Articles - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article04-30-2025

    Evaluation of pathological complete response rates in breast cancer patients undergoing neoadjuvant therapy

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo13

    Abstract

    Original Article

    Evaluation of pathological complete response rates in breast cancer patients undergoing neoadjuvant therapy

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo13

    DOI 10.61622/rbgo/2025rbgo13

    Views167

    Abstract

    Objective:

    This study aims to assess the rate of pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant therapy and to explore its correlation with clinical, molecular, and prognostic factors.

    Methods:

    We conducted this retrospective observational study at Liga Contra o Câncer, a major public oncology reference center in Northeast Brazil. We included patients diagnosed with breast cancer who initiated neoadjuvant therapy between June 2018 and June 2019. Patients with a history of recurrent breast cancer or those who did not undergo surgery were excluded. The primary outcome was the pCR rate, with secondary outcomes including Overall Survival (OS), Disease-Free Survival (DFS), mortality, and disease recurrence. Follow-up extended until August 2022. We performed multivariate Cox regression analysis to correlate outcomes with predetermined variables.

    Results:

    Of the 292 included patients, 63 (21.6%) achieved pCR. The mean follow-up duration was 42.8 months. Multivariate logistic regression analysis revealed an association between pCR and the AC-TH regimen [OR = 2.4; 95%CI = 1.13 – 5.24; p=0.023], as well as between pCR and HER2-positive tumors [OR 2.49; 95% CI = 1.14 – 5.86; p=0.028]. Complete pathological response was associated with higher DFS [HR 0.33; 95%CI 0.13-0.86; p=0.024].

    Conclusion:

    Neoadjuvant therapy demonstrated significant efficacy in achieving pathological response in breast cancer patients. We observed a strong association between the AC-TH regimen, HER2-positive status, and pCR.

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    Evaluation of pathological complete response rates in breast cancer patients undergoing neoadjuvant therapy
  • Original Article04-30-2025

    Depression, anxiety, sexual function and quality of life in women with hyperprolactinemia

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo7

    Abstract

    Original Article

    Depression, anxiety, sexual function and quality of life in women with hyperprolactinemia

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo7

    DOI 10.61622/rbgo/2025rbgo7

    Views169

    Abstract

    Objective:

    To evaluate anxiety, depression, sexual function and quality of life in women with hyperprolactinemia.

    Methods:

    Cross-sectional study with 80 women divided into two groups: 30 women with hyperprolactinemia (Study Group) followed and treated at the endocrine gynecology outpatient clinic and 50 women without hyperprolactinemia, with regular menstrual cycles (Control Group) followed at the family planning outpatient clinic of the State University of Campinas from June 2021 to October 2022. Sociodemographic characteristics, quality of life (SF-36 Questionnaire), sexual function (Female Sexual Function Index Questionnaire), depression (Beck Depression Inventory) and anxiety (Beck Anxiety Scale) were evaluated in both groups. Categorical variables were described as absolute frequency and percentage; numerical variables as mean and standard deviation. Comparison of numerical variables between two groups was performed by Mann-Whitney test, while categorical were compared by Chi-Square or Fisher’s exact tests.

    Results:

    The mean age of women with hyperprolactinemia was 39.6±8.1 years and the Control Group was 31.2±9.5 years (p<0.001). There was no difference in anxiety scores (p=0.66), depression (p=0.08) and general sexual function (p=0.08) in both groups. However, women with hyperprolactinemia had lower scores in the domains of pain and arousal and worse functional capacity than Control Group (p<0.05).

    Conclusion:

    Women with hyperprolactinemia under treatment do not show any impairment in their anxiety, depression and sexual function when compared to women without hyperprolactinemia. However, analysis of quality of life showed that women with hyperprolactinemia have poor functional capacity.

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  • FEBRASGO POSITION STATEMENT03-28-2025

    Follow-up of women after gynecological cancer treatment

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-FPS3

    Abstract

    FEBRASGO POSITION STATEMENT

    Follow-up of women after gynecological cancer treatment

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-FPS3

    DOI 10.61622/rbgo/2025FPS3

    Views260

    Key points

    •The population of female cancer survivors has increased over the last few years, highlighting the importance of appropriate follow-up of these patients.

    •The main objective of long-term follow-up for patients treated for cancer is the early detection of recurrences, whether local, lymph node or distant metastases.

    •Symptom assessment and physical examination play an important role in the follow-up of patients treated for gynecological neoplasms.

    •The use of laboratory or imaging tests to detect recurrence in asymptomatic patients should be based on evidence that it improves survival or provides less morbid treatments, also considering cost and availability.

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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.
  • Letter to the Editor03-18-2025

    Comment on: Access and adequacy of antenatal care in during two phases of the COVID-19 pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo12

    Abstract

    Letter to the Editor

    Comment on: Access and adequacy of antenatal care in during two phases of the COVID-19 pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo12

    DOI 10.61622/rbgo/2025rbgo12

    Views222
    The publication on “Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic.”() Is an interesting issue. This study investigated antenatal care consumption and appropriateness among postpartum caregivers at Florianópolis Hospital from 2020 to 2022, with an emphasis on socio-demographic characteristics and antenatal care. Although this study […]
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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.
  • Letter to the Editor03-18-2025

    Use of calcium during pregnancy: far beyond pre-eclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo11

    Abstract

    Letter to the Editor

    Use of calcium during pregnancy: far beyond pre-eclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo11

    DOI 10.61622/rbgo/2025rbgo11

    Views281
    Dear Editor,We read with interest the Editorial of the Revista Brasileira de Ginecologia e Obstetrícia (RBGO) in which Braga et al. present the initiative of the state of Rio de Janeiro (Brazil) for prediction and secondary prevention of pre-eclampsia.() The authors highlight universal calcium supplementation during pregnancy as a significant innovation, implemented for the first […]
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  • Review Article03-18-2025

    Short cervix and use of cervical pessary for preventing preterm birth in singleton and twin pregnancies: a systematic review and meta-analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo10

    Abstract

    Review Article

    Short cervix and use of cervical pessary for preventing preterm birth in singleton and twin pregnancies: a systematic review and meta-analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo10

    DOI 10.61622/rbgo/2025rbgo10

    Views257

    Abstract

    Objective:

    Preterm birth remains a significant contributor to neonatal morbidity and mortality. The use of cervical pessaries as an intervention for preventing preterm delivery in women with a short cervix has been a subject of interest. We evaluated the effectiveness of cervical pessary compared to standard care in preventing preterm delivery in women with a short cervix.

    Data source:

    Databases were systematically searched in PubMed, Cochrane, and Embase databases in December 2023.

    Study selection:

    Randomized clinical trials with the outcomes of interest were included.

    Data collect:

    We computed risk ratios for binary endpoints, with 95% confidence intervals. Heterogeneity was assessed using I2 statistics. Data were analyzed using R software (version 4.3.0). The primary outcomes of interest were preterm delivery before 37 weeks, and preterm delivery before 34 weeks.

    Data synthesis:

    Seventeen studies with 5,704 patients were included. The use of cervical pessary was associated with a decreased risk of preterm delivery before 37 (RR 0.88; 95% CI 0.81-0.96) and 34 weeks (RR 0.79; 95% CI 0.63-0.99) of gestation in twin pregnancies as compared to standard care without progesterone. There were no significant differences in preterm delivery in singleton pregnancy, neonatal outcomes, preterm premature rupture of the membranes or chorioamnionitis.

    Conclusion:

    The use of cervical pessary was associated with a significant reduction in preterm delivery at 34 and 37 weeks of gestation in twin pregnancies among patients with a short cervix compared to no treatment. No significant difference was found in singleton pregnancies or maternal outcomes.

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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.
    Short cervix and use of cervical pessary for preventing preterm birth in singleton and twin pregnancies: a systematic review and meta-analysis
  • Short Communication03-18-2025

    Contraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo9

    Abstract

    Short Communication

    Contraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo9

    DOI 10.61622/rbgo/2025rbgo9

    Views256

    Abstract

    Objective:

    To evaluate the continuation rate, satisfaction, and reasons for discontinuation of depot medroxyprogesterone acetate (DMPA) in adolescents treated in a mental health service.

    Methods:

    Prospective cohort study conducted in a reference unit for the care of adolescents with mental disorders (MDs) and intellectual disabilities (IDs). All patients received a gynecological consultation and an educational group on contraceptive methods. Sociodemographic data on age, education and gynecological data (menarche, coitarche, regularity of menstrual cycles and presence of symptoms) were collected. Follow-up was quarterly for 12 months, during which symptoms, desire to continue, and satisfaction with the use of the quarterly injectable were assessed.

    Results:

    Eight hundred and sixty-two sexually active adolescents were supported, 532 adolescents chose to use the quarterly injectable, and 69 of these agreed to participate in the study. The mean age of users was 15.5 years (SD=0.91). After 12 months of follow-up, 34 (49.3%) of the 69 adolescents continued to use the method and 36 (52.3%) were satisfied. Among the 33 (47.8%) who discontinued use, the most common reasons were irregular bleeding and weight gain.

    Conclusions:

    Adolescents with intellectual disabilities and/or other mental disorders showed a significant rate of continuation and satisfaction with the use of the depot medroxyprogesterone acetate at 12 months, and the most common reasons for discontinuation were irregular uterine bleeding and weight gain.

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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.
    Contraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate
  • Original Article03-18-2025

    The experience of pregnancy in the COVID-19 pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo8

    Abstract

    Original Article

    The experience of pregnancy in the COVID-19 pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo8

    DOI 10.61622/rbgo/2025rbgo8

    Views322

    Abstract

    Objective:

    To describe women’s experience of pregnancy during the COVID-19 pandemic.

    Methods:

    A qualitative study conducted in a private maternity hospital, from May, 2020 to November, 2021, with women aged ≥ 18 years, gestational age ≥ 36 weeks at birth and ≥ 24 hours post-partum. Data collected through semi-structured interviews, recorded, transcribed, and analyzed adopting Krippendorff’s Content Analysis as theoretical-methodological framework.

    Results:

    Four main themes emerged: Fear, Taking care and celebrating pregnancy: adjusting to the new reality, Harms of Isolation, and Benefits of Isolation. The fear of contamination and its impact on the health of mother and child resulted in the adoption of severe social isolation, including from those considered sources of support by the expecting mother. Overwhelmed, some of the participants reported loneliness and psychic suffering. The opportunity to focus on the pregnancy, the preparations for the arrival of the child, and the family made isolation a beneficial and positive period for other women.

    Conclusion:

    The experience of pregnancy in the Pandemic was an event outside of the ordinary and common. The expecting mother faced her worst fears on a daily basis and attended prenatal care, in order to ensure her child would be born healthy. The celebration of the baby’s life, amid so many deaths, had to be adjusted to the virtual environment. It was a tense, solitary, and ambiguous period, which demanded a lot from the mental health of some participants, but to others, brought advantages that would not have been possible in different times.

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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.
    The experience of pregnancy in the COVID-19 pandemic
  • 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

    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

    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.

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  • Systematic Review05-01-2017

    Zika Virus Infection in Pregnant Women and Microcephaly

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):235-248

    Abstract

    Systematic Review

    Zika Virus Infection in Pregnant Women and Microcephaly

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(5):235-248

    DOI 10.1055/s-0037-1603450

    Views409

    Abstract

    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.

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    Zika Virus Infection in Pregnant Women and Microcephaly
  • 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 Article

    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433

    DOI 10.1055/s-0042-1742292

    Views434

    Abstract

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

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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

    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

    Views419

    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.

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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.
  • 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

    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

    Views387

    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.

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  • Original Article04-09-2024

    Screening and prevention of preterm birth: how is it done in clinical practice?

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32

    Abstract

    Original Article

    Screening and prevention of preterm birth: how is it done in clinical practice?

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32

    DOI 10.61622/rbgo/2024rbgo32

    Views552

    Abstract

    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.

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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

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):986-994

    Abstract

    Review Article

    Efficacy 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

    DOI 10.1055/s-0042-1756148

    Views390

    Abstract

    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).

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  • Original Article04-08-2022

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

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141

    Abstract

    Original Article

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

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141

    DOI 10.1055/s-0041-1741456

    Views385

    Abstract

    Objective

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

    Methods

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

    Results

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

    Conclusion

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

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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.

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