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Original Article06-09-2025
Impact of the Zero Maternal Death by Hemorrhage Strategy on health professionals’ self-perceived knowledge in managing postpartum hemorrhage
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo25
Abstract
Original ArticleImpact of the Zero Maternal Death by Hemorrhage Strategy on health professionals’ self-perceived knowledge in managing postpartum hemorrhage
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo25
Views14Abstract
Objective:
This study aimed to evaluate the results of the Obstetric Hemorrhage Prevention and Management Course – Zero Maternal Death by Hemorrhage Strategy (0MMxH) among healthcare professionals before and after participation.
Methods:
A quasi-experimental design was employed, assessing the educational intervention in a convenience sample of healthcare professionals who had participated in the 0MMxH at least one year prior. Participants completed a retrospective pre-post questionnaire sent via email, focusing on self-perceived knowledge levels and the adoption of best practices in postpartum hemorrhage (PPH) management.
Results:
Out of 129 professionals who completed the 0MMxH training, 85 (65.9%) responded to the questionnaire. The percentages of respondents reporting no or low knowledge before and after the course were: shock index (52.8% to 0%, before and after, respectively), blood loss estimation (35.2% to 1.1%), care sequence for PPH (44.6% to 0%), rational use of crystalloids (37.5% to 1.1%), non-pneumatic anti-shock garment (83.5% to 3.4%), and damage control surgery (74.1% to 8.1%). These results indicate a significant improvement in self-perceived knowledge. After the course, the highest adoption rates of best practices were for shock index (83.5%), blood loss estimation (67.1%), and use of warm crystalloids (58.8%). However, gaps remained regarding non-pharmacological interventions for PPH management.
Conclusion:
Participants reported improved knowledge on most topics covered by the 0MMxH. The program was recognized as a crucial factor in adopting effective PPH management practices, underscoring the importance of training in enhancing obstetric care.
Key-words Health strategiesHealthcare professionalsMaternal mortalityMedical EducationPostpartum hemorrhageSee more -
Original Article06-09-2025
Evaluation of chronic radiation proctitis in patients with cervical cancer treated with pelvic radiotherapy: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo26
Abstract
Original ArticleEvaluation of chronic radiation proctitis in patients with cervical cancer treated with pelvic radiotherapy: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo26
Views11See moreAbstract
Objective:
A combination of chemotherapy and pelvic radiotherapy is recommended to treat locally advanced cervical cancer (CC), which has been associated with acute and chronic toxicities, especially radiation proctitis (RP). The objective of this study was to evaluate the frequency of RP and treatment management in females with CC who underwent pelvic radiotherapy at an oncology referral hospital.
Methods:
This cross-sectional study analyzed the medical records of patients treated with radiotherapy for CC between 2015–2017. We assessed sociodemographic, lifestyle, cancer, treatment, and clinical variables. We identified 298 records of females with CC who underwent pelvic radiotherapy during the defined period. Of these, 14 records were duplicates, 25 were excluded for lacking essential information, and 33 were missing in the archive. Accordingly, 226 relevant medical records were analyzed, with data regarding sociodemographic, clinical, cancer-related, treatment-related, and RP-related variables collected. Pearson's chi-square test was used to compare symptomatic and non-symptomatic patients. Fisher's exact test was used to compare chemotherapy doses. Statistical analysis was performed with Stata V12.1. A P-value less than 0.05 was considered significant.
Results:
The median patient age was 48 years (interquartile range 38–61). Patients predominantly had CC stages IIB and IIIB (>70%). Of the 226 females analyzed, 87(38.5%) experienced RP symptoms, represented by rectal bleeding; of these, 59 underwent colonoscopy, confirming RP in 58(98.3%). Accordingly, of the 226 females analyzed, 58(25.7%) had a confirmed diagnosis of RP. There was a statistically significant association between rectal bleeding and cumulative radiation dose (P < 0.001) and the presence of systemic arterial hypertension (P = 0.036). Regarding treatment, 38(65.5%) participants underwent argon plasma coagulation (APC), and of these, 22(57.9%) had no post-treatment macroscopic bleeding.
Conclusion:
Patients with CC who received radiotherapy at an oncology referral service had a high frequency of RP, and APC helped control bleeding in certain patients.
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Original Article06-09-2025
Epidemiological profile of breast cancer in a reference center in the north region of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo27
Abstract
Original ArticleEpidemiological profile of breast cancer in a reference center in the north region of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo27
Views14See moreAbstract
Objective:
To describe the epidemiological data of women with breast cancer at a referral center in oncology in the northern region of Brazil.
Methods:
This is a retrospective cohort study. The study population consists of patients who were diagnosed with in situ or invasive BC (invasive carcinoma of no special type (ICNST) and invasive lobular carcinoma (ILC)) at the Hospital de Amor da Amazônia, in Porto Velho – Rondônia, between January 2012 and December 2021. The sampling plan adopted was of the convenience type. All patients who received the anatomopathological diagnosis of in situ or invasive BC at the Hospital de Amor da Amazônia from 2012 to 2021 and came from the North region were included. Exclusion criteria were non-origin from the North region and absence of diagnosis established by anatomopathological examination of breast cancer. Analysis of the database and medical records of the Hospital de Amor da Amazônia was carried out to collect information.
Results:
420 patients were included, 99.5% female, with complete elementary school (32,6%) and brown skin (68,1%). The mean age at diagnosis was 49 years. Forty-five percent were born in the northern region and 55% in other regions of Brazil. Eighty percent of tumors were invasive ductal carcinoma; 32.7% were luminal A-like, 25.1% luminal B-like, 19.4% HER2 enriched and 12.8% triple negative. When patients were subdivided by age ≤40 years and > 40 years, there was a statistically significant difference in the association with staging (p=0.000), histological type (p= 0.035), immunohistochemistry subtype (p=0.000), neoadjuvant chemotherapy (p=.000) and genetic counseling (p=0.001). The median survival was 7.99 years. The 5-year overall survival was 81%. The higher the stage, the lower the survival rate. Twenty-four distinct variants were described in patients undergoing genetic testing, 16 of uncertain significance and 8 pathogenic. Three new variants were described: ATM (c.8726G>C), BRCA2 (c.2232A>C) and ERCC5 (c.2164G>Ap).
Conclusion:
In this study, the age at diagnosis of breast cancer was lower, the tumor subtype was more aggressive, and patients were admitted in more advanced stages. Overall survival is lower compared to national and international data. Despite the small number of patients referred to genetic testing, it is important to search for germline mutations to improve patients’ diagnosis and treatment.
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Original Article04-30-2025
Evaluation of pathological complete response rates in breast cancer patients undergoing neoadjuvant therapy
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo13
Abstract
Original ArticleEvaluation of pathological complete response rates in breast cancer patients undergoing neoadjuvant therapy
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo13
Views111See moreAbstract
Objective:
This study aims to assess the rate of pathological complete response (pCR) in breast cancer patients undergoing neoadjuvant therapy and to explore its correlation with clinical, molecular, and prognostic factors.
Methods:
We conducted this retrospective observational study at Liga Contra o Câncer, a major public oncology reference center in Northeast Brazil. We included patients diagnosed with breast cancer who initiated neoadjuvant therapy between June 2018 and June 2019. Patients with a history of recurrent breast cancer or those who did not undergo surgery were excluded. The primary outcome was the pCR rate, with secondary outcomes including Overall Survival (OS), Disease-Free Survival (DFS), mortality, and disease recurrence. Follow-up extended until August 2022. We performed multivariate Cox regression analysis to correlate outcomes with predetermined variables.
Results:
Of the 292 included patients, 63 (21.6%) achieved pCR. The mean follow-up duration was 42.8 months. Multivariate logistic regression analysis revealed an association between pCR and the AC-TH regimen [OR = 2.4; 95%CI = 1.13 - 5.24; p=0.023], as well as between pCR and HER2-positive tumors [OR 2.49; 95% CI = 1.14 - 5.86; p=0.028]. Complete pathological response was associated with higher DFS [HR 0.33; 95%CI 0.13-0.86; p=0.024].
Conclusion:
Neoadjuvant therapy demonstrated significant efficacy in achieving pathological response in breast cancer patients. We observed a strong association between the AC-TH regimen, HER2-positive status, and pCR.
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Original Article04-30-2025
Clinical and epidemiological profile of pregnant and postpartum women affected by COVID-19 who required respiratory support
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo14
Abstract
Original ArticleClinical and epidemiological profile of pregnant and postpartum women affected by COVID-19 who required respiratory support
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo14
Views100Abstract
Objective:
This study described the clinical and epidemiological profile and the management provided to pregnant and postpartum women with COVID-19 who required respiratory support.
Methods:
A descriptive study was conducted with pregnant and postpartum women with confirmed COVID-19 who received care between April 2020 and December 2021 in eight referral centers in northeastern Brazil. Statistical analysis was conducted using Epi-Info 7.2.5 and Medcalc, version 20.112.
Results:
Of the 720 patients admitted, 208 (32.7%) required respiratory support. Mean age of the participants was 28.9±7.1 years. Most (52.8%) were brown-skinned; 31.3% had little formal schooling; 41.1% had a personal income and 23.1% were married. Around half were referred from another hospital. Overall, 36.8% were obese and 36.9% were hypertensive. Criteria for severe acute respiratory syndrome (SARS) were present in 80.7% of cases. Overall, 151 patients (74.7%) required corticoids, and 150 (76.1%) were admitted to an intensive care unit. Non-invasive ventilation was needed in 89.4% of cases, with nasal catheters being the most common type (55.3% of cases). Invasive mechanical ventilation was necessary in 35.5% of cases and 91.6% had a cesarean section. Maternal near miss and death occurred in 24% and 12.9% of cases, respectively.
Conclusion:
Pregnant and postpartum women with COVID-19 who required respiratory support were predominantly brown-skinned, in the third trimester of pregnancy and had been referred from another hospital. The cesarean section rate was high; the presence of criteria for SARS was common and the rates of COVID-19-related maternal near miss and death were high.
Clinical Trials registry:
NCT04462367
Key-words Cesarian sectionCOVID-19Intensive care unitsNear miss, healthcareNoninvasive ventilationObesityPostpartum periodPregnancyPregnancy trimester, thirdRespiration, artificialSARS-CoV-2severe acute respiratory syndromeSee more -
Original Article04-30-2025
The ımpact of demographic and obstetric factors on perception of traumatic birth and breastfeeding attitudes
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo15
Abstract
Original ArticleThe ımpact of demographic and obstetric factors on perception of traumatic birth and breastfeeding attitudes
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo15
Views93Abstract
Objective:
This study aims to examine the effects of sociodemographic and obstetric factors on traumatic birth perception and breastfeeding attitudes in primiparous mothers who have had a vaginal birth in the early postpartum period.
Methods:
The sample of the research, developed with a cross-sectional and correlational design, consisted of 252 women residing in a province in the Western Black Sea region of Türkiye. The data were obtained by employing a Personal Information Form, Traumatic Childbirth Perception Scale, and Breastfeeding Attitudes of The Evaluation Scale. Data analysis was conducted using the statistical programming language R (R version 4.3.3).
Results:
Women who were not employed, had a planned pregnancy, and did not experience health problems during pregnancy had higher mean breastfeeding attitude scores, and this difference was statistically significant. It was determined that a one-unit increase in gestational week led to an average increase of 1.926 units in breastfeeding attitude score, and a one-unit increase in Traumatic Childbirth Perception Scale score led to an average decrease of 0.110 units in breastfeeding attitude score. The mean traumatic childbirth perception scores of women living in urban areas were found to be lower than those living in villages or towns, and the difference was statistically significant.
Conclusion:
The research findings indicate that gestational age, perception of traumatic childbirth, and certain sociodemographic factors significantly affect breastfeeding attitudes. Additionally, mothers living in urban areas have a lower perception of traumatic childbirth. Therefore, individualized approaches to childbirth and breastfeeding support are crucial.
Key-words Breast feedingDelivery, obstetricParturitionperceptionPostpartum periodSociodemographic factorsStress disorders, post-traumaticSee more -
Original Article04-30-2025
Effects of domestic violence on menopausal symptoms, sexual function, and quality of life: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo16
Abstract
Original ArticleEffects of domestic violence on menopausal symptoms, sexual function, and quality of life: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo16
Views129Abstract
Objective:
To investigate the association between lifetime experience of domestic violence and climacteric symptoms, sexual function, and quality of life in climacteric women in Rio Grande do Sul, Brazil.
Methods:
A cross-sectional study was conducted with 700 pre-, peri-, and postmenopausal women, recruited online via an anonymous questionnaire (REDCap platform). Women aged 40 to 65 years, residing in Rio Grande do Sul, and classified by the STRAW+10 criteria were included. Climacteric symptoms and sexual function were assessed using the 10-item Cervantes Scale (CS-10) and the 6-item Female Sexual Function Index (FSFI-6). Data were analyzed using SPSS version 18.0; quantitative data as median [IQR], qualitative as frequencies. Group comparisons used Kruskal-Wallis, Chi-Square, and Spearman's correlation between violence against women (VAW) and/or climacteric groups on CS-10 or FSFI-6. Significance was set at 5%.
Results:
The median [IQR] age of pre- (46 [43 - 50] years), peri- (50 [47 – 52] years), and postmenopausal (55 [51 – 58] years) were different among groups. Prevalence rates of psychological (38.8%), sexual (34.9%), and physical (21.3%) violence were observed. Postmenopausal women showed the poorest outcomes. Premenopausal women experiencing violence had severe anxiety, while postmenopausal women reported feeling worthless. Various sexual dysfunctions were associated with violence, including low desire, lubrication issues, and sexual pain.
Conclusions:
Domestic violence was linked to worse climacteric symptoms, sexual function, and quality of life, particularly in postmenopausal women. These findings underscore the need for improved care and public policies to enhance safety and well-being among women of all ages.
Key-words AnxietyClimactericDomestic violenceMenopausePostmenopauseQuality of lifeSexualitysurveys and questionnairesViolence against womenSee more -
Original Article04-30-2025
Assessıng the predıctıve accuracy of blood-based bıomarkers ın neonatal outcomes for pregestatıonal dıabetes mellıtus
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo17
Abstract
Original ArticleAssessıng the predıctıve accuracy of blood-based bıomarkers ın neonatal outcomes for pregestatıonal dıabetes mellıtus
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo17
Views126Abstract
Objective:
This retrospective study aimed to investigate blood-based immune-inflammatory biomarkers (IIBs) in predicting neonatal outcomes in pregnancies with pregestational diabetes mellitus (PGDM).PIV[(neutrophil×platelet×monocyte)/lymphocyte)], SII (neutrophil×platelet/lymphocyte), and NLR neutrophil/lymphocyte) values were evaluated in all three trimesters, and their correlation with neonatal outcomes was examined.
Methods:
We included 82 cases of PGDM pregnancies delivered after 32 weeks. Maternal age, gravidity, parity, types of diabetes, and route of delivery were noted. For neonatal outcomes, we recorded gestational age at birth, birth weight percentile, existence of fetal growth restriction, LGA, neonatal intensive care unit (NICU) requirement, Apgar Score <7 at 1, 5, or 10 minutes, need for positive pressure ventilation (PPV), need for mechanical ventilation, hypoglycaemia, hyperbilirubinemia and the need for phototherapy. PIV, SII and NLR values were calculated in each trimester and their association with adverse neonatal outcomes was analyzed.
Results:
We could not detect any consistent and significant correlation between SII and PIV values and adverse neonatal outcomes for each trimester. There was a correlation between 3rd trimester NLR and adverse neonatal outcomes, including APGAR <7, the requirement for PPV and mechanical ventilation (p=0.056, 0.013 and 0.060, respectively).
Conclusion:
While SII and PIV values did not consistently correlate with adverse neonatal outcomes throughout each trimester in PGDM pregnancies, 3rd-trimester NLR showed a notable association with the requirement for PPV with statistical significance and with Apgar Score <7 and the requirement for mechanical ventilation without statistical significance. NLR in the third trimester may hold potential as a predictive marker for specific adverse neonatal outcomes in PGDM pregnancies, warranting further investigation.
Key-words biomarkersDiabetes mellitusGestational ageHypoglycemiaInfant, newbornIntensive care units, neonatalLymphocytesMaternal ageMonocytesNeuthrophilsPregancyPregnancy in diabetesRespiration, artificialSee more