Articles - Revista Brasileira de Ginecologia e Obstetrícia

04-09-1998

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

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Abstract
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
DOI 10.1590/S0100-72031998000700009
Cláudia de Carvalho Ramos Bortoletto
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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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04-09-1998

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

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Abstract
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
DOI 10.1590/S0100-72031998000700010
Welkovic Stefan
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Sangramento e Endometrite em Pacientes Portadoras de DIU Pós-Placentário na Maternidade de Encruzilhada Recife (PE) […]
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Case Report04-09-1998

Complete Mole in Twin Pregnancy: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):415-419

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Abstract
Case Report
Complete Mole in Twin Pregnancy: a Case Report
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):415-419
DOI 10.1590/S0100-72031998000700008
Izildinha Maestá,
Iracema M.P. Calderon,
Marilza V.C. Rudge,
Magaly M. Sales,
Fabiano P. Saggioro,
José Carlos Peraçoli
Views112
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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Case Report04-09-1998

Clear Cell Adenocarcinoma of the Endocervix in a 7-year-old Child
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):411-414

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Abstract
Case Report
Clear Cell Adenocarcinoma of the Endocervix in a 7-year-old Child
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):411-414
DOI 10.1590/S0100-72031998000700007
Marta Francis Benevides Rehme,
Mauro Fernando Kürten Ihlenfeld,
Ana Carolina Silva Chuery
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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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Equipments and Methods04-09-1998

Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):405-410

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Abstract
Equipments and Methods
Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):405-410
DOI 10.1590/S0100-72031998000700006
Caio Parente Barbosa,
Marcelo Ettruri Santos,
Ana Cristina Napolitano,
Paula Harue Tamanaka,
Emerson Barchi Cordts
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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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Original Article04-09-1998

Maternal Mortality in São Paulo City in 1996
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403

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Abstract
Original Article
Maternal Mortality in São Paulo City in 1996
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):395-403
DOI 10.1590/S0100-72031998000700005
Luis Carlos Pazero,
Paulo Afonso Ferrigno Marcus,
Carlos Eduardo Pereira Vega,
Krikor Boyaciyan,
Sônia Antonini Barbosa
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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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Original Article04-09-1998

Impact of Advanced Maternal Age on the Outcome of Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):389-394

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Abstract
Original Article
Impact of Advanced Maternal Age on the Outcome of Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):389-394
DOI 10.1590/S0100-72031998000700004
José G. Cecatti,
Aníbal Faúndes,
Fernanda G. C. Surita,
Márcia M. A. Aquino
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Most authors agree on the negative impact of pregnancy in women with advanced maternal age on maternal and perinatal outcome. However, it is not usual to evaluate if some considered risk factors are only confounders because they are present in women over forty years. In order to identify the isolated effect of age on maternal and perinatal outcome of pregnancies in women over forty, 494 pregnancies from this age group were compared to 988 pregnancies among women aged 20 to 29 years, matched by parity. After controlling possible confounding variables through multivariate analysis, advanced maternal age maintained its association with a higher prevalence of hypertension, malpresentation, cesarean section, postpartum hemorrhage, low Apgar score, perinatal death, late fetal death and intrapartum fetal distress. These findings show the need for adequate obstetrical care with special attention to those factors in order to improve maternal and perinatal outcome of pregnancies in women with advanced age.

Key-words High risk pregnancy Hipertension Fetal death Maternal age Perinatal outcome
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Original Article04-09-1998

Diagnosis, Obstetrical Management and Perinatal Outcome in Hydrocephalus
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):381-387

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Abstract
Original Article
Diagnosis, Obstetrical Management and Perinatal Outcome in Hydrocephalus
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(7):381-387
DOI 10.1590/S0100-72031998000700003
Renato Passini Júnior,
Simone Pimenta Nóbrega,
José Guilherme Cecatti,
Ricardo Barini,
João Luiz Pinto e Silva
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Objective: to evaluate the diagnosis, characteristics of pregnancy, maternal complications and perinatal outcome in cases of congenital hydrocephalus, and to associate them with pregnancy and delivery variables. Methods: 116 pregnancies with this diagnosis were evaluated before or after delivery, 112 of them occurring at the Maternity ward of CAISM/UNICAMP during the period between 1986 and 1995. For perinatal variables, complete data of 82 newborns were used. For data analysis, distributions and means were calculated and c² and Fisher exact tests were applied. Results: generally the diagnosis was made before delivery, confirmed by ultrasound and the delivery was through a cesarean section in cases. Cephalocentesis was performed in 11 cases and complications were more frequent in vaginal delivery than cesarean section. Low Apgar scores were more frequent among newborn babies delivered vaginally. Congenital hydrocephalus was also associated with important neonatal and perinatal morbidity and mortality, with other malformations, and a very low number of children without sequelae. Conclusions: the evaluation of these factors may be of great value for the obstetrician who is following pregnant women with this fetal malformation. This could better support the decisions that, although medical and ethical, should take into account the risk-benefit ratio of measures to be taken.

Key-words Fetal malformation Hydrocephalus prenatal diagnosis Ultrasonography
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Original Article10-01-2016

Uterine Fibroid Symptom – Quality of Life questionnaire translation and validation into Brazilian Portuguese
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):518-523

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Abstract
Original Article
Uterine Fibroid Symptom – Quality of Life questionnaire translation and validation into Brazilian Portuguese
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(10):518-523
DOI 10.1055/s-0036-1593833
Rita Oliveira da Silva,
Mariano Tamura Vieira Gomes,
Rodrigo de Aquino Castro,
Cláudio Emílio Bonduki,
Manoel João Batista Castello Girão
Views240
Abstract

Purpose

To translate into Portuguese, culturally adapt and validate the Uterine Fibroid Symptom – Quality of Life (UFS-QoL) questionnaire for Brazilian women with uterine leiomyoma.

Methods

Initially, the UFS-QoL questionnaire was translated into Brazilian Portuguese in accordance with international standards, with subsequent cultural, structural, conceptual and semantic adaptations, so that patients were able to properly answer the questionnaire. Fifty patients with uterine leiomyoma and 19 patients without the disease, confirmed by abdominal pelvic examination and/or transvaginal ultrasound, were selected at the outpatient clinics of the Department of Gynecology of the Universidade Federal de São Paulo (Unifesp). The UFS-QoL questionnaire was administered to all women twice on the same day, with two different interviewers, with an interval of 15 minutes between interviews. After 15 days, the questionnaire was readministered by the first interviewer. Reliability (internal consistency and test-retest), construct and discriminative validity were tested to ratify the questionnaire.

Results

The reliability of the instrument was assessed by Cronbach’s α coefficient with an overall result of 0.97, indicating high reliability. The survey results showed a high correlation (p= 0.94; p 0.001).

Conclusion

The UFS-QoL questionnaire was successfully adapted to the Brazilian Portuguese language and Brazilian culture, showing reliability and validity.

Key-words Leiomyoma Quality of life Questionnaire translation Validation studies
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Case Report03-01-2017

Limb Body Wall Complex Associated with Placenta Accreta: A Mere Coincidence or a Sign of an Etiopathogenic Link?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):142-146

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Abstract
Case Report
Limb Body Wall Complex Associated with Placenta Accreta: A Mere Coincidence or a Sign of an Etiopathogenic Link?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):142-146
DOI 10.1055/s-0037-1598607
Marcos Masaru Okido,
Aderson Tadeu Berezowski,
Sandra Regina Marques Carvalho,
Geraldo Duarte,
Ricardo de Carvalho Cavalli,
Alessandra Cristina Marcolin
Views242
Abstract

A case was reported of a fetus with the anomaly of limb body wall complex associated with placenta accreta. To date, only one account of this condition has been published in the world literature. Due to the low frequency of both complications, the hypothesis has been raised that this association may have happened not by mere coincidence, but rather by a possible common etiopathogenic mechanism. For the first time, a study proposes the existence of a possible etiopathogenic connection between the anomaly of limb body wall complex and hypoxic disorders caused by inadequate placentation in previous uterine scarring.

Key-words complex etiology limb body wall Placenta accreta prenatal diagnosis Ultrasonography
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Original Article01-01-2018

Body Mass Index Changes during Pregnancy and Perinatal Outcomes – A Cross-Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):11-19

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Abstract
Original Article
Body Mass Index Changes during Pregnancy and Perinatal Outcomes – A Cross-Sectional Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):11-19
DOI 10.1055/s-0037-1608885
Sirlei Siani Morais,
Simony Lira Nascimento,
Ana Carolina Godoy-Miranda,
Karina Tamy Kasawara,
Fernanda Garanhani Surita
Views219
Abstract

Objective

To evaluate the relation between changes the body mass index (BMI) percentile, reflected in the Atalah curve, and perinatal outcomes.

Methods

A cross-sectional study with 1,279 women was performed. Data regarding gestational weight, sociodemographic characteristics and perinatal outcomes were collected through medical charts, prenatal card and interviews in the postpartum period. Women could be classified according to the Atalah curve in the following categories: low weight, adequateweight, overweight, and obese. The BMIwas calculated at the first and at the last prenatal care visits, and these values were compared.

Results

An increase in the BMI category according to the Atalah classification occurred in 19.9% of pregnant women, and an increase of 3.4, 5.8 and 6.4 points of BMI were found for women respectively classified in the adequate weight, overweight and obese categories at the first prenatal visit. Women with high school education presented a lower chance of increasing their BMI (odds ratio [OR] 0:47 [0.24- 0.95]). Women who evolved with an increase in the the Atalah classification were associated with cesarean section (OR 1.97-2.28), fetalmacrosomia (OR 4.13-12.54) and large for gestational age newborn (OR 2.88-9.83).

Conclusion

Pregnant women who gained enough weight to move up in their BMI classification according to the Atalah curve had a higher chance of cesarean section and macrosomia. Women classified as obese, according to the Atalah curve, at the first prenatal visit had a high chance of cesarean section and delivering a large for gestational age newborn.

Key-words Atalah curve Cesarean section Fetal weight Obesity Pregnancy Weight gain
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Original Article03-01-2018

Improving Perinatology Residents’ Skills in Breaking Bad News: A Randomized Intervention Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):137-146

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Abstract
Original Article
Improving Perinatology Residents’ Skills in Breaking Bad News: A Randomized Intervention Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(3):137-146
DOI 10.1055/s-0037-1621741
Maria Silvia Vellutini Setubal,
Maria Ângela Reis Goes Monteiro Antonio,
Eliana Martorano Amaral,
John Boulet
Views233
Abstract

Objective

Breaking bad news (BBN) is particularly difficult in perinatology. Previous research has shown that BBN skills can be learned and improved when taught and practiced. This project evaluated whether a structured training session would enhance perinatology residents’ skills in BBN.

Methods

This was a randomized controlled intervention study with year 1 to 4 Perinatology residents from a medical school in Brazil, during the 2014/15 school year. A total of 61 out of 100 (61%) eligible residents volunteered to a structured training program involving communicating a perinatal loss to a simulated patient (SP) portraying the mother followed by the SP’s immediatefeedback,bothvideo recorded. Later, residents were randomly assigned to BBN training based on a setting, perception, invitation, knowledge, emotion and summary (SPIKES) strategy with video reviews (intervention) or no training (control group). All residents returned for a second simulation with the same SP blinded to the intervention and portraying a similar case. Residents’ performances were then evaluated by the SP with a checklist. The statistical analysis included a repeated measures analysis of covariance (RM-ANCOVA). Complementarily, the residents provided their perceptions about the simulation with feedback activities.

Results

Fifty-eight residents completed the program. The simulations lasted on average 12 minutes, feedback 5 minutes and SPIKES training between 1h and 2h30m. There was no significant difference in the residents’ performances according to the SPs’ evaluations (p = 0.55). The participants rated the simulation with feedback exercises highly. These educational activities might have offset SPIKES training impact. Conclusion The SPIKES training did not significantly impact the residents’ performance. The residents endorsed the simulation with feedback as a useful training modality. Further research is needed to determine which modality is more effective.

Key-words education Health communication internship and residency medical patient simulation perinatology
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Case Report09-01-2018

Diagnosis of Atelosteogenesis Type I suggested by Fetal Ultrasonography and Atypical Paternal Phenotype with Mosaicism
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):570-575

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Abstract
Case Report
Diagnosis of Atelosteogenesis Type I suggested by Fetal Ultrasonography and Atypical Paternal Phenotype with Mosaicism
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):570-575
DOI 10.1055/s-0038-1670684
Joanna Goes Castro Meira,
Manoel Alfredo Curvelo Sarno,
Ágatha Cristhina Oliveira Faria,
Guilherme Lopes Yamamoto,
Débora Romeo Bertola,
Gabriela Gayer Scheibler,
Dione Fernandes Tavares,
Angelina Xavier Acosta
Views245
Abstract

Atelosteogenesis type I (AOI) is an autosomal dominant skeletal dysplasia caused by mutations in the filamin B (FLNB) gene with classic and well-recognizable clinical findings. However, parents affected with a mild phenotype, probably with somatic mosaicism, can generate offspring with a much more severe phenotype of AOI. In the present report, we describe a female newborn with classic AOI leading to early neonatal death, whose diagnostic was based on prenatal radiological findings and on the physical examination of the father. Since her father had limb deformities and corporal asymmetry, suggesting somatic mosaicism, his biological samples were analyzed through a gene panel for skeletal dysplasias. A missense mutation not previously described in the literature was detected in the FLNB gene, affecting ~ 20% of the evaluated cells and, therefore, confirming the diagnosis ofmosaic AOI in the father. The molecular analysis of the father was crucial to suggest the diagnosis of AOI in the newborn, since she died early and there were no biological samples available.

Key-words atelosteogenesis exome-target sequencing Fetal ultrasonography FLNB skeletal dysplasia somatic mosaicism
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Case Report01-24-2021

Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models
- Pedro Castro ,
- Heron Werner ,
- Ana Paula Matos ,
- Gerson Ribeiro ,
- Jorge Lopes ,
- Edward Araujo Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):985-987

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Abstract
Case Report
Antenatal Diagnosis of Parapagus Conjoined Twins: 3D Virtual and 3D Physical Models
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):985-987
DOI 10.1055/s-0041-1739297
Pedro Castro ,
Heron Werner ,
Ana Paula Matos ,
Gerson Ribeiro ,
Jorge Lopes ,
Edward Araujo Júnior
Views233
Abstract

Conjoined twins (CTs) are a rare complication from monochorionic and monoamniotic twin pregnancies. We describe the use of 3D technologies, including 3D virtual and 3D physical models on prenatal evaluation of one parapagus CT. A 16-year-old G1P0 woman was referred for fetal magnetic resonance imaging (MRI) anatomical evaluation of a CT at 28 weeks of gestation. 3D images of the fetal surface were generated by the software during the examination for spatial comprehension of the relationship between the fetal parts. The pair of CTs died at the 32^nd week of gestation, a few hours after cesarean section. 3D technologies are an important tool for parental counseling and preparation of the multidisciplinary care team for delivery and neonatal assistance and possible surgical planning for postnatal separation in CTs cases.

Key-words conjoined Twins Magnetic resonance Imaging three-dimensional models
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Original Article05-24-2021

Disease Progression and Obstetric Outcomes of Women with Multiple Sclerosis at a Reference Center in Northeastern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):165-171

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Abstract
Original Article
Disease Progression and Obstetric Outcomes of Women with Multiple Sclerosis at a Reference Center in Northeastern Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(3):165-171
DOI 10.1055/s-0040-1722157
Gabrielle Maria Carvalho de Barros ,
Bianca Etelvina Santos de Oliveira ,
Gabriela Januário Oliveira ,
Rômulo Kunrath Pinto Silva ,
Thiago Nóbrega Cardoso ,
Sabina Bastos Maia
Views250
Abstract

Objective

To describe the obstetric outcomes of patients withmultiple sclerosis (MS) and the impact of pregnancy and the postpartum period on the progression of the disease.

Methods

A case series study performed between December 2019 and February 2020, reporting pregnancies occurred between 1996 and 2019. The subjects included were women with MS undergoing follow-up at an MS referral center in Northeastern Brazil, and who had at least one pregnancy after the onset of MS symptoms, or who had their first relapse in the first year after delivery.

Results

In total, 26 women and 38 pregnancies were analyzed – 32 of them resulted in delivery, and the remaining 6, in miscarriages. There was a significant increase in the prevalence of relapse during the postpartum period when compared with the gestational period. In 16 (42.1%) of the pregnancies, there was exposure to diseasemodifying therapies (DMTs) – 14 (36.8%), to interferon β, and 2 (5.3%), to fingolimod. Higher rates of abortion, prematurity and low birth weight were reported in the group was exposed to DMT when compared with the one who was not.

Conclusion

In the sample of the present study, there was a significant increase in the rate of MS relapse during the postpartum period when compared with the gestational period. Additionally, it seems that exposure to DMTs during pregnancy may affect the obstetric outcomes of the patients.

Key-words Abortion Infant multiple sclerosis Newborn Postpartum period Pregnancy
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FEBRASGO POSITION STATEMENT01-23-2022

Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):999-1009

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Abstract
FEBRASGO POSITION STATEMENT
Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):999-1009
DOI 10.1055/s-0042-1758490
Sara Toassa Gomes Solha ,
Rosiane Mattar ,
Patrícia de Fátima dos Santos Teixeira ,
Maria Izabel Chiamolera ,
Carlos Alberto Maganha ,
Alberto Carlos Moreno Zaconeta ,
Renato Teixeira Souza
Views343
Key points

Recommendations

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Original Article11-01-2018

Obstetric Outcomes among Syrian Refugees: A Comparative Study at a Tertiary Care Maternity Hospital in Turkey
- Sule Ozel,
- Selen Yaman,
- Hatice Kansu-Celik,
- Necati Hancerliogullari,
- Nurgul Balci,
- Yaprak Engin-Ustun
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):673-679

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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
Obstetric Outcomes among Syrian Refugees: A Comparative Study at a Tertiary Care Maternity Hospital in Turkey
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(11):673-679
DOI 10.1055/s-0038-1673427
Sule Ozel,
Selen Yaman,
Hatice Kansu-Celik,
Necati Hancerliogullari,
Nurgul Balci,
Yaprak Engin-Ustun
Views204
Abstract

Objective

The aim of this study was to analyze and compare obstetric and neonatal outcomes between Syrian refugees and ethnic Turkish women.

Methods

Retrospective, observational study. A total of 576 Syrian refugees and 576 ethnic Turkish women were included in this study, which was conducted between January 2015 and December 2015 at a tertiary maternity training hospital in Ankara, Turkey. The demographic characteristics, obstetric and neonatal outcomes were compared. The primary outcomes were pregnancy outcomes and cesarean rates between the groups

Results

The mean age was significantly lower in the refugee group (p< 0.001). Mean gravidity, proportion of adolescent pregnancies, proportion of pregnant women aged 12 to 19 years, and number of pregnancies at < 18 years were significantly higher among the refugee women (p< 0.001). Rates of antenatal follow-up, double testing, triple testing, gestational diabetes mellitus (GDM) screening, and iron replacement therapy were significantly lower in the refugee group (p< 0.001). The primary Cesarean section rate was significantly lower in the refugee group (p= 0.034). Pregnancies in the refugee group were more complicated, with higher rates of preterm delivery (< 37 weeks), preterm premature rupture of membranes (PPROM), and low birth weight (< 2,500 g) when compared with the control group (4.2% versus 0.7%, p< 0.001; 1.6% versus 0.2%, p= 0.011; and 12% versus 5.8%, p< 0.001, respectively). Low education level (odds ratio [OR] = 1.7, 95% confidence interval [CI] = 0.5–0.1), and weight gain during pregnancy (OR = 1.7, 95% CI = 0.5–0.1) were found to be significant indicators for preterm birth/PPROM and low birthweight.

Conclusion

Syrian refugees had increased risks of certain adverse obstetric outcomes, including preterm delivery, PPROM, lower birth weight, and anemia. Several factors may influence these findings; thus, refugee women would benefit from more targeted care during pregnancy and childbirth.

Key-words Antenatal care immigrants neonatal outcomes obstetric outcomes Syrian Refugees
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Editorial09-01-2018

Maternal Mortality in Brazil: Proposals and Strategies for its Reduction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):501-506

Views270

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
Maternal Mortality in Brazil: Proposals and Strategies for its Reduction
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):501-506
DOI 10.1055/s-0038-1672181
Rodolfo Carvalho Pacagnella,
Marcos Nakamura-Pereira,
Flavia Gomes-Sponholz,
Regina Amélia Lopes Pessoa de Aguiar,
Gláucia Virginia de Queiroz Lins Guerra,
Carmen Simone Grilo Diniz,
Brenno Belazi Nery de Souza Campos,
Eliana Martorano Amaral,
Olímpio Barbosa de Moraes Filho
Views270
Maternal mortality is one of the health indicators that most reflect the social conditions of women. The inequities observed in this indicator between high- and low-income countries and among regions in the same country are explained by differences in the provision, in the access, and in the quality of obstetric care and of family planning. […]
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Original Article06-27-2019

Quality of Life among University Students with Premenstrual Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):312-317

Views304

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Original Article
Quality of Life among University Students with Premenstrual Syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):312-317
DOI 10.1055/s-0039-1688709
Fernanda Figueira Victor,
Ariani Impieri Souza,
Cynthia Danúbia Tavares Barreiros,
João Lucas Nunes de Barros,
Flavia Anchielle Carvalho da Silva,
Ana Laura Carneiro Gomes Ferreira
Views304
Abstract

Objective

To evaluate the quality of life among university students with premenstrual syndrome (PMS).

Methods

The cross-sectional study was conducted at the Faculdade Pernambucana de Saúde, in Recife, Brazil, between August 2016 and July 2017. Sociodemographic, gynecological, and lifestyle variables, and PMS occurrence, were investigated among 642 students. The short form of the World Health Organization Quality of Life (WHOQOL Bref) questionnaire was used to evaluate four domains of the quality of life of the students: physical, mental, social relationships, and environmental. The American College of Obstetricians and Gynecologists’ criteria were used to define PMS.

Results

Of the 642 students, 49.9% had PMS, 23.3% had mild PMS and 26.6% had premenstrual dysphoric disorder (PMDD). Most of the students were between 18 and 24 years old, had regular menstrual cycles, and practiced physical activity. Regarding the physical and mental domains of the WHOQOL-Bref questionnaire, a statisticallysignificant difference was observed between the students who did not have and those who had mild or PMDD (p < 0.001). A difference was also found between the students who did not have PMS and those who had mild PMS in the social relationships (p = 0.001) and environmental domains (p = 0.009).

Conclusion

Mild PMS and PMDD are prevalent among university students on healthrelated courses, and the syndrome can affect the students’ self-assessment of all the domains of quality of life.

Key-words medical student Menstruation disturbances premenstrual dysphoric disorder Premenstrual syndrome Quality of life
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Review Article06-01-2016

Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations
- Mário Dias Corrêa Junior,
- Renato Passini Júnior
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(6):301-307

Views236

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
Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations
Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(6):301-307
DOI 10.1055/s-0036-1584942
Mário Dias Corrêa Junior,
Renato Passini Júnior
Views236
Abstract

Introduction

Episiotomy is a controversial procedure, especially because the discussion that surrounds it has gone beyond the field of scientific debate, being adopted as an indicator of the “humanization of childbirth”. The scientific literature indicates that episiotomy should not be performed routinely, but selectively.

Objectives

To review the literature in order to assess whether the implementation of selective episiotomy protects against severe perineal lacerations, the indications for the procedure, and the best technique to perform it.

Methods

A literature search was performed in PubMed using the terms episiotomy or perineal lacerations, and the filter clinical trial. The articles concerning the risk of severe perineal lacerations with or without episiotomy, perineal protection, or episiotomy techniques were selected.

Results

A total of 141 articles were identified, and 24 of them were included in the review. Out of the 13 studies that evaluated the risk of severe lacerations with and without episiotomy, 5 demonstrated a protective role of selective episiotomy, and 4 showed no significant differences between the groups. Three small studies confirmed the finding that episiotomy should be performed selectively and not routinely, and one study showed that midline episiotomy increased the risk of severe lacerations. The most cited indications were primiparity, fetal weight greater than 4 kg, prolonged second stage, operative delivery, and shoulder dystocia. As for the surgical technique, episiotomies performed with wider angles (> 40°) and earlier in the second stage (before “crowning “) appeared to be more protective.

Conclusions

Selective episiotomy decreases the risk of severe lacerations when compared with the non-performance or the performance of routine episiotomy. The use of a proper surgical technique is fundamental to obtain better results, especially in relation to the angle of incision, the distance from the vaginal introitus, and the correct timing for performing the procedure. Not performing the episiotomy when indicated or not applying the correct technique may increase the risk of severe perineal lacerations.

Key-words Episiotomy obstetrical delivery perineal lacerations
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Review Article08-01-2017

Physical Activity during Pregnancy: Recommendations and Assessment Tools
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(8):424-432

Views274

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
Physical Activity during Pregnancy: Recommendations and Assessment Tools
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(8):424-432
DOI 10.1055/s-0037-1604180
Cibele Santini,
Thiago dos Santos Imakawa,
Elaine Christine Dantas Moisés
Views274
Abstract

The literature that supports and recommends the practice of exercise during pregnancy is extensive.However, although a more complete research on ways to evaluate the physical activity performedby pregnant women has been perfomed, it is found that there is no gold standard and that the articles in the area are inconclusive. Thus, the objective of the present article is to review relevant aspects, such as, technique and applicability of the different methods for the assessment of physical activity during pregnancy to providemore reliable and safe information for health professionals to encourage their pregnant patients to engage in the practice of physical activity. This review concluded that all tools for the analysis of physical activity have limitations. Thus, it is necessary to establish the objectives of evaluation in an appropriate manner, as well as to determine their viability and costeffectiveness for the population under study.

Key-words Evaluation physical activity physical exercise questionnaire Pregnancy
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Original Article02-01-2017

Predictors of cesarean delivery in pregnant women with gestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):60-65

Views277

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
Predictors of cesarean delivery in pregnant women with gestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(2):60-65
DOI 10.1055/s-0037-1598644
Carmem Luiza Lucht Gascho,
Danieli Mayumi Kimura Leandro,
Thiago Ribeiro e Silva,
Jean Carl Silva
Views277
Abstract

Purpose

The aim of this study was to evaluate which risk factors may lead patients with gestational diabetes mellitus to cesarean delivery.

Methods

This was a retrospective, descriptive study. The subjects of the study were pregnant women with gestational diabetes mellitus attending a public maternity hospital in the south of Brazil. The primary outcomes assessed were based on maternal and fetal characteristics. The data were correlated using an odds ratio (OR) with a 95% confidence interval (95%CI), calculated using multinomial logistic regression.

Results

A total of 392 patients with gestational diabetes mellitus were analyzed, and 57.4% of them had cesarean deliveries. Among the maternal characteristics, the mean age of the patients and the pregestational body mass index were greater when a cesarean delivery was performed (p = 0.029 and p < 0.01 respectively). Gestational age at birth, newborn weight, weight class according to gestational age, and Apgar score were not significant. The analysis of the OR showed that the chance of cesarean delivery was 2.25 times (95%CI = 1.49-2.39) greater if the pregnant woman was obese, 4.6 times (95%CI = 3.017-7.150) greater if she was a primigravida, and 5.2 times (95% CI = 2.702-10.003) greater if she had a previous cesarean delivery. The other parameters analyzed showed no differences.

Conclusion

The factors that led to an increase in the occurrence of cesarean deliveries included history of a prior cesarean section, first pregnancy, and obesity.

Key-words Cesarean section Gestational diabetes Risk factors
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Original Article08-21-2015

Increased oxidative stress markers may be a promising indicator of risk for primary ovarian insufficiency: a cross-sectional case control study
- Aytekin Tokmak,
- Gülçin Yıldırım,
- Esma Sarıkaya,
- Mehmet Çınar,
- Nihal Boğdaycıoğlu,
- Nafiye Yılmaz
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):411-416

Views108

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
Increased oxidative stress markers may be a promising indicator of risk for primary ovarian insufficiency: a cross-sectional case control study
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(9):411-416
DOI 10.1590/SO100-720320150005397
Aytekin Tokmak,
Gülçin Yıldırım,
Esma Sarıkaya,
Mehmet Çınar,
Nihal Boğdaycıoğlu,
Fatma Meriç Yılmaz,
Nafiye Yılmaz
Views108
PURPOSE:

The aim of this study was to evaluate serum levels of inducible nitric oxide synthase (INOS), myeloperoxidase (MPO), total antioxidant status (TAS), and total oxidative status (TOS) in women with primary ovarian insufficiency (POI) and to compare them with healthy fertile women. We also examined the possible risk factors associated with POI.

METHODS:

This cross-sectional case control study was conducted in Zekai Tahir Burak Women’s Health Education and Research Hospital. The study population consisted of 44 women with POI (study group) and 36 healthy fertile women (control group). In all patients, serum levels of INOS, MPO, TAS, and TOS were determined. INOS and MPO levels were measured by enzyme-linked immunosorbent assay whereas colorimetric method was used for evaluating TAS and TOS levels. Age, body mass index (BMI), obstetric history, smoking status, family history, comorbidities, sonographic findings, complete blood count values, C-reactive protein and baseline hormone levels were also analyzed. Student’s t-test or Mann-Whitney U test was used to compare continuous variables between the groups; categorical data were evaluated by using Pearson χ² or Fisher exact test, when appropriate. Binary logistic regression method was used to identify risk factors for POI.

RESULTS:

We found significantly elevated levels of INOS (234.1±749.5 versus133.8±143.0; p=0.005), MPO (3,438.7±1,228.6 versus 2,481.9±1,230.1; p=0.001), and TOS (4.3±1.4 versus 3.6±1.4; p=0.02) in the sera of the study group when compared to the BMI-age matched control group. However, difference in serum levels of TAS were not significant between the 2 groups (1.7±0.2 versus 1.6±0.2; p=0.15). Logistic regression method demonstrated that BMI <25 kg/m², nulliparity, family history of POI, smoking, and elevated serum levels of INOS, MPO, and TOS were independent risk factors for POI.

CONCLUSION:

We found an increase in INOS, MPO, and TOS in women with POI. These serum markers may be promising in early diagnosis of POI. Further large-scale studies are required to determine whether oxidative stress markers have a role in diagnosing POI.

Key-words Oxidative stress Primary ovarian insufficiency Risk factors
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Editorial12-01-2015

Maternal mortality and the new objectives of sustainable development (2016-2030)
- Joao Paulo Souza
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(12):549-551

Views120

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
Maternal mortality and the new objectives of sustainable development (2016-2030)
Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(12):549-551
DOI 10.1590/SO100-720320150005526
Joao Paulo Souza
Views120
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Screening, diagnosis and management of hypothyroidism in pregnancy: Number 10 – October 2022

Key points

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Obstetric Outcomes among Syrian Refugees: A Comparative Study at a Tertiary Care Maternity Hospital in Turkey

Abstract

Objective

Methods

Results

Conclusion

Maternal Mortality in Brazil: Proposals and Strategies for its Reduction

Quality of Life among University Students with Premenstrual Syndrome

Abstract

Objective

Methods

Results

Conclusion

Selective Episiotomy: Indications, Techinique, and Association with Severe Perineal Lacerations

Abstract

Introduction

Objectives

Methods

Results

Conclusions

Physical Activity during Pregnancy: Recommendations and Assessment Tools

Abstract

Predictors of cesarean delivery in pregnant women with gestational diabetes mellitus

Abstract

Purpose

Methods

Results

Conclusion

Increased oxidative stress markers may be a promising indicator of risk for primary ovarian insufficiency: a cross-sectional case control study

PURPOSE:

METHODS:

RESULTS:

CONCLUSION:

Maternal mortality and the new objectives of sustainable development (2016-2030)

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