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Original Article07-26-2024
Effect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
- Arife Akay
, - Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut , [ ... ],
- Şevki Çelen
Abstract
Original ArticleEffect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo66
- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut ,
- Cantekin İskender ,
- Şevki Çelen
Views232Abstract
Objective
This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG) levels.
Methods
The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free β-hCG and PAPP-A levels of the groups were compared.
Results
There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free β-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free β-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05).
Conclusion
The level of PAPP-A and free β-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.
Key-words Abortion, threatenedAneuploidybiomarkersChorionic gonadotropinPregnancy trimester, firstPregnancy-associated plasma protein-ASubchorionic hematomaSee moreViews232
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 ArticleEffect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo66
- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut ,
- Cantekin İskender ,
- Şevki Çelen
Views232Abstract
Objective
This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG) levels.
Methods
The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free β-hCG and PAPP-A levels of the groups were compared.
Results
There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free β-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free β-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05).
Conclusion
The level of PAPP-A and free β-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.
Key-words Abortion, threatenedAneuploidybiomarkersChorionic gonadotropinPregnancy trimester, firstPregnancy-associated plasma protein-ASubchorionic hematomaSee 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. - Arife Akay
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Original Article06-27-2024
Prevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Abstract
Original ArticlePrevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo51
- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Views180Abstract
Objective
To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.
Methods
We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.
Results
Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.
Conclusion
The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.
Key-words Abortion, habitualAbortion, spontaneousChromosome aberrationsKaryotypeTranslocation, geneticSee moreViews180This 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 ArticlePrevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo51
- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Views180Abstract
Objective
To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.
Methods
We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.
Results
Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.
Conclusion
The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.
Key-words Abortion, habitualAbortion, spontaneousChromosome aberrationsKaryotypeTranslocation, geneticSee 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. - Elaine Cristina Fontes de Oliveira
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Original Article06-27-2024
Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Abstract
Original ArticleClinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Views240Abstract
Objective
To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.
Methods
This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.
Results
A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).
Conclusion
The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.
Key-words coronavirus infectionsCOVID-19Health information systemsMaternal deathPostpartum periodPregnancySARS-CoV-2See moreViews240This 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 ArticleClinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Views240Abstract
Objective
To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.
Methods
This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.
Results
A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).
Conclusion
The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.
Key-words coronavirus infectionsCOVID-19Health information systemsMaternal deathPostpartum periodPregnancySARS-CoV-2See 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. - Gustavo Gonçalves dos Santos
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Original Article06-27-2024
Risk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares , [ ... ],
- Sue Yazaki Sun
Abstract
Original ArticleRisk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo53
- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares ,
- Camilla Parente Salmeron ,
- João Victor Jacomele Caldas ,
- Nathalia Mello ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Sue Yazaki Sun
Views250Abstract
Objective
To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.
Methods
We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.
Results
There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).
Conclusion
Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.
Key-words Hospitals, maternityPostpartum hemorrhagePostpartum periodPregnancyRisk factorsrobson classificationSee moreViews250This 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 ArticleRisk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo53
- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares ,
- Camilla Parente Salmeron ,
- João Victor Jacomele Caldas ,
- Nathalia Mello ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Sue Yazaki Sun
Views250Abstract
Objective
To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.
Methods
We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.
Results
There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).
Conclusion
Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.
Key-words Hospitals, maternityPostpartum hemorrhagePostpartum periodPregnancyRisk factorsrobson classificationSee 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. - Amanda Botelho
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Original Article06-27-2024
The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects
- Claruza Braga Holanda Lavor ,
- Francisca Adriele Vieira Neta ,
- Antonio Brazil Viana Júnior ,
- Francisco das Chagas Medeiros
Abstract
Original ArticleThe impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo42
- Claruza Braga Holanda Lavor ,
- Francisca Adriele Vieira Neta ,
- Antonio Brazil Viana Júnior ,
- Francisco das Chagas Medeiros
Views277Abstract
Objective
To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Methods
Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Results
Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Conclusion
Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
Key-words AnxietyDepressionEndometriosisInflammationLaparoscopyLipidsMental healthPelvic painQuality of lifesurveys and questionnairesSee moreViews277This 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 ArticleThe impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo42
- Claruza Braga Holanda Lavor ,
- Francisca Adriele Vieira Neta ,
- Antonio Brazil Viana Júnior ,
- Francisco das Chagas Medeiros
Views277Abstract
Objective
To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Methods
Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Results
Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Conclusion
Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
Key-words AnxietyDepressionEndometriosisInflammationLaparoscopyLipidsMental healthPelvic painQuality of lifesurveys and questionnairesSee 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. - Claruza Braga Holanda Lavor
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Original Article06-27-2024
The impact of a breast cancer diagnosis on marital outcomes and factors associated with divorce and separation
- Gustavo Werutsky ,
- Mahira Lopes ,
- Rafaela Gomes de Jesus ,
- Antonia Angeli Gazola ,
- Rodrigo Azevedo Pellegrini , [ ... ],
- Andre Poisl Fay
Abstract
Original ArticleThe impact of a breast cancer diagnosis on marital outcomes and factors associated with divorce and separation
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo60
- Gustavo Werutsky ,
- Mahira Lopes ,
- Rafaela Gomes de Jesus ,
- Antonia Angeli Gazola ,
- Rodrigo Azevedo Pellegrini ,
- Taiane Francieli Rebelatto ,
- Laura von Wallwitz Freitas ,
- Ana Paula Heck ,
- Arthur Ferreira da Silva ,
- Matheus Füehr Rodrigues ,
- Gustavo Gössling ,
- Juliana Giacomazzi ,
- Matheus Soares Rocha ,
- Daniela Dornelles Rosa ,
- Carlos Henrique Barrios ,
- Eduardo Henrique Cronemberger ,
- Geraldo Silva Queiroz ,
- José Bines ,
- Sérgio Daniel Simon ,
- Andre Poisl Fay
Views293See moreAbstract
Objective
To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis.
Methods
We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil.
Results
Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 – 3.72, p = 0.0366) than those who underwent breast-conserving surgery.
Conclusion
Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. ClinicalTrials Registration: NCT02663973.
Views293This 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 ArticleThe impact of a breast cancer diagnosis on marital outcomes and factors associated with divorce and separation
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo60
- Gustavo Werutsky ,
- Mahira Lopes ,
- Rafaela Gomes de Jesus ,
- Antonia Angeli Gazola ,
- Rodrigo Azevedo Pellegrini ,
- Taiane Francieli Rebelatto ,
- Laura von Wallwitz Freitas ,
- Ana Paula Heck ,
- Arthur Ferreira da Silva ,
- Matheus Füehr Rodrigues ,
- Gustavo Gössling ,
- Juliana Giacomazzi ,
- Matheus Soares Rocha ,
- Daniela Dornelles Rosa ,
- Carlos Henrique Barrios ,
- Eduardo Henrique Cronemberger ,
- Geraldo Silva Queiroz ,
- José Bines ,
- Sérgio Daniel Simon ,
- Andre Poisl Fay
Views293See moreAbstract
Objective
To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis.
Methods
We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil.
Results
Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 – 3.72, p = 0.0366) than those who underwent breast-conserving surgery.
Conclusion
Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. ClinicalTrials Registration: NCT02663973.
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. - Gustavo Werutsky
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Original Article06-27-2024
The profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study
- Mayara dos Santos Farias Ferreira Silva ,
- Melania Maria Ramos de Amorim ,
- Brena Melo ,
- André Vieira Lanza ,
- Maria Eduarda Trigueiro Ramos , [ ... ],
- Leila Katz
Abstract
Original ArticleThe profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo47
- Mayara dos Santos Farias Ferreira Silva ,
- Melania Maria Ramos de Amorim ,
- Brena Melo ,
- André Vieira Lanza ,
- Maria Eduarda Trigueiro Ramos ,
- Bruna Antunes Durães de Carvalho ,
- Natalia Nunes Tenório ,
- Leila Katz
Views272See moreAbstract
Objective
In Brazil, postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. Data on the profile of women and risk factors associated with PPH are sparse. This study aimed to describe the profile and management of patients with PPH, and the association of risk factors for PPH with severe maternal outcomes (SMO).
Methods
A cross-sectional study was conducted in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) obstetric intensive care unit (ICU) between January 2012 and March 2020, including patients who gave birth at the hospital and that were admitted with PPH to the ICU.
Results
The study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.
Conclusion
The principal factors associated with poor maternal outcome were being multiparous and placental abruption.
Views272This 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 ArticleThe profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo47
- Mayara dos Santos Farias Ferreira Silva ,
- Melania Maria Ramos de Amorim ,
- Brena Melo ,
- André Vieira Lanza ,
- Maria Eduarda Trigueiro Ramos ,
- Bruna Antunes Durães de Carvalho ,
- Natalia Nunes Tenório ,
- Leila Katz
Views272See moreAbstract
Objective
In Brazil, postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. Data on the profile of women and risk factors associated with PPH are sparse. This study aimed to describe the profile and management of patients with PPH, and the association of risk factors for PPH with severe maternal outcomes (SMO).
Methods
A cross-sectional study was conducted in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) obstetric intensive care unit (ICU) between January 2012 and March 2020, including patients who gave birth at the hospital and that were admitted with PPH to the ICU.
Results
The study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.
Conclusion
The principal factors associated with poor maternal outcome were being multiparous and placental abruption.
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. - Mayara dos Santos Farias Ferreira Silva
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Original Article06-27-2024
Prevalence of macrosomic newborn and maternal and neonatal complications in a high-risk maternity
- Kellen Silva Sousa ,
- Henrique Vitor Leite ,
- Mário Dias Corrêa Júnior ,
- Matheus Silva Sousa ,
- Anna Luíza Rocha Queiroz
Abstract
Original ArticlePrevalence of macrosomic newborn and maternal and neonatal complications in a high-risk maternity
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo48
- Kellen Silva Sousa ,
- Henrique Vitor Leite ,
- Mário Dias Corrêa Júnior ,
- Matheus Silva Sousa ,
- Anna Luíza Rocha Queiroz
Views218Abstract
Objective
Evaluate the prevalence of macrosomic newborns (birth weight above 4000 grams) in a high-risk maternity from 2014 to 2019, as well as the maternal characteristics involved, risk factors, mode of delivery and associated outcomes, comparing newborns weighing 4000-4500 grams and those weighing above 4500 grams.
Methods
This is an observational study, case-control type, carried out by searching for data in hospital’s own system and clinical records. The criteria for inclusion in the study were all patients monitored at the service who had newborns with birth weight equal than or greater than 4000 grams in the period from January 2014 to December 2019, being subsequently divided into two subgroups (newborns with 4000 to 4500 grams and newborns above 4500 grams). After being collected, the variables were transcribed into a database, arranged in frequency tables. For treatment and statistical analysis of the data, Excel and R software were used. This tool was used to create graphs and tables that helped in the interpretation of the results. The statistical analysis of the variables collected included both simple descriptive analyzes as well as inferential statistics, with univariate, bivariate and multivariate analysis.
Results
From 2014 to 2019, 3.3% of deliveries were macrosomic newborns. The average gestational age in the birth was 39.4 weeks. The most common mode of delivery (65%) was cesarean section. Diabetes mellitus was present in 30% of the deliveries studied and glycemic control was absent in most patients. Among the vaginal deliveries, only 6% were instrumented and there was shoulder dystocia in 21% of the cases. The majority (62%) of newborns had some complication, with jaundice (35%) being the most common.
Conclusion
Birth weight above 4000 grams had a statistically significant impact on the occurrence of neonatal complications, such as hypoglycemia, respiratory distress and 5th minute APGAR less than 7, especially if birth weight was above 4500 grams. Gestational age was also shown to be statistically significant associated with neonatal complications, the lower, the greater the risk. Thus, macrosomia is strongly linked to complications, especially neonatal complications.
Key-words Diabetes, gestationalFetal macrosomiaFetal weightJaundice, neonatalPregnancy, high riskRisk factorsShoulder dystociaSee moreViews218This 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 ArticlePrevalence of macrosomic newborn and maternal and neonatal complications in a high-risk maternity
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo48
- Kellen Silva Sousa ,
- Henrique Vitor Leite ,
- Mário Dias Corrêa Júnior ,
- Matheus Silva Sousa ,
- Anna Luíza Rocha Queiroz
Views218Abstract
Objective
Evaluate the prevalence of macrosomic newborns (birth weight above 4000 grams) in a high-risk maternity from 2014 to 2019, as well as the maternal characteristics involved, risk factors, mode of delivery and associated outcomes, comparing newborns weighing 4000-4500 grams and those weighing above 4500 grams.
Methods
This is an observational study, case-control type, carried out by searching for data in hospital’s own system and clinical records. The criteria for inclusion in the study were all patients monitored at the service who had newborns with birth weight equal than or greater than 4000 grams in the period from January 2014 to December 2019, being subsequently divided into two subgroups (newborns with 4000 to 4500 grams and newborns above 4500 grams). After being collected, the variables were transcribed into a database, arranged in frequency tables. For treatment and statistical analysis of the data, Excel and R software were used. This tool was used to create graphs and tables that helped in the interpretation of the results. The statistical analysis of the variables collected included both simple descriptive analyzes as well as inferential statistics, with univariate, bivariate and multivariate analysis.
Results
From 2014 to 2019, 3.3% of deliveries were macrosomic newborns. The average gestational age in the birth was 39.4 weeks. The most common mode of delivery (65%) was cesarean section. Diabetes mellitus was present in 30% of the deliveries studied and glycemic control was absent in most patients. Among the vaginal deliveries, only 6% were instrumented and there was shoulder dystocia in 21% of the cases. The majority (62%) of newborns had some complication, with jaundice (35%) being the most common.
Conclusion
Birth weight above 4000 grams had a statistically significant impact on the occurrence of neonatal complications, such as hypoglycemia, respiratory distress and 5th minute APGAR less than 7, especially if birth weight was above 4500 grams. Gestational age was also shown to be statistically significant associated with neonatal complications, the lower, the greater the risk. Thus, macrosomia is strongly linked to complications, especially neonatal complications.
Key-words Diabetes, gestationalFetal macrosomiaFetal weightJaundice, neonatalPregnancy, high riskRisk factorsShoulder dystociaSee 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. - Kellen Silva Sousa
Original Article Archives - Revista Brasileira de Ginecologia e Obstetrícia
