Artigos Originais Archives - Page 14 of 81 - Revista Brasileira de Ginecologia e Obstetrícia

  • Artigos Originais

    Food consumption in postmenopausal women and its relation with anthropometric measurements and time since menopause

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):16-23

    Summary

    Artigos Originais

    Food consumption in postmenopausal women and its relation with anthropometric measurements and time since menopause

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):16-23

    DOI 10.1590/SO100-720320140005138

    Views16

    PURPOSE:

    To evaluate eating in postmenopausal women and its relation to anthropometry, age and time since menopause in São Bernardo do Campo residents.

    METHODS:

    During the period from June to August of 2011, 148 postmenopausal women residents in state of São Paulo (Southeast region of Brazil) were evaluated using a structured questionnaire containing socioeconomic, clinical, anthropometric and food data. The level of physical activity, biochemical variables, Body Mass Index (BMI), abdominal circumference (AC) and dietary intake (energy, protein, carbohydrates and fats, fiber, cholesterol, vitamins A and C, minerals, calcium and iron) were analyzed according to age and time after menopause.

    RESULTS:

    Mean BMI was 29.0≤5.6 kg/m2 and abdominal circumference was 95.7±12.9 cm. The average daily caloric consumption was 1,406.3±476.5 kcal. The calorie intake was significantly more appropriate in normal-weight women and women with AC<88 cm. The same was observed for protein intake (p<0.001 and p=0.006, respectively). No association was observed with age or duration of the postmenopausal period, except for average protein consumption that was higher in the group with five years or less of menopause (p=0.048).

    CONCLUSION:

    The anthropometry of postmenopausal women showed a predominance of overweight and obesity. Dietary intake was adequate in relation to the percentage of calories and macronutrients and calories among most normal-weight women and women with AC<88 cm.

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  • Artigos Originais

    Predictors of fluid intravasation during operative hysteroscopy: a preplanned prospective observational study with 200 cases

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):24-29

    Summary

    Artigos Originais

    Predictors of fluid intravasation during operative hysteroscopy: a preplanned prospective observational study with 200 cases

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):24-29

    DOI 10.1590/S0100-720320140005139

    Views9

    PURPOSE:

    To verify the predictors of intravasation rate during hysteroscopy.

    METHODS:

    Prospective observational study (Canadian Task Force classification II-1). All cases (n=200 women; 22 to 86 years old) were treated in an operating room setting. Considering respective bag overfill to calculate water balance, we tested two multiple linear regression models: one for total intravasation (mL) and the other for absorption rate (mL.min-1). The predictors tested (independent variables) were energy (mono/bipolar), tube patency (with/without tubal ligation), hysterometry (cm), age≤50 years, body surface area (m2), surgical complexity (with/without myomectomy) and duration (min).

    RESULTS:

    Mean intravasation was significantly higher when myomectomy was performed (442±616 versus 223±332 mL; p<0.01). In the proposed multiple linear regression models for total intravasation (adjusted R2=0.44; p<0.01), the only significant predictors were myomectomy and duration (p<0.01).In the proposed model for intravasation rate (R2=0.39; p<0.01), only myomectomy and hysterometry were significant predictors (p=0.02 and p<0.01, respectively).

    CONCLUSIONS:

    Not only myomectomy but also hysterometry were significant predictors of intravasation rate during operative hysteroscopy.

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  • Artigos Originais

    Prevalence of low bone mineral density in postmenopausal breast cancer survivors

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):30-35

    Summary

    Artigos Originais

    Prevalence of low bone mineral density in postmenopausal breast cancer survivors

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):30-35

    DOI 10.1590/SO100-720320140005134

    Views9

    PURPOSE:

    To evaluate the prevalence of low bone mineral density (BMD) in postmenopausal breast cancer survivors.

    METHODS:

    In this cross-sectional study, 115 breast cancer survivors, seeking healthcare at a University Hospital in Brazil, were evaluated. Eligibility criteria included women with amenorrhea ≥12 months and age ≥45 years, treated for breast cancer and metastasis-free for at least five years. BMD was measured by DEXA at the lumbar spine (L1-L4) and femoral neck. Low BMD was considered when total-spine and/or femoral-neck T-score values were <-1.0 Delphi Score (DP) (osteopenia and osteoporosis). The risk factors for low BMD were assessed by interview. Data were analyzed statistically by the χ2 test and Fisher's exact test.

    RESULTS:

    The mean age of breast cancer survivors was 61.6±10.1 years and time since menopause was 14.2±5.6 years, with a mean follow-up of 10.1±3.9 years. Considering spine and femoral neck, 60% of breast cancer survivors had low BMD. By evaluating the risk factors for low BMD, a significant difference was found in the percent distribution for age (higher % of women >50 years with low BMD), personal history of previous fracture (11.6% with low BMD versus 0% with normal BMD) and BMI. A higher frequency of obesity was observed among women with normal BMD (63%) compared to those with low BMD (26.1%) (p<0.05).

    CONCLUSION:

    Postmenopausal breast cancer survivors had a high prevalence of osteopenia and osteoporosis.

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  • Artigos Originais

    Preservation of the fertility and the ovaries in women with benign adnexal tumors

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):36-41

    Summary

    Artigos Originais

    Preservation of the fertility and the ovaries in women with benign adnexal tumors

    Revista Brasileira de Ginecologia e Obstetrícia. 2015;37(1):36-41

    DOI 10.1590/SO100-720320140005179

    Views8

    PURPOSE:

    To evaluate the sparing of fertility and ovaries in women submitted to surgical treatment for benign adnexal tumors.

    METHODS:

    Between February 2010 and January 2014, 206 patients were included in this observational study as they were submitted to surgical treatment for benign ovarian tumors at CAISM, a tertiary hospital. Fertility sparing surgery was defined as tumorectomy or unilateral salpingoophorectomy without hysterectomy in premenopausal women. Preservation of the ovary occurred when at least one ovary or part of it was mantained.

    RESULTS:

    Of the 206 women with benign tumors, 120 (58%) were premenopausal and 86 (42%) were postmenopausal. There were 36 (30%) ovarian germ cell tumors, 31 (26%) epithelial neoplasms and 11 (9%) sex-cord stromal tumors among premenopausal women. In the group of postmenopausal women, 35 (41%) epithelial neoplasms, 27 (31%) sex-cord stromal tumors and 8 (9%) ovarian germ cell tumors were identified. Among 36 women with non-neoplastic ovarian tumors, 21 (58%) had endometriomas and 8 (22%) functional cysts. Among 22 women with extra-ovarian tumors, uterine leiomyomatosis was the most frequent finding (50%). In the group of women who were ≤35 years old, 26 (57%) were treated by tumorectomy and 18 (39%) were submitted to unilateral salpingoophorectomy with sparing of the uterus and the contralateral ovary. Women who were ≤35 years old were more frequently operated by laparoscopy which was associated with a higher number of fertility sparing procedures when compared to laparotomy (p<0.01). Twenty-six (28%) women submitted to hysterectomy with bilateral salpingoophorectomy were premenopausal.

    CONCLUSION:

    Although there is a trend to perform only tumorectomy in women who are ≤35 years old, a significant number of young women is still treated by salpingoophorectomy. Among 36- to 45-year-old women, only 70% had their fertility spared, while 20% had both ovaries removed. However, whenever possible, we must try to preserve the ovaries, mainly in premenopausal women.

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  • Artigos Originais

    Spatial distribution of anti-toxoplasma antibodies in pregnant women from Aracaju, Sergipe, Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):535-540

    Summary

    Artigos Originais

    Spatial distribution of anti-toxoplasma antibodies in pregnant women from Aracaju, Sergipe, Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):535-540

    DOI 10.1590/So100-720320140005086

    Views11

    PURPOSE:

    To analyze the spatial distribution of the prevalence of anti-toxoplasma gondii antibodies in pregnant women from a Brazilian Northeast city, and to correlate such prevalence with average maternal age and place of residence.

    METHODS:

    A descriptive, analytical and ecological study was conducted from January 1st to December 31st 2012. Data were obtained retrospectively from the Medical Specialties Center database and processed with the Epi info statistical package (Epi 7, Centers for Disease Control and Prevention, Atlanta, USA) and with Microsoft Excel 2010. The X2 test was applied to assess the association between the prevalence of antibodies to toxoplasma gondii and the average age. Spatial analysis of infection prevalence was performed using the TerraView software, version 4.2.2, with Kerneldensity estimation, which estimates the quantity of events through maps in order to identify areas with the highest concentration of cases in the city.

    RESULTS:

    The seroprevalence of IgG was 68.5% (95%CI 67.2-69.8) and the prevalence of IgM was 0.36% (95%CI 0.23-0.6). A higher IgG prevalence was associated with increased age in the oldest neighborhoods of the state capital, whereas a higher IgG prevalence among younger women was detected in suburban neighborhoods. The spatial concentration of IgM antibodies was higher in suburban neighborhoods, with no significant correlation between seroprevalence and age.

    CONCLUSION:

    Geoprocessing allowed the identification of areas with the highest prevalence, as well as the most susceptible average age and it was also useful as an instrument for the evaluation and implementation of appropriate preventive measures for this municipality and for other regions of Brazil.

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    Spatial distribution of anti-toxoplasma antibodies in pregnant women from Aracaju, Sergipe, Brazil
  • Artigos Originais

    Medication use during the first trimester of pregnancy: drug safety and adoption of folic acid and ferrous sulphate

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):541-547

    Summary

    Artigos Originais

    Medication use during the first trimester of pregnancy: drug safety and adoption of folic acid and ferrous sulphate

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):541-547

    DOI 10.1590/So100-720320140005051

    Views10

    PURPOSE:

    To identify the profile of use of medication during the first trimester of pregnancy with emphasis on safety assessment and on the adoption of folic acid and ferrous sulfate by pregnant women attended at a Basic Health Unit in Brazil.

    METHODS:

    This was a cross-sectional study nested in a cohort of pregnant women. Medications were classified according to the Anatomical Therapeutic Chemical (ATC), and their safety was evaluated according to the Food and Drug Administration (FDA) and the Brazilian Health Surveillance Agency (ANVISA). The adoption of ferrous sulfate and folic acid was investigated according to the protocol set forth by the Brazilian Ministry of Health.

    RESULTS:

    The survey included 212 pregnant women, 46.7% of whom were taking medications at the time of pregnancy diagnosis, and 97.6% used medication during the first trimester after diagnosis. The highest percentage of self-medication occurred before the beginning of prenatal care (64.9%). According to the FDA criteria, there was a high level of exposure to D and X risk drugs before the beginning of prenatal care (23.0%), which was also observed for drugs not recommended by ANVISA (36.5%). Of the surveyed sample, 32.5% did not follow the protocol of the Brazilian Ministry of Health. In all, 67.9% of pregnant women had inadequate drug exposure. There was a difference between the proportions of drugs used according to the ATC, and the main anatomical groups identified were the drugs that act on blood and blood-forming organs, and anti-infective medications for systemic use. When pregnancy was diagnosed, the use of a large number of medications that act on the genitourinary system and sex hormones (16.2%) was identified, such as oral contraceptives, a fact probably related to the percentage of unplanned pregnancies (67.0%), on the same occasion 4 pregnant women used folic acid and 3 used ferrous sulphate.

    CONCLUSION:

    The present results show that a large number of medications are used during pregnancy. Even if there was little exposure to drugs at the time of diagnosis, there is an overuse of potentially risky medications and self-medication during the first trimester of pregnancy.

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  • Artigos Originais

    Time trend of the rates of cesarean and vaginal delivery according to the source of financing

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):548-554

    Summary

    Artigos Originais

    Time trend of the rates of cesarean and vaginal delivery according to the source of financing

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):548-554

    DOI 10.1590/So100-720320140005038

    Views14

    PURPOSE:

    To analyze the time trend of the rates of cesarean and vaginal delivery according to the source of financing.

    METHODS:

    This was an ecological study of the time series analysis of cesarean and vaginal delivery rates according to the financing source, carried out in Maringá, Paraná State, Brazil, from 2002 to 2012. Information available at the System of Information on Live Births and at the System of Hospital Information of the Brazilian Unified Health System (SUS) was used for data collection. Moving averages were calculated for all mode of delivery rates in order to smooth random fluctuations in the series, dispersion diagrams were designed between the coefficients and years of the study, and polynomial regression models were estimated from the functional relation observed, with the level of significance set at p<0.05.

    RESULTS:

    Throughout the 11 years of the study there were 48,210 births, 77.1% by cesarean delivery and only 22.9% by vaginal delivery. A total of 22,366 procedures were financed by SUS, 54.6% of them being cesareans. Trend analysis was significant for all the regression models, demonstrating an ascending trend for cesarean delivery and a descending trend for vaginal delivery for both types of financing. The non-SUS cesarean rates always exceeded 90.0% and were more frequent than the SUS cesarean rates, even with a 36.0% increase of the latter during the study period.

    CONCLUSION:

    Based on trend analysis, cesarean deliveries will continue to increase in both health financing sources unless new actions and strategies of reduction are implemented, involving the sociocultural, demographic and obstetric characteristics of women, the training and activity of professionals in the area of obstetrics and an adequate structure of health services for providing vaginal delivery.

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    Time trend of the rates of cesarean and vaginal delivery according to the source of financing
  • Artigos Originais

    Illicit drug use by pregnant women infected with HIV

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):555-561

    Summary

    Artigos Originais

    Illicit drug use by pregnant women infected with HIV

    Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(12):555-561

    DOI 10.1590/So100-720320140005155

    Views11

    PURPOSE:

    To determine if illicit drug use increases the vertical transmission of HIV, to identify the risk factors involved in mother and child health and the prevalence of illicit drug use among these pregnant women.

    METHODS:

    Sixty-four (7.6%) of 845 pregnant women from the metropolitan region of Belo Horizonte, Minas Gerais, Brazil, attended in the service between October 1997 and February 2012 reported the use of illicit drugs. Cases were HIV-positive drug users (n=64) and controls were women who did not use drugs (n=192). Three controls were selected for each case. Several conditions of exposure were considered in the control group such as tobacco use, alcohol use, alcohol and tobacco use, maternal age, educational level, ethnicity, and marital status. Problems during the prenatal period, delivery and postpartum, vertical HIV transmission and neonatal outcomes were also investigated.

    RESULTS:

    Univariate analysis showed as significant variables: maternal age, tobacco use, number of prenatal care visits, antiretroviral therapy, mode of infection, and viral load at delivery. Logistic regression revealed as significant variables: maternal age (less than 25 years); tobacco use, and number of prenatal care visits (less than 6). The vertical transmission of HIV was 4,8% (95%CI 1.7–13.3) among drug users and 2,1% (95%CI 0.8–5.2) in the control group, with no statistically significant difference between groups. Neonatal complications were more frequent among drug users, but also with no statistically significant difference between groups.

    CONCLUSION:

    The use of illicit drug is frequent during pregnancy among HIV-infected women. The approach to illicit drug use should be routine during prenatal care visits. These women are more discriminated against and tend to deny their habits or do not seek prenatal care. There was no difference in vertical virus transmission between groups, probably indicating adherence to antiretroviral use for antiretroviral therapies during pregnancy.

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