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Review Article09-18-2024
Neonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis
- Juliana Almeida Oliveira
, - Eloisa Gonçalves da Silva ,
- Ayse Filiz Gokmen Karasu ,
- Anelise Maria Nicolau Silva ,
- Chris Elizabeth Philip
Abstract
Review ArticleNeonatal and maternal outcomes of mRNA versus Non-mRNA COVID-19 vaccines in pregnant patients: a systematic review and meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo69
- Juliana Almeida Oliveira ,
- Eloisa Gonçalves da Silva ,
- Ayse Filiz Gokmen Karasu ,
- Anelise Maria Nicolau Silva ,
- Chris Elizabeth Philip
Views281Abstract
Objective
To compare the effectiveness and safety of non-mRNA versus mRNA COVID-19 vaccines on pregnant women and their newborns in a systematic review with meta-analysis.
Data sources
We searched PubMed, Embase, and Cochrane Central in May 2023.
Study selection
The search strategy yielded 4451 results, 16 studies were fully reviewed. We selected case-control studies analysing non-mRNA versus mRNA vaccines. Data collection and analysis: we assessed the risk of bias using the Cochrane Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. Standardised mean differences were pooled using random-effect models.
Data synthesis
We identified 8 prospective and retrospective studies with a total of 32,153 patients. Non-mRNA vaccines were associated with a higher incidence of fever (OR 2.67; 95% CI 2.08-3.43; p<0.001), and a lower incidence of fetal or neonatal death (OR 0.16; 95% CI 0.08-0.33; p<0.001). In subgroup analyses, the Jansen vaccine (Ad26.COV2.S) was found to have a higher rate of premature labor/delivery (OR 4.48; 95% CI 1.45-13.83; p=0.009) and missed/spontaneous abortion (OR 1.90; 95% CI 1.09-3.30; p=0.02), as compared with the Pfizer (BNT162b2) vaccine.
Conclusion
non-mRNA vaccines are associated with a lower incidence of fetal or neonatal death among pregnant women who receive a Covid19 vaccine, although at an increased rate of pyrexia compared with mRNA vaccines. Other studies are required for better assessment.
PROSPERO
CRD42023421814
Key-words coronavirus infectionsCOVID-19COVID-19 vaccinesInfant, newbornmRNA vaccinesPregnancy complicationsPregnant womenSARS-CoV-2See more
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. - Juliana Almeida Oliveira
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Original Article09-18-2024
Multidisciplinary team training in postpartum hemorrhage: impact on the use of blood products
- Carina Bauer Luiz ,
- Ana Lúcia Letti Müller ,
- Cristiano Caetano Salazar ,
- Teresinha Zanella ,
- Gabriel Cardozo Müller , [ … ],
- Janete Vettorazzi
Abstract
Original ArticleMultidisciplinary team training in postpartum hemorrhage: impact on the use of blood products
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo67
- Carina Bauer Luiz ,
- Ana Lúcia Letti Müller ,
- Cristiano Caetano Salazar ,
- Teresinha Zanella ,
- Gabriel Cardozo Müller ,
- Amanda Vilaverde Perez ,
- Mariana Sbaraini ,
- Maria Lucia Oppermann ,
- Janete Vettorazzi
Views300See moreAbstract
Objective
Compare the number of puerperal women submitted to blood transfusion before and after the implementation of a care protocol for postpartum hemorrhage (PPH) with multidisciplinary team training.
Methods
Cross-sectional study in a university hospital, analyzing births from 2015 to 2019, compared the use of blood products before and after the adoption of a PPH protocol with multidisciplinary training.
Results
Between 2015 and 2019, there were 17,731 births, with 299 (1.7%) postpartum women receiving blood products and 278 postpartum women were considered for this analysis, 128 (0.7%) at Time 1 and 150 (0.8%) at Time 2. After the multiprofessional team training (T2), there was a difference in the complete use of the PPH protocol (use of oxytocin, misoprostol and tranexamic acid) (T1 = 5.1% x T2 = 49.5%, p≤0.0001). An individual categorized analysis revealed that, in the T2 period, there was lower use of blood component units per patient compared to T1 (Mann-Whitney, p=0.006). It should be noted that at T1 and T2, 54% and 24% respectively received two units of blood products. It is important to highlight that after the multidisciplinary team training for the PPH protocol, the goal of zero maternal death due to hemorrhage was reached.
Conclusion
The adoption of a specific protocol for PPH, combined with the training of a multidisciplinary team, had an impact on the ability to identify women at high risk of hemorrhage, resulting in a decrease in the use of blood components.
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. - Carina Bauer Luiz
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Original Article09-06-2024
Immediate prepectoral versus submuscular breast reconstruction in nipple-sparing mastectomy: a retrospective cohort analysis
- Francisco Pimentel Cavalcante ,
- Ticiane Oliveira Lima ,
- Ryane Alcantara ,
- Amanda Cardoso ,
- Guilherme Novita , [ … ],
- Eduardo Millen
Abstract
Original ArticleImmediate prepectoral versus submuscular breast reconstruction in nipple-sparing mastectomy: a retrospective cohort analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo76
- Francisco Pimentel Cavalcante ,
- Ticiane Oliveira Lima ,
- Ryane Alcantara ,
- Amanda Cardoso ,
- Guilherme Novita ,
- Felipe Zerwes ,
- Eduardo Millen
Views283Abstract
Objective
To evaluate early complications in prepectoral breast reconstruction.
Methods
A retrospective cohort study including 180 consecutive cases of nipple-sparing mastectomy, comparing immediate breast reconstruction with subpectoral to prepectoral mammary implants in 2012-2022. Clinical and demographic characteristics and complications in the first three months following surgery were compared between the two techniques.
Results
The prepectoral technique was used in 22 cases (12.2%) and the subpectoral in 158 (87.8%). Median age was higher in the prepectoral group (47 versus 43.8 years; p=0.038), as was body mass index (25.1 versus 23.8; p=0.002) and implant volume (447.5 versus 409 cc; p=0.001). The prepectoral technique was more associated with an inframammary fold (IMF) incision (19 cases, 86.4% versus 85, 53.8%) than with periareolar incisions (3 cases, 13.6% versus 73, 46.2%); (p=0.004). All cases in the prepectoral group underwent direct-to-implant reconstruction compared to 54 cases (34.2%) in the subpectoral group. Thirty-eight complications were recorded: 36 (22.8%) in the subpectoral group and 2 (9.1%) in the prepectoral group (p=0.24). Necrosis of the nipple-areola complex/skin flap occurred in 27 patients (17.1%) in the subpectoral group (prepectoral group: no cases; p=0.04). The groups were comparable regarding dehiscence, seroma, infection, and hematoma. Reconstruction failed in one case per group (p=0.230). In the multivariate analysis, IMF incision was associated with the prepectoral group (aOR: 34.72; 95%CI: 2.84-424.63).
Conclusion
The incidence of early complications was comparable between the two techniques and compatible with previous reports. The clinical and demographic characteristics differed between the techniques. Randomized clinical trials are required.
Key-words Breast implantationBreast implantsBreast neoplasmsMammaplastyMastectomyNipplesPectoralis musclesSurgical procedures, operativeSee 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. - Francisco Pimentel Cavalcante
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Original Article09-06-2024
Thinking on the purposes, roles and activities of networks for research on maternal and perinatal health: opinions of coordinators and members
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo75
Abstract
Original ArticleThinking on the purposes, roles and activities of networks for research on maternal and perinatal health: opinions of coordinators and members
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo75
Views139See moreAbstract
Objective
To identify the opinion of coordinators and members about the essential characteristics and to understand the research networks characteristics, to facilitate their implementation, sustainability and effectiveness so it can be replicated in low and middle-income countries.
Methods
A qualitative study using a semi-structured interview technique was conducted. We selected potential members, managers and participants of networks from publications identified in PubMed. After checking the FIGO congress program, we identified authors who were assigned as speakers at the event. An invitation was sent and interviews were scheduled.
Results
In total, eleven interviews were performed. Coordinators and members of networks have the same goal when they decide to participate in a network. In general, they cited that these individuals had to be committed, responsible and enthusiastic people. The network should be composed also of postgraduate students. A network should allow multi-leadership, co-responsibility, autonomy and empowerment of its members. Effective communication was mentioned as an important pillar for network maintenance. Another motivation is being an author or coauthor in publications. One way to maintain a network running is social or governmental commitment, after resources expire, studies continue.
Conclusion
Networks are different due to the social context where they are inserted, however, some characteristics are common to all of them, such as having engaged leaders. For an effective and sustainable network, commitment and motivation in a leader and members are more in need than financial resources. Ideally, to ensure the operation of the network, the institution where the leader is linked should support this network.
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 Article09-06-2024
Morbidity associated with emergency surgery versus scheduled surgery in patients with placenta accreta spectrum
- Juan José Saldarriaga-Hoyos ,
- Daniela Sarria-Ortiz ,
- Valentina Galindo-Velasco ,
- Luisa Fernanda Rivera-Torres ,
- Albaro José Nieto-Calvache
Abstract
Original ArticleMorbidity associated with emergency surgery versus scheduled surgery in patients with placenta accreta spectrum
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo74
- Juan José Saldarriaga-Hoyos ,
- Daniela Sarria-Ortiz ,
- Valentina Galindo-Velasco ,
- Luisa Fernanda Rivera-Torres ,
- Albaro José Nieto-Calvache
Views164See moreAbstract
Objective
This study aims to evaluate the clinical outcomes of surgical management for placenta accreta spectrum in a Latin American reference hospital specializing in this condition. The evaluation involves a comparison between surgeries performed on an emergent and scheduled basis.
Methods
A retrospective cohort study was conducted on patients with placenta accreta spectrum who underwent surgery between January 2011 and November 2021 at a hospital in Colombia, using data from the institutional PAS registry. The study included patients with intraoperative and/or histological confirmation of PAS, regardless of prenatal suspicion. Clinical outcomes were compared between patients who had emergent surgeries and those who had scheduled surgeries. Descriptive analysis involved summary measures and the Shapiro-Wilk test for quantitative variables, with comparisons made using Pearson’s Chi-squared test and the Wilcoxon rank sum test, applying a significance level of 5%.
Results
A total of 113 patients were included, 84 (74.3%) of them underwent scheduled surgery, and 29 (25.6%) underwent emergency surgery. The emergency surgery group required more transfusions (72.4% vs 48.8%, p=0.047). Patients with intraoperative diagnosis of placenta accreta spectrum (21 women, 19.5%) had a greater volume of blood loss than patients taken into surgery with known presence of placenta accreta spectrum (3500 ml, IQR 1700 – 4000 vs 1700 ml, IQR 1195-2135. p <0.001).
Conclusion
Patients with placenta accreta spectrum undergoing emergency surgery require transfusions more frequently than those undergoing scheduled surgery
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. - Juan José Saldarriaga-Hoyos
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Review Article09-06-2024
Biochemical markers for prediction of the first half pregnancy losses: a review
- Meruyet Kuspanova ,
- Andrey Gaiday ,
- Nurzhamal Dzhardemaliyeva ,
- Maxat Tuganbayev ,
- Maksym Gorobeiko , [ … ],
- Akylbek Tussupkaliyev
Abstract
Review ArticleBiochemical markers for prediction of the first half pregnancy losses: a review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo72
- Meruyet Kuspanova ,
- Andrey Gaiday ,
- Nurzhamal Dzhardemaliyeva ,
- Maxat Tuganbayev ,
- Maksym Gorobeiko ,
- Andrii Dinets ,
- Saule Bermagambetova ,
- Zhanna Amirbekova ,
- Gulshat Oraltayeva ,
- Dinara Omertayeva ,
- Akylbek Tussupkaliyev
Views253Abstract
Objective
26% of all pregnancies end in miscarriage, and up to 10% of clinically diagnosed pregnancies, and recurrent pregnancy loss is 5% among couples of childbearing ages. Although there are several known causes of pregnancy loss in the first half, including recurrent pregnancy loss, including parental chromosomal abnormalities, uterine malformations, endocrinological disorders, and immunological abnormalities, about half of the cases of pregnancy loss in its first half remain unexplained.
Methods
The review includes observational controlled studies (case-control or cohort, longitudinal studies, reviews, meta-analyses), which include the study of biochemical factors for predicting pregnancy losses in the first half, in singlet pregnancy. The Newcastle-Ottawa Scale (NOS) was used to assess the research quality.
Results
Finally, 27 studies were included in the review, which has 134904 examined patients. The results of the review include estimates of β-human chorionic gonadotropin, progesterone, pregnancy-associated protein – A, angiogenic vascular factors, estradiol, α-fetoprotein, homocysteine and CA-125 as a predictors or markers of the first half pregnancy losses.
Conclusion
It may be concluded that to date, research data indicate the unavailability of any reliable biochemical marker for predicting pregnancy losses in its first half and require either a combination of them or comparison with clinical evidence. A fairly new model shall be considered for the assessment of α-fetoprotein in vaginal blood, which may have great prospects in predicting spontaneous miscarriages.
Key-words Biochemical markerLaboratory markerMiscarriagemissed abortionpredictionPregnancySpontaneous abortionSee 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. - Meruyet Kuspanova
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Original Article09-06-2024
Association between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study
- Luciana da Cunha Bernardes Argenta ,
- Nadya Helena Alves dos Santos ,
- Cláudia Saunders ,
- Joana Dias da Costa ,
- Letícia Victoria Souza da Cunha , [ … ],
- Patricia de Carvalho Padilha
Abstract
Original ArticleAssociation between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo68
- Luciana da Cunha Bernardes Argenta ,
- Nadya Helena Alves dos Santos ,
- Cláudia Saunders ,
- Joana Dias da Costa ,
- Letícia Victoria Souza da Cunha ,
- Pamela Melo Krok Fedeszen ,
- Patricia de Carvalho Padilha
Views218See moreAbstract
Objective
To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants.
Methods
Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models.
Results
The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates.
Conclusion
No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.
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. - Luciana da Cunha Bernardes Argenta
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Review Article09-06-2024
Relationship between early age at menarche, older age at menopause and subtypes of breast cancer: a scoping review
- Lucas Casagrande Passoni Lopes ,
- Gabriel Araújo Medeiros ,
- Igor José Nogueira Gualberto ,
- Thales Baptista Gut ,
- Rafael Vasconcelos Silva Ferrazini , [ … ],
- Carlos Antonio Negrato
Abstract
Review ArticleRelationship between early age at menarche, older age at menopause and subtypes of breast cancer: a scoping review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo50
- Lucas Casagrande Passoni Lopes ,
- Gabriel Araújo Medeiros ,
- Igor José Nogueira Gualberto ,
- Thales Baptista Gut ,
- Rafael Vasconcelos Silva Ferrazini ,
- Carlos Antonio Negrato
Views241See moreAbstract
Objective
To determine the relationship between early age at menarche, late age at menopause with specific subtypes of breast cancer (BC).
Methods
A literature search was conducted in Embase, Lilacs, PubMed, Scopus, and Scielo databases, following the Joanna Briggs Institute scoping review protocol and answering the question “How early age at menarche or late age at menopause are related to different breast cancer subtypes?”.
Results
A number of 4,003 studies were identified, of which 17 were selected. Most of the included articles found a clear relationship between early menarche, late menopause and some subtypes of BC, mainly, PR+, ER+, luminal, and HER-2 tumors. However, some studies have found a contradictory relationship and one study didn’t find any relationship between them.
Conclusion
A relationship between early age at menarche and advanced age at menopause was observed with some subtypes of breast cancer, since other factors must be considered in its understanding.
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. - Lucas Casagrande Passoni Lopes
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