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Original Article
Prevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome
- Maria Elisa Franciscatto
,
- Juliana Bosso Taniguchi
,
- Raquel Wohlenberg
,
- Isadora Luísa Riedi
,
- Karen Oppermann
12-04-2024
Views230This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticlePrevalence and factors associated with non-alcoholic fatty liver disease among women with polycystic ovary syndrome
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo81
12-04-2024- Maria Elisa Franciscatto
,
- Juliana Bosso Taniguchi
,
- Raquel Wohlenberg
,
- Isadora Luísa Riedi
,
- Karen Oppermann
Views230Abstract
Objective:
To verify the prevalence and factors associated with Non-Alcoholic Fatty Liver Disease (NAFLD) among women with Polycystic Ovary Syndrome (PCOS).
Methods:
A cross-sectional study was conducted with 53 patients with PCOS. The diagnosis of PCOS followed the Rotterdam criteria. The diagnosis of NAFLD was made through US showing hepatic steatosis, excluding significant alcohol consumption and chronic liver disease. The following variables were compared between the groups of women with and without NAFLD: age, race, anthropometric data, blood pressure levels, liver enzymes, glycemic and lipid profiles, total testosterone, presence of hirsutism, and metabolic syndrome (MS). Variables were compared between the groups using T-test, Mann-Whitney, and Chi-square tests.
Results:
Among 53 patients with PCOS, 50.9% had NAFLD. The NAFLD group had higher weight (p=0.003), BMI (p=0.001), waist circumference (p≤0.001), fasting glucose (p=0.021), HbA1C% (p=0.028), triglycerides (p=0.023), AST (p=0.004), ALT (p=0.001), higher prevalence of MS (p=0.004), and lower levels of HDL cholesterol (p=0.043). The other variables did not differ between the groups. Both groups were predominantly of caucasian race, and there was no significant difference in age.
Conclusion:
The prevalence of NAFLD among patients with PCOS was 50.9%. Metabolic and hepatic enzyme abnormalities were more prevalent in this group compared to the group without the disease. Obesity tripled the prevalence of NAFLD.
Key-words Alcohol drinkingHyperandrogenismmetabolic syndromenon-alcoholic fatty liver diseaseObesityPolycystic ovary syndromeWaist circumferenceSee moreThis 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. - Maria Elisa Franciscatto
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Review Article
Zuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo79
12-04-2024
Views241This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleZuranolone for postpartum depression: a systematic review and meta-analysis of two randomized studies
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo79
12-04-2024Views241See moreAbstract
Objective:
To evaluate the maternal outcomes in women with postpartum depression using zuranolone, the first oral medication indicated to treat postpartum depression.
Methods:
We conducted a systematic search in September 2023, on Pubmed, Embase and Cochrane Trials. We included randomized controlled trials comparing the effectiveness and safety of zuranolone versus placebo in women with postpartum depression. No time or language restrictions were applied. 297 results were retrieved, of which 11 papers were selected and fully reviewed by two authors. Review Manager 5 was used for statistical analysis and Cochrane Risk-of-bias tool for randomized trials was applied for quality assessment.
Results:
We included 2 studies, with 346 women, of whom 174 (50.2%) were treated with zuranolone. Zuranolone was significantly associated to an improvement of Clinical Global Impression response rate; Hamilton Depression Rating Scale 15 days and 45-day remission, 3-day, 15-day, and 45-day symptom remission, and reduction in the dose of antidepressants. As for safety outcomes, it was noticed that zuranolone increases sedation risk, which can be dose related. No significant differences were found for other adverse events.
Conclusion:
These findings suggest that zuranolone might present a safe and effective medication for out-of-hospital treatment of PPD. Sedation effects need to be further assessed.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Review Article
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
12-04-2024
Views213This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleSelf-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
12-04-2024- Gabriela Pereira
,
- Cinthia Madeira de Souza
,
- Amanda Canato Ferracini
,
- Fernanda Garanhani Surita
,
- Sherif Eltonsy
,
- Priscila Gava Mazzola
Views213Abstract
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 reactionsMedication usePregnant womenSelf-medicationSee moreThis 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. - Gabriela Pereira
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FEBRASGO POSITION STATEMENT
Nonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 – 2024
- Andrea Prestes Nácul
,
- Ana Carolina Japur Sá Rosa e Silva
,
- Daniela Angerame Yela
,
- Sebastião Freitas de Medeiros
,
- José Maria Soares Júnior
,
[ … ], - Cristina Laguna Benetti-Pinto
11-25-2024
Views152This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
FEBRASGO POSITION STATEMENTNonclassic congenital adrenal hyperplasia due to 21-hydroxylase deficiency in women: diagnosis and treatment: Number 11 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS11
11-25-2024- Andrea Prestes Nácul
,
- Ana Carolina Japur Sá Rosa e Silva
,
- Daniela Angerame Yela
,
- Sebastião Freitas de Medeiros
,
- José Maria Soares Júnior
,
- Gabriela Pravatta Rezende Antoniassi
,
- Lia Cruz da Costa Damásio
,
- Técia Maria de Oliveira Maranhão
,
- Gustavo Arantes Rosa Maciel
,
- Cristina Laguna Benetti-Pinto
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. - Andrea Prestes Nácul
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FEBRASGO POSITION STATEMENT
Challenges and strategies in adolescent vaccination: Number 12 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS12
11-14-2024
Summary
FEBRASGO POSITION STATEMENTChallenges and strategies in adolescent vaccination: Number 12 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS12
11-14-2024This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Letter to the Editor
The gynecologist and cancer in women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo92
10-23-2024
Summary
Letter to the EditorThe gynecologist and cancer in women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo92
10-23-2024Views117Cervical cancer continues to claim an alarming number of victims around the world, especially among poor women. In Brazil, in 2022, an incidence of 16.3/100,000 women was recorded,() with a projection for 2023 of 17,010 new cases, corresponding to a rate of 15.38/100,000, representing 7% of tumors in women.In the Brazilian reality, where there is […]See moreThis 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. -
Original Article
Nipple-sparing mastectomy in young versus elderly patients
- Antônio Luiz Frasson
,
- Isabela Miranda
,
- Betina Vollbrecht
,
- Carolina Malhone
,
- Ana Beatriz Falcone
,
[ … ], - Martina Lichtenfels
10-23-2024
Views138This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleNipple-sparing mastectomy in young versus elderly patients
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo90
10-23-2024- Antônio Luiz Frasson
,
- Isabela Miranda
,
- Betina Vollbrecht
,
- Carolina Malhone
,
- Ana Beatriz Falcone
,
- Fernanda Barbosa
,
- Francisco Pimentel Cavalcante
,
- Martina Lichtenfels
Views138See moreAbstract
Objective:
In this study, we compared indications and outcomes of 115 young (< 40 years) versus 40 elderly (> 60 years) patients undergoing nipple-sparing mastectomy (NSM) as risk-reducing surgery or for breast cancer (BC) treatment.
Methods:
Between January 2004 and December 2018, young and elderly patients undergoing NSM with complete data from at least 6 months of follow-up were included.
Results:
BC treatment was the main indication for NSM, observed in 85(73.9%) young versus 33(82.5%) elderly patients, followed by risk-reducing surgery in 30(26.1%) young versus 7(17.5%) elderly patients. Complication rates did not differ between the age groups. At a median follow-up of 43 months, the overall recurrence rate was higher in the younger cohort (p = 0.04). However, when stratified into local, locoregional, contralateral, and distant metastasis, no statistical difference was observed. During the follow-up, only 2(1.7%) young patients died.
Conclusion:
Our findings elucidate a higher recurrence rate of breast cancer in younger patients undergoing NSM, which may correlate with the fact that age is an independent prognostic factor. High overall survival and low complication rates were evidenced in the two groups showing the safety of NSM for young and elderly patients.
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. - Antônio Luiz Frasson
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Original Article
Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
- Nicole Zazula Beatrici
,
- Roxana Knobel
,
- Mariana Schmidt Vieira
,
- Iago Felipe Alexandrini
,
- Alberto Trapani Júnior
,
[ … ], - Carla Betina Andreucci
10-23-2024
Views173This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleAccess and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024- Nicole Zazula Beatrici
,
- Roxana Knobel
,
- Mariana Schmidt Vieira
,
- Iago Felipe Alexandrini
,
- Alberto Trapani Júnior
,
- Carla Betina Andreucci
Views173Abstract
Objective:
To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.
Methods:
Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.
Results:
395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.
Conclusion:
The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.
Key-words COVID-19Delivery of health careDiabetesGestationalpandemicsPostpartum periodPregnancyPrenatal caresurveys and questionnairesVaccinationSee moreThis 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. - Nicole Zazula Beatrici
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FEBRASGO POSITION STATEMENT
Hyperprolactinemia in women: diagnostic approach
- Andrea Glezer
,
- Heraldo Mendes Garmes
,
- Leandro Kasuki
,
- Manoel Martins
,
- Paula Condé Lamparelli Elias
,
[ … ], - Andrea Prestes Nácul
04-25-2024
Views1130This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
FEBRASGO POSITION STATEMENTHyperprolactinemia in women: diagnostic approach
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS04
04-25-2024This 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. - Andrea Glezer
-
FEBRASGO POSITION STATEMENT
Hyperprolactinemia in women: treatment
- Cristina Laguna Benetti-Pinto
,
- Andrea Prestes Nácul
,
- Ana Carolina Japur Rosa e Silva
,
- Gustavo Arantes Rosa Maciel
,
- Vania dos Santos Nunes Nogueira
,
[ … ], - Andrea Glezer
04-25-2024
Views1124This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
FEBRASGO POSITION STATEMENTHyperprolactinemia in women: treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS05
04-25-2024This 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. - Cristina Laguna Benetti-Pinto
-
FEBRASGO POSITION STATEMENT
Breech birth care: Number 1 – 2024
- Álvaro Luiz Lage Alves
,
- Alexandre Massao Nozaki
,
- Carla Betina Andreucci Polido
,
- Lucas Barbosa da Silva
,
- Roxana Knobel
00-00-2024
Views942This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
FEBRASGO POSITION STATEMENTBreech birth care: Number 1 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgofps1
00-00-2024This 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. - Álvaro Luiz Lage Alves
-
Letter to the Editor
Letter to Editor: In response to existence of SARS-CoV-2 in the peritoneal fluid
- Gustavo Romero-Velez
,
- Guillermo Ponce de Leon-Ballesteros
,
- Juan Barajas-Gamboa
,
- Jerry Dang
,
- Andrew Strong
,
[ … ], - Mathew Kroh
04-09-2024
Summary
Letter to the EditorLetter to Editor: In response to existence of SARS-CoV-2 in the peritoneal fluid
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo24
04-09-2024This 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. - Gustavo Romero-Velez
-
Editorial
The path to elimination: FEBRASGO 2023’s targeted strategies against cervical cancer in Brazil
- Agnaldo Lopes da Silva Filho
,
- Cecilia Maria Roteli-Martins
,
- Neila Maria de Góis Speck
,
- Newton Sérgio de Carvalho
,
- Eduardo Batista Cândido
,
[ … ], - Júlio César Teixeira
00-00-2024
Views756This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
EditorialThe path to elimination: FEBRASGO 2023’s targeted strategies against cervical cancer in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgoedt2
00-00-2024This 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. - Agnaldo Lopes da Silva Filho
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FEBRASGO POSITION STATEMENT
Use of hormones and risk of venous thromboembolism
- Venina Isabel Poço Viana Leme de Barros
,
- André Luiz Malavasi Longo de Oliveira
,
- Denis Jose do Nascimento
,
- Eduardo Zlotnik
,
- Marcelo Melzer Teruchkin
,
[ … ], - Paulo Francisco Ramos Margarido
04-02-2024
Views748This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
FEBRASGO POSITION STATEMENTUse of hormones and risk of venous thromboembolism
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS02
04-02-2024- Venina Isabel Poço Viana Leme de Barros
,
- André Luiz Malavasi Longo de Oliveira
,
- Denis Jose do Nascimento
,
- Eduardo Zlotnik
,
- Marcelo Melzer Teruchkin
,
- Marcos Arêas Marques
,
- Paulo Francisco Ramos Margarido
Views748See moreKey points
•The risk of venous thromboembolism (VTE) is not increased in women using long-acting reversible contraceptive methods (LARCs) with progestogens.
•Oral contraceptives with levonorgestrel or norgestimate confer half the risk of VTE compared to oral contraceptives containing desogestrel, gestodene or drospirenone.
•Progestogen-only pills do not confer an increased risk of VTE.
•Women using transdermal contraceptive patches and combined oral contraceptives (COCs) are at an approximately eight times greater risk of VTE than non-users of hormonal contraceptives (HCs), corresponding to 9.7 events per 10,000 women/years.
•Vaginal rings increase the risk of VTE by 6.5 times compared to not using HC, corresponding to 7.8 events per 10,000 women/years.
•Several studies have demonstrated an increased risk of VTE in transgender individuals receiving hormone therapy (HT).
•Hormone therapy during menopause increases the risk of VTE by approximately two times, and this risk is increased by obesity, thrombophilia, age over 60 years, surgery and immobilization.
•The route of estrogen administration, the dosage and type of progestogen associated with estrogen may affect the risk of VTE in the climacteric.
•Combined estrogen-progesterone therapy increases the risk of VTE compared to estrogen monotherapy.
•Postmenopausal HT increases the risk of thrombosis at atypical sites.
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. - Venina Isabel Poço Viana Leme de Barros
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FEBRASGO POSITION STATEMENT
Vulvovaginitis in pregnant women
- Geraldo Duarte
,
- Iara Moreno Linhares
,
- Regis Kreitchmann
,
- Andréa da Rocha Tristão
,
- Evelyn Traina
,
[ … ], - Joelma Queiroz Andrade
04-02-2024
Views691This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
FEBRASGO POSITION STATEMENTVulvovaginitis in pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS03
04-02-2024- Geraldo Duarte
,
- Iara Moreno Linhares
,
- Regis Kreitchmann
,
- Andréa da Rocha Tristão
,
- Evelyn Traina
,
- Ivete Canti
,
- Marcos Takimura
,
- Joelma Queiroz Andrade
Views691See moreKey points
• The balanced vaginal microbiome is the main factor defending the vaginal environment against infections. Lactobacilli play a key role in this regard, maintaining the vaginal pH within the normal range (3.8 to 4.5).
•Hormonal and immune adaptations resulting from pregnancy influence changes in the vaginal microbiome during pregnancy.
•An altered vaginal microbiome predisposes to human immunodeficiency virus (HIV) infection.
•Bacterial vaginosis is the main clinical expression of an imbalanced vaginal microbiome.
•Vulvovaginal candidiasis depends more on the host’s conditions than on the etiological agent.
•Trichomonas vaginalis is a protozoan transmitted during sexual intercourse.
•The use of probiotics is not approved for use in pregnant women.
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. - Geraldo Duarte
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Original Article
Early and late-onset preeclampsia: effects of DDAH2 polymorphisms on ADMA levels and association with DDAH2 haplotypes
- Fernanda Santos Mendes
,
- Marcelo Rizzatti Luizon
,
- Ana Cristina dos Santos Lopes
,
- Daniela Alves Pereira
,
- Fernanda Cristina Gontijo Evangelista
,
[ … ], - Patrícia Nessralla Alpoim
00-00-2024
Views581This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleEarly and late-onset preeclampsia: effects of DDAH2 polymorphisms on ADMA levels and association with DDAH2 haplotypes
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo19
00-00-2024- Fernanda Santos Mendes
,
- Marcelo Rizzatti Luizon
,
- Ana Cristina dos Santos Lopes
,
- Daniela Alves Pereira
,
- Fernanda Cristina Gontijo Evangelista
,
- Lara Carvalho Godoi
,
- Luci Maria Dusse
,
- Patrícia Nessralla Alpoim
Views581Abstract
Objective:
To examine whether the DDAH2 promoter polymorphisms -1415G/A (rs2272592), -1151A/C (rs805304) and -449G/C (rs805305), and their haplotypes, are associated with PE compared with normotensive pregnant women, and whether they affect ADMA levels in these groups.
Methods:
A total of 208 pregnant women were included in the study and classified as early-onset (N=57) or late-onset PE (N =49), and as normotensive pregnant women (N = 102).
Results:
Pregnant with early-onset PE carrying the GC and GG genotypes for the DDAH2 -449G/C polymorphism had increased ADMA levels (P=0.01). No association of DDAH2 polymorphisms with PE in single-locus analysis was found. However, the G-C-G haplotype was associated with the risk for late-onset PE.
Conclusion:
It is suggested that DDAH2 polymorphisms could affect ADMA levels in PE, and that DDAH2 haplotypes may affect the risk for PE.
Key-words Asymmetric dimethylarginineDimethylarginine dimethylaminohydrolase 2 geneGenotypeHaplotypesNitric Oxide SynthaseNitric Oxide Synthase Type III/ geneticsPolymorphism, geneticPre-eclampsiaPregnant womenSee moreThis 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. - Fernanda Santos Mendes
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Review Article
Is it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
- Cibele Santini de Oliveira Imakawa
,
- Mariane Nunes de Nadai
,
- Monica Reis
,
- Silvana Maria Quintana
,
- Elaine Christine Dantas Moises
06-29-2022
Views142This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleIs it Necessary to Evaluate Fear of Childbirth in Pregnant Women? A Scoping Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):692-700
06-29-2022- Cibele Santini de Oliveira Imakawa
,
- Mariane Nunes de Nadai
,
- Monica Reis
,
- Silvana Maria Quintana
,
- Elaine Christine Dantas Moises
Views142See moreAbstract
Objective
To review concepts, definitions, and findings about fear of childbirth (FOC).
Methods
A bibliographic review was carried out through the main scientific databases in 2020.
Results
All 32 articles considered potentially relevant were analyzed. A recent study suggests that the global prevalence of FOC can reach up to 14%. Factors such as parity, gestational age, previous birth experience, age and nationality of the woman seem to influence FOC.
Conclusion
Fear of childbirth could be related to an increased risk of adverse obstetric outcomes such as maternal request for cesarean delivery, preterm birth, prolonged labor, postpartum depression, and post-traumatic stress. These evidence highlight the importance of the discussion regarding this topic.
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. - Cibele Santini de Oliveira Imakawa
-
Original Article
Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
- Margot Marie Martin
,
- Roxana Knobel
,
- Vitor Nandi
,
- Jessica Goedert Pereira
,
- Alberto Trapani Junior
,
[ … ], - Carla Betina Andreucci
02-17-2022
Views45This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleAdequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022- Margot Marie Martin
,
- Roxana Knobel
,
- Vitor Nandi
,
- Jessica Goedert Pereira
,
- Alberto Trapani Junior
,
- Carla Betina Andreucci
Views45See moreAbstract
Objective
The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.
Methods
Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis onmaternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.
Results
Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The followingmaternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.
Conclusion
In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.
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. - Margot Marie Martin
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Review Article
Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
- Maria Laura Costa
,
- Ricardo de Carvalho Cavalli
,
- Henri Augusto Korkes
,
- Edson Vieira da Cunha Filho
,
- José Carlos Peraçoli
04-25-2022
Views194This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleDiagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
04-25-2022- Maria Laura Costa
,
- Ricardo de Carvalho Cavalli
,
- Henri Augusto Korkes
,
- Edson Vieira da Cunha Filho
,
- José Carlos Peraçoli
Views194Abstract
Objective
It is a challenge to consider preeclampsia (PE) diagnosis and management in low and middle-income settings, where it represents a major public health concern. The placenta is the underlying cause of disease, and the plasma concentrations of proangiogenic and antiangiogenic factors released by the placenta can reflect the risks of disease progression. Antiangiogenic proteins, such as soluble fms-like tyrosine kinase 1 (sFlt-1), and proangiogenic, like placental growth factors (PlGF), are directly and inversely correlated with the disease onset, respectively.
Methods
Narrative review on the use of biomarkers (sFlt-1 to PlGF ratio) with a suggested guidance protocol.
Results
Key considerations on the use of biomarkers: the sFlt-1/PlGF ratio is mainly relevant to rule out PE between 20 and 36 6/7 weeks in cases of suspected PE; however, it should not replace the routine exams for the diagnosis of PE. The sFlt-1/PlGF ratio should not be performed after confirmed PE diagnosis (only in research settings). In women with suspected PE, sFlt-1/PlGF ratio < 38 can rule out the diagnosis of PE for 1 week (VPN = 99.3) and up to 4 weeks (VPN= 94.3); sFlt-1/PlGF ratio > 38 does not confirm the diagnosis of PE; however, it can assist clinical management. In cases of severe hypertension and/or symptoms (imminent eclampsia), hospitalization is imperative, regardless of the result of the sFlt-1/PlGF ratio.
Conclusion
The use of biomarkers can help support clinical decisions on the management of suspected PE cases, especially to rule out PE diagnosis, thus avoiding unnecessary interventions, especially hospitalizations and elective prematurity
Key-words Hypertensionplacental growth factorPreeclampsiapreterm preeclampsiasoluble fms-like tyrosine kinase 1See moreThis 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. - Maria Laura Costa
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Original Article
COVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021
Views144This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleCOVID-19 in Pregnancy: Implication on Platelets and Blood Indices
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):595-599
11-15-2021Views144See moreAbstract
Objective
To describe the hematological changes, the platelet indices in particular, in pregnant women with coronavirus disease 2019 (COVID-19) compared to healthy pregnant women.
Methods
A retrospective case-control study conducted at the Al Yarmouk Teaching Hospital, in Baghdad, Iraq, involving 100 pregnant women, 50 with positive viral DNA for COVID-19 (case group), and 50 with negative results (control group); both groups were subjected to a thorough hematological evaluation.
Results
Among the main hematological variables analyzed, the platelet indices, namely the mean platelet volume (MPV) and the platelet distribution width (PDW), showed statistically significant differences (MPV: 10.87±66.92 fL for the case group versus 9.84±1.2 fL for the control group; PDW: 14.82±3.18 fL for the case group versus 13.3±2.16 fL for the controls). The criterionvalue of the receiver operating characteristic (ROC) curve forPDWat a cutoffpoint of>11.8 fL showed a weak diagnostic marker, while the MPV at a cutoff value of>10.17 fL showed a good diagnostic marker.
Conclusion
The MPV and PDW are significantly affected by the this viral infection, even in asymptomatic confirmed cases, and we recommend that both parameters be included in the diagnostic panel of this infection.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. -
Short Communication
Surgical Site Infection after Cesarean Delivery in Times of COVID-19
- Vicente Sperb Antonello
,
- Jessica Dallé
,
- Ivan Carlos Ferreira Antonello
,
- Daniela Benzano
,
- Mauro Cunha Ramos
07-30-2021
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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. Summary
Short CommunicationSurgical Site Infection after Cesarean Delivery in Times of COVID-19
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(5):374-376
07-30-2021- Vicente Sperb Antonello
,
- Jessica Dallé
,
- Ivan Carlos Ferreira Antonello
,
- Daniela Benzano
,
- Mauro Cunha Ramos
Views184See moreAbstract
Objective
To analyze effects of the COVID-19 pandemic on the consumption of personal protective equipment and products (PPEP), as well as the frequency of surgical site infection (SSI) among non-COVID-19 patients submitted to cesarean sections.
Methods
A retrospective study was conducted in a maternity unity of a public teaching hospital which was not part of the reference service for COVID-19 treatment. It compared PPEP consumption and the occurrence of SSI after cesarean sections in monthly periods before and after the occurrence of the first case of COVID-19 in Porto Alegre, state of Rio Grande do Sul, Brazil. Personal protective equipment and products consumption was measured as units of masks, gloves, gowns, and caps, and use of alcohol-based products or soap for hand sanitation asml/patient/day. The SSI index was calculated as the proportion of cases of SSI over the number of cesarean sections performed monthly during the study period.
Results
There was an increase in all measured items of PPEP, with consumption of disposable masks with a median of 1,450 units in the pre-COVID period, and of 2550 in the post-COVID period (a 75.9% increase). A decrease of 49% in SSI was detected, with a median of 1.74 in the pre-COVID period and of 0.89 in the post-COVID period.
Conclusion
The increase in consumption of PPEP could be a result of safer practices adopted by healthcare workers with the advent of COVID-19, of which the following reduction in the occurrence of SSI could be a direct consequence. Despite the severity of the crisis, one could state that extreme situations can lead to valuable reflections and opportunities for improvement.
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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. - Vicente Sperb Antonello
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Original Article
Difficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
- Lorgio Rudy Aguilera
,
- Luz Mariana Mojica-Palacios
,
- Federico Urquizu
,
- Mirko Gorena
,
- Freddy Tinajeros Guzmán
,
[ … ], - Albaro José Nieto-Calvache
04-26-2022
Views117This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleDifficulties in the Management of Placenta Accreta Spectrum in Hospitals with Limited Resources
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
04-26-2022- Lorgio Rudy Aguilera
,
- Luz Mariana Mojica-Palacios
,
- Federico Urquizu
,
- Mirko Gorena
,
- Freddy Tinajeros Guzmán
,
- Lina María Vergara Galliadi
,
- Alejandra Hidalgo
,
- Albaro José Nieto-Calvache
Views117See moreAbstract
Objective
Placenta accreta spectrum (PAS) is a serious diseases, and the recommendation is that the treatment is conducted in centers of excellence. Such hospitals are not easy to find in low- and middle-income countries. We seek to describe the process of prenatal diagnosis, surgical management, and postnatal histological analysis in a low-income country referral hospital with limited resources.
Methods
A descriptive, retrospective study was carried out including patients with a pre- or intraoperative diagnosis of PAS. The clinical results of the patients were studied as well as the results of the prenatal ultrasound and the correlation with the postnatal pathological diagnosis.
Results
In total, 129 patients were included. Forty-eight of them had a prenatal PAS ultrasound diagnosis (37.2%). In the remaining 81 (62.8%), the diagnosis was intraoperative. Although hysterectomy was performed in all cases, one-third of the patients (31%) did not have a histological study of the uterus. In 40% of the patients who had a histological study, PAS was not reported by the pathologist.
Conclusion
The frequency of prenatal diagnosis and the availability of postnatal histological studies were very low in the studied population. Surgical skill, favored by a high flow of patients, is an important factor to avoid complications in settings with limited resources.
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. - Lorgio Rudy Aguilera
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Original Article
Adverse Events Related to COVID-19 Vaccines Reported in Pregnant Women in Brazil
- Carla Dinamerica Kobayashi
,
- Victor Bertollo Gomes Porto
,
- Martha Elizabeth Brasil da Nóbrega
,
- Cibelle Mendes Cabral
,
- Tiago Dahrug Barros
,
[ … ], - Cecília Maria Roteli Martins
09-06-2022
Views185This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleAdverse Events Related to COVID-19 Vaccines Reported in Pregnant Women in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):821-829
09-06-2022- Carla Dinamerica Kobayashi
,
- Victor Bertollo Gomes Porto
,
- Martha Elizabeth Brasil da Nóbrega
,
- Cibelle Mendes Cabral
,
- Tiago Dahrug Barros
,
- Cecília Maria Roteli Martins
Views185See moreAbstract
Regulations for the vaccination of pregnant women in Brazil occurred in March 2021. Despite the absence of robust data in the literature on the coronavirus disease 2019 (COVID-19) vaccinations in pregnant women, it is understood that the benefit-risk ratio tends to be favorable when considering the pandemic and the high burden of the disease. However, it is still important to monitor for Events Supposedly Attributable to Vaccination or Immunization (ESAVI) and to draw safety profiles of the different platforms used in pregnant and postpartum women. The present study aims to describe the main characteristics of ESAVIs related to COVID-19 vaccines occurring in pregnant women in the first months of the vaccination campaign in Brazil. During the evaluation period, 1,674 notifications of ESAVIs in pregnant women were recorded, and 582 notifications were included for the analysis. Of the 582 ESAVIs identified, 481 (82%) were classified as non-serious adverse events and 101 (17%) as serious adverse events. Ten deaths were identified, including one death which was considered to be causally related to the vaccine. The other nine maternal deaths had causality C, that is, without causal relationship with the vaccine, and most were due to complications inherent to pregnancy, such as pregnancy-specific hypertensive disorder (PSHD) in 4 cases and 3 due to COVID-19. Despite some limitations in our study, we believe it brings new insights into COVID-19 vaccines in this group and will add to the available evidence.
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. - Carla Dinamerica Kobayashi
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Original Article
Association between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
- Conceição Christina Rigo Vale
,
- Nubia Karla de Oliveira Almeida
,
- Renan Moritz Varnier Rodrigues de Almeida
06-18-2021
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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. Summary
Original ArticleAssociation between Prenatal Care Adequacy Indexes and Low Birth Weight Outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(4):256-263
06-18-2021- Conceição Christina Rigo Vale
,
- Nubia Karla de Oliveira Almeida
,
- Renan Moritz Varnier Rodrigues de Almeida
Views156See moreAbstract
Objective
To investigate the association between prenatal care (PNC) adequacy indexes and the low birth weigth (LBW) outcome.
Methods
A total of 368,093 live term singleton births in the state of Rio de Janeiro (Brazil) from 2015 to 2016 were investigated using data from the Brazilian Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC, in Portuguese). Seven PNC adequacy indexes were evaluated: four developed by Brazilian authors (Ciari Jr. et al., Coutinho et al., Takeda, and an index developed and used by the Brazilian Ministry of Health – MS) and three by authors from other countries (Kessner et al., the Adequacy of Prenatal Care Utilization index – APNCU, and the Graduated Prenatal Care Utilization Index – GINDEX). Adjusted odds ratios were estimated for the PNC adequacy indexes by means of multivariate logistic regression models using maternal, gestational and newborn characteristics as covariates.
Results
When the PNC is classified as “inadequate”, the adjusted odds ratios to the LBWoutcome increase between 42% and 132%, depending on which adequacy index is evaluated. Younger (15 to 17 years old) and older (35 to 45 years old) mothers, those not married, of black or brown ethnicity, with low schooling (who did not finish Elementary School), primiparous, with preterm births, as well as female newborns had increasing odds for LBW. The models presented areas under the receiver operating characteristic (ROC) curve between 80.4% and 81.0%, and sensitivity and specificity that varied, respectively, between 57.7% and 58.6% and 94.3% and 94.5%.
Conclusion
Considering all PNC adequacy indexes evaluated, the APNCU had the best discriminatory power and the best ability to predict the LBW outcome.
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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. - Conceição Christina Rigo Vale
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