Original Article Archives - Page 3 of 55 - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):458-466
    04-11-2022

    Summary

    Original Article

    Hematological Parameters to Predict the Severity of Hyperemesis Gravidarum and Ketonuria

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):458-466
    04-11-2022

    DOI 10.1055/s-0042-1743101

    Views240

    Abstract

    Objective

    Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG.

    Method

    A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared.

    Results

    Themean age of the HG group (n=532) was 26.3 ± 4.1 years, and that of the control group (n=534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n=249) had ketone(+), 33% (n=174), ketone(++), and 21% (n=109), ketone(+++). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p<0.001; and 135.2 ± 30.4/108.9 ± 62.2; p<0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone(+++) than in the groups with ketone(+) or ketone(++): 7.6 ± 1.9/5.5 ± 2.4; p<0.001; 3.8(2.8-4.6)/2.9(2.3- 3.6); p<0.001; and 149.9 ± 48.0/135.9 ± 65.7; p<0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients.

    Conclusion

    The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.

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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.
  • Original Article

    Estimate of Dietary Total Antioxidant Capacity of Pregnant Women and Associated Factors Estimativa da capacidade antioxidante total da dieta de gestantes e fatores associados

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):91-99
    04-08-2022

    Summary

    Original Article

    Estimate of Dietary Total Antioxidant Capacity of Pregnant Women and Associated Factors Estimativa da capacidade antioxidante total da dieta de gestantes e fatores associados

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):91-99
    04-08-2022

    DOI 10.1055/s-0041-1741454

    Views120

    Abstract

    Objective

    To investigate the dietary total antioxidant capacity (DTAC) of pregnant women, and associated factors.

    Methods

    Cross-sectional study conducted with 785 pregnant adult women attended in primary health care centers of Ribeirão Preto, state of São Paulo, Brazil. Two 24-hour dietary recalls were obtained, and the usual intake was estimated through the Multiple Source Method. The DTAC was estimated using the ferric reducing antioxidant power assay. The relationship between the higher DTAC estimate (≥ median of 4.3 mmol/day) and associated factorswas investigated usingadjusted logisticmodels with backward selection.

    Results

    In total, 25% of the pregnant women were classified as overweight, and 32% as obese. Themedian (P25, P75)DTAC was 4.3 (3.3-5.6)mmol/day. Through adjusted logistic regression models with backward selection, a higher chance of DTAC estimates above the median among pregnant womenaged ≥ 35 years old (2.01 [1.24-3.27])was verified when compared with younger pregnant women. Women with prepregnancy overweight (0.63 [0.45-0.89]) and obesity (0.59 [0.40-0.88]) presented a lower chance of DTAC estimates above the median when compared with eutrophic pregnant women. A higher DTAC estimate was positively associated with the use of dietary supplements (1.39 [1.03-1.88]), and negatively associated with total dietary energy (0.59 [0.42-0.85]).

    Conclusion

    The DTAC estimate over the median was associated with greater age, adequate body weight, use of dietary supplements, and lower energy intake.

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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.
  • Original Article

    Levels and Predictors of Anxiety and Depression in Turkish PregnantWoman During the Covid-19 Pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):100-108
    04-08-2022

    Summary

    Original Article

    Levels and Predictors of Anxiety and Depression in Turkish PregnantWoman During the Covid-19 Pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):100-108
    04-08-2022

    DOI 10.1055/s-0041-1741033

    Views175

    Abstract

    Objective

    In addition to being a medical phenomenon, pandemics affect the individual and society on several levels and lead to disruptions. In the pandemic process, different groups in the population, including pregnant women as a defenseless group, are subjected to psychological threat. The present study aimed to determine the levels of anxiety and depression and related factors in pregnant women during the the coronavirus disease 2019 (Covid-19) pandemic.

    Methods

    The present cross-sectional study was conducted with 269 pregnant women through face-to-face interviews held in Istanbul, Turkey. Regarding the data collection tools, the Cronbach α reliability coefficient was of 0.90 for the Beck Anxiety Inventory, and of 0.85 for the Beck Depression Inventory.

    Results

    Among the participating pregnant women, 30.5% had mild, 17.5% had moderate, and 5.9% had severe anxiety symptoms, whereas 35.3% had mild, 16.7% had moderate, and 2.2% had severe depression symptoms. We found that those who were concerned about their health had 5.36 times (p=0.04) more risk of developing anxiety, and 4.82 times (p=0.01) more risk of developing depression than those who were not concerned. Those who had a history of psychiatric disease had 3.92 times (p=0.02) more risk of developing anxiety than those without it.

    Conclusion

    We determined that about half of the pregnant women included in the study had some degree of anxiety and depression during the COVID-19 pandemic. The risk factors for anxiety and depression among the pregnant women were determined as smoking, concerns about health and getting infectedwith the coronavirus, history of psychiatric disease, and undergoing regular antenatal care.

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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.
  • Original Article

    Prevalence of Depression in Pregnant Women with Bariatric Surgery History and Associated Factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):109-117
    04-08-2022

    Summary

    Original Article

    Prevalence of Depression in Pregnant Women with Bariatric Surgery History and Associated Factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):109-117
    04-08-2022

    DOI 10.1055/s-0042-1742682

    Views170

    Abstract

    Objective

    To analyze the prevalence and factors associated with depressive symptoms among Brazilian pregnant women with history of bariatric surgery (BS).

    Methods

    This is a cohort study with 247 women who got pregnant after BS. Based on data collection via Google Form, the recruitment of participants occurred in Facebook groups for 13 months. All of them answered a form with Informed Consent, a general data protocol and the Brazilian version of the Depression, Anxiety and Stress Scale-21. Descriptive and inferential analysis were performed, and a binary logistic regression model was tested to predict the factors associated with depressive symptoms.

    Results

    The prevalence of depressive symptoms was 32.8%, noted as being higher in the first (40.6%) and third (34.3%) gestational trimesters. Significative associations were found between depression and marital status (p=0.000), planned pregnancy (p=0.001), desired pregnancy (p=0.004) and psychiatric history (p=0.000). Women who were not married (odds ratio, OR=3,38; p=0.002) and had a psychiatric history (OR=2.70; p=0.102) had higher chances of showing depression symptoms; while planned and desired pregnancy showed as protective factors to the symptoms of depression.

    Conclusion

    These findings highlight the importance of psychological assistance for pregnant women with history of BS, to prevent development of mental disorders and their outcomes for maternal-child health.

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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.
  • Original Article

    Analysis of the Correlation/Agreement of Maternal-fetal Doppler Parameters in Normal and Growth-Restricted Fetuses

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):118-124
    04-08-2022

    Summary

    Original Article

    Analysis of the Correlation/Agreement of Maternal-fetal Doppler Parameters in Normal and Growth-Restricted Fetuses

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):118-124
    04-08-2022

    DOI 10.1055/s-0041-1741453

    Views172

    Abstract

    Objective

    To assess the degree of correlation/agreement of maternal-fetal Doppler parameters between normal and growth-restricted fetuses (fetal growth restriction [FGR]).

    Methods

    The present observational and retrospective study included 274 singleton pregnancies. The following maternal-fetal Doppler parameters were assessed: uterine artery (UAt), umbilical artery (UA), middle cerebral artery (MCA), cerebroplacental ratio (CPR), and umbilical-cerebral ratio (U/C). The assessment of FGR was based on the Figueiras and Gratacós9 criteria. Spearman correlation coefficients were estimated to assess the correlation between resistance (RI) and pulsatility (PI) indices of Doppler parameters. The agreement between two Doppler parameters was assessed by the Kappa coefficient.

    Results

    In total, 502 Doppler examinations were included, and FGR was observed in 19 out of 274 fetuses. A strong correlation was observed between RI and PI of UAt, UA, and MCA in all of the samples (p<0.001). Of the 502 Doppler examinations, there was agreement between U/C and CPR percentiles for 480 (95.6%) and disagreement for 22 (4.4%), with Kappa coefficient of 0.26, thereby corresponding to weak agreement. Of the 68 cases with estimated fetal weight ≤ 9th percentile (small for gestational age [SGA]), there was agreement between U/C>1.0 and CPR<5th percentile in 61 (88.4%) and disagreement in 7 (5.8%) with Kappa coefficient of 0.49, thereby corresponding to moderate agreement.

    Conclusion

    Strong correlation was observed among RI and PI UAt, UA, and MCA Doppler examinations in the present study; however, weak agreement was observed between U/C and CPR in the normal and FGR fetuses. In SGA, U/C and CPR demonstrated moderate agreement.

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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.
    Analysis of the Correlation/Agreement of Maternal-fetal Doppler Parameters in Normal and Growth-Restricted Fetuses
  • Original Article

    Expression of Endothelin-1 and Endothelial Nitric Oxide Synthase in Normal and Preeclamptic Placentae

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):125-132
    04-08-2022

    Summary

    Original Article

    Expression of Endothelin-1 and Endothelial Nitric Oxide Synthase in Normal and Preeclamptic Placentae

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):125-132
    04-08-2022

    DOI 10.1055/s-0042-1742317

    Views166

    Abstract

    Objective

    To investigate the expression of endothelin-1 (ET-1) and endothelial nitric oxide (NO) synthase (eNOS) in normal and preeclamptic (PE) placentae.

    Methods

    The present cross-sectional analytical study was performed in normal and PE primigravidae (n=10 in each group) who were admitted to the North Okkalapa General and Teaching Hospital from February 2019 to February 2020. Serum samples were collected immediately before delivery, and placental tissues were collected immediately after emergency or elective cesarean section. The expression of placental eNOS was measured by western blot, and the levels of ET-1 in placental tissue homogenates and in the serum were measured by enzyme-linked immunosorbent assay (ELISA).

    Results

    The PEgrouphadsignificantly higher serumlevelsof ET-1(median: 116.56 pg/mL; IQR: 89.14-159.62 pg/mL) than the normal group (median: 60.02 pg/mL; IQR: 50.89-94.37 pg/mL) (p<0.05). However, statistically significant differences were not observed in the levels of ET-1 in placental tissue homogenates between normal and PE placentae (median: 0.007 pg/μg of total protein; IQR: 0.002-0.0123 pg/μg of total protein; andmedian: 0.005 pg/μg of total protein; IQR: 0.003-0.016 pg/μg of total protein respectively). The median and IQR values of relative placental eNOS expression were significantly higher in the PE group than in the normal group (p<0.05). The serum levels of ET-1 level were not significantly correlated with placental ET-1 expression, and neither there was a significant correlation between placental ET-1 and eNOS expression in any of the groups.

    Conclusion

    The serum levels of ET-1 were significantly higher in PE pregnant women compared with normal pregnant women, while the ET-1 levels of placental tissue homogenates were not significantly different. Serum ET-1 rather than placental ET-1 might play a major role in the pathogenesis of PE.

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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.
    Expression of Endothelin-1 and Endothelial Nitric Oxide Synthase in Normal and Preeclamptic Placentae
  • Original Article

    Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141
    04-08-2022

    Summary

    Original Article

    Prevalence of Premenstrual Syndrome and Associated Factors Among Academics of a University in Midwest Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):133-141
    04-08-2022

    DOI 10.1055/s-0041-1741456

    Views296

    Abstract

    Objective

    To investigate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in university students, the factors associated with PMS, the most prevalent symptoms, and the interference of symptoms in academic, family, social, and work activities.

    Methods

    This cross-sectional study included 1,115 university students aged ≥ 18 years from the University of Rio Verde, Goiás. Premenstrual syndrome and PMDD were identified using the Premenstrual Symptoms Screening Tool. Associations with sociodemographic, behavioral, reproductive, nutritional, and health factors were investigated using the Poisson regression.

    Results

    The prevalence of PMS was 46.9% (95% confidence interval [CI] 44.0-49.8), and of PMDD, 11.1% (95% CI 9.3-13.0). The most prevalent symptoms were physical, such as breast tenderness, bloating, e weight gain (73%); followed by psychological ones such as overeating/food cravings, tearful/more sensitive to rejection (> 60%). More than 30% of the patients reported that the symptoms interfered in a moderate-tosevere way in their social and academic activities. After adjusted analysis, PMS was more prevalent in those who were attending the 1st/2nd semester of college (prevalence ratio [PR] 1.44; 95% CI 1.14-1.80), those who consumed alcohol in the last 30 days (PR 1.23; 95% CI 1.04-1.47), and those who had depression (PR 1.49; 95% CI 1.30-1.71).

    Conclusion

    Almost half of the university students had PMS and ~ 11%, PMDD. Physical symptoms were themost common and interfered in amoderate-to-severe way in various aspects of life. Attending the first semesters, consuming alcohol, and having depression were risk factors for PMS. The identification of risk factors for PMS is essential to prevent symptoms and reduce the impact of the syndrome.

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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.
  • Original Article

    Adrenal Androgen Predictive Effects on Clinical andMetabolic Abnormalities of Polycystic Ovary Syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):142-153
    04-08-2022

    Summary

    Original Article

    Adrenal Androgen Predictive Effects on Clinical andMetabolic Abnormalities of Polycystic Ovary Syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(2):142-153
    04-08-2022

    DOI 10.1055/s-0041-1741030

    Views191

    Abstract

    Objective

    To examine the possible effects of adrenal prohormones in the prediction of clinical and metabolic abnormalities in women with polycystic ovary syndrome (PCOS).

    Methods

    The present study enrolled 299 normal cycling non-PCOS, 156 normoandrogenemic, and 474 hyperandrogenemic women with PCOS. Baseline characteristics were compared using a chi-squared test or analysis of variance (ANOVA) as appropriate. The roles of adrenal prohormones and their ratios with total testosterone in predicting co-occurring morbidities in women PCOS were evaluated using univariate and multivariate logistic regression analyses.

    Results

    Adrenal hyperandrogenism per dehydroepiandrosterone sulfate (DHEAS) levels were found in 32% of women with PCOS. In non-PCOS women, dehydroepiandrosterone (DHEA) and its sulfate had no predictive role concerning clinical, anthropometric, and metabolic parameters. In PCOS women, mainly in the hyperandrogenemic group, DHEA showed to be a significant predictor against most anthropometric-metabolic index abnormalities (odds ratio [OR]=0.36-0.97; p<0.05), and an increase in triglycerides (TG) levels (OR=0.76; p=0.006). Dehydroepiandrosterone sulfate presented a few predictive effects regarding PCOS-associated disorders. In controls, DHEAS predicted against the increase in estimated average glucose (OR= 0.38; p=0.036). In the normoandrogenic group, it predicted against elevation in the waist/hip ratio (WHR) (OR= 0.59; p=0.042), and in hyperandrogenemic PCOS women, it predicted against abnormality in the conicity index (CI) (OR=0.31; p=0.028).

    Conclusion

    Dehydroepiandrosterone was shown to be a better predictor of abnormal anthropometric and biochemical parameters in women with PCOS than DHEAS. Thus, regarding adrenal prohormones, DHEA measurement, instead of DHEAS, should be preferred in PCOS management. The effects of androgen prohormones on the prediction of PCOS abnormalities are weak.

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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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