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Original Article
Postoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
- Rogério Serafim Parra
, - Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo , [ ... ],
- Omar Féres
01-23-2022
Summary
Original ArticlePostoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1040-1046
01-23-2022- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo ,
- Omar Féres
Views96See moreAbstract
Objective
The purpose was to assess the rates of postoperative complications and the need of temporary stoma of laparoscopic surgical treatment for bowel endometriosis in a referral center.
Methods
The surgical indication, type of operation, operative time, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, postoperative complications were evaluated.
Results
One-hundred and fifty patients were included. The average duration of surgery was significantly longer for segmental resection (151 minutes) than for disc excision (111.5 minutes, p < 0.001) and shaving (96.8 minutes, p < 0.001). Patients with segmental resection had longer postoperative lengths of hospital stay (1.87 days) compared with patients with disc excision (1.43 days, p < 0.001) and shaving (1.03 days, p < 0.001). A temporary stoma was performed in 2.7% of patients. Grade II and III postoperative complications occurred in 6.7% and 4.7% patients, respectively.
Conclusion
Laparoscopic intestinal resection has an acceptable postoperative complication rate and a low need for a temporary stoma.
Views96
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 ArticlePostoperative Complications and Stoma Rates After Laparoscopic Resection of Deep Infiltrating Endometriosis with Bowel Involvement
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1040-1046
01-23-2022- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo ,
- Omar Féres
Views96See moreAbstract
Objective
The purpose was to assess the rates of postoperative complications and the need of temporary stoma of laparoscopic surgical treatment for bowel endometriosis in a referral center.
Methods
The surgical indication, type of operation, operative time, length of hospital stay, need for a temporary stoma, rate of conversion to open surgery, postoperative complications were evaluated.
Results
One-hundred and fifty patients were included. The average duration of surgery was significantly longer for segmental resection (151 minutes) than for disc excision (111.5 minutes, p < 0.001) and shaving (96.8 minutes, p < 0.001). Patients with segmental resection had longer postoperative lengths of hospital stay (1.87 days) compared with patients with disc excision (1.43 days, p < 0.001) and shaving (1.03 days, p < 0.001). A temporary stoma was performed in 2.7% of patients. Grade II and III postoperative complications occurred in 6.7% and 4.7% patients, respectively.
Conclusion
Laparoscopic intestinal resection has an acceptable postoperative complication rate and a low need for a temporary stoma.
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. - Rogério Serafim Parra
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Original Article
Robson’s Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):830-837
01-06-2022
Summary
Original ArticleRobson’s Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):830-837
01-06-2022Views151See moreAbstract
Objective
To use the Robson Ten Group Classification (RTGC) to analyze cesarean section (CS) rates in a Honduran maternity hospital, with focus in groups that consider induction of labor.
Methods
Cross-sectional study. Women admitted for childbirth (August 2017 to October 2018) were classified according to the RTGC. The CS rate for each group and the contribution to the overall CS rate was calculated, with further analyses of the induction of labor among term primiparous (group 2a), term multiparous (group 4a), and cases with one previous CS (group 5.1).
Results
A total of 4,356 women were considered, with an overall CS rate of 26.1%. Group 3 was the largest group, with 38.6% (1,682/4,356) of the cases, followed by Group 1, with 30.8% (1,342/4,356), and Group 5, with 10.3% (450/4,356). Considering the contribution to overall CS rates per group, Group 5 contributed with 30.4% (345/1,136) of the CSs and within this group, 286/345 (82.9%) had 1 previous CS, with a CS rate > 70%. Groups 1 and 3, with 26.6% (291/1,136) and 13.5% (153/1,136), respectively, were the second and third larger contributors to the CS rate. Groups 2a and 4a had high induction success, with low CS rates (18.4 and 16.9%, respectively).
Conclusion
The RTGC is a useful tool to assess CS rates in different healthcare facilities. Groups 5, 1, and 3 were the main contributors to the CS rate, and groups 2 and 4 showed the impact and importance of induction of labor. These findings may support future interventions to reduce unnecessary CS, especially among primiparous and in women with previous CS.
Views151This 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 ArticleRobson’s Ten Group Classification System to Evaluate Cesarean Section Rates in Honduras: The Relevance of Labor Induction
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):830-837
01-06-2022Views151See moreAbstract
Objective
To use the Robson Ten Group Classification (RTGC) to analyze cesarean section (CS) rates in a Honduran maternity hospital, with focus in groups that consider induction of labor.
Methods
Cross-sectional study. Women admitted for childbirth (August 2017 to October 2018) were classified according to the RTGC. The CS rate for each group and the contribution to the overall CS rate was calculated, with further analyses of the induction of labor among term primiparous (group 2a), term multiparous (group 4a), and cases with one previous CS (group 5.1).
Results
A total of 4,356 women were considered, with an overall CS rate of 26.1%. Group 3 was the largest group, with 38.6% (1,682/4,356) of the cases, followed by Group 1, with 30.8% (1,342/4,356), and Group 5, with 10.3% (450/4,356). Considering the contribution to overall CS rates per group, Group 5 contributed with 30.4% (345/1,136) of the CSs and within this group, 286/345 (82.9%) had 1 previous CS, with a CS rate > 70%. Groups 1 and 3, with 26.6% (291/1,136) and 13.5% (153/1,136), respectively, were the second and third larger contributors to the CS rate. Groups 2a and 4a had high induction success, with low CS rates (18.4 and 16.9%, respectively).
Conclusion
The RTGC is a useful tool to assess CS rates in different healthcare facilities. Groups 5, 1, and 3 were the main contributors to the CS rate, and groups 2 and 4 showed the impact and importance of induction of labor. These findings may support future interventions to reduce unnecessary CS, especially among primiparous and in women with previous CS.
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. -
Original Article
Is There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?
- Albaro José Nieto-Calvache ,
- Alejandra Hidalgo ,
- Juliana Maya ,
- Beatriz Sánchez ,
- Luisa Fernanda Blanco , [ ... ],
- Adriana Messa Bryon
09-06-2022
Summary
Original ArticleIs There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):925-929
09-06-2022- Albaro José Nieto-Calvache ,
- Alejandra Hidalgo ,
- Juliana Maya ,
- Beatriz Sánchez ,
- Luisa Fernanda Blanco ,
- Stiven Ernesto Sinisterra-Díaz ,
- Juan Pablo Benavides-Calvache ,
- Iván Padilla ,
- Ivonne Aldana ,
- Martha Jaramillo ,
- Ana Maria Gómez ,
- Angela María Olarte Castillo ,
- Adriana Messa Bryon
Views204See moreABSTRACT
Objective
Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries.
Methods
This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS.
Results
Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case.
Conclusion
Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
Views204This 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 ArticleIs There a Place for Family-centered Cesarean Delivery during Placenta Accreta Spectrum Treatment?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):925-929
09-06-2022- Albaro José Nieto-Calvache ,
- Alejandra Hidalgo ,
- Juliana Maya ,
- Beatriz Sánchez ,
- Luisa Fernanda Blanco ,
- Stiven Ernesto Sinisterra-Díaz ,
- Juan Pablo Benavides-Calvache ,
- Iván Padilla ,
- Ivonne Aldana ,
- Martha Jaramillo ,
- Ana Maria Gómez ,
- Angela María Olarte Castillo ,
- Adriana Messa Bryon
Views204See moreABSTRACT
Objective
Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries.
Methods
This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS.
Results
Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case.
Conclusion
Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
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. - Albaro José Nieto-Calvache
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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
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
Views164See 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.
Views164This 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
Views164See 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
Placenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings?
- Albaro José Nieto-Calvache ,
- Juan Pablo Benavides-Calvache ,
- Alejandra Hidalgo ,
- Natalia Padilla ,
- Jaime López-Tenorio , [ ... ],
- Juan Manuel Burgos-Luna
09-06-2022
Summary
Original ArticlePlacenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):838-844
09-06-2022- Albaro José Nieto-Calvache ,
- Juan Pablo Benavides-Calvache ,
- Alejandra Hidalgo ,
- Natalia Padilla ,
- Jaime López-Tenorio ,
- Alejandro Victoria ,
- Martin Rengifo ,
- Mauricio Mejía ,
- Lina María Vergara-Galliadi ,
- Stiven Ernesto Sinisterra-Díaz ,
- Juliana Maya ,
- María Andrea Zambrano ,
- Juan Manuel Burgos-Luna
Views276Abstract
Objective
The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital.
Methods
A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological).
Results
A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency.
Conclusion
The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential.
Key-words false positiveoperative surgical procedurePlacenta accretaprenatal ultrasonic diagnosisUltrasonographySee moreViews276This 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 ArticlePlacenta Accreta Spectrum Prenatal Diagnosis Performance: Are Ultrasound False-positive Results Acceptable in Limited-resources Settings?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):838-844
09-06-2022- Albaro José Nieto-Calvache ,
- Juan Pablo Benavides-Calvache ,
- Alejandra Hidalgo ,
- Natalia Padilla ,
- Jaime López-Tenorio ,
- Alejandro Victoria ,
- Martin Rengifo ,
- Mauricio Mejía ,
- Lina María Vergara-Galliadi ,
- Stiven Ernesto Sinisterra-Díaz ,
- Juliana Maya ,
- María Andrea Zambrano ,
- Juan Manuel Burgos-Luna
Views276Abstract
Objective
The immediate referral of patients with risk factors for placenta accreta spectrum (PAS) to specialized centers is recommended, thus favoring an early diagnosis and an interdisciplinary management. However, diagnostic errors are frequent, even in referral centers (RCs). We sought to evaluate the performance of the prenatal diagnosis for PAS in a Latin American hospital.
Methods
A retrospective descriptive study including patients referred due to the suspicion of PAS was conducted. Data from the prenatal imaging studies were compared with the final diagnoses (intraoperative and/or histological).
Results
A total of 162 patients were included in the present study. The median gestational age at the time of the first PAS suspicious ultrasound was 29 weeks, but patients arrived at the PAS RC at 34 weeks. The frequency of false-positive results at referring hospitals was 68.5%. Sixty-nine patients underwent surgery based on the suspicion of PAS at 35 weeks, and there was a 28.9% false-positive rate at the RC. In 93 patients, the diagnosis of PAS was ruled out at the RC, with a 2.1% false-negative frequency.
Conclusion
The prenatal diagnosis of PAS is better at the RC. However, even in these centers, false-positive results are common; therefore, the intraoperative confirmation of the diagnosis of PAS is essential.
Key-words false positiveoperative surgical procedurePlacenta accretaprenatal ultrasonic diagnosisUltrasonographySee 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. - Albaro José Nieto-Calvache
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Original Article
Use of Urodynamics by Gynecologists and Urologists in Brazil
- Mucio Barata Diniz ,
- Marina Franklin Ribeiro ,
- Luísa Aguiar Monteiro Dias ,
- Marilene Vale de Castro Monteiro
08-29-2022
Summary
Original ArticleUse of Urodynamics by Gynecologists and Urologists in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):654-659
08-29-2022- Mucio Barata Diniz ,
- Marina Franklin Ribeiro ,
- Luísa Aguiar Monteiro Dias ,
- Marilene Vale de Castro Monteiro
Views89See moreAbstract
Objective
Urodynamic studies (UDSs) are a set of tests that assess the storage and emptying of urine, and they are widely used by gynecologists and urologists in the management of urinary incontinence (UI), despite the discussion about its indications. The objectives of the present study were to verify whether UDSs are routinely used in the conservative and surgical approaches to female UI, their other clinical indications, and to compare the responses of Brazilian gynecologists and urologists.
Methods
The present is an opinion survey applied from August 2020 to January 2021 through a semistructured questionnaire about the clinical practice sent by e-mail to all participants. The responses were compared through statistical analyses.
Results
Of the 329 participants, 238 were gynecologists (72.3%) and 91, urologists (27.7%). Most gynecologists (73.5%) and urologists (86.6%) do not request UDSs before the conservative treatment of UI; but UDSs are indicated in the preoperative period of anti-incontinence surgeries. Most participants request UDSs in the initial approach to overactive bladder (gynecologists: 88.2%; urologists: 96.7%), and the urologist has greater chance to request this study (odds ratio [OR] = 3.9). For most participants, it is necessary to request uroculture before the UDSs.
Conclusion
Most Brazilian gynecologists and urologists who participated in the present study do not request UDSs before the conservative treatment of UI, according to national and internacional guidelines, and often request it before the surgical treatment for female UI. The indication of this exam in the initial approach of idiopathic overactive bladder should be reviewed by the participants.
Views89This 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 ArticleUse of Urodynamics by Gynecologists and Urologists in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):654-659
08-29-2022- Mucio Barata Diniz ,
- Marina Franklin Ribeiro ,
- Luísa Aguiar Monteiro Dias ,
- Marilene Vale de Castro Monteiro
Views89See moreAbstract
Objective
Urodynamic studies (UDSs) are a set of tests that assess the storage and emptying of urine, and they are widely used by gynecologists and urologists in the management of urinary incontinence (UI), despite the discussion about its indications. The objectives of the present study were to verify whether UDSs are routinely used in the conservative and surgical approaches to female UI, their other clinical indications, and to compare the responses of Brazilian gynecologists and urologists.
Methods
The present is an opinion survey applied from August 2020 to January 2021 through a semistructured questionnaire about the clinical practice sent by e-mail to all participants. The responses were compared through statistical analyses.
Results
Of the 329 participants, 238 were gynecologists (72.3%) and 91, urologists (27.7%). Most gynecologists (73.5%) and urologists (86.6%) do not request UDSs before the conservative treatment of UI; but UDSs are indicated in the preoperative period of anti-incontinence surgeries. Most participants request UDSs in the initial approach to overactive bladder (gynecologists: 88.2%; urologists: 96.7%), and the urologist has greater chance to request this study (odds ratio [OR] = 3.9). For most participants, it is necessary to request uroculture before the UDSs.
Conclusion
Most Brazilian gynecologists and urologists who participated in the present study do not request UDSs before the conservative treatment of UI, according to national and internacional guidelines, and often request it before the surgical treatment for female UI. The indication of this exam in the initial approach of idiopathic overactive bladder should be reviewed by the participants.
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. - Mucio Barata Diniz
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Original Article
Sexual Violence Suffered by Women in Early and Late Adolescence: Care Provided and Follow-Up
- Alejandra Suyapa Becerra Torres ,
- Ana Luiza Teixeira ,
- Maria Teresa Ferreira Côrtes ,
- Ândria Cléia Alves ,
- Otávio Alabarse , [ ... ],
- Arlete Fernandes
08-29-2022
Summary
Original ArticleSexual Violence Suffered by Women in Early and Late Adolescence: Care Provided and Follow-Up
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):667-677
08-29-2022- Alejandra Suyapa Becerra Torres ,
- Ana Luiza Teixeira ,
- Maria Teresa Ferreira Côrtes ,
- Ândria Cléia Alves ,
- Otávio Alabarse ,
- Renata Cruz Soares de Azevedo ,
- Arlete Fernandes
Views142Abstract
Objective
To compare the sexual violence suffered by women in early and late adolescence, the reactions triggered after the aggression, and the care provided.
Methods
A retrospective study in which we reviewed the medical records of 521 female adolescents treated by a multidisciplinary team at a reference hospital in the city of Campinas, state of São Paulo, Brazil. We analyzed sociodemographic variables, and those pertainin to the characteristics of the episodes of violence, the emergency care, and the physical and psychological reactions observed during the follow-up. For the analysis, the sample was divided into groups of early (10 to 14 years) and late (15 to 18 years) adolescence. We used the Chi-squared/Fisher Exact, Mann-Whitney, and Kruskal-Wallis tests to compare the groups; the level of significance adopted was 5%.
Results
The early group (n= 242) contained more adolescents who were enrolled in school (p< 0.001), suffered more daytime aggressions (p= 0.031), in their residences (p< 0.001), by an aggressor with whom they were acquainted (p< 0.001), had greater need of legal protection (p= 0.001), and took longer to seek care (p= 0.048). Feelings of guilt, shame, and the perception of violence were similar between the groups. In the late group (n= 279), there was greater consumption of alcohol during the aggression (p= 0,005); they received significantly more prophylaxis treatments; reported more physical symptoms (p= 0.033), sleep disorders (p= 0.003), symptoms of anxiety (p= 0.045), and feelings of anguish (p= 0.011); and had more prescriptions of psychotropics (p= 0.005). Only 52% completed the 6-month follow-up, with no differences between the groups.
Conclusion
The age groups showed differences in the characteristics of the episodes of violence; early adolescents took longer to seek help, and the late group presented more intense symptoms and psychological worsening during the follow-up. Measures of prevention and specific care aimed at this population are needed.
Key-words Adolescenceemergency careMental healthretrospective studysexual assaultSexual violenceWomenSee moreViews142This 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 ArticleSexual Violence Suffered by Women in Early and Late Adolescence: Care Provided and Follow-Up
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):667-677
08-29-2022- Alejandra Suyapa Becerra Torres ,
- Ana Luiza Teixeira ,
- Maria Teresa Ferreira Côrtes ,
- Ândria Cléia Alves ,
- Otávio Alabarse ,
- Renata Cruz Soares de Azevedo ,
- Arlete Fernandes
Views142Abstract
Objective
To compare the sexual violence suffered by women in early and late adolescence, the reactions triggered after the aggression, and the care provided.
Methods
A retrospective study in which we reviewed the medical records of 521 female adolescents treated by a multidisciplinary team at a reference hospital in the city of Campinas, state of São Paulo, Brazil. We analyzed sociodemographic variables, and those pertainin to the characteristics of the episodes of violence, the emergency care, and the physical and psychological reactions observed during the follow-up. For the analysis, the sample was divided into groups of early (10 to 14 years) and late (15 to 18 years) adolescence. We used the Chi-squared/Fisher Exact, Mann-Whitney, and Kruskal-Wallis tests to compare the groups; the level of significance adopted was 5%.
Results
The early group (n= 242) contained more adolescents who were enrolled in school (p< 0.001), suffered more daytime aggressions (p= 0.031), in their residences (p< 0.001), by an aggressor with whom they were acquainted (p< 0.001), had greater need of legal protection (p= 0.001), and took longer to seek care (p= 0.048). Feelings of guilt, shame, and the perception of violence were similar between the groups. In the late group (n= 279), there was greater consumption of alcohol during the aggression (p= 0,005); they received significantly more prophylaxis treatments; reported more physical symptoms (p= 0.033), sleep disorders (p= 0.003), symptoms of anxiety (p= 0.045), and feelings of anguish (p= 0.011); and had more prescriptions of psychotropics (p= 0.005). Only 52% completed the 6-month follow-up, with no differences between the groups.
Conclusion
The age groups showed differences in the characteristics of the episodes of violence; early adolescents took longer to seek help, and the late group presented more intense symptoms and psychological worsening during the follow-up. Measures of prevention and specific care aimed at this population are needed.
Key-words Adolescenceemergency careMental healthretrospective studysexual assaultSexual violenceWomenSee 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. - Alejandra Suyapa Becerra Torres
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Original Article
Cytology-based Screening for Anal Intraepithelial Neoplasia in Immunocompetent Brazilian Women with a History of High-Grade Cervical Intraepithelial Neoplasia or Cancer
- Vivian de Oliveira Rodrigues Brum ,
- Alessandra de Souza Oliveira Tricoti ,
- Gabriel Duque Pannain ,
- Denise Gasparetii Drumond ,
- Isabel Cristina Gonçalves Leite
08-29-2022
Summary
Original ArticleCytology-based Screening for Anal Intraepithelial Neoplasia in Immunocompetent Brazilian Women with a History of High-Grade Cervical Intraepithelial Neoplasia or Cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):678-685
08-29-2022- Vivian de Oliveira Rodrigues Brum ,
- Alessandra de Souza Oliveira Tricoti ,
- Gabriel Duque Pannain ,
- Denise Gasparetii Drumond ,
- Isabel Cristina Gonçalves Leite
Views106See moreAbstract
Objective
To determine the prevalence and possible variables associated with anal intraepithelial neoplasia and anal cancer in immunocompetent women with high-grade cervical intraepithelial neoplasia.
Methods
A cross-sectional study involving immunocompetent women with a histological diagnosis of high-grade cervical intraepithelial neoplasia and cervical cancer, conducted between January 2016 and September 2020. All women underwent anal cytology and answered a questionnaire on characterization and potential risk factors. Women with altered cytology were submitted to anoscopy and biopsy.
Results
A total of 69 women were included in the study. Of these, 7 (10.1%) had abnormal anal cytology results: (high-grade lesion, atypical squamous cells of undetermined significance, and atypical squamous cells, cannot exclude high-grade lesions: 28,5% each; low grade lesion: 14,3%). Of the anoscopies, 3 (42.8%) showed alterations. Of the 2 (28,5% of all abnormal cytology results) biopsies performed, only 1 showed low-grade anal intraepithelial neoplasia. The average number of pregnancies, vaginal deliveries, and abortions was associated with abnormal anal cytology. However, the highest mean regarding the cesarean sections was associated with normal cytology.
Conclusion
The prevalence of anal intraepithelial neoplasia was compatible with data from recent studies, especially those conducted in Brazil. Opportunistic screening for anal intraepithelial neoplasia in this high-risk population should be considered. Anal cytology is suitable for this purpose, due to its low cost and feasibility in public health services.
Views106This 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 ArticleCytology-based Screening for Anal Intraepithelial Neoplasia in Immunocompetent Brazilian Women with a History of High-Grade Cervical Intraepithelial Neoplasia or Cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):678-685
08-29-2022- Vivian de Oliveira Rodrigues Brum ,
- Alessandra de Souza Oliveira Tricoti ,
- Gabriel Duque Pannain ,
- Denise Gasparetii Drumond ,
- Isabel Cristina Gonçalves Leite
Views106See moreAbstract
Objective
To determine the prevalence and possible variables associated with anal intraepithelial neoplasia and anal cancer in immunocompetent women with high-grade cervical intraepithelial neoplasia.
Methods
A cross-sectional study involving immunocompetent women with a histological diagnosis of high-grade cervical intraepithelial neoplasia and cervical cancer, conducted between January 2016 and September 2020. All women underwent anal cytology and answered a questionnaire on characterization and potential risk factors. Women with altered cytology were submitted to anoscopy and biopsy.
Results
A total of 69 women were included in the study. Of these, 7 (10.1%) had abnormal anal cytology results: (high-grade lesion, atypical squamous cells of undetermined significance, and atypical squamous cells, cannot exclude high-grade lesions: 28,5% each; low grade lesion: 14,3%). Of the anoscopies, 3 (42.8%) showed alterations. Of the 2 (28,5% of all abnormal cytology results) biopsies performed, only 1 showed low-grade anal intraepithelial neoplasia. The average number of pregnancies, vaginal deliveries, and abortions was associated with abnormal anal cytology. However, the highest mean regarding the cesarean sections was associated with normal cytology.
Conclusion
The prevalence of anal intraepithelial neoplasia was compatible with data from recent studies, especially those conducted in Brazil. Opportunistic screening for anal intraepithelial neoplasia in this high-risk population should be considered. Anal cytology is suitable for this purpose, due to its low cost and feasibility in public health services.
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. - Vivian de Oliveira Rodrigues Brum
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