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Original Article
Hazards of Repeat Pregnancy during Adolescence: A Case-control Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):437-443
08-01-2018
Summary
Original ArticleHazards of Repeat Pregnancy during Adolescence: A Case-control Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):437-443
08-01-2018Views150See moreAbstract
Objective
To evaluate the social, obstetric and psychological risk factors related to repeat pregnancy in teenagers.
Methods
A case control study conducted at Centro de Atenção à Saúde Integral da Mulher (Caism, in the Portuguese acronym), in Campinas, Brazil, from 2015 to 2017. Three groups were selected: a case-group of adolescents who had repeat pregnancy and two control-groups, one consisting of adolescents who had delivered at first time and another one of adult women with more than one deliveries. Participants were asked about habits, socio-demographics characteristics, reproductive and obstetric history and assessed psychological issues.
Results
Ninety women were enrolled, 30 in each study group. Adolescents with repeat pregnancy have lower self-esteem scores and more ineffective contraceptive use. When compared with teens at first delivery, they had less schooling level (odds ratio [OR] 4.03 [1.37-11.8]), more school abandon (OR 8.16 [2.36-28.2]) and drugs use (OR 4.97[1.39-17.8]). Non-white skin color (OR 6.2 [1.15-41.0]), drugs use (OR 17.5 [2.62-116.6]) and first sexual intercourse under 15y (OR 18.0[2.82-115.0]) were found as higher risk factors for repeat pregnancy when comparing adolescents and adults.Moreover, adolescents withmore than one gestation had lower self-esteem and greater susceptibility to unplanned pregnancy.
Conclusion
There was an association between repeat pregnancy among adolescents and lower education, early onset of sexual activity, non-white skin color, low use of contraception and increased use of drugs.
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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 ArticleHazards of Repeat Pregnancy during Adolescence: A Case-control Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):437-443
08-01-2018Views150See moreAbstract
Objective
To evaluate the social, obstetric and psychological risk factors related to repeat pregnancy in teenagers.
Methods
A case control study conducted at Centro de Atenção à Saúde Integral da Mulher (Caism, in the Portuguese acronym), in Campinas, Brazil, from 2015 to 2017. Three groups were selected: a case-group of adolescents who had repeat pregnancy and two control-groups, one consisting of adolescents who had delivered at first time and another one of adult women with more than one deliveries. Participants were asked about habits, socio-demographics characteristics, reproductive and obstetric history and assessed psychological issues.
Results
Ninety women were enrolled, 30 in each study group. Adolescents with repeat pregnancy have lower self-esteem scores and more ineffective contraceptive use. When compared with teens at first delivery, they had less schooling level (odds ratio [OR] 4.03 [1.37-11.8]), more school abandon (OR 8.16 [2.36-28.2]) and drugs use (OR 4.97[1.39-17.8]). Non-white skin color (OR 6.2 [1.15-41.0]), drugs use (OR 17.5 [2.62-116.6]) and first sexual intercourse under 15y (OR 18.0[2.82-115.0]) were found as higher risk factors for repeat pregnancy when comparing adolescents and adults.Moreover, adolescents withmore than one gestation had lower self-esteem and greater susceptibility to unplanned pregnancy.
Conclusion
There was an association between repeat pregnancy among adolescents and lower education, early onset of sexual activity, non-white skin color, low use of contraception and increased use of drugs.
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Original Article
Maternal Factors Associated with Low Birth Weight in Term Neonates: A Case-controlled Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):444-449
08-01-2018
Summary
Original ArticleMaternal Factors Associated with Low Birth Weight in Term Neonates: A Case-controlled Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):444-449
08-01-2018Views122See moreAbstract
Objective
To identify maternal factors associated with the presence of low birth weight in term neonates.
Methods
Matched hospital-based case-controlled study performed in a high complexity institution located in the city of Neiva, Colombia. The study included women with term gestation and singleton live fetuses. Patients with prior diseases, coming from other regions, with pregnancy resulting from assisted reproduction, or with a diagnosis of fetal abnormality or aneuploidy were excluded. Low birth weight was the dependent variable, and the independent variables that were analyzed were maternal sociodemographic and clinical characteristics. Adjusted and non-adjusted odds ratios (aOR and OR) together with the 95% confidence intervals (95% CI) were reported.
Results
The study included 270 participants (90 cases and 180 controls). Controlling for maternal age, educational level, socioeconomic and civil status, social security and the presence of maternal disease during gestation, it was found that weight gain (aOR 0.77, 95% CI 0.70-0.85) and the absence of prenatal care (aOR 8.20, 95% CI 3.22-20.87) were among the factors associated with low birth weight.
Conclusions
The absence of weight gain and of prenatal care are factors associated with the presence of low birth weight in term neonates and should be considered in clinical practice.
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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 ArticleMaternal Factors Associated with Low Birth Weight in Term Neonates: A Case-controlled Study
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):444-449
08-01-2018Views122See moreAbstract
Objective
To identify maternal factors associated with the presence of low birth weight in term neonates.
Methods
Matched hospital-based case-controlled study performed in a high complexity institution located in the city of Neiva, Colombia. The study included women with term gestation and singleton live fetuses. Patients with prior diseases, coming from other regions, with pregnancy resulting from assisted reproduction, or with a diagnosis of fetal abnormality or aneuploidy were excluded. Low birth weight was the dependent variable, and the independent variables that were analyzed were maternal sociodemographic and clinical characteristics. Adjusted and non-adjusted odds ratios (aOR and OR) together with the 95% confidence intervals (95% CI) were reported.
Results
The study included 270 participants (90 cases and 180 controls). Controlling for maternal age, educational level, socioeconomic and civil status, social security and the presence of maternal disease during gestation, it was found that weight gain (aOR 0.77, 95% CI 0.70-0.85) and the absence of prenatal care (aOR 8.20, 95% CI 3.22-20.87) were among the factors associated with low birth weight.
Conclusions
The absence of weight gain and of prenatal care are factors associated with the presence of low birth weight in term neonates and should be considered in clinical practice.
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Original Article
Gene Polymorphisms in FAS (Rs3740286 and Rs4064) Are Involved in Endometriosis Development in Brazilian Women, but not those in CASP8 (rs13416436 and rs2037815)
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):450-457
08-01-2018
Summary
Original ArticleGene Polymorphisms in FAS (Rs3740286 and Rs4064) Are Involved in Endometriosis Development in Brazilian Women, but not those in CASP8 (rs13416436 and rs2037815)
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):450-457
08-01-2018Views126Abstract
Objective
The present study aims to investigate the association between caspase-8 (CASP8) (rs13416436 and rs2037815) and Fas cell surface death receptor (FAS) (rs3740286 and rs4064) polymorphisms with endometriosis in Brazilian women.
Methods
In the present case-control study, 45 women with a diagnosis of endometriosis and 78 normal healthy women as a control group were included. The genotyping was determined by real-time polymerase chain reaction (PCR) with Taqman hydrolysis probes (Thermo Fisher Scientific, Darmstadt, Germany). Genotypic and allelic frequencies were analyzed using Chi-squared (χ2) test. In order to determine the inheritance models and haplotypes ,SNPStats (Institut Català d’Oncologia, Barcelona, Spain) was used. Levels of 5% (p = 0.05) were considered statistically significant.
Results
No significant difference was observed in genotypic or allelic frequencies between control and endometriosis groups for rs13416436 and rs2037815 (CASP8 gene). On the other hand, a significant difference between rs3740286 and rs4064 (FAS gene) was found. Regarding polymorphisms in the FAS gene, a statistically significant differencewas found in co-dominant and dominantmodels. Only the haplotype containing the rs3740286A and rs4064G alleles in the FAS gene were statistically significant.
Conclusion
The polymorphisms in the CASP8 gene were not associated with endometriosis. The results indicate an association between FAS gene polymorphisms and the risk of developing endometriosis.
Key-words ApoptosisEndometriosisGenetic polymorphismGenetic predisposition to diseaseReal-time polymerase chain reactionSee morePlumX Metrics- Citations
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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 ArticleGene Polymorphisms in FAS (Rs3740286 and Rs4064) Are Involved in Endometriosis Development in Brazilian Women, but not those in CASP8 (rs13416436 and rs2037815)
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):450-457
08-01-2018Views126Abstract
Objective
The present study aims to investigate the association between caspase-8 (CASP8) (rs13416436 and rs2037815) and Fas cell surface death receptor (FAS) (rs3740286 and rs4064) polymorphisms with endometriosis in Brazilian women.
Methods
In the present case-control study, 45 women with a diagnosis of endometriosis and 78 normal healthy women as a control group were included. The genotyping was determined by real-time polymerase chain reaction (PCR) with Taqman hydrolysis probes (Thermo Fisher Scientific, Darmstadt, Germany). Genotypic and allelic frequencies were analyzed using Chi-squared (χ2) test. In order to determine the inheritance models and haplotypes ,SNPStats (Institut Català d’Oncologia, Barcelona, Spain) was used. Levels of 5% (p = 0.05) were considered statistically significant.
Results
No significant difference was observed in genotypic or allelic frequencies between control and endometriosis groups for rs13416436 and rs2037815 (CASP8 gene). On the other hand, a significant difference between rs3740286 and rs4064 (FAS gene) was found. Regarding polymorphisms in the FAS gene, a statistically significant differencewas found in co-dominant and dominantmodels. Only the haplotype containing the rs3740286A and rs4064G alleles in the FAS gene were statistically significant.
Conclusion
The polymorphisms in the CASP8 gene were not associated with endometriosis. The results indicate an association between FAS gene polymorphisms and the risk of developing endometriosis.
Key-words ApoptosisEndometriosisGenetic polymorphismGenetic predisposition to diseaseReal-time polymerase chain reactionSee morePlumX Metrics- Citations
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Original Article
Frozen Section in the Management of Ovarian and Uterine Tumors: The Past 5 Years in a Tertiary Centre
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):458-464
08-01-2018
Summary
Original ArticleFrozen Section in the Management of Ovarian and Uterine Tumors: The Past 5 Years in a Tertiary Centre
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):458-464
08-01-2018Views100See moreAbstract
Objective
Intraoperative frozen section (IFS) is a valuable resource, and its use in gynecological pathology has not been sufficiently emphasized. The main goal of the present study is to evaluate the reliability and agreement rates between IFS and the final paraffin section (PS) and determine how reliable IFS is.
Methods
A retrospective study of all IFSs performed on uterine tumors and suspicious adnexal masses between January 2012 and December 2016 (excluding metastases) at the department of obstetrics and gynecology of the Centro Hospitalar Tondela Viseu. Frozen versus permanent section diagnosis were compared regarding the histologic type of the tumor, and the depth of myometrial invasion.
Results
A total of 286 cases were eligible for the present study, including 102 (35.7%) IFSs of uterine tumors, and 184 (64.3%) IFSs of ovarian tumors. The overall rate of deferred cases was 5.2% (15/286). The accuracy of the diagnosis in cases of endometrial carcinoma was 96.25% (77/80). Among the ovarian tumors, misdiagnoses occurred in 2 cases (1.1%), corresponding to a borderline tumor (serous type) and a clear cell intracystic adenocarcinoma.
Conclusion
The IFS analysis plays an important role in selected situations and is associated to a high sensitivity and specificity in cases of ovarian and endometrial tumors. Its high accuracy is almost universally associated with the possibility of obtaining an optimal surgical treatment at the time of the first surgical approach.
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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 ArticleFrozen Section in the Management of Ovarian and Uterine Tumors: The Past 5 Years in a Tertiary Centre
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):458-464
08-01-2018Views100See moreAbstract
Objective
Intraoperative frozen section (IFS) is a valuable resource, and its use in gynecological pathology has not been sufficiently emphasized. The main goal of the present study is to evaluate the reliability and agreement rates between IFS and the final paraffin section (PS) and determine how reliable IFS is.
Methods
A retrospective study of all IFSs performed on uterine tumors and suspicious adnexal masses between January 2012 and December 2016 (excluding metastases) at the department of obstetrics and gynecology of the Centro Hospitalar Tondela Viseu. Frozen versus permanent section diagnosis were compared regarding the histologic type of the tumor, and the depth of myometrial invasion.
Results
A total of 286 cases were eligible for the present study, including 102 (35.7%) IFSs of uterine tumors, and 184 (64.3%) IFSs of ovarian tumors. The overall rate of deferred cases was 5.2% (15/286). The accuracy of the diagnosis in cases of endometrial carcinoma was 96.25% (77/80). Among the ovarian tumors, misdiagnoses occurred in 2 cases (1.1%), corresponding to a borderline tumor (serous type) and a clear cell intracystic adenocarcinoma.
Conclusion
The IFS analysis plays an important role in selected situations and is associated to a high sensitivity and specificity in cases of ovarian and endometrial tumors. Its high accuracy is almost universally associated with the possibility of obtaining an optimal surgical treatment at the time of the first surgical approach.
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Original Article
A Simple, Reproducible and Low-cost Simulator for Teaching Surgical Techniques to Repair Obstetric Anal Sphincter Injuries
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):465-470
08-01-2018
Summary
Original ArticleA Simple, Reproducible and Low-cost Simulator for Teaching Surgical Techniques to Repair Obstetric Anal Sphincter Injuries
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):465-470
08-01-2018Views167See moreAbstract
Objective
To describe and evaluate the use of a simple, low-cost, and reproducible simulator for teaching the repair of obstetric anal sphincter injuries (OASIS).
Methods
Twenty resident doctors in obstetrics and gynecology and four obstetricians participated in the simulation. A fourth-degree tear model was created using lowcost materials (condom simulating the rectal mucosa, cotton tissue simulating the internal anal sphincter, and bovine meat simulating the external anal sphincter). The simulator was initially assembled with the aid of anatomical photos to study the anatomy and meaning of each component of the model. The laceration was created and repaired, using end-to-end or overlapping application techniques.
Results
The model cost less than R$ 10.00 and was assembled without difficulty, which improved the knowledge of the participants of anatomy and physiology. The sutures of the layers (rectal mucosa, internal sphincter, and external sphincter) were performed in keeping with the surgical technique. All participants were satisfied with the simulation and felt it improved their knowledge and skills. Between 3 and 6 months after the training, 7 participants witnessed severe lacerations in their practice and reported that the simulation was useful for surgical correction.
Conclusion
The use of a simulator for repair training in OASIS is affordable (low-cost and easy to perform). The simulation seems to improve the knowledge and surgical skills necessary to repair severe lacerations. Further systematized studies should be performed for evaluation.
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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 ArticleA Simple, Reproducible and Low-cost Simulator for Teaching Surgical Techniques to Repair Obstetric Anal Sphincter Injuries
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):465-470
08-01-2018Views167See moreAbstract
Objective
To describe and evaluate the use of a simple, low-cost, and reproducible simulator for teaching the repair of obstetric anal sphincter injuries (OASIS).
Methods
Twenty resident doctors in obstetrics and gynecology and four obstetricians participated in the simulation. A fourth-degree tear model was created using lowcost materials (condom simulating the rectal mucosa, cotton tissue simulating the internal anal sphincter, and bovine meat simulating the external anal sphincter). The simulator was initially assembled with the aid of anatomical photos to study the anatomy and meaning of each component of the model. The laceration was created and repaired, using end-to-end or overlapping application techniques.
Results
The model cost less than R$ 10.00 and was assembled without difficulty, which improved the knowledge of the participants of anatomy and physiology. The sutures of the layers (rectal mucosa, internal sphincter, and external sphincter) were performed in keeping with the surgical technique. All participants were satisfied with the simulation and felt it improved their knowledge and skills. Between 3 and 6 months after the training, 7 participants witnessed severe lacerations in their practice and reported that the simulation was useful for surgical correction.
Conclusion
The use of a simulator for repair training in OASIS is affordable (low-cost and easy to perform). The simulation seems to improve the knowledge and surgical skills necessary to repair severe lacerations. Further systematized studies should be performed for evaluation.
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-
Original Article
Perineal Trauma in a Low-risk Maternity with High Prevalence of Upright Position during the Second Stage of Labor
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):379-383
07-01-2018
Summary
Original ArticlePerineal Trauma in a Low-risk Maternity with High Prevalence of Upright Position during the Second Stage of Labor
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):379-383
07-01-2018Views196See moreAbstract
Objective
Perineal trauma is a negative outcome during labor, and until now it is unclear if the maternal position during the second stage of labormay influence the risk of acquiring severe perineal trauma. We have aimed to determine the prevalence of perineal trauma and its risk factors in a low-risk maternity with a high incidence of upright position during the second stage of labor.
Methods
A retrospective cohort study of 264 singleton pregnancies during labor was performed at a low-risk pregnancymaternity during a 6-month period. Perineal trauma was classified according to the Royal College of Obstetricians and Gynecologists (RCOG), and perineal integrity was divided into three categories: no tears; first/ second-degree tears + episiotomy; and third and fourth-degree tears. A multinomial analysis was performed to search for associated factors of perineal trauma.
Results
From a total of 264 women, there were 2 cases (0.75%) of severe perineal trauma, which occurred in nulliparous women younger than 25 years old. Approximately 46% (121) of the women had no tears, and 7.95% (21) performed mediolateral episiotomies. Perineal trauma was not associated with maternal position (p = 0.285), health professional (obstetricians or midwives; p = 0.231), newborns with 4 kilos or more (p = 0.672), and labor analgesia (p = 0.319). The multinomial analysis showed that white and nulliparous presented, respectively, 3.90 and 2.90 times more risk of presenting perineal tears.
Conclusion
The incidence of severe perineal trauma was low. The prevalence of upright position during the second stage of labor was 42%. White and nulliparous women were more prone to develop perineal tears.
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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 ArticlePerineal Trauma in a Low-risk Maternity with High Prevalence of Upright Position during the Second Stage of Labor
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):379-383
07-01-2018Views196See moreAbstract
Objective
Perineal trauma is a negative outcome during labor, and until now it is unclear if the maternal position during the second stage of labormay influence the risk of acquiring severe perineal trauma. We have aimed to determine the prevalence of perineal trauma and its risk factors in a low-risk maternity with a high incidence of upright position during the second stage of labor.
Methods
A retrospective cohort study of 264 singleton pregnancies during labor was performed at a low-risk pregnancymaternity during a 6-month period. Perineal trauma was classified according to the Royal College of Obstetricians and Gynecologists (RCOG), and perineal integrity was divided into three categories: no tears; first/ second-degree tears + episiotomy; and third and fourth-degree tears. A multinomial analysis was performed to search for associated factors of perineal trauma.
Results
From a total of 264 women, there were 2 cases (0.75%) of severe perineal trauma, which occurred in nulliparous women younger than 25 years old. Approximately 46% (121) of the women had no tears, and 7.95% (21) performed mediolateral episiotomies. Perineal trauma was not associated with maternal position (p = 0.285), health professional (obstetricians or midwives; p = 0.231), newborns with 4 kilos or more (p = 0.672), and labor analgesia (p = 0.319). The multinomial analysis showed that white and nulliparous presented, respectively, 3.90 and 2.90 times more risk of presenting perineal tears.
Conclusion
The incidence of severe perineal trauma was low. The prevalence of upright position during the second stage of labor was 42%. White and nulliparous women were more prone to develop perineal tears.
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Original Article
First-trimester Combined Screening Test for Aneuploidies in Brazilian Unselected Pregnancies: Diagnostic Performance of Fetal Medicine Foundation Algorithm
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):384-389
07-01-2018
Summary
Original ArticleFirst-trimester Combined Screening Test for Aneuploidies in Brazilian Unselected Pregnancies: Diagnostic Performance of Fetal Medicine Foundation Algorithm
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):384-389
07-01-2018Views108Abstract
Objective
The main objective of this study was to examine the diagnostic performance of the first-trimester combined test for aneuploidies in unselected pregnancies from Rio de Janeiro and compare it with the examples available in the literature.
Methods
We investigated 3,639 patients submitted to aneuploidy screening from February 2009 to September 2015. The examination is composed of the Fetal Medicine Foundation risk evaluation based on nuchal translucency evaluation, mother’s age, presence of risk factors, presence of the nasal bone and Doppler of the ductus venous in addition to biochemical analysis of pregnancy-associated plasma protein A (PAPP-A) and beta-human chorionic gonadotropin (β-hCG) markers. The cut-off point for high risk for aneuploidies was defined as greater than 1:100, with intermediate risk defined between 1:100 and 1:1,000, and low risk defined as less than 1:1,000. The variable aneuploidy was considered as a result not only of trisomy of chromosome 21 but also trisomy of chromosomes 13 and 18.
Results
Excluding the losses, the results of 2,748 patients were analyzed. The firsttrimester combined test achieved 71.4% sensitivity with a 7.4% false-positive (FP) rate, specificity of 92.6%, positive predictive value (PPV) of 6.91% and negative predictive value (NPV) of 99.76%, when the cut-off point considered was greater than 1:1,000. Through a receiving operating characteristics (ROC) curve, the cut-off point that maximized the sensitivity and specificity for the diagnosis of aneuploidies was defined as 1:1,860. When we adjusted the false-positive (FP) rate to 5%, the detection rate for this analysis is 72.7%, with a cut-off point of 1:610.
Conclusion
The combined test of aneuploidy screening showed a detection rate inferior to those described in the literature for a higher FP rate.
Key-words Aneuploidybiomarkerschromosomal anomaliesNuchal translucency measurementPAPP-APregnancy complicationsscreen tests on maternal serumTrisomy 21β-HCGSee morePlumX Metrics- Citations
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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 ArticleFirst-trimester Combined Screening Test for Aneuploidies in Brazilian Unselected Pregnancies: Diagnostic Performance of Fetal Medicine Foundation Algorithm
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):384-389
07-01-2018Views108Abstract
Objective
The main objective of this study was to examine the diagnostic performance of the first-trimester combined test for aneuploidies in unselected pregnancies from Rio de Janeiro and compare it with the examples available in the literature.
Methods
We investigated 3,639 patients submitted to aneuploidy screening from February 2009 to September 2015. The examination is composed of the Fetal Medicine Foundation risk evaluation based on nuchal translucency evaluation, mother’s age, presence of risk factors, presence of the nasal bone and Doppler of the ductus venous in addition to biochemical analysis of pregnancy-associated plasma protein A (PAPP-A) and beta-human chorionic gonadotropin (β-hCG) markers. The cut-off point for high risk for aneuploidies was defined as greater than 1:100, with intermediate risk defined between 1:100 and 1:1,000, and low risk defined as less than 1:1,000. The variable aneuploidy was considered as a result not only of trisomy of chromosome 21 but also trisomy of chromosomes 13 and 18.
Results
Excluding the losses, the results of 2,748 patients were analyzed. The firsttrimester combined test achieved 71.4% sensitivity with a 7.4% false-positive (FP) rate, specificity of 92.6%, positive predictive value (PPV) of 6.91% and negative predictive value (NPV) of 99.76%, when the cut-off point considered was greater than 1:1,000. Through a receiving operating characteristics (ROC) curve, the cut-off point that maximized the sensitivity and specificity for the diagnosis of aneuploidies was defined as 1:1,860. When we adjusted the false-positive (FP) rate to 5%, the detection rate for this analysis is 72.7%, with a cut-off point of 1:610.
Conclusion
The combined test of aneuploidy screening showed a detection rate inferior to those described in the literature for a higher FP rate.
Key-words Aneuploidybiomarkerschromosomal anomaliesNuchal translucency measurementPAPP-APregnancy complicationsscreen tests on maternal serumTrisomy 21β-HCGSee morePlumX Metrics- Citations
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Original Article
Surgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):390-396
07-01-2018
Summary
Original ArticleSurgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):390-396
07-01-2018Views163See moreAbstract
Objective
To outline the demographic and clinical characteristics of patients with deep intestinal endometriosis submitted to surgical treatment at a tertiary referral center with a multidisciplinary team, and correlate those characteristics with the surgical procedures performed and operative complications.
Methods
A prospective cohort from February 2012 to November 2016 of 32 women with deep intestinal endometriosis operations. The variables analyzed were: age; obesity; preoperative symptoms (dysmenorrhea, dyspareunia, acyclic pain, dyschezia, infertility, urinary symptoms, constipation and intestinal bleeding); previous surgery for endometriosis; Enzian classification; size of the intestinal lesion; and surgical complications.
Results
Themean age was 37.75 (±5.72) years. A total of 7 patients (22%) had a prior history of endometriosis. The mean of the largest diameter of the intestinal lesions identified intraoperatively was of 28.12 mm (±14.29 mm). In the Enzian classification, there was a predominance of lesions of the rectum and sigmoid, comprising 30 cases (94%). There were no statistically significant associations between the predictor variables and the outcome complications, even after the multiple logistic regression analysis. Regarding the size of the lesion, there was also no significant correlation with the outcome complications (p = 0.18; 95% confidence interval [95%CI]:0.94-1.44); however, there was a positive association between grade 3 of the Enzia classification and the more extensive surgical techniques: segmental intestinal resection and rectosigmoidectomy, with a prevalence risk of 4.4 (p < 0.001; 95%CI:1.60-12.09).
Conclusion
The studied sample consisted of highly symptomatic women. A high prevalence of deep infiltrative endometriosis lesions was found located in the rectum and sigmoid region, and their size correlated directly with the extent of the surgical resection performed.
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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 ArticleSurgical Treatment of Intestinal Endometriosis: Outcomes of Three Different Techniques
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(7):390-396
07-01-2018Views163See moreAbstract
Objective
To outline the demographic and clinical characteristics of patients with deep intestinal endometriosis submitted to surgical treatment at a tertiary referral center with a multidisciplinary team, and correlate those characteristics with the surgical procedures performed and operative complications.
Methods
A prospective cohort from February 2012 to November 2016 of 32 women with deep intestinal endometriosis operations. The variables analyzed were: age; obesity; preoperative symptoms (dysmenorrhea, dyspareunia, acyclic pain, dyschezia, infertility, urinary symptoms, constipation and intestinal bleeding); previous surgery for endometriosis; Enzian classification; size of the intestinal lesion; and surgical complications.
Results
Themean age was 37.75 (±5.72) years. A total of 7 patients (22%) had a prior history of endometriosis. The mean of the largest diameter of the intestinal lesions identified intraoperatively was of 28.12 mm (±14.29 mm). In the Enzian classification, there was a predominance of lesions of the rectum and sigmoid, comprising 30 cases (94%). There were no statistically significant associations between the predictor variables and the outcome complications, even after the multiple logistic regression analysis. Regarding the size of the lesion, there was also no significant correlation with the outcome complications (p = 0.18; 95% confidence interval [95%CI]:0.94-1.44); however, there was a positive association between grade 3 of the Enzia classification and the more extensive surgical techniques: segmental intestinal resection and rectosigmoidectomy, with a prevalence risk of 4.4 (p < 0.001; 95%CI:1.60-12.09).
Conclusion
The studied sample consisted of highly symptomatic women. A high prevalence of deep infiltrative endometriosis lesions was found located in the rectum and sigmoid region, and their size correlated directly with the extent of the surgical resection performed.
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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. 
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