Articles - Revista Brasileira de Ginecologia e Obstetrícia

Original Article04-09-1998

Clinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):371-376

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Abstract
Original Article
Clinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):371-376
DOI 10.1590/S0100-72031998000700001
Luiz Antonio Verdiani,
Cássia Raquel Teatin Juliato,
Sophie F. Mauricette Derchain,
Júlio Eduardo Ferro
Views143
The purpose of the present study was to evaluate some epidemiological, clinical and pathological characteristics of the different grades of vulvar intraepithelial neoplasia (VIN), and its relation with the presence of human papillomavirus (HPV). The charts of 46 women with VIN, examined from 1986 through 1997, were reviewed. For statistical analysis the chi² with yates correction when appropriate, and Fisher’s exact tests were used. Regarding the grade of VIN, six women presented VIN 1, six others had VIN 2 and the remaining 34 presented VIN 3. All women presented similar characteristics such as age, menstrual status and age at first sexual intercourse. Women with more than one lifetime sexual partner had a tendency to show more VIN 3 (p = 0.090). Cigarette smoking was significantly associated with the severity of the vulvar lesion (p = 0.031). HPV was significantly more frequent in women younger than 35 years of age (p = 0.005) and in women with multiple lesions (p = 0.089). Although the number of lesions were not related to the severity of VIN (p = 0.703), lesions with extensions greater than 2 cm were significantly associated with VIN 3 (p = 0.009). The treatment of choice for VIN 3 was surgery, including local resection and simple vulvectomy. Eight women relapsed, and only one had VIN 2. We concluded that among women with VIN, cigarette smoking and more than one lifetime sexual partner were associated with high-grade lesions. HPV was more frequent among patients younger than 35 years of age presenting multiple lesions. Women with VIN 3 presented lesions bigger than 2 cm and a high relapse rate, despite the type of treatment applied.

Key-words HPV Smoking VIN Vulvar intraepithelial neoplasia
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Original Article04-05-1998

Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
- Alexandre Faisal Cury,
- Sidney A. L. Garcia
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555

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Abstract
Original Article
Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(10):551-555
DOI 10.1590/S0100-72031998001000002
Alexandre Faisal Cury,
Sidney A. L. Garcia
Views99
Purpose: to assess the validity of fetal weight estimation by a method based on uterine height — Johnson’s rule. Methods: one hundred and one pregnant women and their newborn children were studied. The fetal weight was estimated using an adaptation of Johnson’s rule, which consists of the clinical application of a mathematical model to calculate the fetal weight based on the uterine height and the height of fetal presentation. The estimated weight was obtained on the day of delivery and was compared to the weight observed after birth. This, in turn, was the control of the analysis of validity of the method used. On the same date, a detailed obstetrical ultrasonography (US) was conducted which included the fetal weight, calculated by the use of Sheppard’s tables. This weight, estimated by US, was compared to the birth weight. Results: the results have proven that the clinical estimate used in this study has a similar value to that of the US calculation of birth weight. The accuracy of the clinical method, with variations of 5%, 10% and 15% between estimated and observed weights, was 55.3%, 73% and 86.7%, respectively. Those of the US were 60.7%, 75.4% and 91.1%, respectively. When comparing both sets of figures, values were not different from a statistical standpoint. Conclusion: the clinical evaluation has shown to be accurate, similarly to the US, when calculating the birth weight.

Key-words Fetal weight Normal pregnancy Ultrasonography
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04-05-1998

Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
- Fábio Sgarbosa
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485

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Abstract
Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
DOI 10.1590/S0100-72031998000800011
Fábio Sgarbosa
Views59
Indice de Líquido Amniótico em Gestantes Diabéticas e a Qualidade do Controle Glicêmico na Gestação.[…]
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04-05-1998

Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
- Luiz Ayrton Santos Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485

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Abstract
Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):485-485
DOI 10.1590/S0100-72031998000800010
Luiz Ayrton Santos Júnior
Views65
Avaliação do Grau Nuclear da Célula Maligna da Mama como Parâmetro de Atividade Proliferativa Tumoral: Comparação com a Expressão do Antígeno Nuclear de Proliferação Celular (PCNA/ciclina).[…]
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Case Report04-05-1998

Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484

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Abstract
Case Report
Prenatal diagnosis of arthrogryposis multiplex congenita: a case report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):481-484
DOI 10.1590/S0100-72031998000800009
Carlos Augusto Alencar Júnior,
Francisco Edson de Lucena Feitosa,
Mac Gontei,
Sammya Bezerra Maia,
Dalgimar Beserra de Meneses
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Arthrogryposis multiplex congenita is characterized by multiple joint contractures present at birth. Prenatal diagnosis is difficult. There are few reports in the literature. Fetal akinesia, abnormal limb position, intrauterine growth retardation, and polyhydramnios are the main findings of the ultrasonographic diagnosis. The authors describe a case of arthrogryposis multiplex congenita ultrasonographically diagnosed in the third gestational trimester. The main findings were absence of fetal movements, polyhydramnios, symmetrical and non-symmetrical fetal growth retardation with marked decrease of abdominal and thoracic circumference, low-set ears, micrognathia, continuous flexure contracture of limbs, internal rotation of the femur, and clubfoot on the right.

Key-words Fetal malformation prenatal diagnosis Ultrasonography
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Original Article04-05-1998

Screening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479

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Abstract
Original Article
Screening of breast cancer metastasis at preoperative work-up
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):475-479
DOI 10.1590/S0100-72031998000800008
Maria Bethânia da Costa Chein,
Luciane Maria Oliveira Brito,
Simão Rotstein,
Luiz Henrique Gebrim,
Aldo Franklin F Reis,
Luciana Dessen Padilha
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Purpose: to analyze the frequency of preoperative bilateral synchronic cancer and occult metastases in 454 operable breast cancer patients, at Instituto Nacional de Câncer (Brazil). Methods: the preoperative evaluation consisted of mammography, bone scan with X-ray if necessary, and chest X-ray. 260 (57.3 %) of 454 patients underwent liver echography. We calculated the cost X effectiveness ratio considering only the direct costs (monetary value) and the effectiveness was analyzed based on the number of metastases identifid by the screening tests. Results: we did not find any case of bilateral synchronic cancer, and the frequency of patients with metastasis was 2% (9/454). The diagnosis of bone metastasis was 1.5 % (7/454). The percentage of lung (2/454) and liver (1/260) metastasis was the same, 0.4 %. Most of the patients with metastases were in stage IIIb (44.5 %). The results of the screening tests showed the alteration of the initial clinical stage in 9 patients only (2%). The total cost of the screening tests for the diagnosis of systemic disease in 9 patients, was US$ 131,020.00. The cost of each diagnosed metastasise, for a total of 10 (two were found in one of the patients), was US$ 29,221.85 and the cost/effectiveness ratio was 22.3%. Conclusious: the results showed that screening for metastases in the preoperative clinical staging of breast cancer should be limited to patients symptomatic for systemic disease or in clinical stage III and that the cost/effectiveness ratio of the tests demonstrated a reduced benefit in the preoperative evaluation.

Key-words Breast cancer Health care costs Metastasis Ultrasonography
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Original Article04-05-1998

Second-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473

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Abstract
Original Article
Second-degree family history as a risk factor for breast cancer
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):469-473
DOI 10.1590/S0100-72031998000800007
Rafael Marques de Souza,
Anderson Rech Lazzaron,
Rafael Defferrari,
Álvaro A. Borba,
Luciana Scherer,
Antônio L. Frasson
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Purpose: to evaluate the association between second-degree family history of breast cancer and the risk to develop the disease. Methods: case-control study of incident cases. Sixty-six incident breast cancer cases and 198 controls were selected among women who were submitted to mammography in a private clinic between January 1994 and July 1997. Cases and controls were paired regarding age, age at menarche, at first live birth, at menopause, parity, oral contraceptives and use of hormonal replacement therapy. Results: there was no significant difference between cases and controls regarding all risk factors evaluated, besides second-degree family history. Patients with breast cancer were more likely to have second-degree relatives with breast cancer when compared to controls (OR=2.77; 95% CI, 1.03-7.38; p=0.039). Conclusions: malignant neoplasm of the breast is significantly associated with a second-degree family history of this disease.

Key-words Breast neoplasms Heredity Risk factors
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Original Article04-05-1998

Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(8):463-467
DOI 10.1590/S0100-72031998000800006
Orlando José de Almeida,
Marcelo Alvarenga,
José Guilherme Cecatti,
Jessé de Paula Neves Jorge,
Júlia Kawamura Tambascia
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Purpose: to evaluate, in a prospective way, the performance of the fine needle aspiration biopsy in the differential diagnosis of palpable breast masses. Method: the sensitivity, specificity, positive and negative predictive values for this test were evaluated in 102 women with age above 30 years and a palpable breast mass, who were attended at the University of Campinas. All punctures were performed by the same examiner. Results: the procedure had a sensitivity of 97%, specificity of 87%, positive predictive value of 94% and negative predictive value of 93%. The insufficient or unsatisfactory sample rate was 16% for the first aspiration, decreasing to 2% with a new procedure. Conclusions: this test showed to be highly sensitive and specific for the differential diagnosis of palpable breast masses, reassuring its great importance for the clinical approach of palpable masses.

Key-words Breast cancer Fine needle aspiration biopsy
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Original Article05-01-2016

Incidence of Cervical Human Papillomavirus and Cervical Intraepithelial Neoplasia in Women with Positive and Negative HIV Status
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(5):231-238

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Abstract
Original Article
Incidence of Cervical Human Papillomavirus and Cervical Intraepithelial Neoplasia in Women with Positive and Negative HIV Status
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(5):231-238
DOI 10.1055/s-0036-1583294
Benito Pio Vitorio Ceccato Junior,
Mark Drew Crosland Guimarães,
Ana Paula Ceccato Lopes,
Lorena Fiorini Nascimento,
Luísa Magalhães Novaes,
Dora Méndez del Castillo,
Victor Hugo Melo
Views226
Abstract

Objectives

To evaluate the incidence and factors associated with cervical intraepithelial neoplasia (CIN) and cervical infection by human papillomavirus (HPV) among HIV-positive and HIV-negative women.

Methods

A cohort of 103 HIV positive and 113 HIV negative women were monitored between October 2008 and February 2012, for at least one year. Procedures included cervical cytology, DNA/HPV detection by polymerase chain reaction, colposcopy with biopsy if necessary, followed by an interview for exposure characteristics data. CIN was based on the histopathological results.

Results

The incidence of CIN was of 8.8 and 4.6 cases/100 women-years in HIVpositive and HIV-negative women, respectively. HIV-positive women presented a hazard ratio (HR) of 2.8 for CIN and developed lesions earlier (0.86 year) than HIVnegative women (2 years) (p = 0.01). The risk of developing CIN decreased with age (HR = 0.9) and marital status (HR = 0.4). HPV patients presented a higher incidence of CIN when compared HIV-positive and HIV-negative women (p = 0.01). The incidence of HPV cervical infection was 18.1 and 11.4 cases/100 women-years in HIV-positive and HIV-negative women, respectively. Those HIV-positive presented earlier HPV infection (p = 0.002). The risk of developing HPV infection decreased with age and was higher among HIV-positive women. HPV 16 was the most common type in HIV-positive women, and also the type most closely associated with CIN in HIV-negative women.

Conclusions

HIV-positive women had a greater incidence of HPV and CIN, and in a shorter time interval. More rigorous and timely clinical control is required for this group.

Key-words Cervical intraepithelial neoplasia HIV infections HPV DNA probes Papillomavirus infections Polymerase chain reaction
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Original Article03-27-2020

High Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil
- Emiliana Claro Avila ,
- Fabiana Finger-Jardim ,
- Carla Vitola Gonçalves ,
- Vanusa Pousada da Hora ,
- Marcelo Alves Soares ,
- Ana Maria Barral de Martínez
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):5-11

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Abstract
Original Article
High Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(1):5-11
DOI 10.1055/s-0039-1700794
Emiliana Claro Avila ,
Fabiana Finger-Jardim ,
Carla Vitola Gonçalves ,
Vanusa Pousada da Hora ,
Marcelo Alves Soares ,
Ana Maria Barral de Martínez
Views216
Abstract

Objective

Estimate the prevalence of human herpesvirus type 1 HSV-1 DNA in placental samples, its incidence in umbilical cord blood of newborns and the associated risk factors.

Methods

Placental biopsies and umbilical cord blood were analyzed, totaling 480 samples, from asymptomatic parturients and their newborns at a University Hospital. Nested polymerase chain reaction (PCR) and gene sequencingwere used to identify the virus; odds ratio (OR) and relative risk (RR) were performed to compare risk factors associated with this condition.

Results

The prevalence of HSV-1 DNA in placental samples was 37.5%, and the incidence in cord blood was 27.5%. Hematogenous transplacental route was identified in 61.4% from HSV-1+ samples of umbilical cord blood paired with the placental tissue. No evidence of the virus was observed in the remaining 38.6% of placental tissues, suggesting an ascendant infection from the genital tract, without replication in the placental tissue, resulting in intra-amniotic infection and vertical transmission, seen by the virus in the cord blood. The lack of condom use increased the risk of finding HSV-1 in the placenta and umbilical cord blood.

Conclusion

The occurrence of HSV-1 DNA in the placenta and in cord blood found suggests vertical transmission from asymptomatic pregnant women to the fetus.

Key-words herpesvirus HSV-1 Placenta Umbilical cord Vertical transmission
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Review Article08-26-2020

Gynecological Surgery and COVID-19: What is the Impact and How Should I Manage it?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):415-419

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Abstract
Review Article
Gynecological Surgery and COVID-19: What is the Impact and How Should I Manage it?
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(7):415-419
DOI 10.1055/s-0040-1715146
Julio Cesar Rosa-e-Silva ,
Paulo Ayroza Ribeiro ,
Luiz Gustavo Oliveira Brito ,
Mariano Tamura Vieira Gomes ,
Sergio Podgaec ,
Helizabet Salomão Abdalla Ayroza Ribeiro ,
Carlos Augusto Pires Costa Lino ,
Ricardo Quintairos ,
Walquiria Quida Salles Pereira Primo ,
Agnaldo Lopes da Silva Filho
Views221
Abstract

It is estimated that around 28 million surgeries will be postponed or canceled worldwide as a result of this pandemic, causing a delay in the diagnosis and treatment of more than 2 million cancer cases. In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-essential surgeries, causing a considerable impact on the number of surgical procedures that decreased by 33.4% in this period. However, some women need treatment for various gynecological diseases that cannot be postponed. The purpose of this article is to present recommendations on surgical treatment during the COVID-19 pandemic.

Key-words COVID-19 gynecological surgery Hysteroscopy Laparoscopy
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Review Article01-11-2023

Incidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):796-807

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Abstract
Review Article
Incidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(12):796-807
DOI 10.1055/s-0043-1772595
Abolfazl Akbari ,
Ahmadreza Zarifian ,
Alireza Hadizadeh ,
Ezat Hajmolarezaei
Views229
Abstract

Objective

Menopause causes several changes in the body that may affect the response to COVID-19. We aimed to investigate the possible association between menopausal status and incidence and outcomes in COVID-19 patients.

Methods

Combinations of keywordsCOVID-19, menopause, and estrogen were used to search the PubMed, Embase, Web-of-Science, and Scopus databases for articles reporting the incidence and outcomes of COVID-19 (discharge, length-of-admission, intensive care, or mortality) in premenopausal women, available through December 29, 2022. Data from studies comparing the incidence of COVID-19 infection with the age-matched male population were pooled and meta-analyzed using a random-effects model.

Results

Overall, 1,564 studies were retrieved, of which 12 were finally included in the systematic review to compare disease outcomes, and 6 were meta-analyzed for the incidence of COVID-19 in premenopausal and postmenopausal women. All studies reported better COVID-19-associated outcomes in premenopausal women compared with postmenopausal women. After adjusting for confounding factors, three studies found better outcomes in postmenopausal women, and two found no association between menopausal status and COVID-19 outcomes. Our meta-analysis found a higher incidence of COVID-19 infection among premenopausal women than postmenopausal women, when compared with age-matched men (odds ratio = 1.270; 95% confidence interval: 1.086–1.486; p = 0.003).

Conclusion

The incidence of COVID-19 was significantly higher in premenopausal women than in postmenopausal women when compared with age-matched men. Although premenopausal women may have more favorable COVID-19-associated outcomes, the presumed preventive effect of estrogens on the incidence and related outcomes of COVID-19 in premenopausal women cannot be proven at present. Further longitudinal studies comparing pre- and post-menopausal women are required to provide further insight into this matter.

Key-words Climacteric COVID-19 Estrogen Menopause
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Original Article01-19-2021

Malignant Uterine Neoplasms Attended at a Brazilian Regional Hospital: 16-years Profile and Time Elapsed for Diagnosis and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):137-144

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Abstract
Original Article
Malignant Uterine Neoplasms Attended at a Brazilian Regional Hospital: 16-years Profile and Time Elapsed for Diagnosis and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(2):137-144
DOI 10.1055/s-0040-1718434
Elaine Cristina Candido ,
Nelio Neves Veiga Junior ,
Monique Possari Minari ,
Maria Carolina Szymanski Toledo ,
Daniela Angerame Yela ,
Julio Cesar Teixeira
Views219
Abstract

Objective

The present study aims to evaluate the profile of endometrial carcinomas and uterine sarcomas attended in a Brazilian cancer center in the period from 2001 to 2016 and to analyze the impact of time elapsed fromsymptoms to diagnoses or treatment in cancer stage and survival.

Methods

This observational study with 1,190 cases evaluated the year of diagnosis, age-group, cancer stage and histological type. A subgroup of 185 women with endometrioid histology attended in the period from 2012 to 2017 was selected to assess information about initial symptoms, diagnosticmethods, overall survival, and to evaluate the influence of the time elapsed from symptoms to diagnosis and treatment on staging and survival. The statistics used were descriptive, trend test, and the Kaplan- Meier method, with p-values < 0.05 for significance.

Results

A total of 1,068 (89.7%) carcinomas (77.2% endometrioid and 22.8% nonendometrioid) and 122 (10.3%) sarcomas were analyzed, with an increasing trend in the period (p < 0.05). Histologies of non-endometrioid carcinomas, G3 endometrioid, and carcinosarcomas constituted 30% of the cases. Non-endometrioid carcinomas and sarcomas weremore frequently diagnosed in patients over 70 years of age and those on stage IV (p < 0.05). The endometrioid subgroup with 185 women reported 92% of abnormal uterine bleeding and 43% diagnosis after curettage. The average time elapsed between symptoms to diagnosis was 244 days, and between symptoms to treatment was 376 days, all without association with staging (p = 0.976) and survival (p = 0.160). Only 12% of the patients started treatment up to 60 days after diagnosis.

Conclusion

The number of uterine carcinoma and sarcoma cases increased over the period of 2001 to 2016. Aggressive histology comprised 30% of the patients and, for endometrioid carcinomas, the time elapsed between symptoms and diagnosis or treatment was long, although without association with staging or survival.

Key-words Endometrial neoplasms Epidemiology Neoplasm staging Survival analysis uterine sarcomas
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Original Article10-23-2024

The role of HIV as an independent risk factor to cervical HSIL recurrence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo85

Views328

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Abstract
Original Article
The role of HIV as an independent risk factor to cervical HSIL recurrence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo85
DOI 10.61622/rbgo/2024rbgo85
Fernanda Villar Fonseca ,
Newton Sérgio de Carvalho ,
Carlos Afonso Maestri ,
Manuella Fernandes Martins ,
Dora Pedroso Kowacs
Views328
ABSTRACT

Objective:

To evaluate the role of being human immunodeficiency virus (HIV) positive for predicting the risk of recurrence in women with a cervical high grade squamous intraepithelial lesion (HSIL) diagnosis.

Methods:

Retrospective observational case-control study, comprising HIV positive (case) and HIV negative (control) women in a 1:4 ratio. Women assisted by the Erasto Gaertner Hospital, between 2009-2018, with cervical HSIL diagnosis, submitted to treatment by Loop electrosurgical excision procedure (LEEP), and with a minimum follow-up of 18 months, were included. The immunological status, number and time to recurrence were analyzed, with p<0.05 considered significant. In a second analysis, only patients with free margins were evaluated.

Results:

The sample consisted of 320 women (64 cases and 256 controls). Presence of HIV, CD4 levels <200 and detectable viral load (CV) were associated with high risk of recurrence, with odds ratio (OR) of 5.4 (p<0.001/95CI:2.8-10); 3.6 (p<0.001 /IC95:0.6-21.1) and 1.8 (p=0.039 /IC95:0.3-9.3), respectively. In the sample with free margins (n=271), this risk was also higher among seropositive patients, with OR 4.18 (p=0.001/95CI:1.8-9.2).

Conclusion:

HIV is an independent risk factor for cervical HSIL recurrence and reduced disease-free survival time. Glandular involvement, compromised margins, undetectable CV and CD4<200 also increase the risk of relapse.

Key-words Disease-free survival Electrosurgery Excision margins HIV infections Recurrence Risk factors Squamous intraepithelial lesions Uterine cervical neoplasms
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Review Article06-22-2020

Aortic Isthmus Doppler Velocimetry in Fetuses with Intrauterine Growth Restriction: A Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(5):289-296

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This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Aortic Isthmus Doppler Velocimetry in Fetuses with Intrauterine Growth Restriction: A Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(5):289-296
DOI 10.1055/s-0040-1710301
Mariana Martins Ferraz ,
Flávia do Vale Araújo ,
Paulo Roberto Nassar de Carvalho ,
Renato Augusto Moreira de Sá
Views222
Abstract

Intrauterine growth restriction (IUGR) is associated with poor perinatal prognosis and a higher risk of stillbirth, neonatal death, and cerebral palsy. Its detection and the evaluation of its severity by new Doppler velocimetric parameters, such as aortic isthmus (AoI), are of great relevance for obstetrical practice. The AoI is a vascular segment that represents a point of communication between the right and left fetal circulations. It is considered to be a functional arterial shunt that reflects the relationship between the systemic and cerebral impedances, and has recently been proposed as a tool to detect the status of hemodynamic balance and prognosis of IUGR in fetuses. In the present review, we noticed that in healthy fetuses, the AoI net flow is always antegrade, but in fetuses with IUGR the deterioration of placental function leads to progressive reduction in its flow until it becomes mostly retrograde; this point is associated with a drastic reduction in oxygen delivery to the brain. The more impaired the AoI flow is, the greater is the risk of impairment in the Doppler velocimetry of other vessels; and the alterations of the AoI Doppler seem to precede other indicators of severe hypoxemia. Although there seems to be an association between the presence of retrograde flow in the AoI and the risk of long-term neurologic disability, its role in the prediction of perinatal morbi-mortality remains unclear. The AoI Doppler seems to be a promising tool in the management of fetuses with IUGR, but more studies are needed to investigate its employment in clinical practice.

Key-words aortic isthmus Doppler Doppler velocimetry Intrauterine growth restriction Intrauterine growth retardation placental insufﬁciency
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Original Article08-04-2023

Treatment and Management Experience of Idiopathic Granulomatous Mastitis in a Low-income Country
- Pedro Antonio Llancari,
- Antonio Ortiz ,
- Juan Becerra ,
- Ricardo Muñoz ,
- Christiam Valeriano ,
- Rommy Helena Novoa
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(6):319-324

Views239

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Treatment and Management Experience of Idiopathic Granulomatous Mastitis in a Low-income Country
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(6):319-324
DOI 10.1055/s-0043-1770089
Pedro Antonio Llancari,
Antonio Ortiz ,
Juan Becerra ,
Ricardo Muñoz ,
Christiam Valeriano ,
Rommy Helena Novoa
Views239
Abstract

Objective

Reporting our experience of the management and treatment of Idiopathic granulomatous mastitis (IGM) in a low-income country by describing patients characteristics and therapy with emphasis on conservative surgical excision and postoperative care as the cornerstone of treatment.

Methods

A retrospective cohort of women with histopathological diagnosis of IGM from 2014 to 2018 at Instituto Nacional Materno Perinatal in Lima, Peru. Patients’ characteristics, clinical presentation, treatment, management, postoperative care, and follow-up were analyzed.

Results

Thirty-eight patients with histopathological diagnosis of IGM were identified. Their average age was 35.9 years and 23 (60.5%) reported previous use of hormonal contraceptives. Nine (23.7%) patients had chronic mastitis with previous treatment. The time from the onset of symptoms to the first clinic consult was 5.1 months on average. Twenty-one (55.3%) patients had the lesion in the right breast, with a mean size of 6.9 cm. Conservative surgical excision was performed in all patients. Additionally, 86.8% required corticosteroids and 78.9% were treated with antibiotics. Complete remission was obtained at 141 days on average (range 44 to 292 days). Six (15.8%) women reported ipsilateral recurrence and 5 (13.2%), contralateral. The latency time was 25.5 months on average.

Conclusion

The conservative surgical treatment demonstrated and close follow-up made for a high cure rate, but with recurrence similar to that reported in the literature. Use of gloves is an alternative to manage post operative wounds in a low-income country. The most frequent adverse effect was breast surgical scar.

Key-words Breast corticosteroid idiopathic granulomatous mastitis Recurrence Surgery
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Original Article07-01-2015

Prevalence of congenital abnormalities identified in fetuses with 13, 18 and 21 chromosomal trisomy
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):333-338

Views213

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Prevalence of congenital abnormalities identified in fetuses with 13, 18 and 21 chromosomal trisomy
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(7):333-338
DOI 10.1590/S0100-720320150005373
Caroline Soares Cristofari Emer,
Julio Alejandro Peña Duque,
Ana Lúcia Letti Müller,
Rejane Gus,
Maria Teresa Vieira Sanseverino,
André Anjos da Silva,
José Antonio de Azevedo Magalhães
Views213
PURPOSE:

To describe the prevalence of malformations found in fetuses with trisomy of chromosomes 13, 18 and 21 by identifying the most frequent within each condition.

METHODS:

A retrospective cross-sectional study with the analysis of trisomy cases of chromosomes 13, 18 and 21 diagnosed through fetal karyotype obtained by amniocentesis/cordocentesis, between October 1994 and May 2014, at a Teaching Hospital in Brazil Southern Region. Malformations identified through morphological ultrasonography were described and, subsequently, confirmed in newborn examinations and/or fetal autopsy. The results were analyzed using Fisher’s test and analysis of variance (ANOVA), with a 5% level of significance (p=0.05).

RESULTS:

Sixty-nine cases of trisomy were diagnosed among 840 exams; nine were excluded due to outcome outside Hospital de Clínicas de Porto Alegre or incomplete records, remaining 60 cases (nine cases of chromosome 13 trisomy, 26 of chromosome 18, and 25 of chromosome 21). In all three groups, heart disease occurred in most cases; the ventricular septal defect was more prevalent and occurred in 66.7% of the trisomy 13 group. Gastrointestinal abnormalities were more prevalent in the trisomy 18 group, especially omphalocele (38.5%; p<0.01). Genitourinary anomalies were more significantly frequent in the trisomy 13 group (pyelectasis, 55.6% - p<0.01; ambiguous genitalia, 33.3% - p=0.01). Central nervous system defects were identified in all cases of trisomy 13. Facial cracks were significantly more prevalent among fetuses with trisomy 13 (66.7%; p<0.01). Hand and feet malformations significantly differed among the trisomy groups. Hand defects occurred in 50% of trisomy 18 cases, and in 44.4% of all trisomy 13 cases (p<0.01); congenital clubfoot was more common in the trisomy 18 group, being detected in 46.2% of fetuses (p<0.01). The abnormalities were found in 50.9, 27.3 and 21.7% of trisomy 18, 13 and 21 cases respectively.

CONCLUSION:

Many fetal malformations identified at ultrasound are suggestive of trisomy and represent an important tool for etiologic diagnosis and prenatal and pre-conception genetic counseling.

Key-words Aneuploidy Chromosome aberrations Fetus/abnormalities Trisomy Ultrasonography, prenatal
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Review Article04-15-2019

Isthmocele: From Risk Factors to Management
- Piergiorgio Iannone ,
- Giulia Nencini,
- Gloria Bonaccorsi,
- Ruby Martinello,
- Giovanni Pontrelli,
- Gennaro Scutiero
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):44-52

Views293

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Isthmocele: From Risk Factors to Management
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):44-52
DOI 10.1055/s-0038-1676109
Piergiorgio Iannone ,
Giulia Nencini,
Gloria Bonaccorsi,
Ruby Martinello,
Giovanni Pontrelli,
Marco Scioscia,
Luigi Nappi,
Pantaleo Greco,
Gennaro Scutiero
Views293
Abstract

Objective

The aim of the present study was to perform a comprehensive review of the literature to provide a complete and clear picture of isthmocele-a hypoechoic area within themyometriumat the site of the uterine scar of a previous cesarean section-by exploring in depth every aspect of this condition.

Methods

A comprehensive review of the literature was performed to identify the most relevant studies about this topic.

Results

Every aspect of isthmocele has been studied and described: pathophysiology, clinical symptoms, classification, and diagnosis. Its treatment, both medical and surgical, has also been reported according to the actual literature data.

Conclusion

Cesarean section is the most common surgical procedure performed worldwide, and one of the consequences of this technique is isthmocele. A single and systematic classification of isthmocele is needed to improve its diagnosis and management. Further studies should be performed to better understand its pathogenesis.

Key-words cesarean section scar defect Hysteroscopy isthmocele Laparoscopy niche
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Original Article05-16-2019

Variables Associated with Endometriosis-related Pain: A Pilot Study using a Visual Analogue Scale
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):170-175

Views183

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Variables Associated with Endometriosis-related Pain: A Pilot Study using a Visual Analogue Scale
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(3):170-175
DOI 10.1055/s-0039-1679879
Mauro Cozzolino ,
Maria Elisabetta Coccia,
Giacomo Lazzeri,
Francesca Basile,
Gianmarco Troiano
Views183
Abstract

Objective

Endometriosis is a complex disease, and pain is an important component of the syndrome. One of the most used methods to assess pain is the visual analogue scale (VAS). The aim of the present research was to study the pain experienced by patients who referred to our unit for endometriosis, using the VAS to understand the variables that could influence it.

Methods

We have conducted a prospective study from February 2012 to December 2016, enrolling 388 patients who referred to a university hospital, in Florence, Italy. We have included in the present study patients during their follow-up for endometriosis; we have also included patients who underwent surgery with a histological diagnosis of endometriosis. We have collected sociodemographic and clinical information regarding age, body mass index (BMI), smoking habit, number of pregnancies, and endometriosis staging. Finally, we have administered the VAS for several symptoms.

Results

Dysmenorrhea was the symptom associated with the highest perception of pain (mean VAS score of 5.76). The logistic regression showed that the stage of endometriosis could influence the pain associated to constipation and to dysuria. The linear regression showed that age couldinfluencethe pain associated to constipation, to dyspareunia,and to dysmenorrhea. A positive correlation was found between dysmenorrhea and chronic pelvic pain(CPP), between dysmenorrhea and dyspareunia, and between constipation and dysuria.

Conclusion

Using a validated method, the VAS, we have studied the pain experienced by a group of patients with a history of endometriosis and observed that smoking habit and BMI did not influence the VAS scores, and that dysmenorrhea was associated with the highest perception of pain.

Key-words Chronic pelvic pain constipation Dysmenorrhea Dyspareunia Endometriosis visual analogue scale
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Original Article11-01-2018

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

Views402

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Do Food Intake and Food Cravings Change during the Menstrual Cycle of Young Women?
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):686-692
DOI 10.1055/s-0038-1675831
Luciana Bronzi de Souza,
Karine Anusca Martins,
Mariana Morais Cordeiro,
Ymárdila de Souza Rodrigues,
Bruna Paola Murino Rafacho,
Rafael Aiello Bomfim
Views402
Abstract

Objective

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

Methods

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

Results

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

Conclusion

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

Key-words Feeding behavior follicular phase food intake luteal phase Menstrual cycle Nutrition assessment
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Original Article04-17-2020

Quality of Life in Women with Deep Endometriosis: A Cross-Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(2):90-95

Views227

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Quality of Life in Women with Deep Endometriosis: A Cross-Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(2):90-95
DOI 10.1055/s-0040-1708091
Daniela Angerame Yela ,
Iuri de Paula Quagliato ,
Cristina Laguna Benetti-Pinto
Views227
Abstract

Objective

To describe clinical and sociodemographic characteristics of women with deep infiltrating endometriosis (DIE) and assess their quality of life (QOL) during 6 months of medical treatment.

Methods

A descriptive cross-sectional study of 60 women diagnosed with DIE either by surgery or image methods (ultrasound or magnetic resonance), who received clinical treatment for at least 6 months in the Universidade de Campinas, Campinas, state of São Paulo, Brazil. Both the SF-36 and the EHP-30 questionnaires were used to assess the quality of life.

Results

The mean age of the patients was 37.7 ± 6.0 years old, with 50% presenting dysmenorrhea; 57% dyspareunia; and 50% chronic pelvic pain. The SF-36 and the EHP-30 revealed impaired quality of life. In the SF-36, the worst domains were limitation due to emotional aspects (40.2 ± 43.1) and self-esteem and disposition (46.1 ± 24.8), whereas in the EHP-30 they were social well-being (50.3 ± 30.6); infertility (48.0 ± 36.3); and sexual intercourse (54.0 ± 32.1).

Conclusion

Although clinically treated, women with deep endometriosis present impairment in different domains of quality of life regardless of the questionnaire used for evaluation.

Key-words Dysmenorrhea Endometriosis Pelvic pain Quality of life
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Review Article09-30-2019

Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):564-574

Views232

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):564-574
DOI 10.1055/s-0039-1695737
Cristina Laguna Benetti-Pinto ,
Ticiana Aparecida Alves de Mira,
Daniela Angerame Yela,
Cassia Raquel Teatin-Juliato,
Luiz Gustavo Oliveira Brito
Views232
Abstract

Objective

To assess the efficacy of non-surgical treatment for adenomyosis.

Data Sources

A search was performed by two authors in the Pubmed, Scopus, and Scielo databases and in the grey literature from inception to March 2018, with no language restriction.

Selection of Studies

We have included prospective randomized studies for treating symptomaticwomen with adenomyosis (abnormal uterine bleeding and/or pelvic pain) diagnosed by ultrasound or magnetic resonance imaging.

Data Collection

Studies were primarily selected by title and abstract. The articles that were eligible for inclusion were evaluated in their entirety, and their data was extracted for further processing and analysis.

Data Synthesis

From567retrieved records only 5 remained for analysis. The intervention groups were: levonorgestrel intrauterine system (LNG-IUS)(n= 2), dienogest (n= 2), and letrozole (n= 1). Levonorgestrel intrauterine system was effective to control bleeding when compared to hysterectomy or combined oral contraceptives (COCs). One study assessed chronic pelvic pain and reported that LNG-IUS was superior to COC to reduce symptoms. Regarding dienogest, it was efficient to reduce pelvic pain when compared to placebo or goserelin, but less effective to control bleeding than gonadotropin-releasing hormone (GnRH) analog. Letrozolewas as efficient asGnRHanalog to relieve dysmenorrhea and dyspareunia, but not for chronic pelvic pain. Reduction of uterine volumewas seen with aromatase inhibitors, GnRH analog, and LGN-IUD.

Conclusion

Levonorgestrel intrauterine system and dienogest have significantly improved the control of bleeding and pelvic pain, respectively, in women with adenomyosis. However, there is insufficient data from the retrieved studies to endorse eachmedication for this disease. Further randomized control tests (RCTs) are needed to address pharmacological treatment of adenomyosis.

Key-words abnormal menstrual bleeding Adenomyosis medical treatment Pelvic pain systematic review
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Review Article03-24-2022

Commercial Surrogacy: An Overview
- Pedro Brandão ,
- Nicolás Garrido
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1141-1158

Views453

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
Commercial Surrogacy: An Overview
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1141-1158
DOI 10.1055/s-0042-1759774
Pedro Brandão ,
Nicolás Garrido
Views453
Abstract

Objective

Surrogacy is the process in which a woman carries and delivers a baby to other person or couple, known as intended parents. When carriers are paid for surrogacy, this is known as commercial surrogacy. The objective of the present work is to review the legal, ethical, social, and cultural aspects of commercial surrogacy, as well as the current panorama worldwide.

Methods

This is a review of the literature published in the 21^st century on commercial surrogacy.

Results

A total of 248 articles were included as the core of the present review. The demand for surrogate treatments by women without uterus or with important uterine disorders, single men and same-sex male couples is constantly increasing worldwide. This reproductive treatment has important ethical dilemmas. In addition, legislation defers widely worldwide and is in constant change. Therefore, patients look more and more for treatments abroad, which can lead to important legal problems between countries with different laws. Commercial surrogacy is practiced in several countries, in most of which there is no specific legislation. Some countries have taken restrictive measures against this technique because of reports of exploitation of carriers.

Conclusion

Commercial surrogacy is a common practice, despite important ethical and legal dilemmas. As a consequence of diverse national legislations, patients frequently resort to international commercial surrogacy programs. As of today, there is no standard international legal context, and this practice remains largely unregulated.

Key-words Bioethics Fertilization in vitro legislation medical medical tourism surrogacy
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Review Article07-30-2021

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):395-402

Views482

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Review Article
The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S)
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):395-402
DOI 10.1055/s-0041-1730289
Alexandra Ruivo Coelho ,
Gonçalo Cardoso ,
Marta Espanhol Brito ,
Inês Neves Gomes ,
Maria João Cascais
Views482
Abstract

In a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, andmenstrual cycle.Onthe other hand, an imbalance causedby low energy availability dueto a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of themost recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote theacquisition ofmore consolidated knowledgeon an undervaluedtheme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.

Key-words Amenorrhea bone health female athlete low energy availability menstrual dysfunction
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Clinicopathologic Analysis of Vulvar Intraepithelial Neoplasia: review of 46 Cases

Estimation of Fetal Weight: Comparison Between a Clinical Method and Ultrasonography

Indice de líquido amniótico em gestantes diabéticas e a qualidade do controle glicêmico na gestação

Avaliação do grau nuclear da célula maligna da mama como parâmetro de atividade proliferativa tumoral: comparação com a expressão do antígeno nuclear de proliferação celular (PCNA/ciclina)

Prenatal diagnosis of arthrogryposis multiplex congenita: a case report

Screening of breast cancer metastasis at preoperative work-up

Second-degree family history as a risk factor for breast cancer

Fine needle aspiration biopsy: performance in the differential diagnosis of palpable breast masses

Incidence of Cervical Human Papillomavirus and Cervical Intraepithelial Neoplasia in Women with Positive and Negative HIV Status

Abstract

Objectives

Methods

Results

Conclusions

High Incidence of Herpes Simplex Virus-1 in Cord Blood and Placenta Infection of Women in Southern Brazil

Abstract

Objective

Methods

Results

Conclusion

Gynecological Surgery and COVID-19: What is the Impact and How Should I Manage it?

Abstract

Incidence and Outcomes Associated with Menopausal Status in COVID-19 Patients: A Systematic Review and Meta-analysis

Abstract

Objective

Methods

Results

Conclusion

Malignant Uterine Neoplasms Attended at a Brazilian Regional Hospital: 16-years Profile and Time Elapsed for Diagnosis and Treatment

Abstract

Objective

Methods

Results

Conclusion

The role of HIV as an independent risk factor to cervical HSIL recurrence

ABSTRACT

Objective:

Methods:

Results:

Conclusion:

Aortic Isthmus Doppler Velocimetry in Fetuses with Intrauterine Growth Restriction: A Literature Review

Abstract

Treatment and Management Experience of Idiopathic Granulomatous Mastitis in a Low-income Country

Abstract

Objective

Methods

Results

Conclusion

Prevalence of congenital abnormalities identified in fetuses with 13, 18 and 21 chromosomal trisomy

PURPOSE:

METHODS:

RESULTS:

CONCLUSION:

Isthmocele: From Risk Factors to Management

Abstract

Objective

Methods

Results

Conclusion

Variables Associated with Endometriosis-related Pain: A Pilot Study using a Visual Analogue Scale

Abstract

Objective

Methods

Results

Conclusion

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

Abstract

Objective

Methods

Results

Conclusion

Quality of Life in Women with Deep Endometriosis: A Cross-Sectional Study

Abstract

Objective

Methods

Results

Conclusion

Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review

Abstract

Objective