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Original Article10-03-2000
Prognostic Indicators In Lymph Node-Negative Breast Cancer: Estrogen Receptor and P53 and c-erbB-2 Protein Expression
- Adriana Harter Teixeira Bolaséll,
- Cláudio Galleano Zettler,
- Jeferson Vinholes,
- Simone Márcia Machado,
- Cláudia Kliemann
Views142This 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 ArticlePrognostic Indicators In Lymph Node-Negative Breast Cancer: Estrogen Receptor and P53 and c-erbB-2 Protein Expression
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):449-454
DOI 10.1590/S0100-72032000000700008
- Adriana Harter Teixeira Bolaséll,
- Cláudio Galleano Zettler,
- Jeferson Vinholes,
- Simone Márcia Machado,
- Cláudia Kliemann
Views142See morePurpose: to evaluate the prognostic value of estrogen receptor and p53 and c-erbB-2 proteins in lymph node-negative breast cancer. Methods: an immunohistochemical study was made in paraffin-embedded tissues from the file of the Instituto de Pesquisas Cito-Oncológicas of the Fundação Faculdade Federal de Ciências Médicas de Porto Alegre of fifty cases of postmenopausal women, who were treated at the Irmandade da Santa Casa de Misericórdia de Porto Alegre and at the Santa Rita Hospital from 1990 to 1994. For statistical analysis c² with Yates correction, as well as exact Fisher tests were used and Kaplan Meier curves compared with log-rank test. The mean follow-up of the patients was 3.6 years (3.1-4.5). Of the 50 cases, 14 showed recurrence during the period of follow-up. Results: the mean age was 61 years (46-78). Modified radical mastectomy was performed in 35 patients (70%) and 15 (30%) were submitted to lumpectomy/axillary dissection and postoperative radiation therapy. Fifty percent of the patients who showed recurrence did it in the first three years after the diagnosis. The mean size of the tumor was 2.8 cm (1.98-3.13) and the most frequent histological type was invasive ductal carcinoma of no special type (92%), according to the Bloom and Richardson graduation, 3 being stage I (6.6%), 35 stage II (76%) and 8 stage III (17.4%). In the tumors with recurrence, there was no grade I, 9 stage II (25.7%) and 3 stage III (37.5%). In relation to the prognosis, the disease-free interval was less when there was association of a poorly differentiated tumor with negative estrogen receptor (p = 0.006), positive p53 (p = 0.006) and positive c-erbB-2 (p = 0.001). Conclusion: postmenopausal women with lymph node-negative breast cancer showed worse prognosis in relation to disease-free interval when they presented poorly differentiated tumor associated with negative estrogen receptor, positive p53 and positive c-erbB-2.
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 Article10-03-2000
Factors Related to Obesity and Android Pattern of Body Fat Distribution in Climacteric Women
- Diana Beatriz Filip Raskin,
- Aarão Mendes Pinto-Neto,
- Lúcia Helena Simões Costa Paiva,
- Analisa Raskin,
- Edson Zangiacomi Martinez
Abstract
Original ArticleFactors Related to Obesity and Android Pattern of Body Fat Distribution in Climacteric Women
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):435-441
DOI 10.1590/S0100-72032000000700006
- Diana Beatriz Filip Raskin,
- Aarão Mendes Pinto-Neto,
- Lúcia Helena Simões Costa Paiva,
- Analisa Raskin,
- Edson Zangiacomi Martinez
Views134See morePurpose: to describe sociodemographic characteristics of a group of climacteric women in order to discover the frequency and the variables associated with obesity and android profile of body fat distribution. Methods: an observational study was carried out in 518 patients aged 45 to 65 years, in a climacterium outpatient clinic. Age, color, menopausal status, duration of menopause, physical activity, smoking status, diet, alcohol intake, personal and family antecedents of arterial hypertension, diabetes mellitus, cardiovascular disease, dyslipidemia and obesity were considered. Body mass index and the waist/hip ratio were the dependent variables. For the statistical analysis Wilcoxon test, Pearson’s correlation coefficient, with a 5% level of significance, and multivariate analysis using regression model were used. Results: more than two thirds of the participants were nonobese with an android profile and postmenopausal. One fourth had physical activity and were smokers; half reported an inadequate diet and one fifth were alcoholics. Patients with an android profile presented higher mean age than women with gynecoid pattern. Personal antecedents of obesity, arterial hypertension, diabetes and family history of diabetes were related to obesity and android pattern. Postmenopausal status was significantly associated with the android profile. Conclusions: the majority of the participants were nonobese with an android profile, white, postmenopausal, sedentary, neither smokers nor alcoholics. The main factors related to obesity and android pattern were personal antecedents of obesity, arterial hypertension, diabetes, family history of diabetes and particularly, postmenopausal status with android profile.
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 Article10-03-2000
Gastroschisis: Prenatal Evaluation of Prognostic Factors for Postnatal Outcome
- Liliana Patroni,
- Maria de Lourdes Brizot,
- Samir A. Mustafá,
- Mário H.B. Carvalho,
- Marcos Marquês Silva, [ … ],
- Marcelo Zugaib
Abstract
Original ArticleGastroschisis: Prenatal Evaluation of Prognostic Factors for Postnatal Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):421-428
DOI 10.1590/S0100-72032000000700004
- Liliana Patroni,
- Maria de Lourdes Brizot,
- Samir A. Mustafá,
- Mário H.B. Carvalho,
- Marcos Marquês Silva,
- Seyzo Miyadahira,
- Marcelo Zugaib
Views105See morePurpose: to evaluate 24 cases of gastroschisis, in relation to the prognostic factors that interfered with postnatal outcome. Patients and Method: twenty-four pregnancies with fetal prenatal ultrasound diagnosis of gastroschisis, during an 8-year period, were analyzed. Gastroschisis was classified into isolated, when there were no other structural abnormalities, or associated, when other abnormalities were present. For both groups the following parameters were examined: ultrasound bowel dilatation (>18 mm), obstetric complications and postnatal outcome. Nonparametric Mann-Whitney and exact Fisher’s tests were used for statistical analyses. Results: in 9 cases (37.5%) gastroschisis was associated with other abnormalities, and in 15 cases it was isolated (62.5%). All cases of associated gastroschisis had a letal prognosis, therefore the overall mortality rate was 60.8%. In the group of isolated gastroschisis, all were born alive and were submitted to surgery, but the survival rate after surgical correction was 60%. The median gestational age at birth was 35 weeks and birth weight 2,365 grams. Premature delivery was observed in 10 cases, mainly as a consequence of obstetric complication. Two newborns were small for gestational age, and only 3 had birth weight >2,500 grams. Oligohydramnios was found in 46.6% and it was more frequent in the group of postnatal death (66.7%). Ultrasound assessment of bowel showed bowel dilatation in 86.6%, however, without relation to the prognosis and postnatal bowel findings. There was no significant difference between gestational age at birth and birth weight comparing the survivor and postnatal death groups. Conclusions: isolated gastroschisis had a better prognosis when compared to associated, therefore this prenatal differentiation is important. Isolated gastroschisis was often associated with prematurity, small birth weight and obstetric complications. Prenatal diagnosis allows better monitoring of fetal and obstetric conditions. Delivery should be at term, unless presenting with obstetric complications.
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. -
10-03-2000
MAIS UMA META ATINGIDA
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(7):399-399
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. -
07-23-2000
Isoformas de Prolactina no Fluido Folicular de Pacientes Submetidas a FIV
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):658-658
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. -
07-23-2000
Avaliação Clínica e Urodinâmica de Mulheres com Instabilidade Vesical Antes e Após Eletro-estimulação Funcional do Assoalho Pélvico
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):658-658
Abstract
Avaliação Clínica e Urodinâmica de Mulheres com Instabilidade Vesical Antes e Após Eletro-estimulação Funcional do Assoalho Pélvico
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):658-658
DOI 10.1590/S0100-72032000001000012
Views57Avaliação Clínica e Urodinâmica de Mulheres com Instabilidade Vesical Antes e Após Eletro-estimulação Funcional do Assoalho Pélvico[…]See 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. -
07-23-2000
Estudo Retrospectivo da Prova de Trabalho de Parto na Viabilização do Parto Vaginal em Gestantes com uma Cesárea Anterior
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):657-657
Abstract
Estudo Retrospectivo da Prova de Trabalho de Parto na Viabilização do Parto Vaginal em Gestantes com uma Cesárea Anterior
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):657-657
DOI 10.1590/S0100-72032000001000010
Views63Estudo Retrospectivo da Prova de Trabalho de Parto na Viabilização do Parto Vaginal em Gestantes com uma Cesárea Anterior[…]See 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. -
07-23-2000
Impacto da Ação Educativa sobre a Taxa de Abandono do Serviço de Esterilidade Conjugal da UNICAMP
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):657-657
Abstract
Impacto da Ação Educativa sobre a Taxa de Abandono do Serviço de Esterilidade Conjugal da UNICAMP
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(10):657-657
DOI 10.1590/S0100-72032000001000011
Views60Impacto da Ação Educativa sobre a Taxa de Abandono do Serviço de Esterilidade Conjugal da UNICAMP[…]See 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.
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Original Article03-27-2020
Gestational Diabetes in the Population Served by Brazilian Public Health Care. Prevalence and Risk Factors
- Pâmela Antoniazzi dos Santos
,
- José Mauro Madi
,
- Emerson Rodrigues da Silva
,
- Daiane de Oliveira Pereira Vergani
,
- Breno Fauth de Araújo
,
[ … ], - Rosa Maria Rahmi Garcia
Abstract
Original ArticleGestational 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
- Pâmela Antoniazzi dos Santos
,
- José Mauro Madi
,
- Emerson Rodrigues da Silva
,
- Daiane de Oliveira Pereira Vergani
,
- Breno Fauth de Araújo
,
- Rosa Maria Rahmi Garcia
Views368See moreAbstract
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.
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. - Pâmela Antoniazzi dos Santos
-
Systematic Review05-01-2017
Zika Virus Infection in Pregnant Women and Microcephaly
- Geraldo Duarte,
- Antonio Fernandes Moron,
- Artur Timerman,
- César Eduardo Fernandes,
- Corintio Mariani Neto, [ … ],
- Rossana Pulcineli Vieira Francisco
Abstract
Systematic ReviewZika Virus Infection in Pregnant Women and Microcephaly
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):235-248
- Geraldo Duarte,
- Antonio Fernandes Moron,
- Artur Timerman,
- César Eduardo Fernandes,
- Corintio Mariani Neto,
- Gutemberg Leão de Almeida Filho,
- Heron Werner Junior,
- Hilka Flavia Barra do Espírito Santo,
- João Alfredo Piffero Steibel,
- João Bortoletti Filho,
- Juvenal Barreto Borriello de Andrade,
- Marcelo Burlá,
- Marcos Felipe Silva de Sá,
- Newton Eduardo Busso,
- Paulo César Giraldo,
- Renato Augusto Moreira de Sá,
- Renato Passini Junior,
- Rosiane Mattar,
- Rossana Pulcineli Vieira Francisco
Views409Abstract
From the discovery of the Zika virus (ZIKV) in 1947 in Uganda (Africa), until its arrival in South America, it was not known that it would affect human reproductive life so severely. Today, damagetothe central nervous system is known to be multiple, and microcephaly is considered the tip of the iceberg. Microcephaly actually represents the epilogue of this infection’s devastating process on the central nervous system of embryos and fetuses. As a result of central nervous system aggression by the ZIKV, this infection brings the possibility of arthrogryposis, dysphagia, deafness and visual impairment. All of these changes of varying severity directly or indirectly compromise the future life of these children, and are already considered a congenital syndrome linked to the ZIKV. Diagnosis is one of the main difficulties in the approach of this infection. Considering the clinical part, it has manifestations common to infections by the dengue virus and the chikungunya fever, varying only in subjective intensities. The most frequent clinical variables are rash, febrile state, non-purulent conjunctivitis and arthralgia, among others. In terms of laboratory resources, there are also limitations to the subsidiary diagnosis. Molecular biology tests are based on polymerase chain reaction (PCR)with reverse transcriptase (RT) action, since the ZIKV is a ribonucleic acid (RNA) virus. The RT-PCR shows serum or plasma positivity for a short period of time, no more than five days after the onset of the signs and symptoms. The ZIKVurine test is positive for a longer period, up to 14 days. There are still no reliable techniques for the serological diagnosis of this infection. If there are no complications (meningoencephalitis or Guillain-Barré syndrome), further examination is unnecessary to assess systemic impairment. However, evidence is needed to rule out other infections that also cause rashes, such as dengue, chikungunya, syphilis, toxoplasmosis, cytomegalovirus, rubella, and herpes. There is no specific antiviral therapy against ZIKV, and the therapeutic approach to infected pregnant women is limited to the use of antipyretics and analgesics. Anti-inflammatory drugs should be avoided until the diagnosis of dengue is discarded. There is no need to modify the schedule of prenatal visits for pregnant women infected by ZIKV, but it is necessary to guarantee three ultrasound examinations during pregnancy for low-risk pregnancies, and monthly for pregnant women with confirmed ZIKV infection. Vaginal delivery and natural breastfeeding are advised.
Key-words arbovirus infectionsblindness/ etiologydeafness/ etiologymicrocephaly/ ultrasonographyPregnancy complicationsReal-time polymerase chain reactionZika virusSee 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. -
Review Article06-27-2022
Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433
Abstract
Review ArticlePolycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433
Views434See moreAbstract
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.
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. -
Review Article05-01-2018
Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction
- Marianna Amaral Pedroso,
- Kirsten Rebecca Palmer,
- Ryan James Hodges,
- Fabricio da Silva Costa,
- Daniel Lorber Rolnik
Abstract
Review ArticleUterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):287-293
- Marianna Amaral Pedroso,
- Kirsten Rebecca Palmer,
- Ryan James Hodges,
- Fabricio da Silva Costa,
- Daniel Lorber Rolnik
Views419See moreAbstract
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.
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. -
Review Article09-16-2019
Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
- Júlia Ferreira Fante,
- Thais Daniel Silva,
- Elaine Cristine Lemes Mateus-Vasconcelos,
- Cristine Homsi Jorge Ferreira,
- Luiz Gustavo Oliveira Brito
Abstract
Review ArticleDo Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519
- Júlia Ferreira Fante,
- Thais Daniel Silva,
- Elaine Cristine Lemes Mateus-Vasconcelos,
- Cristine Homsi Jorge Ferreira,
- Luiz Gustavo Oliveira Brito
Views387See moreAbstract
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.
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 Article04-09-2024
Screening and prevention of preterm birth: how is it done in clinical practice?
- Roberta Bulsing dos Santos
,
- Janete Vettorazzi
,
- Marcos Wengrover Rosa
,
- Ellen Machado Arlindo
,
- Edimárlei Gonsales Valério
Abstract
Original ArticleScreening and prevention of preterm birth: how is it done in clinical practice?
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
- Roberta Bulsing dos Santos
,
- Janete Vettorazzi
,
- Marcos Wengrover Rosa
,
- Ellen Machado Arlindo
,
- Edimárlei Gonsales Valério
Views552Abstract
Objective:
To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country.
Methods:
Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices.
Results:
The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix.
Conclusion:
In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.
Key-words attitudes, practiceCervical length measurementgynecologistshealth knowledgeInfant, prematureobstetriciansPreterm birthPreventionScreeningsurveys and questionnairesSee 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. - Roberta Bulsing dos Santos
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Review Article01-23-2022
Efficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review
- Ayane Cristine Alves Sarmento
,
- Ana Paula Ferreira Costa
,
- Juliana Lírio
,
- José Eleutério Jr
,
- Pedro Vieira Baptista
,
[ … ], - Ana Katherine Gonçalves
Abstract
Review ArticleEfficacy of Hormonal and Nonhormonal Approaches to Vaginal Atrophy and Sexual Dysfunctions in Postmenopausal Women: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):986-994
- Ayane Cristine Alves Sarmento
,
- Ana Paula Ferreira Costa
,
- Juliana Lírio
,
- José Eleutério Jr
,
- Pedro Vieira Baptista
,
- Ana Katherine Gonçalves
Views390See moreAbstract
Objective
To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women.
Data Sources
We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied.
Selection of Studies
We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women.
Data Collection
Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors.
Data Synthesis
A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic floor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO2 laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study).
Conclusion
We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).
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. - Ayane Cristine Alves Sarmento
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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
Abstract
Original ArticlePrevalence 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
- Ana Paula Rodrigues Rezende
,
- Fernanda Rassi Alvarenga
,
- Marcelo Ramos
,
- Débora Luiza Franken
,
- Juvenal Soares Dias da Costa
,
- Marcos Pascoal Pattussi
,
- Vera Maria Vieira Paniz
Views385Abstract
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 studiespremenstrual dysphoric disorderPremenstrual syndromeRisk factorsStudentsSee 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. - Ana Paula Rodrigues Rezende
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Review Article06-01-2018
Breastfeeding and the Benefits of Lactation for Women’s Health
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):354-359
Abstract
Review ArticleBreastfeeding and the Benefits of Lactation for Women’s Health
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):354-359
Views573See moreAbstract
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.
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. -
Review Article09-01-2017
Preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512
Abstract
Review ArticlePreeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512
Views648Abstract
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 syndromeHigh risk pregnancyPreeclampsiapregnancy arterial hypertensionPregnancy complicationsSee 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. -
Review Article09-25-2020
Primary Dysmenorrhea: Assessment and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):501-507
Abstract
Review ArticlePrimary Dysmenorrhea: Assessment and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):501-507
Views582See moreAbstract
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.
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. -
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
Abstract
Review ArticleMultiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):554-562
Views456See moreAbstract
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.
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. -
Review Article05-01-2018
Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction
- Marianna Amaral Pedroso,
- Kirsten Rebecca Palmer,
- Ryan James Hodges,
- Fabricio da Silva Costa,
- Daniel Lorber Rolnik
Abstract
Review ArticleUterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(5):287-293
- Marianna Amaral Pedroso,
- Kirsten Rebecca Palmer,
- Ryan James Hodges,
- Fabricio da Silva Costa,
- Daniel Lorber Rolnik
Views419See moreAbstract
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.
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. -
Review Article02-01-2016
Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials
- Rafael Mendes Moroni,
- Pedro Sergio Magnani,
- Jorge Milhem Haddad,
- Rodrigo de Aquino Castro,
- Luiz Gustavo Oliveira Brito
Abstract
Review ArticleConservative 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
- Rafael Mendes Moroni,
- Pedro Sergio Magnani,
- Jorge Milhem Haddad,
- Rodrigo de Aquino Castro,
- Luiz Gustavo Oliveira Brito
Views396See moreWe 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.
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. -
Review Article09-16-2019
Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
- Júlia Ferreira Fante,
- Thais Daniel Silva,
- Elaine Cristine Lemes Mateus-Vasconcelos,
- Cristine Homsi Jorge Ferreira,
- Luiz Gustavo Oliveira Brito
Abstract
Review ArticleDo Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519
- Júlia Ferreira Fante,
- Thais Daniel Silva,
- Elaine Cristine Lemes Mateus-Vasconcelos,
- Cristine Homsi Jorge Ferreira,
- Luiz Gustavo Oliveira Brito
Views387See moreAbstract
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.
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. -
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
Abstract
Review ArticleCovid-19 and Pregnancy: An Overview
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):420-426
- Pedro Castro
,
- Ana Paula Matos
,
- Heron Werner
,
- Flávia Paiva Lopes
,
- Gabriele Tonni
,
- Edward Araujo Júnior
Views280See moreAbstract
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.
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. - Pedro Castro
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