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Original Article
The role of HIV as an independent risk factor to cervical HSIL recurrence
- Fernanda Villar Fonseca
, - Newton Sérgio de Carvalho ,
- Carlos Afonso Maestri ,
- Manuella Fernandes Martins ,
- Dora Pedroso Kowacs
10-23-2024
Summary
Original ArticleThe role of HIV as an independent risk factor to cervical HSIL recurrence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo85
10-23-2024- Fernanda Villar Fonseca ,
- Newton Sérgio de Carvalho ,
- Carlos Afonso Maestri ,
- Manuella Fernandes Martins ,
- Dora Pedroso Kowacs
Views192ABSTRACT
Objective:
To evaluate the role of being human immunodeficiency virus (HIV) positive for predicting the risk of recurrence in women with a cervical high grade squamous intraepithelial lesion (HSIL) diagnosis.
Methods:
Retrospective observational case-control study, comprising HIV positive (case) and HIV negative (control) women in a 1:4 ratio. Women assisted by the Erasto Gaertner Hospital, between 2009-2018, with cervical HSIL diagnosis, submitted to treatment by Loop electrosurgical excision procedure (LEEP), and with a minimum follow-up of 18 months, were included. The immunological status, number and time to recurrence were analyzed, with p<0.05 considered significant. In a second analysis, only patients with free margins were evaluated.
Results:
The sample consisted of 320 women (64 cases and 256 controls). Presence of HIV, CD4 levels <200 and detectable viral load (CV) were associated with high risk of recurrence, with odds ratio (OR) of 5.4 (p<0.001/95CI:2.8-10); 3.6 (p<0.001 /IC95:0.6-21.1) and 1.8 (p=0.039 /IC95:0.3-9.3), respectively. In the sample with free margins (n=271), this risk was also higher among seropositive patients, with OR 4.18 (p=0.001/95CI:1.8-9.2).
Conclusion:
HIV is an independent risk factor for cervical HSIL recurrence and reduced disease-free survival time. Glandular involvement, compromised margins, undetectable CV and CD4<200 also increase the risk of relapse.
Key-words Disease-free survivalElectrosurgeryExcision marginsHIV infectionsRecurrenceRisk factorsSquamous intraepithelial lesionsUterine cervical neoplasmsSee moreViews192
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 ArticleThe role of HIV as an independent risk factor to cervical HSIL recurrence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo85
10-23-2024- Fernanda Villar Fonseca ,
- Newton Sérgio de Carvalho ,
- Carlos Afonso Maestri ,
- Manuella Fernandes Martins ,
- Dora Pedroso Kowacs
Views192ABSTRACT
Objective:
To evaluate the role of being human immunodeficiency virus (HIV) positive for predicting the risk of recurrence in women with a cervical high grade squamous intraepithelial lesion (HSIL) diagnosis.
Methods:
Retrospective observational case-control study, comprising HIV positive (case) and HIV negative (control) women in a 1:4 ratio. Women assisted by the Erasto Gaertner Hospital, between 2009-2018, with cervical HSIL diagnosis, submitted to treatment by Loop electrosurgical excision procedure (LEEP), and with a minimum follow-up of 18 months, were included. The immunological status, number and time to recurrence were analyzed, with p<0.05 considered significant. In a second analysis, only patients with free margins were evaluated.
Results:
The sample consisted of 320 women (64 cases and 256 controls). Presence of HIV, CD4 levels <200 and detectable viral load (CV) were associated with high risk of recurrence, with odds ratio (OR) of 5.4 (p<0.001/95CI:2.8-10); 3.6 (p<0.001 /IC95:0.6-21.1) and 1.8 (p=0.039 /IC95:0.3-9.3), respectively. In the sample with free margins (n=271), this risk was also higher among seropositive patients, with OR 4.18 (p=0.001/95CI:1.8-9.2).
Conclusion:
HIV is an independent risk factor for cervical HSIL recurrence and reduced disease-free survival time. Glandular involvement, compromised margins, undetectable CV and CD4<200 also increase the risk of relapse.
Key-words Disease-free survivalElectrosurgeryExcision marginsHIV infectionsRecurrenceRisk factorsSquamous intraepithelial lesionsUterine 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. - Fernanda Villar Fonseca
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Original Article
Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
- Nicole Zazula Beatrici ,
- Roxana Knobel ,
- Mariana Schmidt Vieira ,
- Iago Felipe Alexandrini ,
- Alberto Trapani Júnior , [ ... ],
- Carla Betina Andreucci
10-23-2024
Summary
Original ArticleAccess and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024- Nicole Zazula Beatrici ,
- Roxana Knobel ,
- Mariana Schmidt Vieira ,
- Iago Felipe Alexandrini ,
- Alberto Trapani Júnior ,
- Carla Betina Andreucci
Views146Abstract
Objective:
To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.
Methods:
Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.
Results:
395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.
Conclusion:
The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.
Key-words COVID-19Delivery of health careDiabetesGestationalpandemicsPostpartum periodPregnancyPrenatal caresurveys and questionnairesVaccinationSee moreViews146This 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 ArticleAccess and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024- Nicole Zazula Beatrici ,
- Roxana Knobel ,
- Mariana Schmidt Vieira ,
- Iago Felipe Alexandrini ,
- Alberto Trapani Júnior ,
- Carla Betina Andreucci
Views146Abstract
Objective:
To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.
Methods:
Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.
Results:
395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.
Conclusion:
The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.
Key-words COVID-19Delivery of health careDiabetesGestationalpandemicsPostpartum periodPregnancyPrenatal caresurveys and questionnairesVaccinationSee 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. - Nicole Zazula Beatrici
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Original Article
Nipple-sparing mastectomy in young versus elderly patients
- Antônio Luiz Frasson ,
- Isabela Miranda ,
- Betina Vollbrecht ,
- Carolina Malhone ,
- Ana Beatriz Falcone , [ ... ],
- Martina Lichtenfels
10-23-2024
Summary
Original ArticleNipple-sparing mastectomy in young versus elderly patients
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo90
10-23-2024- Antônio Luiz Frasson ,
- Isabela Miranda ,
- Betina Vollbrecht ,
- Carolina Malhone ,
- Ana Beatriz Falcone ,
- Fernanda Barbosa ,
- Francisco Pimentel Cavalcante ,
- Martina Lichtenfels
Views118See moreAbstract
Objective:
In this study, we compared indications and outcomes of 115 young (< 40 years) versus 40 elderly (> 60 years) patients undergoing nipple-sparing mastectomy (NSM) as risk-reducing surgery or for breast cancer (BC) treatment.
Methods:
Between January 2004 and December 2018, young and elderly patients undergoing NSM with complete data from at least 6 months of follow-up were included.
Results:
BC treatment was the main indication for NSM, observed in 85(73.9%) young versus 33(82.5%) elderly patients, followed by risk-reducing surgery in 30(26.1%) young versus 7(17.5%) elderly patients. Complication rates did not differ between the age groups. At a median follow-up of 43 months, the overall recurrence rate was higher in the younger cohort (p = 0.04). However, when stratified into local, locoregional, contralateral, and distant metastasis, no statistical difference was observed. During the follow-up, only 2(1.7%) young patients died.
Conclusion:
Our findings elucidate a higher recurrence rate of breast cancer in younger patients undergoing NSM, which may correlate with the fact that age is an independent prognostic factor. High overall survival and low complication rates were evidenced in the two groups showing the safety of NSM for young and elderly patients.
Views118This 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 ArticleNipple-sparing mastectomy in young versus elderly patients
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo90
10-23-2024- Antônio Luiz Frasson ,
- Isabela Miranda ,
- Betina Vollbrecht ,
- Carolina Malhone ,
- Ana Beatriz Falcone ,
- Fernanda Barbosa ,
- Francisco Pimentel Cavalcante ,
- Martina Lichtenfels
Views118See moreAbstract
Objective:
In this study, we compared indications and outcomes of 115 young (< 40 years) versus 40 elderly (> 60 years) patients undergoing nipple-sparing mastectomy (NSM) as risk-reducing surgery or for breast cancer (BC) treatment.
Methods:
Between January 2004 and December 2018, young and elderly patients undergoing NSM with complete data from at least 6 months of follow-up were included.
Results:
BC treatment was the main indication for NSM, observed in 85(73.9%) young versus 33(82.5%) elderly patients, followed by risk-reducing surgery in 30(26.1%) young versus 7(17.5%) elderly patients. Complication rates did not differ between the age groups. At a median follow-up of 43 months, the overall recurrence rate was higher in the younger cohort (p = 0.04). However, when stratified into local, locoregional, contralateral, and distant metastasis, no statistical difference was observed. During the follow-up, only 2(1.7%) young patients died.
Conclusion:
Our findings elucidate a higher recurrence rate of breast cancer in younger patients undergoing NSM, which may correlate with the fact that age is an independent prognostic factor. High overall survival and low complication rates were evidenced in the two groups showing the safety of NSM for young and elderly patients.
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. - Antônio Luiz Frasson
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Original Article
Multidisciplinary team training in postpartum hemorrhage: impact on the use of blood products
- Carina Bauer Luiz ,
- Ana Lúcia Letti Müller ,
- Cristiano Caetano Salazar ,
- Teresinha Zanella ,
- Gabriel Cardozo Müller , [ ... ],
- Janete Vettorazzi
09-18-2024
Summary
Original ArticleMultidisciplinary team training in postpartum hemorrhage: impact on the use of blood products
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo67
09-18-2024- Carina Bauer Luiz ,
- Ana Lúcia Letti Müller ,
- Cristiano Caetano Salazar ,
- Teresinha Zanella ,
- Gabriel Cardozo Müller ,
- Amanda Vilaverde Perez ,
- Mariana Sbaraini ,
- Maria Lucia Oppermann ,
- Janete Vettorazzi
Views166See moreAbstract
Objective
Compare the number of puerperal women submitted to blood transfusion before and after the implementation of a care protocol for postpartum hemorrhage (PPH) with multidisciplinary team training.
Methods
Cross-sectional study in a university hospital, analyzing births from 2015 to 2019, compared the use of blood products before and after the adoption of a PPH protocol with multidisciplinary training.
Results
Between 2015 and 2019, there were 17,731 births, with 299 (1.7%) postpartum women receiving blood products and 278 postpartum women were considered for this analysis, 128 (0.7%) at Time 1 and 150 (0.8%) at Time 2. After the multiprofessional team training (T2), there was a difference in the complete use of the PPH protocol (use of oxytocin, misoprostol and tranexamic acid) (T1 = 5.1% x T2 = 49.5%, p≤0.0001). An individual categorized analysis revealed that, in the T2 period, there was lower use of blood component units per patient compared to T1 (Mann-Whitney, p=0.006). It should be noted that at T1 and T2, 54% and 24% respectively received two units of blood products. It is important to highlight that after the multidisciplinary team training for the PPH protocol, the goal of zero maternal death due to hemorrhage was reached.
Conclusion
The adoption of a specific protocol for PPH, combined with the training of a multidisciplinary team, had an impact on the ability to identify women at high risk of hemorrhage, resulting in a decrease in the use of blood components.
Views166This 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 ArticleMultidisciplinary team training in postpartum hemorrhage: impact on the use of blood products
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo67
09-18-2024- Carina Bauer Luiz ,
- Ana Lúcia Letti Müller ,
- Cristiano Caetano Salazar ,
- Teresinha Zanella ,
- Gabriel Cardozo Müller ,
- Amanda Vilaverde Perez ,
- Mariana Sbaraini ,
- Maria Lucia Oppermann ,
- Janete Vettorazzi
Views166See moreAbstract
Objective
Compare the number of puerperal women submitted to blood transfusion before and after the implementation of a care protocol for postpartum hemorrhage (PPH) with multidisciplinary team training.
Methods
Cross-sectional study in a university hospital, analyzing births from 2015 to 2019, compared the use of blood products before and after the adoption of a PPH protocol with multidisciplinary training.
Results
Between 2015 and 2019, there were 17,731 births, with 299 (1.7%) postpartum women receiving blood products and 278 postpartum women were considered for this analysis, 128 (0.7%) at Time 1 and 150 (0.8%) at Time 2. After the multiprofessional team training (T2), there was a difference in the complete use of the PPH protocol (use of oxytocin, misoprostol and tranexamic acid) (T1 = 5.1% x T2 = 49.5%, p≤0.0001). An individual categorized analysis revealed that, in the T2 period, there was lower use of blood component units per patient compared to T1 (Mann-Whitney, p=0.006). It should be noted that at T1 and T2, 54% and 24% respectively received two units of blood products. It is important to highlight that after the multidisciplinary team training for the PPH protocol, the goal of zero maternal death due to hemorrhage was reached.
Conclusion
The adoption of a specific protocol for PPH, combined with the training of a multidisciplinary team, had an impact on the ability to identify women at high risk of hemorrhage, resulting in a decrease in the use of blood components.
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. - Carina Bauer Luiz
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Original Article
A new screening of preterm birth in gestation with short cervix after pessary plus progesterone
- Marcelo Santucci França ,
- Valter Lacerda de Andrade Jr. ,
- Alan Roberto Hatanaka ,
- Roberto Santos ,
- Francisco Herlanio Costa Carvalho , [ ... ],
- Rodolfo de Carvalho Pacagnella
09-06-2024
Summary
Original ArticleA new screening of preterm birth in gestation with short cervix after pessary plus progesterone
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo39i
09-06-2024- Marcelo Santucci França ,
- Valter Lacerda de Andrade Jr. ,
- Alan Roberto Hatanaka ,
- Roberto Santos ,
- Francisco Herlanio Costa Carvalho ,
- Maria Laura Costa ,
- Gabriela Ubeda Santucci França ,
- Rosiane Mattar ,
- Ben Willem Mol ,
- Antonio Fernandes Moron ,
- Rodolfo de Carvalho Pacagnella
Views136See moreAbstract
Objective
This study aims to create a new screening for preterm birth < 34 weeks after gestation with a cervical length (CL) ≤ 30 mm, based on clinical, demographic, and sonographic characteristics.
Methods
This is a post hoc analysis of a randomized clinical trial (RCT), which included pregnancies, in middle-gestation, screened with transvaginal ultrasound. After observing inclusion criteria, the patient was invited to compare pessary plus progesterone (PP) versus progesterone only (P) (1:1). The objective was to determine which variables were associated with severe preterm birth using logistic regression (LR). The area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for both groups after applying LR, with a false positive rate (FPR) set at 10%.
Results
The RCT included 936 patients, 475 in PP and 461 in P. The LR selected: ethnics white, absence of previous curettage, previous preterm birth, singleton gestation, precocious identification of short cervix, CL < 14.7 mm, CL in curve > 21.0 mm. The AUC (CI95%), sensitivity, specificity, PPV, and PNV, with 10% of FPR, were respectively 0.978 (0.961-0.995), 83.4%, 98.1%, 83.4% and 98.1% for PP < 34 weeks; and 0.765 (0.665-0.864), 38.7%, 92.1%, 26.1% and 95.4%, for P < 28 weeks.
Conclusion
Logistic regression can be effective to screen preterm birth < 34 weeks in patients in the PP Group and all pregnancies with CL ≤ 30 mm.
Views136This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleA new screening of preterm birth in gestation with short cervix after pessary plus progesterone
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo39i
09-06-2024- Marcelo Santucci França ,
- Valter Lacerda de Andrade Jr. ,
- Alan Roberto Hatanaka ,
- Roberto Santos ,
- Francisco Herlanio Costa Carvalho ,
- Maria Laura Costa ,
- Gabriela Ubeda Santucci França ,
- Rosiane Mattar ,
- Ben Willem Mol ,
- Antonio Fernandes Moron ,
- Rodolfo de Carvalho Pacagnella
Views136See moreAbstract
Objective
This study aims to create a new screening for preterm birth < 34 weeks after gestation with a cervical length (CL) ≤ 30 mm, based on clinical, demographic, and sonographic characteristics.
Methods
This is a post hoc analysis of a randomized clinical trial (RCT), which included pregnancies, in middle-gestation, screened with transvaginal ultrasound. After observing inclusion criteria, the patient was invited to compare pessary plus progesterone (PP) versus progesterone only (P) (1:1). The objective was to determine which variables were associated with severe preterm birth using logistic regression (LR). The area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) were calculated for both groups after applying LR, with a false positive rate (FPR) set at 10%.
Results
The RCT included 936 patients, 475 in PP and 461 in P. The LR selected: ethnics white, absence of previous curettage, previous preterm birth, singleton gestation, precocious identification of short cervix, CL < 14.7 mm, CL in curve > 21.0 mm. The AUC (CI95%), sensitivity, specificity, PPV, and PNV, with 10% of FPR, were respectively 0.978 (0.961-0.995), 83.4%, 98.1%, 83.4% and 98.1% for PP < 34 weeks; and 0.765 (0.665-0.864), 38.7%, 92.1%, 26.1% and 95.4%, for P < 28 weeks.
Conclusion
Logistic regression can be effective to screen preterm birth < 34 weeks in patients in the PP Group and all pregnancies with CL ≤ 30 mm.
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. - Marcelo Santucci França
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Original Article
Association between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study
- Luciana da Cunha Bernardes Argenta ,
- Nadya Helena Alves dos Santos ,
- Cláudia Saunders ,
- Joana Dias da Costa ,
- Letícia Victoria Souza da Cunha , [ ... ],
- Patricia de Carvalho Padilha
09-06-2024
Summary
Original ArticleAssociation between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo68
09-06-2024- Luciana da Cunha Bernardes Argenta ,
- Nadya Helena Alves dos Santos ,
- Cláudia Saunders ,
- Joana Dias da Costa ,
- Letícia Victoria Souza da Cunha ,
- Pamela Melo Krok Fedeszen ,
- Patricia de Carvalho Padilha
Views146See moreAbstract
Objective
To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants.
Methods
Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models.
Results
The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates.
Conclusion
No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.
Views146This 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 ArticleAssociation between dietary patterns and infant birth weight in brazilian pregnancy women with gestational diabetes: a cross-sectional study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo68
09-06-2024- Luciana da Cunha Bernardes Argenta ,
- Nadya Helena Alves dos Santos ,
- Cláudia Saunders ,
- Joana Dias da Costa ,
- Letícia Victoria Souza da Cunha ,
- Pamela Melo Krok Fedeszen ,
- Patricia de Carvalho Padilha
Views146See moreAbstract
Objective
To evaluate the association between the dietary patterns (DPs) of pregnant women with GDM (gestational diabetes mellitus) and the birth weight (BW) of the infants.
Methods
Cross-sectional study with 187 adult pregnant women with GDM attended at a maternity in Rio de Janeiro from 2011 to 2014. Dietary intake was assessed in the third trimester using a semiquantitative food frequency questionnaire (FFQ). The outcomes were BW and weight adequacy for gestational age (GA). Reduced Rank Regression (RRR) was used to explain the following response variables: density of carbohydrates, fibres, and saturated fatty acids. Statistical analyzes included multinomial logistic regression models.
Results
The mean BW was 3261.9 (± 424.5) g. Three DPs were identified, with DP 3 (high consumption of refined carbohydrates, fast foods/snacks, whole milk, sugars/sweets, and soft drinks and low consumption of beans, vegetables, and low-fat milk and derivatives) being the main pattern, explaining 48.37% of the response variables. In the multinomial logistic regression analysis no statistically significant association was found between the tertiles of DPs and BW or the adequacy of weight for GA, even after adjustments of confounding covariates.
Conclusion
No significant associations were found between maternal DPs in the third trimester of pregnancy and infant BW or adequacy of weight for GA.
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. - Luciana da Cunha Bernardes Argenta
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Original Article
Morbidity associated with emergency surgery versus scheduled surgery in patients with placenta accreta spectrum
- Juan José Saldarriaga-Hoyos ,
- Daniela Sarria-Ortiz ,
- Valentina Galindo-Velasco ,
- Luisa Fernanda Rivera-Torres ,
- Albaro José Nieto-Calvache
09-06-2024
Summary
Original ArticleMorbidity associated with emergency surgery versus scheduled surgery in patients with placenta accreta spectrum
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo74
09-06-2024- Juan José Saldarriaga-Hoyos ,
- Daniela Sarria-Ortiz ,
- Valentina Galindo-Velasco ,
- Luisa Fernanda Rivera-Torres ,
- Albaro José Nieto-Calvache
Views122See moreAbstract
Objective
This study aims to evaluate the clinical outcomes of surgical management for placenta accreta spectrum in a Latin American reference hospital specializing in this condition. The evaluation involves a comparison between surgeries performed on an emergent and scheduled basis.
Methods
A retrospective cohort study was conducted on patients with placenta accreta spectrum who underwent surgery between January 2011 and November 2021 at a hospital in Colombia, using data from the institutional PAS registry. The study included patients with intraoperative and/or histological confirmation of PAS, regardless of prenatal suspicion. Clinical outcomes were compared between patients who had emergent surgeries and those who had scheduled surgeries. Descriptive analysis involved summary measures and the Shapiro-Wilk test for quantitative variables, with comparisons made using Pearson’s Chi-squared test and the Wilcoxon rank sum test, applying a significance level of 5%.
Results
A total of 113 patients were included, 84 (74.3%) of them underwent scheduled surgery, and 29 (25.6%) underwent emergency surgery. The emergency surgery group required more transfusions (72.4% vs 48.8%, p=0.047). Patients with intraoperative diagnosis of placenta accreta spectrum (21 women, 19.5%) had a greater volume of blood loss than patients taken into surgery with known presence of placenta accreta spectrum (3500 ml, IQR 1700 – 4000 vs 1700 ml, IQR 1195-2135. p <0.001).
Conclusion
Patients with placenta accreta spectrum undergoing emergency surgery require transfusions more frequently than those undergoing scheduled surgery
Views122This 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 ArticleMorbidity associated with emergency surgery versus scheduled surgery in patients with placenta accreta spectrum
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo74
09-06-2024- Juan José Saldarriaga-Hoyos ,
- Daniela Sarria-Ortiz ,
- Valentina Galindo-Velasco ,
- Luisa Fernanda Rivera-Torres ,
- Albaro José Nieto-Calvache
Views122See moreAbstract
Objective
This study aims to evaluate the clinical outcomes of surgical management for placenta accreta spectrum in a Latin American reference hospital specializing in this condition. The evaluation involves a comparison between surgeries performed on an emergent and scheduled basis.
Methods
A retrospective cohort study was conducted on patients with placenta accreta spectrum who underwent surgery between January 2011 and November 2021 at a hospital in Colombia, using data from the institutional PAS registry. The study included patients with intraoperative and/or histological confirmation of PAS, regardless of prenatal suspicion. Clinical outcomes were compared between patients who had emergent surgeries and those who had scheduled surgeries. Descriptive analysis involved summary measures and the Shapiro-Wilk test for quantitative variables, with comparisons made using Pearson’s Chi-squared test and the Wilcoxon rank sum test, applying a significance level of 5%.
Results
A total of 113 patients were included, 84 (74.3%) of them underwent scheduled surgery, and 29 (25.6%) underwent emergency surgery. The emergency surgery group required more transfusions (72.4% vs 48.8%, p=0.047). Patients with intraoperative diagnosis of placenta accreta spectrum (21 women, 19.5%) had a greater volume of blood loss than patients taken into surgery with known presence of placenta accreta spectrum (3500 ml, IQR 1700 – 4000 vs 1700 ml, IQR 1195-2135. p <0.001).
Conclusion
Patients with placenta accreta spectrum undergoing emergency surgery require transfusions more frequently than those undergoing scheduled surgery
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. - Juan José Saldarriaga-Hoyos
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Original Article
Thinking on the purposes, roles and activities of networks for research on maternal and perinatal health: opinions of coordinators and members
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo75
09-06-2024
Summary
Original ArticleThinking on the purposes, roles and activities of networks for research on maternal and perinatal health: opinions of coordinators and members
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo75
09-06-2024Views95See moreAbstract
Objective
To identify the opinion of coordinators and members about the essential characteristics and to understand the research networks characteristics, to facilitate their implementation, sustainability and effectiveness so it can be replicated in low and middle-income countries.
Methods
A qualitative study using a semi-structured interview technique was conducted. We selected potential members, managers and participants of networks from publications identified in PubMed. After checking the FIGO congress program, we identified authors who were assigned as speakers at the event. An invitation was sent and interviews were scheduled.
Results
In total, eleven interviews were performed. Coordinators and members of networks have the same goal when they decide to participate in a network. In general, they cited that these individuals had to be committed, responsible and enthusiastic people. The network should be composed also of postgraduate students. A network should allow multi-leadership, co-responsibility, autonomy and empowerment of its members. Effective communication was mentioned as an important pillar for network maintenance. Another motivation is being an author or coauthor in publications. One way to maintain a network running is social or governmental commitment, after resources expire, studies continue.
Conclusion
Networks are different due to the social context where they are inserted, however, some characteristics are common to all of them, such as having engaged leaders. For an effective and sustainable network, commitment and motivation in a leader and members are more in need than financial resources. Ideally, to ensure the operation of the network, the institution where the leader is linked should support this network.
Views95This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleThinking on the purposes, roles and activities of networks for research on maternal and perinatal health: opinions of coordinators and members
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo75
09-06-2024Views95See moreAbstract
Objective
To identify the opinion of coordinators and members about the essential characteristics and to understand the research networks characteristics, to facilitate their implementation, sustainability and effectiveness so it can be replicated in low and middle-income countries.
Methods
A qualitative study using a semi-structured interview technique was conducted. We selected potential members, managers and participants of networks from publications identified in PubMed. After checking the FIGO congress program, we identified authors who were assigned as speakers at the event. An invitation was sent and interviews were scheduled.
Results
In total, eleven interviews were performed. Coordinators and members of networks have the same goal when they decide to participate in a network. In general, they cited that these individuals had to be committed, responsible and enthusiastic people. The network should be composed also of postgraduate students. A network should allow multi-leadership, co-responsibility, autonomy and empowerment of its members. Effective communication was mentioned as an important pillar for network maintenance. Another motivation is being an author or coauthor in publications. One way to maintain a network running is social or governmental commitment, after resources expire, studies continue.
Conclusion
Networks are different due to the social context where they are inserted, however, some characteristics are common to all of them, such as having engaged leaders. For an effective and sustainable network, commitment and motivation in a leader and members are more in need than financial resources. Ideally, to ensure the operation of the network, the institution where the leader is linked should support this network.
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 Archives - Page 3 of 55 - Revista Brasileira de Ginecologia e Obstetrícia
