

Key-words breast milk Breastfeeding Postpartum period
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Review Article09-01-2017

Preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512

Views646

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
Preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512
DOI 10.1055/s-0037-1604471
José Geraldo Lopes Ramos,
Nelson Sass,
Sérgio Hofmeister Martins Costa
Views646
Abstract

The authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia. The early treatment of acute hypertension, use of magnesium sulfate and early hospitalization in cases of preeclampsia are concepts to pursue the reduction of our pregnant women’s mortality.

Key-words HELLP syndrome High risk pregnancy Preeclampsia pregnancy arterial hypertension Pregnancy complications
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Review Article09-25-2020

Primary Dysmenorrhea: Assessment and Treatment
- Inês Guimarães ,
- Ana Margarida Póvoa
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):501-507

Views582

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
Primary Dysmenorrhea: Assessment and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):501-507
DOI 10.1055/s-0040-1712131
Inês Guimarães ,
Ana Margarida Póvoa
Views582
Abstract

Primary dysmenorrhea is defined asmenstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of themenstrual cycle. It hasmajor implications for quality of life, such as limitation of daily activities and psychological stress, being one of themain causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, nonpharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments’ contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.

Key-words Dysmenorrhea hormonal contraception Menstrual cycle NSAIDs Pain
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Review Article09-01-2018

Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):554-562

Views454

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
Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):554-562
DOI 10.1055/s-0038-1668117
Danielly Scaranello Santana,
Fernanda Garanhani Surita,
José Guilherme Cecatti
Views454
Abstract

Twin pregnancy accounts for 2 to 4% of total births, with a prevalence ranging from 0.9 to 2.4% in Brazil. It is associated with worse maternal and perinatal outcomes. Many conditions, such as severe maternal morbidity (SMM) (potentially life-threatening conditions and maternal near-miss) and neonatal near-miss (NNM) still have not been properly investigated in the literature. The difficulty in determining the conditions associated with twin pregnancy probably lies in its relatively low occurrence and the need for larger population studies. The use of the whole population and of databases from large multicenter studies, therefore, may provide unprecedented results. Since it is a rare condition, it ismore easily evaluated using vital statistics from birth e-registries. Therefore, we have performed a literature review to identify the characteristics of twin pregnancy in Brazil and worldwide. Twin pregnancy has consistently been associated with SMM, maternal near-miss (MNM) and perinatal morbidity, with still worse results for the second twin, possibly due to some characteristics of the delivery, including safety and availability of appropriate obstetric care to women at a high risk of perinatal complications.

Key-words High risk pregnancy Maternal morbidity Multiple pregnancies Perinatal morbidity
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Review Article05-01-2018

Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):287-293

Views418

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
Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):287-293
DOI 10.1055/s-0038-1660777
Marianna Amaral Pedroso,
Kirsten Rebecca Palmer,
Ryan James Hodges,
Fabricio da Silva Costa,
Daniel Lorber Rolnik
Views418
Abstract

Objective

To perform a comprehensive review of the current evidence on the role of uterine artery Doppler, isolated or in combination with other markers, in screening for preeclampsia (PE) and fetal growth restriction (FGR) in the general population. The review included recently published large cohort studies and randomized trials.

Methods

A search of the literature was conducted usingMedline, PubMed, MeSH and ScienceDirect. Combinations of the search terms “preeclampsia,” “screening,” “prediction,” “Doppler,” “Doppler velocimetry,” “fetal growth restriction,” “small for gestational age” and “uterine artery” were used. Articles in English (excluding reviews) reporting the use of uterine artery Doppler in screening for PE and FGR were included.

Results

Thirty articles were included. As a single predictor, uterine artery Doppler detects less than 50% of the cases of PE and no more than 40% of the pregnancies affected by FGR. Logistic regression-based models that allow calculation of individual risk based on the combination of multiple markers, in turn, is able to detect ~ 75% of the cases of preterm PE and 55% of the pregnancies resulting in small for gestational age infants.

Conclusion

The use of uterine artery Doppler as a single predictive test for PE and FGR has poor accuracy. However, its combined use in predictive models is promising, being more accurate in detecting preterm PE than FGR.

Key-words Doppler Fetal growth restriction Preeclampsia Screening Uterine arteries
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Review Article02-01-2016

Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(2):97-111

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
Review Article
Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(2):97-111
DOI 10.1055/s-0035-1571252
Rafael Mendes Moroni,
Pedro Sergio Magnani,
Jorge Milhem Haddad,
Rodrigo de Aquino Castro,
Luiz Gustavo Oliveira Brito
Views396
We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD = [1]1.24SDs; CI 95% = [1]1.77 to [1]0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD = [1]4.4 points; CI 95% = [1]16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD = 0.9g; 95%CI = 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.

Key-words electrical stimulation Meta-analysis Physiotherapy systematic review Urinary incontinence
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Review Article09-16-2019

Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519

Views386

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
Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519
DOI 10.1055/s-0039-1695002
Júlia Ferreira Fante,
Thais Daniel Silva,
Elaine Cristine Lemes Mateus-Vasconcelos,
Cristine Homsi Jorge Ferreira,
Luiz Gustavo Oliveira Brito
Views386
Abstract

Objective

We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence – UI, fecal incontinence – FI, and pelvic organ prolapse – POP).

Data

sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies.

Data collection

Two authors performed data extraction into a standardized spreadsheet.

Data synthesis

Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n= 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n= 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n= 3), low educational level (n= 4), low access to information (n= 5) and socioeconomic status (n= 3).

Conclusion

Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.

Key-words knowledge Pelvic floor systematic review Urinary incontinence
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Review Article08-26-2020

Covid-19 and Pregnancy: An Overview
- Pedro Castro ,
- Ana Paula Matos ,
- Heron Werner ,
- Flávia Paiva Lopes ,
- Gabriele Tonni ,
- Edward Araujo Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):420-426

Views280

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
Covid-19 and Pregnancy: An Overview
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):420-426
DOI 10.1055/s-0040-1713408
Pedro Castro ,
Ana Paula Matos ,
Heron Werner ,
Flávia Paiva Lopes ,
Gabriele Tonni ,
Edward Araujo Júnior
Views280
Abstract

Since the World Health Organization (WHO) declared coronavirus infection (COVID-19) a Public Health Emergency of International Concern in January 2020, there have been many concerns about pregnant women and the possible effects of this emergency with catastrophic outcomes inmany countries. Information on COVID-19 and pregnancy are scarce and spread throughout a fewcase series, with no more than 50 cases in total. The present review provides a brief analysis of COVID-19, pregnancy in the COVID-19 era, and the effects of COVID-19 on pregnancy.

Key-words COVID-19 Delivery Pregnancy Prenatal care
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Gastroschisis: Prenatal Diagnosis x Neonatal Outcome

2001 Uma Odisséia no Universo Científico Feminino

Methods of treatment of genuine stress incontinence: a comparative study between a pelvic floor exercise program and a pelvic floor electrical stimulation

Comparison of the results of the treatment of stress urinary incontinence with three different surgical procedures

Increasing the Chances of Natural Conception: Opinion Statement from the the Brazilian Federation of Gynecology and Obstetrics Associations – FEBRASGO Committee of Gynecological Endocrinology

Abstract

Do Food Intake and Food Cravings Change during the Menstrual Cycle of Young Women?

Abstract

Objective

Methods

Results

Conclusion

Efficacy, Safety, and Acceptability of Misoprostol in the Treatment of Incomplete Miscarriage: A Systematic Review and Meta-analysis

Abstract

Objective

Data sources

Selection of studies

Data collection

Data synthesis

Conclusion

Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis

Abstract

Objective

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

Abstract

Introduction

Objective

Methods

Results

Conclusion

Tribulus Terrestris for Female Sexual Dysfunction: A Systematic Review

Abstract

Objective

Data sources

Data collection

Data synthesis

Results

Conclusion

Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil

Abstract

Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors

Abstract

Objective

Materials and Methods

Results

Conclusion

Breastfeeding and the Benefits of Lactation for Women’s Health

Abstract

Preeclampsia

Abstract

Primary Dysmenorrhea: Assessment and Treatment

Abstract

Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity

Abstract

Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

Abstract

Objective

Methods

Results

Conclusion

Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

Abstract

Objective

Data

Data collection

Data synthesis

Conclusion

Covid-19 and Pregnancy: An Overview

Abstract

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