Articles - Revista Brasileira de Ginecologia e Obstetrícia

Editorial
Ética em pesquisa
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):494-494
04-09-1998

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Summary
Editorial
Ética em pesquisa
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(9):494-494
04-09-1998
DOI 10.1590/S0100-72031998000900001
Views43
Ética em Pesquisa […]
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Resumos de Teses
Estudo Controlado e Randomizado para Prevenção de Infecção Pós-Cesárea com Penicilina e Cefalotina
- Moisés Mendonça Neto
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):424-424
04-09-1998

Views37

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.
Summary
Resumos de Teses
Estudo Controlado e Randomizado para Prevenção de Infecção Pós-Cesárea com Penicilina e Cefalotina
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):424-424
04-09-1998
DOI 10.1590/S0100-72031998000700011
Moisés Mendonça Neto
Views37
Estudo Controlado e Randomizado para Prevenção de Infecção Pós-Cesárea com Penicilina e Cefalotina […]
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Resumos de Teses
Estudo Morfológico e Morfométrico do Endométrio de Mulheres na Pós-Menopausa Durante Terapêutica Estrogênica Contínua, Associada ao Acetato de Medroxiprogesterona a Cada Dois, Três e Quatro Meses
- Cláudia de Carvalho Ramos Bortoletto
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-423
04-09-1998

Views33

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.
Summary
Resumos de Teses
Estudo Morfológico e Morfométrico do Endométrio de Mulheres na Pós-Menopausa Durante Terapêutica Estrogênica Contínua, Associada ao Acetato de Medroxiprogesterona a Cada Dois, Três e Quatro Meses
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-423
04-09-1998
DOI 10.1590/S0100-72031998000700009
Cláudia de Carvalho Ramos Bortoletto
Views33
Estudo Morfológico e Morfométrico do Endométrio de Mulheres na Pós-Menopausa Durante Terapêutica Estrogênica Contínua, Associada ao Acetato de Medroxiprogesterona a Cada Dois, Três e Quatro Meses[…]
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Resumos de Teses
Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada – Recife (PE)
- Welkovic Stefan
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-424
04-09-1998

Views37

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.
Summary
Resumos de Teses
Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada – Recife (PE)
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):423-424
04-09-1998
DOI 10.1590/S0100-72031998000700010
Welkovic Stefan
Views37
Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada Recife (PE) […]
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Relato de Caso
Complete Mole in Twin Pregnancy: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):415-419
04-09-1998

Views72

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Summary
Relato de Caso
Complete Mole in Twin Pregnancy: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):415-419
04-09-1998
DOI 10.1590/S0100-72031998000700008
Izildinha Maestá,
Iracema M.P. Calderon,
Marilza V.C. Rudge,
Magaly M. Sales,
Fabiano P. Saggioro,
José Carlos Peraçoli
Views72
Twin pregnancy in which a normal fetus and a complete mole develop at the same time is a rare event. Clinical complications and malignancy are frequent in this type of disease.This report is about a case of a late diagnosis due to the presence of the fetus. The diagnosis was made when the pregnancy was interrupted and then confirmed by histopathological study and flow cytometry. The pregnancy was terminated transpelvically due to massive uterine hemorrhage. The post-molar follow-up showed the persistence of high levels of bhCG. The patient’s complete recovery was achieved after the administration of methotrexate. The diagnosis, natural history, and procedures for this rare disease are discussed in view of this case.

Key-words Chemotherapy Complete hydatidiform mole Gestational trophoblastic disease Hemorrhage Pregnancy complications Twin pregnancy Ultrasonography
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Relato de Caso
Clear Cell Adenocarcinoma of the Endocervix in a 7-year-old Child
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):411-414
04-09-1998

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Summary
Relato de Caso
Clear Cell Adenocarcinoma of the Endocervix in a 7-year-old Child
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):411-414
04-09-1998
DOI 10.1590/S0100-72031998000700007
Marta Francis Benevides Rehme,
Mauro Fernando Kürten Ihlenfeld,
Ana Carolina Silva Chuery
Views84
Clear cell adenocarcinoma of the vagina and cervix is a rare disease associated commonly with the use of diethylstilbestrol (DES) during pregnancy. The most commom complaint is irregular vaginal bleeding, which could be confused with vaginitis in children and abnormalities in the hypothalamic-pituitary axis in adolescents. We report a case of clear cell adenocarcinoma of the endocervix in a 7-year-old child who was attended at the Children and Adolescent Gynecology Sector, and we call attention to the diagnosis of genital cancer which, in spite of its rarity at this age, must be considered in children with genital bleeding.

Key-words Carcinoma Childhood and adolescence Uterine cervix Vaginal cancer
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Equipamentos e Métodos
Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):405-410
04-09-1998

Views76

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Summary
Equipamentos e Métodos
Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):405-410
04-09-1998
DOI 10.1590/S0100-72031998000700006
Caio Parente Barbosa,
Marcelo Ettruri Santos,
Ana Cristina Napolitano,
Paula Harue Tamanaka,
Emerson Barchi Cordts
Views76
Objective: to demonstrate the effectiveness of video-hysteroscopic endometrial resection in the treatment of abnormal uterine bleeding. Patients and method: The authors studied 60 records of patients with abnormal uterine bleeding who did not respond to clinical treatment. Results: eighty-eight percent of the patients had adequate response to the treatment (53% oligomenorrhea and 35% amenorrhea). The complication rate was 8.3% (5 uterine perforations). Conclusion: video-hysteroscopic endometrial resection is an effective technique to treat abnormal uterine bleeding which failed to respond to clinical management. The intra and postoperative complication rates are low.

Key-words Endometrial hyperplanaresection Hysteroscopy
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Trabalhos Originais
Maternal Mortality in São Paulo City in 1996
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403
04-09-1998

Views100

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Summary
Trabalhos Originais
Maternal Mortality in São Paulo City in 1996
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403
04-09-1998
DOI 10.1590/S0100-72031998000700005
Luis Carlos Pazero,
Paulo Afonso Ferrigno Marcus,
Carlos Eduardo Pereira Vega,
Krikor Boyaciyan,
Sônia Antonini Barbosa
Views100
Purpose: to establish a list of diseases promoting maternal death according to frequency. Methods: In 1996, 65,406 deaths were recorded in the City of São Paulo, 26,778 of which were of women. Of these, 4591 were within the 10-49 year age bracket. We analyzed the latter group, regarding at the field “Cause of Death” in the Death Certificate, trying to establish some correlation between the described pathology, and the pregnancy-puerperium cycle. We separated for a further study 293 Death Certificates, from which we selected, after hospital survey and/or home visits, a total of 119 positive cases for maternal death. The positive cases for maternal death were then tabulated, grouped and analyzed according to age and pathology, using the great medical care groups. Results: as regards the 119 positive cases for maternal death, we did not find any reference to the pregnancy-puerperium state in 53 of them (that is, 40.54% subnotifying). The cases were grouped according to pathology, where we found a predominance of eclampsia/pre-eclampsia cases (18.02%), followed by cases resulting from hemorrhagic complications in the third quarter and puerperium (12.61%), abortion complications (12.61%), puerperal infection (9.91%) and cardiopathies (9.91%). Conclusions: for the first time, we are publishing the Late Maternal Mortality Coefficient for the City of São Paulo, which was 51.33/100,000 born alive. However, we used for the official publication the Maternal Mortality Coefficient for death within up to 42 days of puerperium, which was, 48.03/100,000 born alive for the city of São Paulo. We should bear in mind that no correction factor should be applied to these figures since we have made an active search of cases.

Key-words Cardiopathy in pregnancy Eclampsia Hemorrhagic complications in pregnancy Maternal mortality Maternal mortality coefficient Pregnancy complications
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Review Article
Timing of semen cryopreservation: before or after processing?
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo36
04-09-2024

Views361

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Summary
Review Article
Timing of semen cryopreservation: before or after processing?
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo36
04-09-2024
DOI 10.61622/rbgo/2024rbgo36
Ana Paula de Souza Kussler ,
Ivan Cunha Bustamante Filho ,
Elisa Negri ,
Edison Capp ,
Helena von Eye Corleta
Views361
Abstract

Objective:

Seminal cryopreservation causes significant damage to the sperm; therefore, different methods of cryopreservation have been studied. The aim of the study was to compare the effects of density gradient processing and washing/centrifugation with seminal plasma removal for cryopreservation in semen parameters.

Methods:

Seminal samples of 26 normozoospermic patients were divided into 3 parts: with seminal plasma; after washing/centrifugation; and after selection through density gradient. The samples were cryopreserved for at least two weeks. Motility, sperm count, morphology and viability were evaluated before cryopreservation and after thawing.

Results:

Density gradient processing selected motile and viable sperm with normal morphology in fresh samples (p<0.05). Cryopreservation negatively affected all sperm parameters regardless of the processing performed, and even if the sperm recovery was lower in the density gradient after the thawing, progressive motility, total motility, viability and morphology remained higher (p<0.05).

Conclusion:

Cryopreservation significantly compromises sperm parameters (motility, morphology, viability). In normozoospermic patients, the density gradients select better quality spermatozoa compared to other processing methods; this benefit was kept after thawing.

Key-words Centrifugation Cryopreservation Density gradient Semen Seminal plasma Sperm count Sperm wash Spermatozoa
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Original Article
Comparison of medical image interpretation time between conventional and automated methods of breast ultrasound
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo15
00-00-2024

Views359

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Summary
Original Article
Comparison of medical image interpretation time between conventional and automated methods of breast ultrasound
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo15
00-00-2024
DOI 10.61622/rbgo/2024AO15
Katyane Larissa Alves ,
Ruffo Freitas Junior ,
Régis Resende Paulinelli ,
Marcus Nascimento Borges
Views359
Abstract

Objective:

To compare the medical image interpretation’s time between the conventional and automated methods of breast ultrasound in patients with breast lesions. Secondarily, to evaluate the agreement between the two methods and interobservers.

Methods:

This is a cross-sectional study with prospective data collection. The agreement’s degrees were established in relation to the breast lesions’s ultrasound descriptors. To determine the accuracy of each method, a biopsy of suspicious lesions was performed, considering the histopathological result as the diagnostic gold standard.

Results:

We evaluated 27 women. Conventional ultrasound used an average medical time of 10.77 minutes (± 2.55) greater than the average of 7.38 minutes (± 2.06) for automated ultrasound (p<0.001). The degrees of agreement between the methods ranged from 0.75 to 0.95 for researcher 1 and from 0.71 to 0.98 for researcher 2. Among the researchers, the degrees of agreement were between 0.63 and 1 for automated ultrasound and between 0.68 and 1 for conventional ultrasound. The area of the ROC curve for the conventional method was 0.67 (p=0.003) for researcher 1 and 0.72 (p<0.001) for researcher 2. The area of the ROC curve for the automated method was 0. 69 (p=0.001) for researcher 1 and 0.78 (p<0.001) for researcher 2.

Conclusion:

We observed less time devoted by the physician to automated ultrasound compared to conventional ultrasound, maintaining accuracy. There was substantial or strong to perfect interobserver agreement and substantial or strong to almost perfect agreement between the methods.

Key-words Breast neoplasms breast ultrasound Diagnostic imaging three-dimensional imaging
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Original Article
Factors associated with the absence of postpartum consultations in a high-risk population
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo23
04-09-2024

Views358

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Summary
Original Article
Factors associated with the absence of postpartum consultations in a high-risk population
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo23
04-09-2024
DOI 10.61622/rbgo/2024rbgo23
Ana Carolina Gomes Pereira ,
Tábata Regina Zumpano dos Santos ,
Helymar da Costa Machado ,
Fernanda Garanhani de Castro Surita
Views358
Abstract

Objective:

To assess the rate of missed postpartum appointments at a referral center for high-risk pregnancy and compare puerperal women who did and did not attend these appointments to identify related factors.

Methods:

This was a retrospective cross-sectional study with all women scheduled for postpartum consultations at a high-risk obstetrics service in 2018. The variables selected to compare women were personal, obstetric, and perinatal. The variables of interest were obtained from the hospital’s electronic medical records. Statistical analyses were performed using the Chi-square, Fisher’s exact, or Mann–Whitney tests. For the variable of the interbirth interval, a receiver operating characteristic curve (ROC) was used to best discriminate whether or not patients attended the postpartum consultation. The significance level for the statistical tests was 5%.

Results:

A total of 1,629 women scheduled for postpartum consultations in 2018 were included. The rate of missing the postpartum consultation was 34.8%. A shorter interbirth interval (p = 0.039), previous use of psychoactive substances (p = 0.027), current or former smoking (p = 0.003), and multiparity (p < 0.001) were associated with non-attendance.

Conclusion:

This study showed a high rate of postpartum appointment non-attendance. This is particularly relevant because it was demonstrated in a high-risk obstetric service linked to clinical severity or social vulnerability cases. This highlights the need for new approaches to puerperal women before hospital discharge and new tools to increase adherence to postpartum consultations, especially for multiparous women.

Key-words High risk pregnancy Postnatal care Postpartum period Pregnant women Referral and consultation
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Original Article
Prevalence of colorectal symptoms and anal incontinence in patients with pelvic organ prolapse attended at an outpatient urogynecology service
- Marco Arellano ,
- Fernanda Santis-Moya ,
- Andrea Maluenda ,
- Alejandro Pattillo ,
- Bernardita Blümel ,
- Javier Pizarro-Berdichevsky
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo10
00-00-2024

Views355

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Summary
Original Article
Prevalence of colorectal symptoms and anal incontinence in patients with pelvic organ prolapse attended at an outpatient urogynecology service
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo10
00-00-2024
DOI 10.61622/rbgo/2024AO10
Marco Arellano ,
Fernanda Santis-Moya ,
Andrea Maluenda ,
Alejandro Pattillo ,
Bernardita Blümel ,
Dominga Pohlhammer ,
Silvana Gonzalez ,
Javier Pizarro-Berdichevsky
Views355
Abstract

Objective:

To analyze data of patients with symptomatic pelvic organ prolapse evaluated with PFDI20 and its subscales to report the prevalence of lower gastrointestinal symptoms and anal incontinence in the population of a public hospital and analyze its impact on quality of life.

Methods:

Cross-sectional study of patients with symptomatic POP. Patients were evaluated with demographic data, POP-Q, pelvic floor ultrasonography, urological parameters, and pelvic floor symptoms (PFDI-20), and quality of life (P-QoL) surveys. Patients were classified as CRADI-8 “positive” for colorectal symptoms, with responses “moderate” in at least 3 and/or “severe” in at least 2 of the items in the CRADI-8 questionnaires.

Results:

One hundred thirteen patients were included. 42.5% (48) were considered positive for colorectal symptoms on CRADI-8. 53.4% presented anal incontinence. No significant differences were found in sociodemographic variables, POP-Q stage, ultrasound parameters, or urological parameters. Positive patients had a significantly worse result in PFDI-20, POPDI (48 vs 28; p<0.001), UDI6 (51 vs 24; p<0.001), and in the areas of social limitation (44.4 vs 22.2; p = 0.045), sleep- energy (61.5 vs 44.4; p = 0.08), and severity (56.8 vs 43.7, p=0.015) according to P-QoL.

Conclusion:

Moderate or severe colorectal symptoms are seen in 40% of patients with symptomatic POP in our unit. Full evaluation of pelvic floor dysfunction symptoms should be performed routinely in urogynecology units.

Key-words Anal incontinence Colorectal symptoms pelvic organ prolapse Quality of life
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Letter to the Editor
Letter to Editor: “Combined aerobic and strength training improves dynamic stability and can prevent against static stability decline in postmenopausal women: A randomized clinical trial”
- Arshdeep Kaur ,
- Amit Kumar
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo26
04-09-2024

Views351

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.
Summary
Letter to the Editor
Letter to Editor: “Combined aerobic and strength training improves dynamic stability and can prevent against static stability decline in postmenopausal women: A randomized clinical trial”
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo26
04-09-2024
DOI 10.61622/rbgo/2024rbgo26
Arshdeep Kaur ,
Amit Kumar
Views351
Dear Editor,First and foremost, we express our gratitude towards the authors for their clear and concise description of the positive effects of aerobic and strength training on dynamic stability.() Additionally, their ability to provide a focused and informative introduction section is commendable. The study piqued our interest in further exploring the benefits of aerobic and […]
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Original Article
Bacteriological characteristics of primary breast abscesses in patients from the community in the era of microbial resistance
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo34
04-09-2024

Views342

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.
Summary
Original Article
Bacteriological characteristics of primary breast abscesses in patients from the community in the era of microbial resistance
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo34
04-09-2024
DOI 10.61622/rbgo/2024rbgo34
Vicente Sperb Antonello ,
Jessica Dallé ,
Mirela Foresti Jimenez ,
Patrícia Tramontini ,
Andrei Gustavo Reginatto
Views342
Abstract

Objective:

The aim of this study is to evaluate the etiological profile and antimicrobial resistance in breast abscess cultures from patients from the community, treated at a public hospital located in Porto Alegre, Brazil.

Methods:

This is an retrospective cross-sectional study that evaluated the medical records of patients with bacterial isolates in breast abscess secretion cultures and their antibiograms, from January 2010 to August 2022.

Results:

Based on 129 positive cultures from women from the community diagnosed with breast abscesses and treated at Fêmina Hospital, 99 (76.7%) of the patients had positive cultures for Staphylococcus sp, 91 (92%) of which were cases of Staphylococcus aureus. Regarding the resistance profile of S. aureus, 32% of the strains were resistant to clindamycin, 26% to oxacillin and 5% to trimethoprim-sulfamethoxazole. The antimicrobials vancomycin, linezolid and tigecycline did not show resistance for S. aureus.

Conclusion:

Staphylococcus aureus was the most common pathogen found in the breast abscess isolates during the study period. Oxacillin remains a good option for hospitalized patients. The use of sulfamethoxazole plus trimethoprim should be considered as a good option for use at home, due to its low bacterial resistance, effectiveness and low cost.

Key-words Abscess;Breast diseases Microbial drug resistance Staphylococcus aureus Sulfamethoxazole
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Original Article
Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo20
03-15-2024

Views338

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.
Summary
Original Article
Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo20
03-15-2024
DOI 10.61622/rbgo/2024AO20
João Vitor Quadra Vieira dos Santos ,
Antônio Rebello Horta Görgen ,
Tiago Bortolini ,
Gabriel Veber Moisés da Silva ,
Emanuel Burck dos Santos ,
Patric Machado Tavares ,
Nelson Silvonei da Silva Batezini ,
Tiago Elias Rosito
Views338
Abstract

Objective:

To present a series of cases with our initial experience and short-term outcomes of a modified vaginal mucosal flap urethroplasty.

Methods:

Patients diagnosed with urethral stricture and operated by the same operative technique between January 2012 and January 2018 were followed for at least 6 months. Uroflowmetry and clinical outcomes were evaluated.

Results:

Nineteen patients were included with an average age of 56.4 years, mean preoperative Qmax of 5.3 ml/s, and PVR of 101.4 mL. After 6 months of the procedure, the mean Qmax improved to 14.7 mL/s (p<0.05), PVR decreased to 47.3 mL (p<0.05), and 84.2% of all patients reported improvement in clinical self-reported symptoms. There was an improvement in symptoms such as voiding effort in 84.2% of patients, weak stream (89.5%), and recurrent urinary tract infection (85.7%). The success rate (absence of symptoms and normal Qmax with no significant PVR) of the procedure was 84.2%.

Conclusion:

The described technique was considered effective for the treatment of female urethra stricture, with a high clinical success rate and an objective improvement of Qmax and decrease in PVR after 6 months of the procedure.

Key-words Urethral stricture Urethroplasty Urinary bladder neck obstruction Urological surgical procedures
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Review Article
Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis
- Claudia López-Ruiz ,
- Jerutsa Catalina Orjuela ,
- Diego Fernando Rojas-Gualdrón ,
- Marcela Jimenez-Arango ,
- José Fernando de los Ríos ,
- Claudia Vargas
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):55-66
02-28-2022

Views338

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.
Summary
Review Article
Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(1):55-66
02-28-2022
DOI 10.1055/s-0041-1740595
Claudia López-Ruiz ,
Jerutsa Catalina Orjuela ,
Diego Fernando Rojas-Gualdrón ,
Marcela Jimenez-Arango ,
José Fernando de los Ríos ,
Elsa Maria Vásquez-Trespalacios ,
Claudia Vargas
Views338
Abstract

Objective

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

Data Sources

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

Method of Study

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

Conclusion

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

Key-words laparoscopic hysterectomy Opioid Pain robotic-assisted hysterectomy transversus abdominis plane block
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Review Article
Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):692-700
06-29-2022

Views144

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.
Summary
Review Article
Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):692-700
06-29-2022
DOI 10.1055/s-0042-1751062
Cibele Santini de Oliveira Imakawa ,
Mariane Nunes de Nadai ,
Monica Reis ,
Silvana Maria Quintana ,
Elaine Christine Dantas Moises
Views144
Abstract

Objective

To review concepts, definitions, and findings about fear of childbirth (FOC).

Methods

A bibliographic review was carried out through the main scientific databases in 2020.

Results

All 32 articles considered potentially relevant were analyzed. A recent study suggests that the global prevalence of FOC can reach up to 14%. Factors such as parity, gestational age, previous birth experience, age and nationality of the woman seem to influence FOC.

Conclusion

Fear of childbirth could be related to an increased risk of adverse obstetric outcomes such as maternal request for cesarean delivery, preterm birth, prolonged labor, postpartum depression, and post-traumatic stress. These evidence highlight the importance of the discussion regarding this topic.

Key-words childbirth Delivery Fear Obstetric labor pregnant
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Original Article
Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
- Margot Marie Martin ,
- Roxana Knobel ,
- Vitor Nandi ,
- Jessica Goedert Pereira ,
- Alberto Trapani Junior ,
- Carla Betina Andreucci
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022

Views45

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.
Summary
Original Article
Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022
DOI 10.1055/s-0041-1741450
Margot Marie Martin ,
Roxana Knobel ,
Vitor Nandi ,
Jessica Goedert Pereira ,
Alberto Trapani Junior ,
Carla Betina Andreucci
Views45
Abstract

Objective

The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.

Methods

Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis onmaternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.

Results

Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The followingmaternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.

Conclusion

In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.

Key-words access to health services COVID-19 Prenatal care Primary health care
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Review Article
Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
04-25-2022

Views197

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Summary
Review Article
Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
04-25-2022
DOI 10.1055/s-0042-1744286
Maria Laura Costa ,
Ricardo de Carvalho Cavalli ,
Henri Augusto Korkes ,
Edson Vieira da Cunha Filho ,
José Carlos Peraçoli
Views197
Abstract

Objective

It is a challenge to consider preeclampsia (PE) diagnosis and management in low and middle-income settings, where it represents a major public health concern. The placenta is the underlying cause of disease, and the plasma concentrations of proangiogenic and antiangiogenic factors released by the placenta can reflect the risks of disease progression. Antiangiogenic proteins, such as soluble fms-like tyrosine kinase 1 (sFlt-1), and proangiogenic, like placental growth factors (PlGF), are directly and inversely correlated with the disease onset, respectively.

Methods

Narrative review on the use of biomarkers (sFlt-1 to PlGF ratio) with a suggested guidance protocol.

Results

Key considerations on the use of biomarkers: the sFlt-1/PlGF ratio is mainly relevant to rule out PE between 20 and 36 6/7 weeks in cases of suspected PE; however, it should not replace the routine exams for the diagnosis of PE. The sFlt-1/PlGF ratio should not be performed after confirmed PE diagnosis (only in research settings). In women with suspected PE, sFlt-1/PlGF ratio < 38 can rule out the diagnosis of PE for 1 week (VPN = 99.3) and up to 4 weeks (VPN= 94.3); sFlt-1/PlGF ratio > 38 does not confirm the diagnosis of PE; however, it can assist clinical management. In cases of severe hypertension and/or symptoms (imminent eclampsia), hospitalization is imperative, regardless of the result of the sFlt-1/PlGF ratio.

Conclusion

The use of biomarkers can help support clinical decisions on the management of suspected PE cases, especially to rule out PE diagnosis, thus avoiding unnecessary interventions, especially hospitalizations and elective prematurity

Key-words Hypertension placental growth factor Preeclampsia preterm preeclampsia soluble fms-like tyrosine kinase 1
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Original Article
COVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021

Views146

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Summary
Original Article
COVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021
DOI 10.1055/s-0041-1733912
Wassan Nori ,
Ban Hadi Hameed ,
Asmaa Rajih Thamir ,
Amenah Fadhil
Views146
Abstract

Objective

To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women.

Methods

A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation.

Results

Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87±66.92 fL for the case group versus 9.84±1.2 fL for the control group; PDW: 14.82±3.18 fL for the case group versus 13.3±2.16 fL for the controls). The criterionvalue of the receiver operating characteristic (ROC) curve forPDWat a cutoffpoint of>11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of>10.17 fL showed a good diagnostic marker.

Conclusion

The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.

Key-words COVID-19 Mean platelet volume platelet distribution width platelet indices Pregnancy
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Short Communication
Surgical Site Infection after Cesarean Delivery in Times of COVID-19
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):374-376
07-30-2021

Views192

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.
Summary
Short Communication
Surgical Site Infection after Cesarean Delivery in Times of COVID-19
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):374-376
07-30-2021
DOI 10.1055/s-0041-1729144
Vicente Sperb Antonello ,
Jessica Dallé ,
Ivan Carlos Ferreira Antonello ,
Daniela Benzano ,
Mauro Cunha Ramos
Views192
Abstract

Objective

To analyze effects of the COVID-19 pandemic on the consumption of personal protective equipment and products (PPEP), as well as the frequency of surgical site infection (SSI) among non-COVID-19 patients submitted to cesarean sections.

Methods

A retrospective study was conducted in a maternity unity of a public teaching hospital which was not part of the reference service for COVID-19 treatment. It compared PPEP consumption and the occurrence of SSI after cesarean sections in monthly periods before and after the occurrence of the first case of COVID-19 in Porto Alegre, state of Rio Grande do Sul, Brazil. Personal protective equipment and products consumption was measured as units of masks, gloves, gowns, and caps, and use of alcohol-based products or soap for hand sanitation asml/patient/day. The SSI index was calculated as the proportion of cases of SSI over the number of cesarean sections performed monthly during the study period.

Results

There was an increase in all measured items of PPEP, with consumption of disposable masks with a median of 1,450 units in the pre-COVID period, and of 2550 in the post-COVID period (a 75.9% increase). A decrease of 49% in SSI was detected, with a median of 1.74 in the pre-COVID period and of 0.89 in the post-COVID period.

Conclusion

The increase in consumption of PPEP could be a result of safer practices adopted by healthcare workers with the advent of COVID-19, of which the following reduction in the occurrence of SSI could be a direct consequence. Despite the severity of the crisis, one could state that extreme situations can lead to valuable reflections and opportunities for improvement.

Key-words Cesarean section coronavirus personal protective equipment Surgical wound infection
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Original Article
Difficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
- Lorgio Rudy Aguilera ,
- Luz Mariana Mojica-Palacios ,
- Federico Urquizu ,
- Mirko Gorena ,
- Freddy Tinajeros Guzmán ,
- Albaro José Nieto-Calvache
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
04-26-2022

Views119

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Summary
Original Article
Difficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
04-26-2022
DOI 10.1055/s-0042-1742408
Lorgio Rudy Aguilera ,
Luz Mariana Mojica-Palacios ,
Federico Urquizu ,
Mirko Gorena ,
Freddy Tinajeros Guzmán ,
Lina María Vergara Galliadi ,
Alejandra Hidalgo ,
Albaro José Nieto-Calvache
Views119
Abstract

Objective

Placenta accreta spectrum (PAS) is a serious diseases, and the recommendation is that the treatment is conducted in centers of excellence. Such hospitals are not easy to find in low- and middle-income countries. We seek to describe the process of prenatal diagnosis, surgical management, and postnatal histological analysis in a low-income country referral hospital with limited resources.

Methods

A descriptive, retrospective study was carried out including patients with a pre- or intraoperative diagnosis of PAS. The clinical results of the patients were studied as well as the results of the prenatal ultrasound and the correlation with the postnatal pathological diagnosis.

Results

In total, 129 patients were included. Forty-eight of them had a prenatal PAS ultrasound diagnosis (37.2%). In the remaining 81 (62.8%), the diagnosis was intraoperative. Although hysterectomy was performed in all cases, one-third of the patients (31%) did not have a histological study of the uterus. In 40% of the patients who had a histological study, PAS was not reported by the pathologist.

Conclusion

The frequency of prenatal diagnosis and the availability of postnatal histological studies were very low in the studied population. Surgical skill, favored by a high flow of patients, is an important factor to avoid complications in settings with limited resources.

Key-words developing countries Latin America Placenta accreta
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Original Article
Adverse Events Related to COVID-19 Vaccines Reported in Pregnant Women in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):821-829
09-06-2022

Views186

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Summary
Original Article
Adverse Events Related to COVID-19 Vaccines Reported in Pregnant Women in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):821-829
09-06-2022
DOI 10.1055/s-0042-1755461
Carla Dinamerica Kobayashi ,
Victor Bertollo Gomes Porto ,
Martha Elizabeth Brasil da Nóbrega ,
Cibelle Mendes Cabral ,
Tiago Dahrug Barros ,
Cecília Maria Roteli Martins
Views186
Abstract

Regulations for the vaccination of pregnant women in Brazil occurred in March 2021. Despite the absence of robust data in the literature on the coronavirus disease 2019 (COVID-19) vaccinations in pregnant women, it is understood that the benefit-risk ratio tends to be favorable when considering the pandemic and the high burden of the disease. However, it is still important to monitor for Events Supposedly Attributable to Vaccination or Immunization (ESAVI) and to draw safety profiles of the different platforms used in pregnant and postpartum women. The present study aims to describe the main characteristics of ESAVIs related to COVID-19 vaccines occurring in pregnant women in the first months of the vaccination campaign in Brazil. During the evaluation period, 1,674 notifications of ESAVIs in pregnant women were recorded, and 582 notifications were included for the analysis. Of the 582 ESAVIs identified, 481 (82%) were classified as non-serious adverse events and 101 (17%) as serious adverse events. Ten deaths were identified, including one death which was considered to be causally related to the vaccine. The other nine maternal deaths had causality C, that is, without causal relationship with the vaccine, and most were due to complications inherent to pregnancy, such as pregnancy-specific hypertensive disorder (PSHD) in 4 cases and 3 due to COVID-19. Despite some limitations in our study, we believe it brings new insights into COVID-19 vaccines in this group and will add to the available evidence.

Key-words adverse event Brazil COVID-19 vaccines Pregnant women vaccine-preventable diseases
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Original Article
Association between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):256-263
06-18-2021

Views159

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Summary
Original Article
Association between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):256-263
06-18-2021
DOI 10.1055/s-0041-1728779
Conceição Christina Rigo Vale ,
Nubia Karla de Oliveira Almeida ,
Renan Moritz Varnier Rodrigues de Almeida
Views159
Abstract

Objective

To investigate the association between prenatal care (PNC) adequacy indexes and the low birth weigth (LBW) outcome.

Methods

A total of 368,093 live term singleton births in the state of Rio de Janeiro (Brazil) from 2015 to 2016 were investigated using data from the Brazilian Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC, in Portuguese). Seven PNC adequacy indexes were evaluated: four developed by Brazilian authors (Ciari Jr. et al., Coutinho et al., Takeda, and an index developed and used by the Brazilian Ministry of Health – MS) and three by authors from other countries (Kessner et al., the Adequacy of Prenatal Care Utilization index – APNCU, and the Graduated Prenatal Care Utilization Index – GINDEX). Adjusted odds ratios were estimated for the PNC adequacy indexes by means of multivariate logistic regression models using maternal, gestational and newborn characteristics as covariates.

Results

When the PNC is classified as “inadequate”, the adjusted odds ratios to the LBWoutcome increase between 42% and 132%, depending on which adequacy index is evaluated. Younger (15 to 17 years old) and older (35 to 45 years old) mothers, those not married, of black or brown ethnicity, with low schooling (who did not finish Elementary School), primiparous, with preterm births, as well as female newborns had increasing odds for LBW. The models presented areas under the receiver operating characteristic (ROC) curve between 80.4% and 81.0%, and sensitivity and specificity that varied, respectively, between 57.7% and 58.6% and 94.3% and 94.5%.

Conclusion

Considering all PNC adequacy indexes evaluated, the APNCU had the best discriminatory power and the best ability to predict the LBW outcome.

Key-words Low birth weight maternal and newborn health perinatal epidemiology Prenatal care
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Comparison of medical image interpretation time between conventional and automated methods of breast ultrasound

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Letter to Editor: “Combined aerobic and strength training improves dynamic stability and can prevent against static stability decline in postmenopausal women: A randomized clinical trial”

Bacteriological characteristics of primary breast abscesses in patients from the community in the era of microbial resistance

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Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases

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

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Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review

Abstract

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Methods

Results

Conclusion

Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women

Abstract

Objective

Methods

Results

Conclusion

Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers

Abstract

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COVID-19 in Pregnancy: Implication on Platelets and Blood Indices

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Methods

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Surgical Site Infection after Cesarean Delivery in Times of COVID-19

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Results