Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):11-15
DOI 10.1590/S0100-72032012000100003
PURPOSE: The present study examined the relationship between some clinical variables and quality of life in a group of patients with endometriosis. METHODS: A total of 130 women seen at a multidisciplinary center specializing in gynecology endometriosis in 2008 participated in the study. This was a cross-sectional study conducted with a convenience sample. The diagnosis of endometriosis was performed by biopsy according to the criteria of the American Society for Reproductive Medicine. The clinical and demographic data were collected from the patients' records. Pain intensity was assessed by a visual numerical scale (0-10), and data on the quality of life were collected using the SF-36. Data analysis consisted of descriptive and inferential statistical tests, Spearman correlation coefficient and Kruskal-Wallis test to compare scores between groups. Nonparametric tests were used for analysis because data were not normally distributed. RESULTS: The patients were 21 to 54 years of age [ or = 34, standard diversion (SD)=6.56], 87% had a university degree, and 75% were married. Seventeen percent reported cases of endometriosis in the family. The average time of onset of symptoms was 4.5 years (SD=6.6), 63% of patients were in stage 3 or 4 of endometriosis 36% of patients had severe or disabling dysmenorrhea and the average intensity of pain according to a visual numerical scale was of 5.6 (SD=3.5). Results suggest that the staging of the disease did not determine the intensity of pain. The time of onset of symptoms also showed no relationship to pain intensity and SF-36 scores. On the other hand, the intensity of pain was associated with lower scores on some scales of the SF-36. CONCLUSION: Patients with endometriosis had lower scores of quality of life than the general population and lower than those of some other diseases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):16-21
DOI 10.1590/S0100-72032012000100004
PURPOSE: To analyze and compare the knowledge and opinions of Law and Medical students regarding the issue of abortion in Brazil. METHODS: This was a cross-sectional study involving 125 graduate students from the class of 2010. Of these, 52 were medical students (MED group) and 73 law students (LAW group). A questionnaire was applied based on published research about the topic. Dependent variables were: monitoring the abortion debate, knowledge concerning situations where abortion is permitted under Brazilian law, opinion about situations that agree with extending legal permission to terminate pregnancy and prior knowledge of someone who has undergone induced abortion. Independent variables were: sex, age, household income and graduation course. Statistical analysis: χ² and Fisher's exact tests, with the level of significance set at 5%. RESULTS: Most interviewees reported monitoring the debate on abortion in Brazil (67.3% of the MED group and 70.2% of the LAW group, p>0.05). When assessing knowledge on the subject, medical students had a significantly higher percentage of correct answers than law students (100.0 and 87.5%, respectively; p=0.005) regarding the legality of abortion for pregnancies resulting from rape. Elevated percentages of correct responses were also recorded for both groups in relation to pregnancies that threaten the life of the mother (94.2 and 87.5% for MED and LAW groups, respectively), but without statistical significance. A significant percentage of respondents declared they were in favor of extending legal abortion to other situations, primarily in cases of anencephaly (68%), pregnancy severely harming the mother's physical health (42.1%) or that of the fetus in cases of severe congenital malformation (33.7%). CONCLUSION: Results showed a satisfactory knowledge on the part of law and medical school graduate students regarding the legality of abortion in Brazil, combined with a favorable trend towards extending legal permission to other situations not covered by the law. It is important to underscore the inclusion of this topic in the undergraduate curriculum and the development of inter-professional teaching strategies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):22-27
DOI 10.1590/S0100-72032012000100005
PURPOSE: Evaluate the effects of ipriflavone during fetogenesis, since no studies have been conducted to assess its effect during this period. METHODS: 60 pregnant rats were divided randomly into four groups (n=15). G-control (1 mL of distilled water) and three groups treated intragastrically with ipriflavone from the 16th to the 20th post coitus (PC) day: G-300 (300 mg/kg), G-1,500 (1,500 mg/kg) and G-3,000 (3,000 mg/kg). The animals were weighed, anaesthetized intraperitoneally with xylazine and ketamine at doses of 180 mg/kg and 10 mg/kg, respectively, and sacrificed by total exsanguination on the 21st day. A complete blood count was performed and serum cholesterol, triglycerides, AST, ALT, urea, creatinine, and glucose were determined in pregnant rats. After laparotomy, the liver, kidneys, adrenals, spleen and ovaries were removed and weighed; fetuses and placentas were also weighed to obtain the average weight of the litters. Four fetuses (two males and two females) were chosen at random for the determination of the length and weight of brain, liver, kidneys and lungs. Statistical analysis: ANOVA followed by Dunnett's test. For raw data without normal distribution and homoscedasticity, we used the Kruskal-Wallis test followed by the Mann-Whitney test. Proportions were analyzed by the χ² test (p<0.05). RESULTS: Triglyceride levels (mg/dL) were: Control-G (138.8±21.8), G-300 (211.2±63.9) G-1,500 (251.5±65.2) G-3,000 (217.7±49.6); p<0.05. The body weight of fetuses (g) was: G-Control (male 3.3±0.3; female 3.1±0.3), G-300 (male 3.4±0.2; female 3.1±0.4), G-1,500 (male 3.5±0.3; female 3.2±0.3), G-3,000 (male 3.4±0.5; female 3.1±0.4). CONCLUSION: Ipriflavone did not cause maternal toxicity, but increased triglyceride levels and reduced hematocrit at higher doses. The body and organ weights of the fetuses did not change with dam treatment. There were no external malformations or fetal deaths.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):28-33
DOI 10.1590/S0100-72032012000100006
PURPOSE: To describe the characteristics of mothers and children and to evaluate the factors associated with discontinuation of exclusive breastfeeding. METHODS: A cross-sectional study on infants under six months of age who attended the vaccination campaign in 2008. In the sample design, vaccination units were selected by drawing lots and infants were similarly selected later at each unit systematically. A semi-structured instrument was used for data collection, containing questions about children's nutrition and socio-demographic characteristics. We used Odds Ratio and the χ² test for data analysis, accepting as the critical level p<0.05. RESULTS: The prevalence of breastfeeding for infants under 120 and 180 days of age was 89.5 and 85% respectively, and exclusive breastfeeding was 50.6 and 39.7% for infants less than 120 and 180 days of age, respectively. The factors most related to the abandonment of exclusive breastfeeding in infants under six months were maternal employment outside the home (OR=2.73; 95%CI=1.74-4.29) and use of pacifiers (OR=4.26; 95%CI=2.85-6.38). The mother being multiparous (OR=0.57; 95%CI=0.40-0.81) and receiving postpartum care in the public health care network (OR=0.55; 95%CI=0.39-0.79) represented protective factors against the practice of early cessation of breastfeeding. CONCLUSIONS: The prevalence of breastfeeding and exclusive breastfeeding in the municipality of Uberlândia is among the highest in the country and the factors most often associated with the practice of early weaning were maternal employment outside the home, offering pacifiers to the infants, receiving postpartum care in the private health sector, and primiparity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):34-39
DOI 10.1590/S0100-72032012000100007
PURPOSE: To compare the maternal and perinatal outcomes of patients with placenta previa, after the adoption of a prolonged maternal hospital stay, to those of a 1991 series. METHODS: We performed a retrospective study comparing 108 cases of placenta previa hospitalized in the Maternity School Assis Chateaubriand, Universidade Federal do Ceará, during the period from 01/01/2006 to 12/31/2010, with those obtained in 1991, when 101 cases of the pathology were observed at our institution. The following maternal and perinatal data were collected: maternal age, parity, gestational age at delivery, mode of delivery, maternal stay length, Apgar scores at the 1st and 5th minutes, birth weight, adequacy of birth weight, neonatal length stay, maternal and neonatal morbidity and mortality rates (maternal, fetal, neonatal and perinatal). Statistical analysis was performed using the χ² and Fisher's exact tests. The results were considered significant when p<0.05. RESULTS: In 1991, placenta previa was found in 1.13% of cases (101/8900). In the present study, the prevalence was 0.43% (108/24726). No maternal death was observed in either series. Regarding the study of 1991, the current patients were significantly younger, with lower parity, were hospitalized longer, had better Apgar scores at 1st and 5th minutes, and had longer neonatal hospitalization. Also, we identified reduction of fetal, neonatal and perinatal mortality. CONCLUSIONS: Perinatal outcomes in patients with placenta previa were significantly improved between 1991 and the years 2006 and 2010. However, we can not say whether this improvement was due to the prolonged maternal hospital stay.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(1):40-46
DOI 10.1590/S0100-72032012000100008
PURPOSE: To determine the frequency and the association of serum markers for inherited and acquired thrombophilias in pregnant women with a history of severe pre-eclampsia in previous pregnancies. METHODS: Case-control study consisting of 81 pregnant women with a history of severe pre-eclampsia in previous pregnancies (study group) and 32 women with no history of severe pre-eclampsia in previous pregnancies (control group). The presence of inherited thrombophilia and antiphospholipid antibodies was screened in both groups. We used the chi-square test with Yates correction to assess associations and calculate the relative risks. RESULTS: The presence of thrombophilia was detected in 60.0% of patients with a previous history of pre-eclampsia and in 6.0% of the control patients. A significant association was found between pre-eclampsia in a previous pregnancy and the presence of markers for hereditary thrombophilia/antiphospholipid antibodies (p<0.05). The relative risk to develop pre-eclampsia was found to be 1.57 (1.34
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):328-333
DOI 10.1590/S0100-72032011001100002
PURPOSE: to determine the prevalence of Chlamydia and gonorrhea in a sample of women from Curitiba. METHODS: this was a cross-sectional study with a sample of sexually active non-pregnant women aged between 16 and 23 years-old, with an intact uterus, with up to four sexual partners, without evidence of fever or purulent cervicitis, submitted to pelvic examination and PCR-based urine- testing for Chlamydia and gonorrhea. Exclusion criteria included: vaccination for HPV, vaccination history for the past 21 days, previous abnormal cytology, history of genital warts, splenectomy, immune disorders, and use of immunosuppressive drugs. An interview regarding sociodemographic and obstetric data and gynecological risk behavior for sexual transmitted diseases was applied. For statistical analysis, we used the c2 or Fisher’s exact test to assess the association between variables. RESULTS: the prevalence of Chlamydia and gonorrhea infection in the study group was 10.7 and 1.5%, respectively, and the rate of coinfection was 0.9%. No correlation was found between the age range of the volunteers, the onset of sexual activity, the number of sexual partners and of new sexual partners in the last six months, and the presence of Chlamydia or gonorrhea. In women who had vaginal discharge or ectropion, the prevalence of Chlamydia infection was two times higher than in those without such signs. CONCLUSIONS: the results of this study were similar to national studies using PCR in urine samples for the detection of Chlamydia and gonorrhea in samples of non-pregnant women of the same age groups and with the same background. Since the volunteers with more than four sexual partners and those who had purulent endocervicitis were excluded, it is believed that the prevalence of Chlamydia and gonorrhea infection could have been greater in this population.