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Original Article
Follicle Viability after Vitrification of Bovine Ovarian Tissue
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):614-621
11-01-2017
Summary
Original ArticleFollicle Viability after Vitrification of Bovine Ovarian Tissue
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):614-621
11-01-2017Views87See moreAbstract
Purpose
The present study aimed to evaluate the impact of vitrification on the viability of follicles using a three-dimensional (3D) in vitro culture.
Methods
Bovine ovarian tissue samples (n = 5) obtained from slaughterhouses were utilized. The cortex was cut into small fragments of 2 x 3 x 0.5 mm using a tissue slicer. From these fragments, secondary follicles were first isolated by mechanical and enzymatic methods, then encapsulated in alginate gel and individually cultured for 20 days. Additional fragments of the same ovarian tissue were vitrified in a solution containing 25% glycerol and 25% ethylene glycol. After warming, the follicles underwent the same follicular isolation process that was performed for the fresh follicles.
Results
A total of 61 follicles were isolated, 51 from fresh ovarian tissue, and 10 from vitrified tissue. After the culture, the vitrified and fresh follicles showed 20% and 43.1% survival rates respectively (p = 0.290),with no significant differences. At the end of the culture, therewere no significant differences in follicular diameter between the vitrified (422.93 ± 85.05 μm) and fresh (412.99 ± 102.55 μm) groups (p = 0.725). Fresh follicles showed higher mean rate of antrum formation when compared with vitrified follicles (47.1% and 20.0% respectively), but without significant difference (p = 0.167).
Conclusions
The follicles were able to develop, grow and form antrum in the 3D system after vitrification, despite the lower results obtained with the fresh tissue.
Views87
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 ArticleFollicle Viability after Vitrification of Bovine Ovarian Tissue
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(11):614-621
11-01-2017Views87See moreAbstract
Purpose
The present study aimed to evaluate the impact of vitrification on the viability of follicles using a three-dimensional (3D) in vitro culture.
Methods
Bovine ovarian tissue samples (n = 5) obtained from slaughterhouses were utilized. The cortex was cut into small fragments of 2 x 3 x 0.5 mm using a tissue slicer. From these fragments, secondary follicles were first isolated by mechanical and enzymatic methods, then encapsulated in alginate gel and individually cultured for 20 days. Additional fragments of the same ovarian tissue were vitrified in a solution containing 25% glycerol and 25% ethylene glycol. After warming, the follicles underwent the same follicular isolation process that was performed for the fresh follicles.
Results
A total of 61 follicles were isolated, 51 from fresh ovarian tissue, and 10 from vitrified tissue. After the culture, the vitrified and fresh follicles showed 20% and 43.1% survival rates respectively (p = 0.290),with no significant differences. At the end of the culture, therewere no significant differences in follicular diameter between the vitrified (422.93 ± 85.05 μm) and fresh (412.99 ± 102.55 μm) groups (p = 0.725). Fresh follicles showed higher mean rate of antrum formation when compared with vitrified follicles (47.1% and 20.0% respectively), but without significant difference (p = 0.167).
Conclusions
The follicles were able to develop, grow and form antrum in the 3D system after vitrification, despite the lower results obtained with the fresh tissue.
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
Induction of Labor using Misoprostol in a Tertiary Hospital in the Southeast of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):523-528
10-01-2017
Summary
Original ArticleInduction of Labor using Misoprostol in a Tertiary Hospital in the Southeast of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):523-528
10-01-2017Views219See moreAbstract
Purpose
To assess cases of labor induction with vaginal 25-μg tablets of misoprostol and maternal outcomes in a tertiary hospital in southeastern Brazil.
Methods
This was a retrospective cohort study of 412 pregnant women with indication for labor induction. Labor induction was performed with vaginal 25-μg tablets ofmisoprostol in pregnant women with Bishop scores < 6. Stepwise regression analysis was used to identify the factors present at the beginning of induction that could be used as predictors of successful labor induction.
Results
A total of 69% of the pregnant women who underwent labor induction progressed to vaginal delivery, and 31% of the women progressed to cesarean section. One or two misoprostol tablets were used in 244 patients (59.2%). Of the 412 patients, 197 (47.8%) required oxytocin later on in the labor process, after induction with misoprostol. The stepwise regression analysis showed that only Bishop scores of 4 and 5 and previous vaginal delivery were independent factors with statistical significance in the prediction of successful vaginal labor induction (β = 0.23, p < 0.001, for a Bishop score of 4 and 5, and β = 0.22, p < 0.001, for previous vaginal delivery).
Conclusion
Higher Bishop scores and previous vaginal delivery were the best predictors of successful labor induction with vaginal 25-μg tablets of misoprostol.
Views219This 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 ArticleInduction of Labor using Misoprostol in a Tertiary Hospital in the Southeast of Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):523-528
10-01-2017Views219See moreAbstract
Purpose
To assess cases of labor induction with vaginal 25-μg tablets of misoprostol and maternal outcomes in a tertiary hospital in southeastern Brazil.
Methods
This was a retrospective cohort study of 412 pregnant women with indication for labor induction. Labor induction was performed with vaginal 25-μg tablets ofmisoprostol in pregnant women with Bishop scores < 6. Stepwise regression analysis was used to identify the factors present at the beginning of induction that could be used as predictors of successful labor induction.
Results
A total of 69% of the pregnant women who underwent labor induction progressed to vaginal delivery, and 31% of the women progressed to cesarean section. One or two misoprostol tablets were used in 244 patients (59.2%). Of the 412 patients, 197 (47.8%) required oxytocin later on in the labor process, after induction with misoprostol. The stepwise regression analysis showed that only Bishop scores of 4 and 5 and previous vaginal delivery were independent factors with statistical significance in the prediction of successful vaginal labor induction (β = 0.23, p < 0.001, for a Bishop score of 4 and 5, and β = 0.22, p < 0.001, for previous vaginal delivery).
Conclusion
Higher Bishop scores and previous vaginal delivery were the best predictors of successful labor induction with vaginal 25-μg tablets of misoprostol.
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
Medical Termination of Delayed Miscarriage: Four-Year Experience with an Outpatient Protocol
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):529-533
10-01-2017
Summary
Original ArticleMedical Termination of Delayed Miscarriage: Four-Year Experience with an Outpatient Protocol
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):529-533
10-01-2017Views94See moreAbstract
Purpose
To evaluate the efficacy of an outpatient protocol with vaginal misoprostol to treat delayed miscarriage.
Methods
Retrospective analysis of prospectively collected data on women medically treated for missed abortion with an outpatient protocol. The inclusion criteria were: ultrasound-based diagnosis of missed abortion with less than 10 weeks; no heavy bleeding, infection, inflammatory bowel disease ormisoprostol allergy; nomore than 2 previous spontaneous abortions; the preference of the patient regarding the medical management. The protocol consisted of: 1) a single dose of 800 μg of misoprostol administered intravaginally at the emergency department, after which the patients were discharged home; 2) clinical and ultrasonographic evaluation 48 hours later - if the intrauterine gestational sac was still present, the application of 800 μg of vaginal misoprostol was repeated, and the patients were discharged home; 3) clinical and ultrasonography evaluation 7 days after the initiation of the protocol - if the intrauterine gestational sac was still present, surgical management was proposed. The protocol was introduced in January 2012. Every woman received oral analgesia and written general recommendations. We also gave them a paper form to be presented and filled out at each evaluation.
Results
Complete miscarriage with misoprostol occurred in 340 women (90.2%). Surgery was performed in 37 (9.8%) patients, representing the global failure rate of the protocol. Miscarriage was completed after the first misoprostol administration in 208 (55.2%) women, with a success rate after the second administration of 78.1% (132/169). The average age of the women with complete resolution using misoprostol was superior to the average age of those who required surgery (33.99 years versus 31.74 years; p = 0.031). Based on the ultrasonographic findings in the first evaluation, the women diagnosed with fetal loss achieved greater success rates compared with those diagnosed with empty sac (p = 0.049).
Conclusions
We conclude this is an effective and safe option in the majority of delayed miscarriage cases during the first trimester, reducing surgical procedures and their consequences.
Views94This 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 ArticleMedical Termination of Delayed Miscarriage: Four-Year Experience with an Outpatient Protocol
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):529-533
10-01-2017Views94See moreAbstract
Purpose
To evaluate the efficacy of an outpatient protocol with vaginal misoprostol to treat delayed miscarriage.
Methods
Retrospective analysis of prospectively collected data on women medically treated for missed abortion with an outpatient protocol. The inclusion criteria were: ultrasound-based diagnosis of missed abortion with less than 10 weeks; no heavy bleeding, infection, inflammatory bowel disease ormisoprostol allergy; nomore than 2 previous spontaneous abortions; the preference of the patient regarding the medical management. The protocol consisted of: 1) a single dose of 800 μg of misoprostol administered intravaginally at the emergency department, after which the patients were discharged home; 2) clinical and ultrasonographic evaluation 48 hours later - if the intrauterine gestational sac was still present, the application of 800 μg of vaginal misoprostol was repeated, and the patients were discharged home; 3) clinical and ultrasonography evaluation 7 days after the initiation of the protocol - if the intrauterine gestational sac was still present, surgical management was proposed. The protocol was introduced in January 2012. Every woman received oral analgesia and written general recommendations. We also gave them a paper form to be presented and filled out at each evaluation.
Results
Complete miscarriage with misoprostol occurred in 340 women (90.2%). Surgery was performed in 37 (9.8%) patients, representing the global failure rate of the protocol. Miscarriage was completed after the first misoprostol administration in 208 (55.2%) women, with a success rate after the second administration of 78.1% (132/169). The average age of the women with complete resolution using misoprostol was superior to the average age of those who required surgery (33.99 years versus 31.74 years; p = 0.031). Based on the ultrasonographic findings in the first evaluation, the women diagnosed with fetal loss achieved greater success rates compared with those diagnosed with empty sac (p = 0.049).
Conclusions
We conclude this is an effective and safe option in the majority of delayed miscarriage cases during the first trimester, reducing surgical procedures and their consequences.
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
Incidence of Bacteriuria after Urodynamic Study with or without Antibiotic Prophylaxis in Women with Urinary Incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):534-540
10-01-2017
Summary
Original ArticleIncidence of Bacteriuria after Urodynamic Study with or without Antibiotic Prophylaxis in Women with Urinary Incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):534-540
10-01-2017Views100See moreAbstract
Introduction
The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study.
Methods
Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS.
Results
We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria.We didn’t observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group.
Conclusion
The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.
Views100This 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 ArticleIncidence of Bacteriuria after Urodynamic Study with or without Antibiotic Prophylaxis in Women with Urinary Incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):534-540
10-01-2017Views100See moreAbstract
Introduction
The presence of bacteria in urine is called bacteriuria, which may be symptomatic or asymptomatic. The manipulation of the urinary tract during urodynamic study (UDS), which is an invasive procedure, can result in urinary tract infection (UTI). Studies on the use of prophylactic antibiotics for UDSs are contradictory. Some investigators concluded that they were valuable and others did not. The objective of this study is to evaluate the efficacy of antibiotic prophylaxis before UDS. This is a placebo-control randomized double-blind study.
Methods
Two-hundred and seventeen women affected by urinary incontinence were eligible for this study. All patients had presented negative urine culture previous to the UDS. They were randomized in four groups: group A received placebo, group B received 500 mg of levofloxacin, group C received 80 mg trimethoprim and 400 mg sulfamethoxazole and group D received 100 mg of nitrofurantoin. A urine culture was performed 14 days after the UDS.
Results
We observed asymptomatic bacteriuria after the UDS in five patients in group A, one in group B, one in group C and one in group D. Only one patient on group A had symptomatic bacteriuria.We didn’t observe statistical difference between the groups. When we recategorized the patients in two groups, the incidence of bacteriuria was significantly higher in the placebo group compared with the antibiotic group.
Conclusion
The conclusion is that antibiotic prophylaxis before the UDS did not reduce the incidence of UTI in women within the target population.
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
Sirtuin 1 Levels in Recurrent Implantation Failure
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):541-544
10-01-2017
Summary
Original ArticleSirtuin 1 Levels in Recurrent Implantation Failure
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):541-544
10-01-2017Views95See moreAbstract
Sirtuin 1 has an important role in cellular processes, including apoptosis and cellular stress. The purpose of this study was to assess serum sirtuin 1 levels in women with recurrent implantation failure (RIF). In this cross-sectional study, we included 28 women with RIF, 29 healthy women who had conceived by in vitro fertilization (IVF), and 30 women with a 1-cycle failure of IVF as controls. Human serum nicotinamide adenine dinucleotide (NAD)-dependent deacetylase sirtuin-1 (SIRT1/SIRT2L1) levels were detected using a commercial colorimetric kit. Recurrent implantation failure patients have higher sirtuin 1 levels than non-pregnant women and healthy pregnant women, but this difference did not reach statistical significance due to the low number of patients in our study. These higher sirtuin 1 levels may result from the inflammation imbalance of RIF patients. The only statistically significant correlation found was between age and sirtuin (r = 0.277, p = 0.009).
Views95This 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 ArticleSirtuin 1 Levels in Recurrent Implantation Failure
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):541-544
10-01-2017Views95See moreAbstract
Sirtuin 1 has an important role in cellular processes, including apoptosis and cellular stress. The purpose of this study was to assess serum sirtuin 1 levels in women with recurrent implantation failure (RIF). In this cross-sectional study, we included 28 women with RIF, 29 healthy women who had conceived by in vitro fertilization (IVF), and 30 women with a 1-cycle failure of IVF as controls. Human serum nicotinamide adenine dinucleotide (NAD)-dependent deacetylase sirtuin-1 (SIRT1/SIRT2L1) levels were detected using a commercial colorimetric kit. Recurrent implantation failure patients have higher sirtuin 1 levels than non-pregnant women and healthy pregnant women, but this difference did not reach statistical significance due to the low number of patients in our study. These higher sirtuin 1 levels may result from the inflammation imbalance of RIF patients. The only statistically significant correlation found was between age and sirtuin (r = 0.277, p = 0.009).
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
Clinical Characteristics in a Sample of Transsexual People
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):545-551
10-01-2017
Summary
Original ArticleClinical Characteristics in a Sample of Transsexual People
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):545-551
10-01-2017Views163See moreAbstract
Purpose
To assess the clinical characteristics of subjects with gender dysphoria (GD).
Method
A cross-sectional study of adults with GD. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Sociodemographic data, clinical data and life habits were recorded.
Results
Total of 44 subjects participated in the study: 36 (82%) trans women and 8 (18%) trans men. Forty-three (98%) of the GD patients had anxiety (36 [100%] trans women and 7 [87.5%] trans men), and 36 (82%) had depression (29 [80.5%] trans women and 7 [87.5%] trans men). Suicide had been attempted by 32 (73%) subjects. The rates of depression were lower among the subjects living with partners, parents, or other people than among those living alone (p = 0.03), and it was also lower among the subjects who were married compared to those who were dating or single (p = 0.03).
Conclusion
Improving the relationship status may reduce the prevalence of depressive symptoms in GD patients. There was a high rate of attempted suicide in this sample.
Views163This 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 ArticleClinical Characteristics in a Sample of Transsexual People
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):545-551
10-01-2017Views163See moreAbstract
Purpose
To assess the clinical characteristics of subjects with gender dysphoria (GD).
Method
A cross-sectional study of adults with GD. Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Sociodemographic data, clinical data and life habits were recorded.
Results
Total of 44 subjects participated in the study: 36 (82%) trans women and 8 (18%) trans men. Forty-three (98%) of the GD patients had anxiety (36 [100%] trans women and 7 [87.5%] trans men), and 36 (82%) had depression (29 [80.5%] trans women and 7 [87.5%] trans men). Suicide had been attempted by 32 (73%) subjects. The rates of depression were lower among the subjects living with partners, parents, or other people than among those living alone (p = 0.03), and it was also lower among the subjects who were married compared to those who were dating or single (p = 0.03).
Conclusion
Improving the relationship status may reduce the prevalence of depressive symptoms in GD patients. There was a high rate of attempted suicide in this sample.
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
Breaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):552-559
10-01-2017
Summary
Original ArticleBreaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):552-559
10-01-2017Views151See moreAbstract
Objective
Resident doctors usually face the task to communicate bad news in perinatology without any formal training. The impact on parents can be disastrous. The objective of this paper is to analyze the perception of residents regarding a training program in communicating bad news in perinatology based on video reviews and setting, perception, invitation, knowledge, emotion, and summary (SPIKES) strategy.
Methods
We performed the analysis of complementary data collected from participants in a randomized controlled intervention study to evaluate the efficacy of a training program on improving residents’ skills to communicate bad news. Data were collected using a Likert scale. Through a thematic content analysis we tried to to apprehend the meanings, feelings and experiences expressed by resident doctors in their comments as a response to an open-ended question. Half of the group received training, consisting of discussions of video reviews of participants’ simulated encounters communicating a perinatal loss to a “mother” based on the SPIKES strategy. We also offered training sessions to the control group after they completed participation. Twenty-eight residents who were randomized to intervention and 16 from the control group received training. Twenty written comments were analyzed.
Results
The majority of the residents evaluated training highly as an education activity to help increase knowledge, ability and understanding about breaking bad news in perinatology. Three big categories emerged fromresidents’ comments: SPIKES training effects; bad news communication in medical training; and doctors’ feelings and relationship with patients.
Conclusions
Residents took SPIKES training as a guide to systematize the communication of bad news and to amplify perceptions of the emotional needs of the patients. They suggested the insertion of a similar training in their residency programs curricula.
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 ArticleBreaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):552-559
10-01-2017Views151See moreAbstract
Objective
Resident doctors usually face the task to communicate bad news in perinatology without any formal training. The impact on parents can be disastrous. The objective of this paper is to analyze the perception of residents regarding a training program in communicating bad news in perinatology based on video reviews and setting, perception, invitation, knowledge, emotion, and summary (SPIKES) strategy.
Methods
We performed the analysis of complementary data collected from participants in a randomized controlled intervention study to evaluate the efficacy of a training program on improving residents’ skills to communicate bad news. Data were collected using a Likert scale. Through a thematic content analysis we tried to to apprehend the meanings, feelings and experiences expressed by resident doctors in their comments as a response to an open-ended question. Half of the group received training, consisting of discussions of video reviews of participants’ simulated encounters communicating a perinatal loss to a “mother” based on the SPIKES strategy. We also offered training sessions to the control group after they completed participation. Twenty-eight residents who were randomized to intervention and 16 from the control group received training. Twenty written comments were analyzed.
Results
The majority of the residents evaluated training highly as an education activity to help increase knowledge, ability and understanding about breaking bad news in perinatology. Three big categories emerged fromresidents’ comments: SPIKES training effects; bad news communication in medical training; and doctors’ feelings and relationship with patients.
Conclusions
Residents took SPIKES training as a guide to systematize the communication of bad news and to amplify perceptions of the emotional needs of the patients. They suggested the insertion of a similar training in their residency programs curricula.
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
Reference Ranges for Ultrasonographic Measurements of the Uterine Cervix in Low-Risk Pregnant Women
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):443-452
09-01-2017
Summary
Original ArticleReference Ranges for Ultrasonographic Measurements of the Uterine Cervix in Low-Risk Pregnant Women
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):443-452
09-01-2017Views171See moreAbstract
Objective
To define transvaginal ultrasound reference ranges for uterine cervix measurements according to gestational age (GA) in low-risk pregnancies.
Methods
Cohort of low-risk pregnantwomen undergoing transvaginal ultrasound exams every 4 weeks, comprisingmeasurements of the cervical length and volume, the transverse and anteroposterior diameters of the cervix, and distance fromthe entrance of the uterine artery into the cervix until the internal os. The inter- and intraobserver variabilities were assessed with the linear correlation coefficient and the Student t-test. Within each period of GA, 2.5, 10, 50, 90 and 97.5 percentiles were estimated, and the variation by GA was assessed with analysis of variance for dependent samples. Mean values and Student t-test were used to compare the values stratified by control variables.
Results
After confirming the high reproducibility of the method, 172 women followed in this cohort presented a reduction in cervical length, with an increase in volume and in the anteroposterior and transverse diameters during pregnancy. Smaller cervical lengths were associated with younger age, lower parity, and absence of previous cesarean section (C-section).
Conclusion
In the studied population, we observed cervical length shortening throughout pregnancy, suggesting a physiological reduction mainly in the vaginal portion of the cervix. In order to better predict pretermbirth, cervical insufficiency and premature rupture of membranes, reference curves and specific cut-off values need to be validated.
Views171This 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 ArticleReference Ranges for Ultrasonographic Measurements of the Uterine Cervix in Low-Risk Pregnant Women
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):443-452
09-01-2017Views171See moreAbstract
Objective
To define transvaginal ultrasound reference ranges for uterine cervix measurements according to gestational age (GA) in low-risk pregnancies.
Methods
Cohort of low-risk pregnantwomen undergoing transvaginal ultrasound exams every 4 weeks, comprisingmeasurements of the cervical length and volume, the transverse and anteroposterior diameters of the cervix, and distance fromthe entrance of the uterine artery into the cervix until the internal os. The inter- and intraobserver variabilities were assessed with the linear correlation coefficient and the Student t-test. Within each period of GA, 2.5, 10, 50, 90 and 97.5 percentiles were estimated, and the variation by GA was assessed with analysis of variance for dependent samples. Mean values and Student t-test were used to compare the values stratified by control variables.
Results
After confirming the high reproducibility of the method, 172 women followed in this cohort presented a reduction in cervical length, with an increase in volume and in the anteroposterior and transverse diameters during pregnancy. Smaller cervical lengths were associated with younger age, lower parity, and absence of previous cesarean section (C-section).
Conclusion
In the studied population, we observed cervical length shortening throughout pregnancy, suggesting a physiological reduction mainly in the vaginal portion of the cervix. In order to better predict pretermbirth, cervical insufficiency and premature rupture of membranes, reference curves and specific cut-off values need to be validated.
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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