-
Original Article
Adequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
- Margot Marie Martin
, - Roxana Knobel ,
- Vitor Nandi ,
- Jessica Goedert Pereira ,
- Alberto Trapani Junior , [ ... ],
- Carla Betina Andreucci
02-17-2022
Summary
Original ArticleAdequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022- Margot Marie Martin ,
- Roxana Knobel ,
- Vitor Nandi ,
- Jessica Goedert Pereira ,
- Alberto Trapani Junior ,
- Carla Betina Andreucci
Views44See moreAbstract
Objective
The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.
Methods
Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis onmaternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.
Results
Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The followingmaternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.
Conclusion
In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.
Views44
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 ArticleAdequacy of Antenatal Care during the COVID-19 Pandemic: Observational Study with Postpartum Women
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):398-408
02-17-2022- Margot Marie Martin ,
- Roxana Knobel ,
- Vitor Nandi ,
- Jessica Goedert Pereira ,
- Alberto Trapani Junior ,
- Carla Betina Andreucci
Views44See moreAbstract
Objective
The present study aimed to evaluate the antenatal care adequacy for women who gave birth at the University Hospital of Santa Catarina in Florianopolis (Brazil) during the COVID-19 pandemic, and to evaluate the association of adequacy with sociodemographic, clinical, and access characteristics.
Methods
Data were collected between October and December 2020, including 254 patients who delivered in the University Hospital from Federal University of Santa Catarina and answered our questionnaires. Additional data were obtained from patients’ antenatal booklets. Antenatal care was classified as adequate, intermediate, or inadequate according to the number of appointments, gestational age at the beginning of follow-up, and tests results. We carried out a descriptive statistical analysis and a bivariate/with odds ratio analysis onmaternal sociodemographic, clinical and health access variables that were compared with antenatal adequacy.
Results
Antenatal care was considered adequate in 35.8% of cases, intermediate in 46.8%, and inadequate in 17.4%. The followingmaternal variables were associated with inadequate prenatal care (intermediate or inadequate prenatal care): having black or brown skin colour, having two or more children, being of foreign nationality, not being fluent in Portuguese, and using illicit drugs during pregnancy; the clinical variables were more than 6 weeks between appointments, and not attending high-risk antenatal care; as for access, the variables were difficulties in attending or scheduling appointments, and attending virtual appointments only.
Conclusion
In a sample of pregnant women from a teaching hospital in Florianópolis during the COVID-19 pandemic, antenatal care was considered adequate in 35.8%, intermediate in 46.8%, and inadequate in 17.4% of cases.
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. - Margot Marie Martin
-
Original Article
Quality of Life of Pregnant Women with Systemic Lupus Erythematosus
- Larissa Rodrigues ,
- Maria Laura Costa ,
- Francisco Carlos Specian ,
- Maria Margarida Fialho Sim-Sim ,
- Fernanda Garanhani Surita
02-17-2022
Summary
Original ArticleQuality of Life of Pregnant Women with Systemic Lupus Erythematosus
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):475-482
02-17-2022- Larissa Rodrigues ,
- Maria Laura Costa ,
- Francisco Carlos Specian ,
- Maria Margarida Fialho Sim-Sim ,
- Fernanda Garanhani Surita
Views138See moreAbstract
Objective
To assess the quality of life (QoL) of pregnant women with systemic lupus erythematosus (SLE) treated at a high-risk prenatal outpatient clinic during the third trimester of gestation.
Methods
An observational descriptive study was performed in a high-risk prenatal outpatient clinic. Women in the third trimester of pregnancy and undergoing antenatal care between July 2017 and July 2019 answered the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions divided into 4 domains (physical, psychological, social and environmental).
Results
We interviewed 50 pregnant women with a mean gestational age of 30 weeks (standard deviation [SD]: 10 weeks) who were diagnosed with SLE. The average age of the participants was 30 years (SD: 14.85), and the average time since the diagnosis of SLE was of 9.06 years (SD: 6.8 years). Most participants had a partner, did not plan their pregnancy (76%), and did not use contraception prior to pregnancy (80%). The score of each domain ranges from 0 (the worst score) to 100 (the best score). The means ± SDs of the scores of the participants on each domain were: physical - 52.21 ± 18.44); psychological - 64.17 ± 18.56); social - 66.33 ± 27.09); and environmental - 64.56 (18.53). The means ± SDs of the general QoL, and health-related QoL items were of 70.50 ± 24.06 and 70.00 ± 30.72 respectively.
Conclusion
The physical domain presented the lowest scores compared with the other three domains. Pregnant women with SLE had high overall QoL scores, and their health-related QoL scores were also relatively high.
Views138This 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 ArticleQuality of Life of Pregnant Women with Systemic Lupus Erythematosus
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):475-482
02-17-2022- Larissa Rodrigues ,
- Maria Laura Costa ,
- Francisco Carlos Specian ,
- Maria Margarida Fialho Sim-Sim ,
- Fernanda Garanhani Surita
Views138See moreAbstract
Objective
To assess the quality of life (QoL) of pregnant women with systemic lupus erythematosus (SLE) treated at a high-risk prenatal outpatient clinic during the third trimester of gestation.
Methods
An observational descriptive study was performed in a high-risk prenatal outpatient clinic. Women in the third trimester of pregnancy and undergoing antenatal care between July 2017 and July 2019 answered the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions divided into 4 domains (physical, psychological, social and environmental).
Results
We interviewed 50 pregnant women with a mean gestational age of 30 weeks (standard deviation [SD]: 10 weeks) who were diagnosed with SLE. The average age of the participants was 30 years (SD: 14.85), and the average time since the diagnosis of SLE was of 9.06 years (SD: 6.8 years). Most participants had a partner, did not plan their pregnancy (76%), and did not use contraception prior to pregnancy (80%). The score of each domain ranges from 0 (the worst score) to 100 (the best score). The means ± SDs of the scores of the participants on each domain were: physical - 52.21 ± 18.44); psychological - 64.17 ± 18.56); social - 66.33 ± 27.09); and environmental - 64.56 (18.53). The means ± SDs of the general QoL, and health-related QoL items were of 70.50 ± 24.06 and 70.00 ± 30.72 respectively.
Conclusion
The physical domain presented the lowest scores compared with the other three domains. Pregnant women with SLE had high overall QoL scores, and their health-related QoL scores were also relatively high.
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. - Larissa Rodrigues
-
Original Article
Cervical Cancer Screening with HPV Testing: Updates on the Recommendation
- Carla Fabrine Carvalho ,
- Julio Cesar Teixeira ,
- Joana Froes Bragança ,
- Sophie Derchain ,
- Luiz Carlos Zeferino , [ ... ],
- Diama Bhadra Vale
02-15-2022
Summary
Original ArticleCervical Cancer Screening with HPV Testing: Updates on the Recommendation
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):264-271
02-15-2022- Carla Fabrine Carvalho ,
- Julio Cesar Teixeira ,
- Joana Froes Bragança ,
- Sophie Derchain ,
- Luiz Carlos Zeferino ,
- Diama Bhadra Vale
Views248Abstract
The present update is a reassessment of the 2018 ‘Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil’ (Zeferino et al.)9, according to the changes observed in new international guidelines and knowledge updates. The most relevant and recent guidelines were assessed. Questions regarding the clinical practice were formulated, and the answers considered the perspective of the public and private sectors of the Brazilian health system. The review addressed risk-based strategies regarding age to start and stop screening, the use of cytology and colposcopy to support management decisions, treatment, follow-up strategies, and screening in specific groups, including vaccinated women. The update aims to improve the prevention of cervical cancer and to reduce overtreatment and the misuse of HPV testing.
Key-words accessibility of health servicesearly detection of cancerhuman papillomavirus DNA testsMass screeningUterine cervical neoplasmsSee moreViews248This 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 ArticleCervical Cancer Screening with HPV Testing: Updates on the Recommendation
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):264-271
02-15-2022- Carla Fabrine Carvalho ,
- Julio Cesar Teixeira ,
- Joana Froes Bragança ,
- Sophie Derchain ,
- Luiz Carlos Zeferino ,
- Diama Bhadra Vale
Views248Abstract
The present update is a reassessment of the 2018 ‘Guidelines for HPV-DNA Testing for Cervical Cancer Screening in Brazil’ (Zeferino et al.)9, according to the changes observed in new international guidelines and knowledge updates. The most relevant and recent guidelines were assessed. Questions regarding the clinical practice were formulated, and the answers considered the perspective of the public and private sectors of the Brazilian health system. The review addressed risk-based strategies regarding age to start and stop screening, the use of cytology and colposcopy to support management decisions, treatment, follow-up strategies, and screening in specific groups, including vaccinated women. The update aims to improve the prevention of cervical cancer and to reduce overtreatment and the misuse of HPV testing.
Key-words accessibility of health servicesearly detection of cancerhuman papillomavirus DNA testsMass screeningUterine cervical neoplasmsSee 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. - Carla Fabrine Carvalho
-
Original Article
Perioperative Outcomes in Pregnant Women Who Underwent Surgery for Adnexal Torsion
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):336-342
02-09-2022
Summary
Original ArticlePerioperative Outcomes in Pregnant Women Who Underwent Surgery for Adnexal Torsion
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):336-342
02-09-2022Views142See moreAbstract
Objective
To evaluate clinical characteristics, maternal and fetal outcomes in pregnant women who underwent surgery for adnexal torsion (AT).
Methods
All patients, who underwent surgical operation due to AT during pregnancy at the Department of Obstetrics and Gynecology, School of Medicine, Ege University between 2005 and 2020 were retrospectively investigated. Main clinical and perioperative outcomes were evaluated.
Results
A total of 21 patients who underwent surgery due to AT during pregnancy were included. Of all patients, 61.9% underwent laparoscopy and the remaining 38.1% underwent laparotomy. The most common surgical procedure was adnexal detorsion in both groups (48%). Mean gestational age at the time of diagnosis, duration of surgery and hospitalization were significantly lower in the laparoscopy group, when compared with the laparotomy group (p=0.006, p=0.001, and p=0.001, respectively.) One of the patients had an infection during the postoperative period. Spontaneous abortion was only observed in one case.
Conclusion
It can be concluded that the surgical intervention implemented for the exact diagnosis and treatment of AT (laparotomy or laparoscopy) did not have an unfavorable effect on pregnancy outcomes such as abortion, preterm delivery, and fetal anomaly. However, laparoscopy may be superior to laparotomy in terms of advantages.
Views142This 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 ArticlePerioperative Outcomes in Pregnant Women Who Underwent Surgery for Adnexal Torsion
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):336-342
02-09-2022Views142See moreAbstract
Objective
To evaluate clinical characteristics, maternal and fetal outcomes in pregnant women who underwent surgery for adnexal torsion (AT).
Methods
All patients, who underwent surgical operation due to AT during pregnancy at the Department of Obstetrics and Gynecology, School of Medicine, Ege University between 2005 and 2020 were retrospectively investigated. Main clinical and perioperative outcomes were evaluated.
Results
A total of 21 patients who underwent surgery due to AT during pregnancy were included. Of all patients, 61.9% underwent laparoscopy and the remaining 38.1% underwent laparotomy. The most common surgical procedure was adnexal detorsion in both groups (48%). Mean gestational age at the time of diagnosis, duration of surgery and hospitalization were significantly lower in the laparoscopy group, when compared with the laparotomy group (p=0.006, p=0.001, and p=0.001, respectively.) One of the patients had an infection during the postoperative period. Spontaneous abortion was only observed in one case.
Conclusion
It can be concluded that the surgical intervention implemented for the exact diagnosis and treatment of AT (laparotomy or laparoscopy) did not have an unfavorable effect on pregnancy outcomes such as abortion, preterm delivery, and fetal anomaly. However, laparoscopy may be superior to laparotomy in terms of advantages.
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
Emotional and Clinical Aspects Observed in Women with Gestational Trophoblastic Disease: A Multidisciplinary Action
- Ana Carolina Gomes França ,
- Elza Maria Hartmann Uberti ,
- Karine Paiva Muller ,
- Rodrigo Bernardes Cardoso ,
- Fabiana Giguer , [ ... ],
- Antonio Braga
02-09-2022
Summary
Original ArticleEmotional and Clinical Aspects Observed in Women with Gestational Trophoblastic Disease: A Multidisciplinary Action
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):343-351
02-09-2022- Ana Carolina Gomes França ,
- Elza Maria Hartmann Uberti ,
- Karine Paiva Muller ,
- Rodrigo Bernardes Cardoso ,
- Fabiana Giguer ,
- Patricia El Beitune ,
- Antonio Braga
Views147See moreAbstract
Objective
To evaluate the emotional and clinical aspects observed in women with gestational trophoblastic disease (GTD) followed-up in a reference center (RC) by a multidisciplinary team.
Methods
Retrospective cohort study of the clinical records of 186 women with GTD and of the emotional aspects (EA) observed in these women by a teamof psychologists and reported by the 389 support groups conducted from 2014 to 2018.
Results
The women were young (mean age: 31.2 years), 47% had no living child, 60% had planned the pregnancy, and 50% participated in two or more SG. Most women (n=137; 73.6%) reached spontaneous remission ofmolar gestation in a median time of 10 weeks and had a total follow-up time of seven months. In the group of 49 women (26.3%) who progressed to gestational trophoblastic neoplasia (GTN), time to remission after chemotherapy was 18 weeks, and total follow-up time was 36 months. EA included different levels of anxiety and depression,more evident in 9.1% of the women; these symptoms tended to occur more frequently in women older than 40 years (p=0.067), less educated (p=0.054), and whose disease progressed to GTN (p=0.018), as well as in those who had to undergo multi-agent chemotherapy (p=0.028) or hysterectomy (p=0.001) adjuvant to clinical treatment.
Conclusion
This study found several EA in association with all types of GTD. It also highlights the importance of specialized care only found in a RC, essential to support the recovery of the mental health of these women.
Views147This 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 ArticleEmotional and Clinical Aspects Observed in Women with Gestational Trophoblastic Disease: A Multidisciplinary Action
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):343-351
02-09-2022- Ana Carolina Gomes França ,
- Elza Maria Hartmann Uberti ,
- Karine Paiva Muller ,
- Rodrigo Bernardes Cardoso ,
- Fabiana Giguer ,
- Patricia El Beitune ,
- Antonio Braga
Views147See moreAbstract
Objective
To evaluate the emotional and clinical aspects observed in women with gestational trophoblastic disease (GTD) followed-up in a reference center (RC) by a multidisciplinary team.
Methods
Retrospective cohort study of the clinical records of 186 women with GTD and of the emotional aspects (EA) observed in these women by a teamof psychologists and reported by the 389 support groups conducted from 2014 to 2018.
Results
The women were young (mean age: 31.2 years), 47% had no living child, 60% had planned the pregnancy, and 50% participated in two or more SG. Most women (n=137; 73.6%) reached spontaneous remission ofmolar gestation in a median time of 10 weeks and had a total follow-up time of seven months. In the group of 49 women (26.3%) who progressed to gestational trophoblastic neoplasia (GTN), time to remission after chemotherapy was 18 weeks, and total follow-up time was 36 months. EA included different levels of anxiety and depression,more evident in 9.1% of the women; these symptoms tended to occur more frequently in women older than 40 years (p=0.067), less educated (p=0.054), and whose disease progressed to GTN (p=0.018), as well as in those who had to undergo multi-agent chemotherapy (p=0.028) or hysterectomy (p=0.001) adjuvant to clinical treatment.
Conclusion
This study found several EA in association with all types of GTD. It also highlights the importance of specialized care only found in a RC, essential to support the recovery of the mental health of these women.
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. - Ana Carolina Gomes França
-
Original Article
Impact of Carbohydrate Counting Method during Pregnancy in Women with Pregestational Diabetes Mellitus: A Controlled Clinical Trial
- Larissa Mello de Oliveira ,
- Gabriella Pinto Belfort ,
- Patricia de Carvalho Padilha ,
- Eliane Lopes Rosado ,
- Letícia Barbosa Gabriel da Silva , [ ... ],
- Claudia Saunders
02-09-2022
Summary
Original ArticleImpact of Carbohydrate Counting Method during Pregnancy in Women with Pregestational Diabetes Mellitus: A Controlled Clinical Trial
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):220-230
02-09-2022- Larissa Mello de Oliveira ,
- Gabriella Pinto Belfort ,
- Patricia de Carvalho Padilha ,
- Eliane Lopes Rosado ,
- Letícia Barbosa Gabriel da Silva ,
- Sanmira Fagherazzi ,
- Lenita Zajdenverg ,
- Roberto Luís Zagury ,
- Claudia Saunders
Views179See moreAbstract
Objective
To evaluate the effect of the carbohydrate counting method (CCM) on glycemic control,maternal, and perinatal outcomes of pregnant women with pregestational diabetes mellitus (DM).
Methods
Nonrandomized controlled clinical trial performed with 89 pregnant women who had pregestational DMand received prenatal care in a public hospital in Rio de Janeiro, state of Rio de Janeiro, Brazil, between 2009 and 2014, subdivided into historic control group and intervention group, not simultaneous. The intervention group (n=51) received nutritional guidance from the carbohydrate counting method (CCM), and the historical control group (n=38), was guided by the traditionalmethod (TM). The Mann-Whitney test or the Wilcoxon test were used to compare intra- and intergroup outcomes andanalysis of variance (ANOVA) for repeated measures, corrected by the Bonferroni post-hoc test,was used to assess postprandial blood glucose.
Results
Only the CCM group showed a reduction in fasting blood glucose. Postprandial blood glucose decreased in the 2nd (p=0.00) and 3rd (p=0.00) gestational trimester in the CCM group, while in the TM group the reduction occurred only in the 2nd trimester (p=0.015). For perinatal outcomes and hypertensive disorders of pregnancy, there were no differences between groups. Cesarean delivery was performed in 82% of the pregnant women and was associated with hypertensive disorders (gestational hypertension or pre-eclampsia; p=0.047).
Conclusion
Both methods of nutritional guidance contributed to the reduction of postprandial glycemia of women and no differences were observed for maternal and perinatal outcomes. However, CCM had a better effect on postprandial glycemia and only this method contributed to reducing fasting blood glucose throughout the intervention. ReBEC Clinical Trials Database The present study was registered in the ReBEC Clinical Trials Database (Registro Brasileiro de Ensaios Clínicos, number RBR-524z9n).
Views179This 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 ArticleImpact of Carbohydrate Counting Method during Pregnancy in Women with Pregestational Diabetes Mellitus: A Controlled Clinical Trial
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):220-230
02-09-2022- Larissa Mello de Oliveira ,
- Gabriella Pinto Belfort ,
- Patricia de Carvalho Padilha ,
- Eliane Lopes Rosado ,
- Letícia Barbosa Gabriel da Silva ,
- Sanmira Fagherazzi ,
- Lenita Zajdenverg ,
- Roberto Luís Zagury ,
- Claudia Saunders
Views179See moreAbstract
Objective
To evaluate the effect of the carbohydrate counting method (CCM) on glycemic control,maternal, and perinatal outcomes of pregnant women with pregestational diabetes mellitus (DM).
Methods
Nonrandomized controlled clinical trial performed with 89 pregnant women who had pregestational DMand received prenatal care in a public hospital in Rio de Janeiro, state of Rio de Janeiro, Brazil, between 2009 and 2014, subdivided into historic control group and intervention group, not simultaneous. The intervention group (n=51) received nutritional guidance from the carbohydrate counting method (CCM), and the historical control group (n=38), was guided by the traditionalmethod (TM). The Mann-Whitney test or the Wilcoxon test were used to compare intra- and intergroup outcomes andanalysis of variance (ANOVA) for repeated measures, corrected by the Bonferroni post-hoc test,was used to assess postprandial blood glucose.
Results
Only the CCM group showed a reduction in fasting blood glucose. Postprandial blood glucose decreased in the 2nd (p=0.00) and 3rd (p=0.00) gestational trimester in the CCM group, while in the TM group the reduction occurred only in the 2nd trimester (p=0.015). For perinatal outcomes and hypertensive disorders of pregnancy, there were no differences between groups. Cesarean delivery was performed in 82% of the pregnant women and was associated with hypertensive disorders (gestational hypertension or pre-eclampsia; p=0.047).
Conclusion
Both methods of nutritional guidance contributed to the reduction of postprandial glycemia of women and no differences were observed for maternal and perinatal outcomes. However, CCM had a better effect on postprandial glycemia and only this method contributed to reducing fasting blood glucose throughout the intervention. ReBEC Clinical Trials Database The present study was registered in the ReBEC Clinical Trials Database (Registro Brasileiro de Ensaios Clínicos, number RBR-524z9n).
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. - Larissa Mello de Oliveira
-
Original Article
Could Aspirin Treatment Modify the Assessment of the Uterine Arteries?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):231-237
02-09-2022
Summary
Original ArticleCould Aspirin Treatment Modify the Assessment of the Uterine Arteries?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):231-237
02-09-2022Views174See moreAbstract
Objective
To analyze whether acetylsalicylic (ASA) intake modifies the mean uterine arteries pulsatility index (UtA-PI) at the 2nd or 3rd trimester in a cohort of pregnant women with abnormal mean UtA-PI at between 11 and 14 weeks of gestation.
Methods
This is a retrospective cohort study. Singleton pregnancies with abnormal mean UtA-PI at between 11 and 14 weeks of gestation were studied. The participants were divided into 3 groups: 1) If the participant did not take ASA during pregnancy; 2) If the participant took ASA before 14 weeks of gestation; and 3) If the participant took ASA after 14 weeks of gestation. The mean UtA-PI was evaluated at the 2nd and 3rd trimesters, and it was considered to improve when it decreased below the 95th percentile. The prevalence ratio (PR) and the number needed to treat (NNT) werecalculated.
Results
A total of 72 participants with a mean UtA-PI>95th percentile at the 1st trimester of gestation were evaluated. Out of the 18 participants who took ASA, 8 participants started it before 14 weeks of gestation and 10 after. A total of 33.3% of these participants had improved the mean UtA-PI at the 2nd and 3rd trimesters of gestation, although it was not statistically significant (p=0.154). The prevalence ratio was 0.95 (95% confidence interval [CI]: 0.31-1.89), but between the 1st and 2nd trimesters of gestation, the PR was 0.92 (95%CI: 0.21-0.99) and it was statistically significant.
Conclusion
The present work demonstrates a modification of the mean UtA-PI in participants who took ASA compared with those who did not. It is important to check if ASA can modify the normal limits of uterine arteries because this could have an impact on surveillance.
Views174This 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 ArticleCould Aspirin Treatment Modify the Assessment of the Uterine Arteries?
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):231-237
02-09-2022Views174See moreAbstract
Objective
To analyze whether acetylsalicylic (ASA) intake modifies the mean uterine arteries pulsatility index (UtA-PI) at the 2nd or 3rd trimester in a cohort of pregnant women with abnormal mean UtA-PI at between 11 and 14 weeks of gestation.
Methods
This is a retrospective cohort study. Singleton pregnancies with abnormal mean UtA-PI at between 11 and 14 weeks of gestation were studied. The participants were divided into 3 groups: 1) If the participant did not take ASA during pregnancy; 2) If the participant took ASA before 14 weeks of gestation; and 3) If the participant took ASA after 14 weeks of gestation. The mean UtA-PI was evaluated at the 2nd and 3rd trimesters, and it was considered to improve when it decreased below the 95th percentile. The prevalence ratio (PR) and the number needed to treat (NNT) werecalculated.
Results
A total of 72 participants with a mean UtA-PI>95th percentile at the 1st trimester of gestation were evaluated. Out of the 18 participants who took ASA, 8 participants started it before 14 weeks of gestation and 10 after. A total of 33.3% of these participants had improved the mean UtA-PI at the 2nd and 3rd trimesters of gestation, although it was not statistically significant (p=0.154). The prevalence ratio was 0.95 (95% confidence interval [CI]: 0.31-1.89), but between the 1st and 2nd trimesters of gestation, the PR was 0.92 (95%CI: 0.21-0.99) and it was statistically significant.
Conclusion
The present work demonstrates a modification of the mean UtA-PI in participants who took ASA compared with those who did not. It is important to check if ASA can modify the normal limits of uterine arteries because this could have an impact on surveillance.
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
Historical Clinical Outcomes of Children with Myelomeningocele Meeting the Criteria for Fetal Surgery: A Retrospective Cohort Survey of Brazilian Patients
- Fernando Maia Peixoto-Filho ,
- Tatiana Protzenko Cervante ,
- Antonio Rosa Bellas ,
- Saint Clair Gomes Junior ,
- Denise Araújo Lapa , [ ... ],
- Renato Augusto Moreira de Sá
02-09-2022
Summary
Original ArticleHistorical Clinical Outcomes of Children with Myelomeningocele Meeting the Criteria for Fetal Surgery: A Retrospective Cohort Survey of Brazilian Patients
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):238-244
02-09-2022- Fernando Maia Peixoto-Filho ,
- Tatiana Protzenko Cervante ,
- Antonio Rosa Bellas ,
- Saint Clair Gomes Junior ,
- Denise Araújo Lapa ,
- Gregório Lorenzo Acácio ,
- Paulo Roberto Nassar de Carvalho ,
- Renato Augusto Moreira de Sá
Views115See moreAbstract
Objective
To analyze the historical clinical outcomes of children with myelomeningocele (MMC) meeting the criteria for fetal surgery, but who underwent postnatal primary repair.
Methods
Data from children undergoing postnatal MMC repair between January 1995 and January 2015 were collected from the Neurosurgery Outpatient Clinic’s medical records. Children were included if they had ≥1 year of postoperative follow-up andmet the criteria for fetal surgery. The children’s data were then stratified according to whether they received a shunt or not. The primary outcome was mortality, and secondary outcomes were educational delays, hospitalization, recurrent urinary tract infections (UTIs), and renal failure.
Results
Over the 20-year period, 231 children with MMC were followed up. Based on clinical data recorded at the time of birth, 165 (71.4%) qualify of fetal surgery. Of the 165 patients, 136 (82.4%) underwent shunt placement. The mortality rate was 5.1% in the group with shunt and 0% in the group without, relative risk (RR) 3.28 (95% confidence interval, 95% CI, 0.19-55.9). The statistically significant RRs for adverse outcomes in the shunted group were 1.86 (95% CI, 1.01-3.44) for UTI, 30 (95% CI, 1.01-537) for renal failure, and 1.77 (95% CI, 1.09-2.87) for hospitalizations.
Conclusion
Children with MMC qualifying for fetal surgery who underwent shunt placement were more likely to have recurrent UTIs, develop renal failure, and be hospitalized. Since approximately half of the shunt procedures could be avoided by fetal surgery, there is a clinical benefit and a possible financial benefit to the implementation of this technology in our setting.
Views115This 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 ArticleHistorical Clinical Outcomes of Children with Myelomeningocele Meeting the Criteria for Fetal Surgery: A Retrospective Cohort Survey of Brazilian Patients
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):238-244
02-09-2022- Fernando Maia Peixoto-Filho ,
- Tatiana Protzenko Cervante ,
- Antonio Rosa Bellas ,
- Saint Clair Gomes Junior ,
- Denise Araújo Lapa ,
- Gregório Lorenzo Acácio ,
- Paulo Roberto Nassar de Carvalho ,
- Renato Augusto Moreira de Sá
Views115See moreAbstract
Objective
To analyze the historical clinical outcomes of children with myelomeningocele (MMC) meeting the criteria for fetal surgery, but who underwent postnatal primary repair.
Methods
Data from children undergoing postnatal MMC repair between January 1995 and January 2015 were collected from the Neurosurgery Outpatient Clinic’s medical records. Children were included if they had ≥1 year of postoperative follow-up andmet the criteria for fetal surgery. The children’s data were then stratified according to whether they received a shunt or not. The primary outcome was mortality, and secondary outcomes were educational delays, hospitalization, recurrent urinary tract infections (UTIs), and renal failure.
Results
Over the 20-year period, 231 children with MMC were followed up. Based on clinical data recorded at the time of birth, 165 (71.4%) qualify of fetal surgery. Of the 165 patients, 136 (82.4%) underwent shunt placement. The mortality rate was 5.1% in the group with shunt and 0% in the group without, relative risk (RR) 3.28 (95% confidence interval, 95% CI, 0.19-55.9). The statistically significant RRs for adverse outcomes in the shunted group were 1.86 (95% CI, 1.01-3.44) for UTI, 30 (95% CI, 1.01-537) for renal failure, and 1.77 (95% CI, 1.09-2.87) for hospitalizations.
Conclusion
Children with MMC qualifying for fetal surgery who underwent shunt placement were more likely to have recurrent UTIs, develop renal failure, and be hospitalized. Since approximately half of the shunt procedures could be avoided by fetal surgery, there is a clinical benefit and a possible financial benefit to the implementation of this technology in our setting.
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. - Fernando Maia Peixoto-Filho
Original Article Archives - Page 3 of 55 - Revista Brasileira de Ginecologia e Obstetrícia
