Articles - Revista Brasileira de Ginecologia e Obstetrícia

Original Article06-27-2002

The Trial of Labor After one Cesarean Section
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):161-166

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Abstract
Original Article
The Trial of Labor After one Cesarean Section
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):161-166
DOI 10.1590/S0100-72032002000300003
Iracema de Mattos Paranhos Calderon,
Jacqueline Leite Frade,
Joelcio Francisco Abbade,
Carolina Prado Diniz,
Ivete Dalben,
Marilza Vieira Cunha Rudge
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Purpose: to study trial of labor (TOL) for vaginal birth after one previous cesarean section. Methods: this is a retrospective cohort study that included 438 pregnant women with one previous cesarean section and their 450 newborns. They were divided into two groups – with and without TOL. The minimum sample size was 121 pregnant mothers per group. TOL was considered as an independent variable and vaginal birth and maternal and perinatal complication frequency as dependent variables. Both univariate and multivariate analyses were performed. The comparison of observed frequencies (%) was analyzed by the chi-squared test (chi²) with 5% significance, and linear regression from the odds ratio (OR) and confidence interval of 95% (CI95%). Results: TOL was used in 59.2% of vaginal deliveries. It was less used in women over 40 years (2.7% vs 6.7%) and in those with clinical or obstetrical diseases such as arterial hypertension (7.0%) and bleeding in the third trimester (0.3%). There was a higher risk for puerperal complications with cesarean deliveries (OR = 3.53, CI 95% = 1.57-7.93), independent of TOL. Perinatal mortality was dependent on neonatal weight and fetal malformations, not on TOL. Newborns from mothers not submitted to TOL were at a higher risk for developing breathing complications (OR = 1.92 CI 95% = 1.20-3.07). Conclusions: The results confirm that trial of labor after a previous cesarean section is a safe method – assisting vaginal delivery in 59.2% of births and not interfering with maternal and perinatal mortality. It is a treatment that should be stimulated.

Key-words Maternal and perinatal complications Previous cesarean section Trial of labor
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DECLARAÇÃO DE BARCELONA
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):151-151

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Abstract
DECLARAÇÃO DE BARCELONA
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(3):151-151
DOI 10.1590/S0100-72032002000300001
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DECLARAÇÃO DE BARCELONA […]
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A Grande Vitória
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):07-07

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Abstract
A Grande Vitória
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):07-07
DOI 10.1590/S0100-72032002000100001
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A Grande Vitória[…]
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Original Article06-20-2002

Microinvasive Carcinoma in the Cone Specimen in Women With Colposcopically Directed Biopsy Suggesting CIN 3
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):37-43

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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
Microinvasive Carcinoma in the Cone Specimen in Women With Colposcopically Directed Biopsy Suggesting CIN 3
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):37-43
DOI 10.1590/S0100-72032002000100006
Priscila Garcia Figueiredo,
Renata Clementino Gontijo,
Sophie Françoise Mauricette Derchain,
Fabiana Yumi Nakano,
Julio César Teixeira,
Edson Zangiacomi Martinez
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Purpose: to determine the factors associated with the detection of a microinvasive carcinoma in the cervical cone of women with a previous colposcopically directed biopsy compatible with cervical intraepithelial neoplasia (CIN) 3 and to evaluate the proportion of involved margins. Patients and methods: we reviewed the medical records of 385 women (mean age: 39 years) submitted to cold conization or conization by high frequency surgery (HFS) with a loop during the period from January 1993 to July 2000. These procedures were indicated on the basis of a biopsy compatible with (CIN) 3. Results: the diagnosis of the cone was compatible with (CIN) 3 in 243 (63%) women and with (CIN) 2 in 13 (3%). Only 10 presented HPV/CIN 1 (3%) and eight had no residual disease in the cone. However, 101 (26%) women presented a microinvasive carcinoma in the cone and 10 (3%) presented a frankly invasive carcinoma. Age, menstrual status and number of deliveries were not related to the severity of the cone lesion. Women with oncologic colpocytology changes suggestive of invasion presented a significantly higher risk of having a microinvasive or invasive carcinoma as determined by final histology (p<0.01), although 52 of the 243 women with CIN 2 or CIN 3 in the cone also showed a suggestion of invasion at colpocytology. Among the women with CIN 2 or 3, the epithelium was white in 44%, dotted in 21%, and mosaic-like in 17%. This proportion was similar for women with a microinvasive or invasive carcinoma, with these images being detected in 37%, 23% and 21% of the cases, respectively. Involvement of the cone margins was significantly higher among women submitted to HFS (49%) than among those submitted to cold conization (29%). Conclusion: the absence of independent clinical and colposcopic factors associated with the detection of a microinvasive carcinoma in women submitted to conization on the basis of a biopsy compatible with (CIN) 3 justifies the conical excision of the squamocolumnar junction in high grade cervical lesions.

Key-words Carcinoma, microinvasive Colposcopy Conization Intraepithelial neoplasia
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Erratum06-19-2002
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1)

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Abstract
Erratum
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1)
DOI 10.1590/S0100-72032002000100018
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Associação entre a incisura Diastólica das artérias uterinas e a histologia do leito placentário em grávidas com pré-eclâmpsia […]
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Resumos de Teses06-19-2002

Contribuição ao Estudo do Laser de Vapor de Cobre no Tratamento da Endometriose Induzida Cirurgicamente em Coelhas
- Maurício Paulo Angelo Mieli
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):71-71

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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
Resumos de Teses
Contribuição ao Estudo do Laser de Vapor de Cobre no Tratamento da Endometriose Induzida Cirurgicamente em Coelhas
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):71-71
DOI 10.1590/S0100-72032002000100017
Maurício Paulo Angelo Mieli
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Contribuição ao Estudo do Laser de Vapor de Cobre no Tratamento da Endometriose Induzida Cirurgicamente em Coelhas […]
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Resumos de Teses06-19-2002

Avaliação do Potencial de Peroxidação Lipídica no Fluido Peritoneal de Mulheres Inférteis com Endometriose Pélvica
- Vivian Ferreira do Amaral
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):70-70

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Abstract
Resumos de Teses
Avaliação do Potencial de Peroxidação Lipídica no Fluido Peritoneal de Mulheres Inférteis com Endometriose Pélvica
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):70-70
DOI 10.1590/S0100-72032002000100016
Vivian Ferreira do Amaral
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Avaliação do Potencial de Peroxidação Lipídica no Fluido Peritoneal de Mulheres Inférteis com Endometriose Pélvica […]
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Resumos de Teses06-19-2002

Prevalência das Neoplasias Intra-epiteliais Cervicais e Lesões Induzidas pelo HPV nas Mulheres Soropositivas/AIDS
- Susana Cristina Aidé Viviani Fialho
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):70-70

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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
Resumos de Teses
Prevalência das Neoplasias Intra-epiteliais Cervicais e Lesões Induzidas pelo HPV nas Mulheres Soropositivas/AIDS
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):70-70
DOI 10.1590/S0100-72032002000100015
Susana Cristina Aidé Viviani Fialho
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Prevalência das Neoplasias Intra-epiteliais Cervicais e Lesões Induzidas pelo HPV nas Mulheres Soropositivas/AIDS […]
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Nominata 202412-31-2024

Nominata 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:eRBGO20242024

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Abstract
Nominata 2024
Nominata 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:eRBGO20242024
DOI 10.61622/rbgo/2024nominata02024
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We wish to thank everyone who contributed to the edition of the Revista Brasileira de Ginecologia e Obstetrícia – RBGO volume 46, year 2024, especially the authors and reviewers whose work and opinions were essential to maintain the scientific and methodological rigor of the published articles.A. Seval Ozgu-Erdinc, University of Health Sciences, Ankara Eğitim ve […]
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Review Article12-04-2024

Self-medication among pregnant women in comparison to the general population: a scoping review of the main characteristics
- Gabriela Pereira ,
- Cinthia Madeira de Souza ,
- Amanda Canato Ferracini ,
- Fernanda Garanhani Surita ,
- Sherif Eltonsy ,
- Priscila Gava Mazzola
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo77

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Abstract
Review Article
Self-medication among pregnant women in comparison to the general population: a scoping review of the main characteristics
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo77
DOI 10.61622/rbgo/2024rbgo77
Gabriela Pereira ,
Cinthia Madeira de Souza ,
Amanda Canato Ferracini ,
Fernanda Garanhani Surita ,
Sherif Eltonsy ,
Priscila Gava Mazzola
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Abstract

Objective:

An in-depth evaluation of the published evidence is needed on self-medication, specifically the evidence focusing on vulnerable groups, such as pregnant women. This scoping review aims to provide an overview of the differences in self-medication prevalence and study characteristics among different groups, while identifying gaps in the literature.

Methods:

A literature search was performed in PubMed and Web of Science, including articles published in the last 10 years for the pregnant women group (PWG) and the general population group (GPG). Data on study design, self-medication prevalence, medications used, and other variables were collected, tabulated, and summarized.

Results:

From 2888 screened articles, 75 were considered including 108,559 individuals. The self-medication (SM) in the PWG ranged from 2.6 to 72.4% and most studies had an SM prevalence between 21 and 50% and in the GPG, 32 from 50 studies had a SM prevalence higher than 50%. The reviewed studies varied considerably in methodology, requiring careful interpretation. While most of the studies assessed self-medication during the entire pregnancy, self-medication definition was often inconsistent between studies. Acetaminophen was the most used medication and headache was the most frequent symptom leading to self-medication initiation in the PWG.

Conclusions:

Self-medication among pregnant women showed a lower prevalence when compared to the general population. The medications used and symptoms reported were similar between groups. However, methodological differences must be carefully considered. Pregnant women should carefully follow their physicians’ advice before initiating self-medication to avoid preventable maternal and fetal adverse effects.

Key-words drug-related side effects and adverse reactions Medication use Pregnant women Self-medication
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Review Article12-04-2024

Metformin versus insulin in gestational diabetes mellitus: a systematic review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo89

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Abstract
Review Article
Metformin versus insulin in gestational diabetes mellitus: a systematic review
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo89
DOI 10.61622/rbgo/2024rbgo89
Giovanna Noronha Berti ,
Igor Gutschov Oviedo Garcia ,
João Pedro Ruas Floriano de Toledo ,
Júlia Rodrigues Tatemoto ,
Lais Watanabe Marino ,
Mariana de Medeiros Legori ,
Sérgio Floriano de Toledo
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Abstract

Objective:

The aim of this study is to assess the use of metformin with or without insulin for the treatment of Gestational Diabetes Mellitus compared to insulin alone.

Data sources:

This article consists of a systematic review of randomized clinical trials. The searches were carried out on MEDLINE including 7 studies, between 2010 to 2021.

Study selection:

Randomized clinical trials comparing metformin and insulin written in English, Spanish or Portuguese, with no time limit, were included.

Data collection:

Data was extracted from all the 7 articles and compared statistically when possible. Whenever data was not available or couldn’t be statistically compared, the main results were described in detail.

Data synthesis:

Insulin alone is not superior than metformin with or without insulin on gestational diabetes mellitus.

Conclusion:

There is a potential viability of using metformin as an alternative compared to insulin alone in the treatment of Gestational Diabetes Mellitus. However, all assessed outcomes have a very low level of certainty of evidence and more studies are necessary to support these findings.

Key-words Gestational diabetes Insulin therapy Metformin Pregnancy complications
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Letter to the Editor12-04-2024

Comment on: Effects of COVID-19 on human placentas in the second and third trimester
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo88

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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
Letter to the Editor
Comment on: Effects of COVID-19 on human placentas in the second and third trimester
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo88
DOI 10.61622/rbgo/2024rbgo88
Nayara Ribeiro Máximo de Almeida ,
Mateus Augusto Felix de Melo ,
Pâmela Marillac Rodrigues Feijó de Melo ,
Julio Martinez Santos ,
Johnnatas Mikael Lopes
Views141
Recent evidence demonstrates na increase in negative maternal and neonatal outcomes in cases of SARS-CoV-2 infection, such as greater severity of the disease, need for mechanical ventilation and longer hospitalization in intensive care units.(,) The greater severity of infectious diseases in pregnancy occurs due to anatomical and immunological changes, such as a change in the […]
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Original Article12-04-2024

Analysis of vaginal microbiota before and after treatment of high-grade squamous intraepithelial lesions of the uterine cervix
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo86

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Abstract
Original Article
Analysis of vaginal microbiota before and after treatment of high-grade squamous intraepithelial lesions of the uterine cervix
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo86
DOI 10.61622/rbgo/2024rbgo86
Patrícia Mendonça Ventura ,
Isabel Cristina Chulvis do Val Guimarães ,
Luis Guillermo Coca Velarde ,
Susana Cristina Aidé Viviani Fialho ,
Douglas Guedes Ferreira ,
Matheus Madureira Fernandes ,
Rafael Augusto Chaves Machado
Views207
Abstract

Objective:

HPV infection is considered the most common sexually transmitted virus today. The persistence of HPV is the main cause for the development of precursor lesions and cervical cancer. There are environmental and non-environmental factors that contribute to the persistence of the virus. Studies indicate a possible relationship between the vaginal microbiota (environmental factor) and the risk of high-grade cervical squamous intraepithelial lesions and cervical cancer. This study evaluates the association between the type of vaginal microbiota and the occurrence of high-grade squamous intraepithelial lesions of the cervix.

Methods:

Observational, longitudinal, prospective, and analytical studies carried out between 2019 and 2021, which evaluated the vaginal microbiota of patients diagnosed with high-grade cervical squamous intraepithelial lesion before and after treatment in two collections with an interval of 6 months, using scrapings and vaginal swabs.

Results:

In Group I (with lesions) 28 women participated and 29 in Group II (without lesions). According to Nugent, in the initial collection of Group I, 16 women (57%) had lactobacillary microbiota, eight (28%) intermediate, and four (14%) coccus. In Group II, twenty-one (75%) were lactobacillary, one (3%) was intermediate, and seven (24%) werecoccus. With p=0.03.

Conclusion:

According to Nugent’s criteria, there was an association between the type of vaginal microbiota and the occurrence of high-grade cervical squamous intraepithelial lesions of the cervix. The same was not observed in the Donders classification. Studies with a larger sample are needed to confirm our results.

Key-words Cervixuteri microbiota Papillomavirus infections squamous intraepithelial lesions of the cervix Uterine cervical neoplasms Vaginosis, bacterial
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Original Article12-04-2024

Systemic inflammatory indices as a non-invasive grading modality for endometriosis: a comparative study versus exploratory laparoscopy
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo84

Views207

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Abstract
Original Article
Systemic inflammatory indices as a non-invasive grading modality for endometriosis: a comparative study versus exploratory laparoscopy
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo84
DOI 10.61622/rbgo/2024rbgo84
Ahmed Sabra Ibrahim Mohammed Sabra ,
Shreen Naguib Aboelezz Moselhy ,
Ahmed Kasem Mohamed Zain Eldin
Views207
Abstract

Objective:

Included evaluation of the possibility of using the systemic inflammatory indices for preoperative screening for the presence and severity of endometriosis (EM) in comparison to the findings of the exploratory laparoscopy

Methods:

88 women with clinical manifestations suggestive of EM were evaluated clinically and by US and gave blood samples for estimation of serum cancer antigen-125 (CA125), platelet and total and differential leucocytic counts for calculation of inflammatory indices; the Systemic Immune-Inflammation index, the Systemic Inflammation Response Index (SIRI), the Neutrophil-Lymphocyte ratio (NLR), the Neutrophil-Monocyte ratio, the Neutrophil-Platelet ratio and the Platelet-Lymphocyte ratio. Then, patients were prepared to undergo laparoscopy for diagnosis and staging.

Results:

Laparoscopy detected EM lesions in 63 patients; 27 of stage I-II and 36 of stage III-IV. Positive laparoscopy showed significant relation with US grading, high serum CA125 levels, platelet and inflammatory cell counts and indices. Statistical analyses defined high SIRI and NLR as the significant predictors for positive laparoscopy and high serum CA125 and NLR as the most significant predictors for severe EM (stage III-IV) on laparoscopy

Conclusion:

The intimate relation between EM and inflammation was reflected systematically as high levels of blood cellular components, but indices related to neutrophil especially NLR and SIRI showed highly significant relation to the presence and severity of EM and might be used as routine, cheap and non-invasive screening test before exploratory laparoscopy to guide the decision-making.

Key-words CA125 antigen Endometriosis Inflammation Laparoscopy Leukocyte count Lymphocytes Neutrophils
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Letter to the Editor12-04-2024

Comment on: Effect of combined training on body image, body composition and functional capacity in patients with breast cancer: controlled clinical trial
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo96

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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
Letter to the Editor
Comment on: Effect of combined training on body image, body composition and functional capacity in patients with breast cancer: controlled clinical trial
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo96
DOI 10.61622/rbgo/2024rbgo96
Piyush Bharadwaj ,
Divya Khati ,
Simran Sunil Khutarkar ,
Sweta Verma
Views193
Dear Editor,I am writing to express my appreciation for the recent article titled “Effect of Combined Training on Body Image, Body Composition, and Functional Capacity in Patients with Breast Cancer: Controlled Clinical Trial,” published online on June 20, 2023. The study provides crucial insights into the benefits of combined training for breast cancer patients, highlighting […]
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Review Article12-04-2024

Female genital tract microbiome: the influence of probiotics on assisted reproduction
- Ana Sofia Almeida Santana ,
- Ana Margarida Póvoa
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo82

Views214

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
Female genital tract microbiome: the influence of probiotics on assisted reproduction
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo82
DOI 10.61622/rbgo/2024rbgo82
Ana Sofia Almeida Santana ,
Ana Margarida Póvoa
Views214
Abstract

Assisted reproductive technology (ART) has been evolving since 1978, with the number of techniques performed increasing over the years. Despite continued advances, some couples continue to have difficulties getting pregnant, and it has recently been considered that the microbiome of the female genital tract (FGT) may influence embryo implantation and the establishment of pregnancy. This review aims to evaluate the role of probiotics on reproductive outcomes in infertile women on ART. A search throughout medical databases was performed, and six articles met the criteria. Five studies showed improvements in pregnancy rates, with only one demonstrating statistical significance. One article showed no improvement but reported a statistically significant reduction in the miscarriage rate in the probiotic group. Further research is needed to evaluate the true potential of probiotics, namely to assess whether they effectively modulate the FGT microbiome and if these changes are maintained over time.

Key-words Abortion, spontaneous Embryo implantation Genitalia, female Infertility, female Pregnancy outcome Pregnancy rate Probiotics Reproductive techniques, assisted, Microbiota
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Original Article06-19-2002

Computerized Antepartum Cardiotocography Analysis in High Risk Pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):29-36

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Abstract
Original Article
Computerized Antepartum Cardiotocography Analysis in High Risk Pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):29-36
DOI 10.1590/S0100-72032002000100005
Roseli Mieko Yamamoto Nomura,
Rossana Pulcineli Vieira Francisco,
Débora Simões Steinman,
Seizo Miyadahira,
Marcelo Zugaib
Views106
Purpose: to study computerized cardiotocography performed in high-risk pregnancies, analyze the results, and correlate the criteria to perinatal results. Patients and Methods: two hundred and thirty-three high-risk pregnancies were studied prospectively, performing a total of 485 computerized cardiotocographies. The exclusion criteria included fetal anomalies and signal loss over 20% (proportion of 3.75-millisecond periods in which there were no valid pulse intervals). The perinatal results of 71 pregnancies were correlated to the last cardiotocography, performed at least seven days before birth, excluding patients with absent or reversed end diastolic velocities in the umbilical arteries. Results: thirty-three examinations with signal loss over 20% were excluded. The normal criteria were met in 404 (83.3%), and 62.1% examinations met the criteria within 20 minutes and 79% within 30 minutes. The abnormal computerized cardiotocography was related significantly (p<0.05) to adverse perinatal results, such as: preterm delivery, first minute Apgar score less than 7 (33%), neonatal intensive care admission (55.5%) and intubation of newborn at delivery (44.4%). Conclusions: computerized cardiotocography in high-risk pregnancies met the normal criteria in most of the cases, with the examination performed for 30 minutes. The cases that did not meet the criteria correlated significantly to adverse perinatal results.

Key-words Cardiotocography Fetal heart rate Fetal well-being
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Original Article06-19-2002

Predictive Model using Risk Factors for Cesarean Section
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):21-28

Views122

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
Predictive Model using Risk Factors for Cesarean Section
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):21-28
DOI 10.1590/S0100-72032002000100004
Alfredo de Almeida Cunha,
Margareth Crisóstomo Portela,
Abés Mahomed Amed,
Luiz Camano
Views122
Purpose: to investigate antepartum factors related to cesarean section and develop a cesarean section predictive model. Methods: the study design was a retrospective cohort which included all the cared 843 deliveries in a third level unit from June 1993 through November 1994. Children with 1,000 g birthweight and above were included. The dependent variable was cesarean section (c-section). Independent variables were antepartum factors related to c-section. Logistic regression was used to develop a predictive model. Results: our model showed risk of c-section according to the following variables: maternal age under 20 years (OR = 0.396) and over 28 years (OR = 2.133); previous vaginal deliveries (OR = 0.626); previous c-section (OR = 4.576); prenatal care (OR = 2.346); breech presentation (OR = 4.174); twin pregnancies (OR = 14.065); late obstetrical hemorrhage (OR = 28.189); mild preeclampsia (OR = 2.180); severe preeclampsia OR=16.738; chronic hypertension OR=4.927 and other clinical problems (OR = 2.012). The predictive model had a concordance of 82.3% between probabilities and responses. Conclusions: our study identified 12 antepartum factors related to c-section. It was possible to develop a cesarean section predictive model taking into account all previously identified antepartum risk factors.

Key-words Cesarean section Delivery, mode of Predictive model Pregnancy complications
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Original Article06-19-2002

Maternal Morbidity and Perinatal Morbidity and Mortality Associated with Ascendant Infection in Premature Rupture of Membranes
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):15-20

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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
Maternal Morbidity and Perinatal Morbidity and Mortality Associated with Ascendant Infection in Premature Rupture of Membranes
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):15-20
DOI 10.1590/S0100-72032002000100003
José Elias Soares da Rocha,
Ana Claire Pimenteira Tomaz,
Dinalva Bezerra da Rocha,
Antônio Fernando Bezerra,
Ana Luzia de Campos Lopes,
Ana Maria Omena Breda,
Silvia Danielle Alves Souza
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Purpose: to evaluate the effects of ascending infection on the mother and newborn in the cases of premature rupture of membranes. Methods: this was a prospective study, carried out to evaluate 50 pregnant women with premature rupture of membranes (PROM) and their newborns. The clinical chorioamnionitis was investigated by clinical findings (thermal curve, abdominal pain by groping and/or uterine softening, smell and other characteristics of vaginal secretion) and subsidiary tests (white blood cell count and C-reactive protein). The histologic chorioamnionitis was investigated by macroscopic and microscopic study (placenta, membranes and cord). In the microscopic study optic microscopy with hematoxylin-eosin staining was used. The newborns were evaluated as to weight and Apgar score in the first and fifth minutes of life. White blood cell count, culture of auditory canal swab and aspirated gastric material culture complemented the study. Statistical analysis was performed using the Fisher exact test and the Student t-test, with level of significance set at 5% (p < 0.05). Results: The rate of clinical chorioamnionitis was 29.4% (15/50), while for histologic chorioamnionitis it was 40% (20/50). All the cases of clinical chorioamnionitis had latency times (LT) higher than 24 hours. The newborns presented signal of infection in 31.4% of the cases (16/51), all with LT higher than 24 hours. The main isolated microorganisms of auditive duct and gastric aspirate of newborns were Klebsiella pneumoniae, Staphylococcus aureus, Gram positive coccus and group B Streptococcus. The infected newborns presented lower Apgar scores in the first and fifth minute of life, lower weight and higher perinatal morbidity and mortality when compared with newborns without infection. Conclusions: based on the analysis of results obtained in the present study, it was possible to conclude that the prolonged latency times increase the possibility of ascending infection, leading to higher possibility of premature delivery and high maternal morbidity (clinical chorioamnionitis), as well as perinatal morbidity and mortality.

Key-words Ascending infection Chorioamnionitis Premature rupture of membranes
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Original Article06-19-2002

Maternal Serum Level of C-reactive Protein in Gestations Complicated by Preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):09-13

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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
Maternal Serum Level of C-reactive Protein in Gestations Complicated by Preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):09-13
DOI 10.1590/S0100-72032002000100002
Antônio Carlos Vieira Cabral,
Janaína de Freitas Lázaro,
Zilma Nogueira Reis Vitral
Views67
Purpose: to investigate the association between serum C-reactive protein concentration and preeclampsia occurrence, as well as its relation to the disease severity. Patients and Methods: twenty-seven preeclamptic pregnant women and 27 pregnant women with no clinical intercurrences, in the third trimester of pregnancy, were evaluated in a transversal case-control study. Serum C-reactive protein dosage, besides clinical examination and laboratory tests for the diagnosis of the disease, were performed in the antenatal period. The association between C-reactive protein and the presence of preeclampsia, and the correlation between plasma protein values and blood pressure values were investigated. The chi² significance test and regression analysis through the square minimum technique were used, and the results were considered to be statistically significant when p<0.05. Results: the preeclamptic pregnant women presented mean blood pressure levels higher than their controls (129.9±12.1 and 87.2±6.5 mmHg, respectively) and significantly higher C-reactive protein mean values than the normotensive women (18.9±4.9 and 1.56±0.8 mg/L, respectively). There was a significant association between the C-reactive protein concentration increase and preeclampsia occurrence (p<0.0001, odds ratio: 20.1). It was also observed that the mean arterial pressure and proteinuria presented a direct correlation with the circulating C-reactive protein in maternal blood (p=0.001 and p<0.001, respectively). Conclusion: C-reactive protein is an effective marker of preeclampsia occurrence and significantly correlates with the disease severity. The use of this test for the differential diagnosis of pregnant women in several hypertensive situations and its utilization as a marker of preeclampsia prognosis deserve further studies.

Key-words C-reactive protein Hypertension Proteinuria
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Original Article06-18-2002

Correlation Between Laparoscopic Aspects and Histologic Findings in Peritoneal Endometriotic Lesions
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):93-99

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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
Correlation Between Laparoscopic Aspects and Histologic Findings in Peritoneal Endometriotic Lesions
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):93-99
DOI 10.1590/S0100-72032002000200004
Francesco Antonio Viscomi,
Rogério Dias,
Laurival de Luca,
Mauro Fernando Kürten Ihlenfeld
Views92
Purpose: to evaluate the correlation between the laparoscopic aspects and the stromal histologic findings of peritoneal endometriosis in order to understand the evolutive theory of endometriosis. Methods: sixty-seven women were submitted to laparoscopy for pelvic pain, infertility, ovarian tumor and other pathologies. A peritoneal biopsy was taken from the typical (puckered black) and atypical endometriotic implants. The different aspects of endometriosis were classified as follows: red lesions (Group V), black lesions (Group N) and white lesions (Group B). The histological sections were examined according to a standardized protocol. The histologic parameters used were: depth of the lesion, presence of hemosiderin, vascularization of the stroma and fibrotic tissue in stroma. Results: regarding lesion depth, there were significant differences between the groups. Red lesions were located consistently on the surface of the peritoneum (100%) and black lesions were superficial in 55.6%, intermediate in 38.9% and deep in 5.5%. White lesions were superficial in 28%, intermediate in 68% and deep in 4%. The presence of hemosiderin showed equivalent results in the 3 groups. The large stromal vascularization was present in the red lesions (60%), which a statistically significant difference compared to the other groups. Fibrotic tissue was present in 70.6% of the white lesions (group B), a fact that was significantly different when compared to groups V and N. Conclusion: the parameters analyzed in this study confirmed the importance of the evolutive theory of endometriosis.

Key-words Endometriosis Hemosiderin Laparoscopy Pelvic pain
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Original Article06-18-2002

Role of Clinical History and Physical Examination in the Diagnosis of Urinary Incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):87-91

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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
Role of Clinical History and Physical Examination in the Diagnosis of Urinary Incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):87-91
DOI 10.1590/S0100-72032002000200003
Paulo Cezar Feldner Jr,
Leonardo Robson P.S. Bezerra,
Manoel João Bastista C. Girão,
Rodrigo Aquino de Castro,
Marair Gracio F. Sartori,
Edmund Chada Baracat,
Geraldo Rodrigues de Lima
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Purpose: to analyze the prevalence of urogynecological symptoms and their relationship with final urodynamic diagnosis, and to compare the clinical sign of stress urinary incontinence with urodynamic diagnosis. Methods: a total of 114 patients were included in a retrospective study from June 2000 to January 2001. All patients were evaluated through medical interview, physical examination and urodynamic study. They were classified according to clinical symptom, presence of clinical sign of urine loss and urodynamic study. The data analysis was performed using a test to determine sensitivity, specificity, and positive and negative predictive values. Results: the mean age was 51 years (19-80), 61 patients (53.5%) were in menacme and 53 (46.5%) in postmenopausal stage. Ten (18.8%) were using hormone replacement therapy and 25 (21.9%) had been submitted to surgery for incontinence. The isolated clinical symptom of urine loss was reported in 41 (36.0%) patients, the isolated urgency/urgency-incontinence in 13 (11.4%) and mixed symptoms in 60 (52.6%). In the urodynamic study, of all patients with symptom of isolated urine loss, 34 (83%) had stress urinary incontinence (SUI), no patient had detrusor instability (DI), 2 (4.9%) had mixed incontinence (MI) and 5 (12.1%) had a normal result. Of all patients with isolated urgency/urgency-incontinence, in the urodynamic study, none had SUI, 5 (38.5%) had ID, 1 (7.7%) had MI and 7 (53.8%) had a normal result. Of the patients with mixed symptoms, we identified, on the urodynamic evaluation, 25 (41.6%) who had SUI, 10 (16.7%) ID, 10 (16.7%) MI and 15 (25.0%) a normal result. The clinical sign of urine loss was identified in 50 (43.9%) patients. A total of 35 (70%) had SUI on urodynamic study, 6 (12%) had SUI and another diagnosis and 9 (18%) did not have SUI. Urine loss was absent in 64 (56.1%) women. Of those 23 (35.9%) had SUI on urodynamic study, 7 (11%) had SUI and another diagnosis and 34 (53.1%) did not have SUI. Conclusions: clinical history and physical examination are important in the management of urinary incontinence, although they should not be used as the only diagnostic method. Objective tests are available and should be used together with clinical data.

Key-words Clinical examination Urinary incontinence Urodynamic study
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Original Article06-18-2002

Sentinel Lymph Node Accuracy in Early Breast Cancer Treated with Neoadjuvant Chemotherapy
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):81-86

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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
Sentinel Lymph Node Accuracy in Early Breast Cancer Treated with Neoadjuvant Chemotherapy
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):81-86
DOI 10.1590/S0100-72032002000200002
José Roberto Morales Piato,
Alfredo Carlos Simões Dornellas de Barros,
Katia Maciel Pincerato,
Adriano Oliveira Vigário,
José Aristodemo Pinotti
Views122
Purpose: to evaluate the predictive capacity of the sentinel lymph node (SLN) in relation to the axillary lymph node status in patients with initial invasive breast carcinoma submitted or not to neoadjuvant chemotherapy. Method: a prospective study was performed in 112 patients divided into two groups. The first group comprised 70 patients who had not received previous chemotherapy (Group I) and the second consisted of 42 patients who were submitted to neoadjuvant chemotherapy in three cycles of AC (adriamycin + cyclophosphamide) (Group II). Regarding chemotherapy, we observed partial response >50% in 21 patients, being complete in three of them, and <50% in 19 patients; in two patients progression of the disease occurred. A peritumoral injection of 99mTc dextran was applied with the help of stereotaxy in 29 patients with nonpalpable tumors, 16 of Group I and 13 of Group II. The radioactive accumulation shown by scintigraphy guided the biopsy of the axillary SLN with the help of a probe. The anatomopathologic study of SLN was based initially on a single section. When the LSN was free, it was submitted to serial sections at 50 mum intervals, stained with HE. Results: SLN was identified in 108 patients. No identification has been obtained in four patients, all with nonpalpable lesions (3 patients of Group I and 1 of Group II). The method's accuracy in predicting the axillary lymph node status was 100% in patients who did not receive neoadjuvant chemotherapy and 93% in those to whom this kind of treatment was administered. This difference proved to be statistically significant. Conclusions: the present study allowed us to conclude that in all patients who did not receive previous chemotherapy treatment, the SLN study was effective in predicting the axillary lymph node status. The high rate of false-negative results in the group of patients submitted to neoadjuvant chemotherapy seems to invalidate the use of SLN study these patients.

Key-words Breast cancer Neoadjuvant chemotherapy Sentinel lymph node
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Editorial
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):79-79

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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
Editorial
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(2):79-79
DOI 10.1590/S0100-72032002000200001
Views34
Editorial A Revista Brasileira de Ginecologia e Obstetrícia (RBGO), como já é do conhecimento de todos, é a única publicação na área de Ginecologia e Obstetrícia que está indexada mo SciELO (Scientific Electronic Library Online).[…]
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The Trial of Labor After one Cesarean Section

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Comment on: Effects of COVID-19 on human placentas in the second and third trimester

Analysis of vaginal microbiota before and after treatment of high-grade squamous intraepithelial lesions of the uterine cervix

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Systemic inflammatory indices as a non-invasive grading modality for endometriosis: a comparative study versus exploratory laparoscopy

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Computerized Antepartum Cardiotocography Analysis in High Risk Pregnancies

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Maternal Morbidity and Perinatal Morbidity and Mortality Associated with Ascendant Infection in Premature Rupture of Membranes

Maternal Serum Level of C-reactive Protein in Gestations Complicated by Preeclampsia

Correlation Between Laparoscopic Aspects and Histologic Findings in Peritoneal Endometriotic Lesions

Role of Clinical History and Physical Examination in the Diagnosis of Urinary Incontinence

Sentinel Lymph Node Accuracy in Early Breast Cancer Treated with Neoadjuvant Chemotherapy

Editorial

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