Artigos Originais Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):515-523
DOI 10.1590/S0100-72032005000900003
PURPOSE: the technological improvements in image quality have increased the importance of ultrasound as an imaging method in the study of breast pathologies. The need for a standardized method for lesion characterization, description and reporting in image analysis motivated the development of a breast sonographic report classification system. METHODS: the classification grouped the breast sonographic images in five classes: I - normal; II - benign; III - indeterminate, IV - suspect, and V - highly suspect. The used morphologic ultrasound features were shape, border, contour, echogenicity, echotexture, sound transmission, orientation, and secondary signals. The gold standard test, in the study of 450 lesions, considered sonographic follow-up of the lesions for a period from 6 to 24 months and the histopathology of surgical cases. RESULTS: breast sonographic classification for the diagnosis of breast cancer showed a sensitivity of 90.2% (CI: 82.8-94.9%), a specificity of 96.2% (CI: 94.0-97.6%), a positive predictive value of 84.1% (CI: 76.0-89.9%), and a negative predictive value of 97.8% (CI: 95.9-98.9%), obtaining an accuracy of 95.1%. CONCLUSIONS: the adoption of a sonographic classification system results in the standardization and optimization of the reports. It also aids the comparison with clinical findings, histopathological tests and breast images, avoiding unnecessary procedures and therefore leading to more adequate therapeutical management.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):515-523
DOI 10.1590/S0100-72032005000900003
PURPOSE: the technological improvements in image quality have increased the importance of ultrasound as an imaging method in the study of breast pathologies. The need for a standardized method for lesion characterization, description and reporting in image analysis motivated the development of a breast sonographic report classification system. METHODS: the classification grouped the breast sonographic images in five classes: I - normal; II - benign; III - indeterminate, IV - suspect, and V - highly suspect. The used morphologic ultrasound features were shape, border, contour, echogenicity, echotexture, sound transmission, orientation, and secondary signals. The gold standard test, in the study of 450 lesions, considered sonographic follow-up of the lesions for a period from 6 to 24 months and the histopathology of surgical cases. RESULTS: breast sonographic classification for the diagnosis of breast cancer showed a sensitivity of 90.2% (CI: 82.8-94.9%), a specificity of 96.2% (CI: 94.0-97.6%), a positive predictive value of 84.1% (CI: 76.0-89.9%), and a negative predictive value of 97.8% (CI: 95.9-98.9%), obtaining an accuracy of 95.1%. CONCLUSIONS: the adoption of a sonographic classification system results in the standardization and optimization of the reports. It also aids the comparison with clinical findings, histopathological tests and breast images, avoiding unnecessary procedures and therefore leading to more adequate therapeutical management.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):509-514
DOI 10.1590/S0100-72032005000900002
PURPOSE: to evaluate the luteal function in adolescents with regular menstrual cycles. METHODS: this prospective cohort study included 55 adolescents, aged 14-19 years, with menarche at 12.2 years. Ovulation was identified by ultrasound, starting on the second or fifth day of the cycle. The corpus luteum vascularization and the resistence index of the ovarian vessels were measured by Doppler on the tenth postovulatory day. Progesterone was measured by chemoluminescence on days 6, 9 and 12 of the luteal phase. The endometrial biopsy was performed 8 to 10 days after ovulation. The results were analyzed using the SPSS software and were considered significant when p<0.05. RESULTS: on average ovulation was on day 17. Progesterone levels were 11.4, 10.9 and 3.9 ng/mL on days 6, 9, and 12 after ovulation, respectively; the progesterone mean during the whole luteal phase was 10.3 ng/ml. Luteal vascularization was scarce in 34.6%, mild in 23.6% and exuberant in 41.8%. The resistance index was 0.441. On the tenth day post-ovulation the endometrium was normal in 85.5% and out-of-phase in 14.5%. There was no correlation between the ovulation day and endometrial dating (p=0.294), levels of progesterone and endometrial dating (p=0.454), progesterone and corpus luteum vascularization (p=0.994), or resistance index (p=0.237). There also was no association between endometrium development and degree of vascularization (p=0.611). CONCLUSION: abnormal luteal function in adolescents with regular menstrual cycles was found in 14.5%. Degree of vascularization, resistance index, and serum progesterone were not related to endometrium development.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(9):509-514
DOI 10.1590/S0100-72032005000900002
PURPOSE: to evaluate the luteal function in adolescents with regular menstrual cycles. METHODS: this prospective cohort study included 55 adolescents, aged 14-19 years, with menarche at 12.2 years. Ovulation was identified by ultrasound, starting on the second or fifth day of the cycle. The corpus luteum vascularization and the resistence index of the ovarian vessels were measured by Doppler on the tenth postovulatory day. Progesterone was measured by chemoluminescence on days 6, 9 and 12 of the luteal phase. The endometrial biopsy was performed 8 to 10 days after ovulation. The results were analyzed using the SPSS software and were considered significant when p<0.05. RESULTS: on average ovulation was on day 17. Progesterone levels were 11.4, 10.9 and 3.9 ng/mL on days 6, 9, and 12 after ovulation, respectively; the progesterone mean during the whole luteal phase was 10.3 ng/ml. Luteal vascularization was scarce in 34.6%, mild in 23.6% and exuberant in 41.8%. The resistance index was 0.441. On the tenth day post-ovulation the endometrium was normal in 85.5% and out-of-phase in 14.5%. There was no correlation between the ovulation day and endometrial dating (p=0.294), levels of progesterone and endometrial dating (p=0.454), progesterone and corpus luteum vascularization (p=0.994), or resistance index (p=0.237). There also was no association between endometrium development and degree of vascularization (p=0.611). CONCLUSION: abnormal luteal function in adolescents with regular menstrual cycles was found in 14.5%. Degree of vascularization, resistance index, and serum progesterone were not related to endometrium development.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):485-492
DOI 10.1590/S0100-72032005000800009
PURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE - 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women's failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women's failure to submit to the Pap smear.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):485-492
DOI 10.1590/S0100-72032005000800009
PURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE - 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women's failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women's failure to submit to the Pap smear.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):479-484
DOI 10.1590/S0100-72032005000800008
PURPOSE: to evaluate the prevalence of overweight and obesity among climacteric women. METHODS: this cross-sectional study included 611 women aged between 45 and 60 years attended at a climacteric clinic from January to June 2003. The prevalence of overweight and obesity was evaluated through the body mass index (BMI). Overweight or obesity was considered when there was a BMI equal or higher than 25 kg/m². Sociodemographic and reproductive variables as well as life style were also evaluated. The chi2 test followed by logistic regression was performed for statistical analysis. RESULTS: the average age of the studied women was 51.4 (±4.4) years, whereas 52.9% of them were postmenopausal. About 63.7% of them had a BMI equal or higher than 25 kg/m². The prevalence of overweight and obesity was 33.6 and 30.1%, respectively. The prevalence of overweight and obesity was higher among older women (OR=1.2; 95%IC: 1.1-1.4) or non hormonal therapy users (OR=1.8; 95%IC: 1.2-2.8). The opposite was observed among the women without a professional occupation (OR=0.6; 95%IC: 0.5-0.9) or a steady partner (OR=0.7; 95%IC: 0,4-0,9). CONCLUSIONS: in this study, the prevalence of overweight and obesity was influenced by age, but not by the menopausal status. The association between the marital status and occupation and the BMI strengthens the hypothesis that the health of the climacteric women may be influenced by biological factors as well as by psychosocial factors and life style. The lowest prevalence of overweight and obesity among the users of hormonal therapy may be explained by possible restrictions in relation to its prescription for women with previous overweight or obesity. Further studies are necessary to get more conclusive results, in particular with longitudinal studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):479-484
DOI 10.1590/S0100-72032005000800008
PURPOSE: to evaluate the prevalence of overweight and obesity among climacteric women. METHODS: this cross-sectional study included 611 women aged between 45 and 60 years attended at a climacteric clinic from January to June 2003. The prevalence of overweight and obesity was evaluated through the body mass index (BMI). Overweight or obesity was considered when there was a BMI equal or higher than 25 kg/m². Sociodemographic and reproductive variables as well as life style were also evaluated. The chi2 test followed by logistic regression was performed for statistical analysis. RESULTS: the average age of the studied women was 51.4 (±4.4) years, whereas 52.9% of them were postmenopausal. About 63.7% of them had a BMI equal or higher than 25 kg/m². The prevalence of overweight and obesity was 33.6 and 30.1%, respectively. The prevalence of overweight and obesity was higher among older women (OR=1.2; 95%IC: 1.1-1.4) or non hormonal therapy users (OR=1.8; 95%IC: 1.2-2.8). The opposite was observed among the women without a professional occupation (OR=0.6; 95%IC: 0.5-0.9) or a steady partner (OR=0.7; 95%IC: 0,4-0,9). CONCLUSIONS: in this study, the prevalence of overweight and obesity was influenced by age, but not by the menopausal status. The association between the marital status and occupation and the BMI strengthens the hypothesis that the health of the climacteric women may be influenced by biological factors as well as by psychosocial factors and life style. The lowest prevalence of overweight and obesity among the users of hormonal therapy may be explained by possible restrictions in relation to its prescription for women with previous overweight or obesity. Further studies are necessary to get more conclusive results, in particular with longitudinal studies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):473-478
DOI 10.1590/S0100-72032005000800007
PURPOSE: to analyze the correlation between PROGINS polymorphism and breast cancer. METHODS: a case-control study was carried out from April to October 2004. The genotypes of 50 women with breast cancer and 49 healthy women were analyzed. The 306-base pair Alu insertion polymorphism in the G intron of progesterone receptor gene was detected by polymerase chain reaction and analyzed on 2% agarose gel stained with ethidium bromide. The control and experimental groups were compared regarding genotypes using the statistical Epi-Info 6.0 program and for frequencies the exact Fisher test or chi2 test were used. p value smaller p than 5% was considered to be significant. RESULTS: in relation to PROGINS we found in the studied population a prevalence of 62 (62.6%) wild homozygous, 35 (35.3%) heterozygous individuals and two (2.1%) cases with the presence of the mutation. Regarding PROGINS polymorphism, significance was not evidenced when cases and controls were compared, as related to homozygosis (62 vs 65.3%), heterozygosis (36 vs 34,6%) or the mutation (2.0 vs 2.1%), with p=0.920 (OR=1.01), 0.891 (OR=1.06), and 0.988 (OR=1.10), respectively. CONCLUSIONS: the results show that single-gene PROGINS polymorphism does not confer a substantial risk of breast cancer to its carriers.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):473-478
DOI 10.1590/S0100-72032005000800007
PURPOSE: to analyze the correlation between PROGINS polymorphism and breast cancer. METHODS: a case-control study was carried out from April to October 2004. The genotypes of 50 women with breast cancer and 49 healthy women were analyzed. The 306-base pair Alu insertion polymorphism in the G intron of progesterone receptor gene was detected by polymerase chain reaction and analyzed on 2% agarose gel stained with ethidium bromide. The control and experimental groups were compared regarding genotypes using the statistical Epi-Info 6.0 program and for frequencies the exact Fisher test or chi2 test were used. p value smaller p than 5% was considered to be significant. RESULTS: in relation to PROGINS we found in the studied population a prevalence of 62 (62.6%) wild homozygous, 35 (35.3%) heterozygous individuals and two (2.1%) cases with the presence of the mutation. Regarding PROGINS polymorphism, significance was not evidenced when cases and controls were compared, as related to homozygosis (62 vs 65.3%), heterozygosis (36 vs 34,6%) or the mutation (2.0 vs 2.1%), with p=0.920 (OR=1.01), 0.891 (OR=1.06), and 0.988 (OR=1.10), respectively. CONCLUSIONS: the results show that single-gene PROGINS polymorphism does not confer a substantial risk of breast cancer to its carriers.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):467-472
DOI 10.1590/S0100-72032005000800006
PURPOSE: to evaluate the prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density (BMD) in postmenopausal women. METHODS: a cross-sectional study with survey of data from medical records of patients attended at a climacteric outpatient clinic. Inclusion criteria: postmenopausal women with measured thyroid-stimulating hormone (TSH) and free thyroxin (T4-L). Exclusion criteria: hyperthyroidism and thyroid cancer. Values of TSH >5.0 mIU/ml and normal T4-L were considered to be subclinical hypothyroidism. The 329 selected women (55.2±6.4 years) were divided into three groups: normal thyroid function (control) (n=208), subclinical hypothyroidism (n=53) and clinical hypothyroidism under treatment (n=59). Clinical data, hormonal therapy use, body mass index (BMI=kg/m²), lipid profile (total cholesterol, HDL, LDL, triglycerides) and BMD of lumbar column and femur were obtained. RESULTS: subclinical hypothyroidism was diagnosed in 16.1% of the cases. The groups were homogeneous regarding clinical features, BMI or lipidic profile. BMD in lumbar column and femur was lower in subclinical and clinical hypothyroidism than in euthyroidism (p<0.001). There was a negative correlation between values of TSH and BMD of lumbar column and femur (p<0.001). There was no correlation between TSH values and age, menopause time, BMI, and lipid profile. The total of hormonal therapy users was 65.1%, mean duration of 3.43±2.42 years, not differing between the groups. CONCLUSION: subclinical hypothyroidism with prevalence of 16.1% in postmenopausal women was associated with lower BMD, with no effects on lipid profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):467-472
DOI 10.1590/S0100-72032005000800006
PURPOSE: to evaluate the prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density (BMD) in postmenopausal women. METHODS: a cross-sectional study with survey of data from medical records of patients attended at a climacteric outpatient clinic. Inclusion criteria: postmenopausal women with measured thyroid-stimulating hormone (TSH) and free thyroxin (T4-L). Exclusion criteria: hyperthyroidism and thyroid cancer. Values of TSH >5.0 mIU/ml and normal T4-L were considered to be subclinical hypothyroidism. The 329 selected women (55.2±6.4 years) were divided into three groups: normal thyroid function (control) (n=208), subclinical hypothyroidism (n=53) and clinical hypothyroidism under treatment (n=59). Clinical data, hormonal therapy use, body mass index (BMI=kg/m²), lipid profile (total cholesterol, HDL, LDL, triglycerides) and BMD of lumbar column and femur were obtained. RESULTS: subclinical hypothyroidism was diagnosed in 16.1% of the cases. The groups were homogeneous regarding clinical features, BMI or lipidic profile. BMD in lumbar column and femur was lower in subclinical and clinical hypothyroidism than in euthyroidism (p<0.001). There was a negative correlation between values of TSH and BMD of lumbar column and femur (p<0.001). There was no correlation between TSH values and age, menopause time, BMI, and lipid profile. The total of hormonal therapy users was 65.1%, mean duration of 3.43±2.42 years, not differing between the groups. CONCLUSION: subclinical hypothyroidism with prevalence of 16.1% in postmenopausal women was associated with lower BMD, with no effects on lipid profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):461-466
DOI 10.1590/S0100-72032005000800005
PURPOSE: to compare the effectiveness of glibenclamide and acarbose with that of insulin for the treatment of gestational diabetes mellitus (GDM), in regard to maternal glucose levels, newborn (NB) weight and neonatal hypoglycemia. METHODS: an open, randomized prospective study was carried out. Fifty-seven patients diagnosed with GDM were included. These patients required dietary control and additional therapy. Pregnant women were randomly alloted to one of three groups with different therapies: a control group making use of insulin therapy, a study group making use of glibenclamide and a study group making use of acarbose. The study took seven months (from October 1st 2003 to May 1st 2004). Assessed outcomes were maternal glucose levels in the prenatal period, the need for replacing therapy to achieve glucose level control, NB weight and neonatal hypoglycemia. Statistical analysis was determined by ANOVA with the level of significance set at 5%. RESULTS: maternal characteristics were similar in all the three groups. Glucose level control was not obtained in three of the patients who used glibenclamide (15%) and in seven (38.8%) of the patients who used acarbose. Regarding fasting and postprandial glucose level rates and average NB weight no difference between the three groups was observed. No statistical difference was found for fasting or postprandial glucose levels and average NB weight in any of the three groups. The rate of large for gestational age fetuses was 5.2, 31.5 and 11.1% for the groups treated with insulin, glibenclamide and acarbose, respectively. Neonatal hypoglycemia was observed in six NB. Four of these were from the glibenclamide group (21.0%). CONCLUSIONS: glibenclamide was more effective for glucose level control than acarbose but neither were more efficient than insulin. NB children whose mothers had been alloted to the glibenclamide group showed a higher rate of macrosomia and neonatal hypoglycemia when compared to those newborns whose mothers were subjected to other therapies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):461-466
DOI 10.1590/S0100-72032005000800005
PURPOSE: to compare the effectiveness of glibenclamide and acarbose with that of insulin for the treatment of gestational diabetes mellitus (GDM), in regard to maternal glucose levels, newborn (NB) weight and neonatal hypoglycemia. METHODS: an open, randomized prospective study was carried out. Fifty-seven patients diagnosed with GDM were included. These patients required dietary control and additional therapy. Pregnant women were randomly alloted to one of three groups with different therapies: a control group making use of insulin therapy, a study group making use of glibenclamide and a study group making use of acarbose. The study took seven months (from October 1st 2003 to May 1st 2004). Assessed outcomes were maternal glucose levels in the prenatal period, the need for replacing therapy to achieve glucose level control, NB weight and neonatal hypoglycemia. Statistical analysis was determined by ANOVA with the level of significance set at 5%. RESULTS: maternal characteristics were similar in all the three groups. Glucose level control was not obtained in three of the patients who used glibenclamide (15%) and in seven (38.8%) of the patients who used acarbose. Regarding fasting and postprandial glucose level rates and average NB weight no difference between the three groups was observed. No statistical difference was found for fasting or postprandial glucose levels and average NB weight in any of the three groups. The rate of large for gestational age fetuses was 5.2, 31.5 and 11.1% for the groups treated with insulin, glibenclamide and acarbose, respectively. Neonatal hypoglycemia was observed in six NB. Four of these were from the glibenclamide group (21.0%). CONCLUSIONS: glibenclamide was more effective for glucose level control than acarbose but neither were more efficient than insulin. NB children whose mothers had been alloted to the glibenclamide group showed a higher rate of macrosomia and neonatal hypoglycemia when compared to those newborns whose mothers were subjected to other therapies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):456-460
DOI 10.1590/S0100-72032005000800004
PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4%) or normal delivery (47.6%). The sample was characterized by low socioeconomic and educational levels. The patients were submitted to a regimen of exclusive parenteral antibiotic, only during the hospitalization period (ATP-EX group). These results were compared with results obtained in a historical cohort in the same hospital (20 cases) submitted to a regimen of hospital parenteral antibiotic therapy complemented with ambulatory oral treatment (ATP+VO group). The patients were evaluated clinically on the occasion of periodic return visits in order to identify cases of recurrence and infectious complications. RESULTS: one patient from the ATP+VO group needed to be readmitted to the hospital on the 6th day after her discharge from the hospital with a diagnosis of endometritis recrudescence. No complications were observed among patients from ATP-EX group. CONCLUSION: for the treatment of puerperal endometritis, there was no additional advantage in using supplementary oral antibiotic therapy after patient discharge. The results using exclusive parenteral antibiotic treatment during hospitalization time indicate that it is effective and can be safely used in a population of low socioeconomic level.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):456-460
DOI 10.1590/S0100-72032005000800004
PURPOSE: to analyze the effectiveness and safety of exclusive hospital parenteral antibiotic therapy to treat puerperal endometritis in a population of low socioeconomic level. METHODS: a prospective clinical trial evaluated 21 puerperae with a diagnosis of postpartum endometritis, whose deliveries occurred at a university hospital by cesarean section (52.4%) or normal delivery (47.6%). The sample was characterized by low socioeconomic and educational levels. The patients were submitted to a regimen of exclusive parenteral antibiotic, only during the hospitalization period (ATP-EX group). These results were compared with results obtained in a historical cohort in the same hospital (20 cases) submitted to a regimen of hospital parenteral antibiotic therapy complemented with ambulatory oral treatment (ATP+VO group). The patients were evaluated clinically on the occasion of periodic return visits in order to identify cases of recurrence and infectious complications. RESULTS: one patient from the ATP+VO group needed to be readmitted to the hospital on the 6th day after her discharge from the hospital with a diagnosis of endometritis recrudescence. No complications were observed among patients from ATP-EX group. CONCLUSION: for the treatment of puerperal endometritis, there was no additional advantage in using supplementary oral antibiotic therapy after patient discharge. The results using exclusive parenteral antibiotic treatment during hospitalization time indicate that it is effective and can be safely used in a population of low socioeconomic level.