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Original Article01-23-2022
Experience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
- Karen Hiromi Mori
, - Bárbara Virgínia Tavares ,
- Daniela Angerame Yela ,
- Luis Francisco Cintra Baccaro ,
- Cassia Raquel Teatin Juliato
Abstract
Original ArticleExperience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1014-1020
- Karen Hiromi Mori ,
- Bárbara Virgínia Tavares ,
- Daniela Angerame Yela ,
- Luis Francisco Cintra Baccaro ,
- Cassia Raquel Teatin Juliato
Views153See moreAbstract
Objective
Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years.
Methods
A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018.
Results
We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome.
Conclusion
Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.
Views153
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. Abstract
Original ArticleExperience of a Tertiary Service in the Treatment of Women with Cervical Pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1014-1020
- Karen Hiromi Mori ,
- Bárbara Virgínia Tavares ,
- Daniela Angerame Yela ,
- Luis Francisco Cintra Baccaro ,
- Cassia Raquel Teatin Juliato
Views153See moreAbstract
Objective
Cervical pregnancy is challenging for the medical community, as it is potentially fatal. The treatment can be medical or surgical; however, there are no protocols that establish the best option for each case. The objective of the present study was to describe the cases of cervical pregnancy admitted to a tertiary university hospital over a period of 18 years.
Methods
A retrospective study based on a review of the medical records of all cervical pregnancies admitted to the Women's Hospital at Universidade Estadual de Campinas, Southeastern Brazil, from 2000 to 2018.
Results
We identified 13 cases of cervical pregnancy out of a total of 673 ectopic pregnancies; only 1 case was initially treated with surgery because of hemodynamic instability. Of the 12 cases treated conservatively, 7 were treated with single-dose intramuscular methotrexate, 1, with intravenous and intramuscular methotrexate, 1, with intravenous methotrexate, 1, with 2 doses of intramuscular methotrexate, and 2, with intra-amniotic methotrexate. Of these cases, one had a therapeutic failure that required a hysterectomy. Two women received blood transfusions. Four women required cervical tamponade with a Foley catheter balloon for hemostasis. There was no fatal outcome.
Conclusion
Cervical pregnancy is a rare and challenging condition from diagnosis to treatment. Conservative treatment was the primary method of therapy used, with satisfactory results. In cases of increased bleeding, cervical curettage was the initial treatment, and it was associated with the use of a cervical balloon for hemostasis.
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. - Karen Hiromi Mori
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Original Article01-23-2022
Development and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines
- Cláudia Raulino Tramontt ,
- Juliana Giaj Levra de Jesus ,
- Thanise Sabrina Souza Santos ,
- Fernanda Rauber ,
- Maria Laura da Costa Louzada , [ ... ],
- Patrícia Constante Jaime
Abstract
Original ArticleDevelopment and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1021-1031
- Cláudia Raulino Tramontt ,
- Juliana Giaj Levra de Jesus ,
- Thanise Sabrina Souza Santos ,
- Fernanda Rauber ,
- Maria Laura da Costa Louzada ,
- Vanessa Del Castillo Couto ,
- Jacqueline Resende Berriel Hochberg ,
- Patrícia Constante Jaime
Views165Abstract
Objective
To develop and validate a protocol for the use of the Dietary Guidelines for the Brazilian Population (DGBP) in the individual dietary advice for pregnant women assisted in primary healthcare (PHC).
Methods
Methodological study that involved the elaboration of a protocol in six steps: definition of the format, definition of the instrument to evaluate food consumption, systematization of evidence on food and nutrition needs of pregnant women, extraction of DGBP recommendations, development of messages of dietary guidelines and content, and face validity. The analyses of the validation steps were carried out by calculating the Content Validity Index (CVI) and thematic content analysis.
Results
As products of the steps, the protocol structure was defined and the dietary advice for pregnant women were elaborated, considering physiological changes, food consumption, nutritional and health needs, and socioeconomic conditions of this population. The protocol was well evaluated by experts and health professionals in terms of clarity, relevance (CVI > 0.8), and applicability. In addition, the participants made some suggestions to improve the clarity of the messages and to expand the applicability of the instrument with Brazilian pregnant women.
Conclusion
The instrument developed fills a gap in clinical protocols on dietary advice for pregnant women focused on promoting a healthy diet, contributing to a healthy pregnancy. In addition, it demonstrates potential to contribute to the qualification of PHC professionals and to the implementation of the DGBP recommendations.
Key-words dietary guidelinespractice guidelinesPrenatal nutritionPrimary health carevalidation studySee moreViews165This 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. Abstract
Original ArticleDevelopment and Validation of a Protocol for Pregnant Women Based on the Brazilian Dietary Guidelines
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(11):1021-1031
- Cláudia Raulino Tramontt ,
- Juliana Giaj Levra de Jesus ,
- Thanise Sabrina Souza Santos ,
- Fernanda Rauber ,
- Maria Laura da Costa Louzada ,
- Vanessa Del Castillo Couto ,
- Jacqueline Resende Berriel Hochberg ,
- Patrícia Constante Jaime
Views165Abstract
Objective
To develop and validate a protocol for the use of the Dietary Guidelines for the Brazilian Population (DGBP) in the individual dietary advice for pregnant women assisted in primary healthcare (PHC).
Methods
Methodological study that involved the elaboration of a protocol in six steps: definition of the format, definition of the instrument to evaluate food consumption, systematization of evidence on food and nutrition needs of pregnant women, extraction of DGBP recommendations, development of messages of dietary guidelines and content, and face validity. The analyses of the validation steps were carried out by calculating the Content Validity Index (CVI) and thematic content analysis.
Results
As products of the steps, the protocol structure was defined and the dietary advice for pregnant women were elaborated, considering physiological changes, food consumption, nutritional and health needs, and socioeconomic conditions of this population. The protocol was well evaluated by experts and health professionals in terms of clarity, relevance (CVI > 0.8), and applicability. In addition, the participants made some suggestions to improve the clarity of the messages and to expand the applicability of the instrument with Brazilian pregnant women.
Conclusion
The instrument developed fills a gap in clinical protocols on dietary advice for pregnant women focused on promoting a healthy diet, contributing to a healthy pregnancy. In addition, it demonstrates potential to contribute to the qualification of PHC professionals and to the implementation of the DGBP recommendations.
Key-words dietary guidelinespractice guidelinesPrenatal nutritionPrimary health carevalidation studySee 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. - Cláudia Raulino Tramontt
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Original Article01-23-2022
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
Abstract
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
- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo ,
- Omar Féres
Views121See 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.
Views121This 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. Abstract
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
- Rogério Serafim Parra ,
- Fernando Passador Valério ,
- José Vitor Cabral Zanardi ,
- Marley Ribeiro Feitosa ,
- Hugo Parra Camargo ,
- Omar Féres
Views121See 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 Article01-06-2022
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
Abstract
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
Views180See 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.
Views180This 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. Abstract
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
Views180See 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 Article09-06-2022
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
Abstract
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
- 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
Views224See 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.
Views224This 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. Abstract
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
- 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
Views224See 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 Article09-06-2022
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
Abstract
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
- Carla Dinamerica Kobayashi ,
- Victor Bertollo Gomes Porto ,
- Martha Elizabeth Brasil da Nóbrega ,
- Cibelle Mendes Cabral ,
- Tiago Dahrug Barros ,
- Cecília Maria Roteli Martins
Views199See 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.
Views199This 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. Abstract
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
- Carla Dinamerica Kobayashi ,
- Victor Bertollo Gomes Porto ,
- Martha Elizabeth Brasil da Nóbrega ,
- Cibelle Mendes Cabral ,
- Tiago Dahrug Barros ,
- Cecília Maria Roteli Martins
Views199See 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 Article09-06-2022
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
Abstract
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
- 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
Views322Abstract
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 moreViews322This 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. Abstract
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
- 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
Views322Abstract
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 Article08-29-2022
Use of Urodynamics by Gynecologists and Urologists in Brazil
- Mucio Barata Diniz ,
- Marina Franklin Ribeiro ,
- Luísa Aguiar Monteiro Dias ,
- Marilene Vale de Castro Monteiro
Abstract
Original ArticleUse of Urodynamics by Gynecologists and Urologists in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):654-659
- Mucio Barata Diniz ,
- Marina Franklin Ribeiro ,
- Luísa Aguiar Monteiro Dias ,
- Marilene Vale de Castro Monteiro
Views113See 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.
Views113This 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. Abstract
Original ArticleUse of Urodynamics by Gynecologists and Urologists in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):654-659
- Mucio Barata Diniz ,
- Marina Franklin Ribeiro ,
- Luísa Aguiar Monteiro Dias ,
- Marilene Vale de Castro Monteiro
Views113See 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
Original Article Archives - Revista Brasileira de Ginecologia e Obstetrícia
