-
Original Article
Study of 138 vulvar lichen sclerosus patients and the malignant risk transformation
- Bruna Obeica Vasconcellos
, - Susana Cristina Aidé Viviani Fialho ,
- Isabel Cristina Chulvis do Val Guimarães ,
- Caroline Alves de Oliveira Martins ,
- José Rodrigo de Moraes , [ ... ],
- Faustino Pérez-López
07-26-2024
Summary
Original ArticleStudy of 138 vulvar lichen sclerosus patients and the malignant risk transformation
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo62
07-26-2024- Bruna Obeica Vasconcellos ,
- Susana Cristina Aidé Viviani Fialho ,
- Isabel Cristina Chulvis do Val Guimarães ,
- Caroline Alves de Oliveira Martins ,
- José Rodrigo de Moraes ,
- Rita Maira Zanine ,
- Julia Correa Cardoso Guimarães ,
- Faustino Pérez-López
Views145See moreAbstract
Objective
To report the prevalence of malignant transformation of vulvar lichen sclerosus (VLS) and possible risk factors.
Methods
This is a cohort study with data analysis from medical records of 138 patients with histological diagnosis of VLS registered at the Vulvar Pathology Outpatient Clinic of the University Hospital, between 2007 and 2017. Predominance of risk factors was performed using logistic regression analysis. The variables studied were the length of follow-up, age, regular or irregular follow up; presence of symptoms (dyspareunia, pruritus and/or vulvar burning); histology characteristics, the presence of epithelial hyperplasia; and the presence of autoimmune diseases.
Results
There were 138 patients included in the study, and among them five progressed to malignant transformation. The patients had a median age of 59 years and 83% were symptomatic. The most frequent symptom was itching with 72%. Autoimmune diseases were present in 11.6%, the most prevalent being thyroid disease. All five case of malignant transformation (0.6%) had an irregular follow up. The logistic regression analysis was used among the studied variables, and no statistical significance was found among them (p ≥ 0.05). The relationship between hyperplasia and the clinical outcome of malignant transformation, in which non-significant but acceptable p value close to 0.05 was observed.
Conclusion
The prevalence of malignant transformation in patients with VLS was 0.6%, and common factors were the lack of adherence to medical treatments and the loss of follow-up.
Views145
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 ArticleStudy of 138 vulvar lichen sclerosus patients and the malignant risk transformation
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo62
07-26-2024- Bruna Obeica Vasconcellos ,
- Susana Cristina Aidé Viviani Fialho ,
- Isabel Cristina Chulvis do Val Guimarães ,
- Caroline Alves de Oliveira Martins ,
- José Rodrigo de Moraes ,
- Rita Maira Zanine ,
- Julia Correa Cardoso Guimarães ,
- Faustino Pérez-López
Views145See moreAbstract
Objective
To report the prevalence of malignant transformation of vulvar lichen sclerosus (VLS) and possible risk factors.
Methods
This is a cohort study with data analysis from medical records of 138 patients with histological diagnosis of VLS registered at the Vulvar Pathology Outpatient Clinic of the University Hospital, between 2007 and 2017. Predominance of risk factors was performed using logistic regression analysis. The variables studied were the length of follow-up, age, regular or irregular follow up; presence of symptoms (dyspareunia, pruritus and/or vulvar burning); histology characteristics, the presence of epithelial hyperplasia; and the presence of autoimmune diseases.
Results
There were 138 patients included in the study, and among them five progressed to malignant transformation. The patients had a median age of 59 years and 83% were symptomatic. The most frequent symptom was itching with 72%. Autoimmune diseases were present in 11.6%, the most prevalent being thyroid disease. All five case of malignant transformation (0.6%) had an irregular follow up. The logistic regression analysis was used among the studied variables, and no statistical significance was found among them (p ≥ 0.05). The relationship between hyperplasia and the clinical outcome of malignant transformation, in which non-significant but acceptable p value close to 0.05 was observed.
Conclusion
The prevalence of malignant transformation in patients with VLS was 0.6%, and common factors were the lack of adherence to medical treatments and the loss of follow-up.
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. - Bruna Obeica Vasconcellos
-
Original Article
Agreement between frozen section and histopathology to detect malignancy in adnexal masses according to size and morphology by ultrasound
- Clarissa de Andrade Amaral ,
- Priscila Grecca Pedrão ,
- Luani Rezende Godoy ,
- Yasmin Medeiros Guimarães ,
- Cassia Arantes Petroni Macedo , [ ... ],
- Ricardo dos Reis
07-26-2024
Summary
Original ArticleAgreement between frozen section and histopathology to detect malignancy in adnexal masses according to size and morphology by ultrasound
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo63
07-26-2024- Clarissa de Andrade Amaral ,
- Priscila Grecca Pedrão ,
- Luani Rezende Godoy ,
- Yasmin Medeiros Guimarães ,
- Cassia Arantes Petroni Macedo ,
- Marcia Appel ,
- Guilherme Spagna Accorsi ,
- Jeferson Rodrigo Zanon ,
- Ricardo dos Reis
Views133See moreAbstract
Objective
Management of suspect adnexal masses involves surgery to define the best treatment. Diagnostic choices include a two-stage procedure for histopathology examination (HPE) or intraoperative histological analysis – intraoperative frozen section (IFS) and formalin-fixed and paraffin-soaked tissues (FFPE). Preoperative assessment with ultrasound may also be useful to predict malignancy. We aimed at determining the accuracy of IFS to evaluate adnexal masses stratified by size and morphology having HPE as the diagnostic gold standard.
Methods
A retrospective chart review of 302 patients undergoing IFS of adnexal masses at Hospital de Clínicas de Porto Alegre, between January2005 and September2011 was performed. Data were collected regarding sonographic size (≤10cm or >10cm), characteristics of the lesion, and diagnosis established in IFS and HPE. Eight groups were studied: unilocular lesions; septated/cystic lesions; heterogeneous (solid/cystic) lesions; and solid lesions, divided in two main groups according to the size of lesion, ≤10cm or >10cm. Kappa agreement between IFS and HPE was calculated for each group.
Results
Overall agreement between IFS and HPE was 96.1% for benign tumors, 96.1% for malignant tumors, and 73.3% for borderline tumors. Considering the combination of tumor size and morphology, 100% agreement between IFS and HPE was recorded for unilocular and septated tumors ≤10cm and for solid tumors.
Conclusion
Stratification of adnexal masses according to size and morphology is a good method for preoperative assessment. We should wait for final HPE for staging decision, regardless of IFS results, in heterogeneous adnexal tumors of any size, solid tumors ≤10cm, and all non-solid tumors >10cm.
Views133This 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 ArticleAgreement between frozen section and histopathology to detect malignancy in adnexal masses according to size and morphology by ultrasound
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo63
07-26-2024- Clarissa de Andrade Amaral ,
- Priscila Grecca Pedrão ,
- Luani Rezende Godoy ,
- Yasmin Medeiros Guimarães ,
- Cassia Arantes Petroni Macedo ,
- Marcia Appel ,
- Guilherme Spagna Accorsi ,
- Jeferson Rodrigo Zanon ,
- Ricardo dos Reis
Views133See moreAbstract
Objective
Management of suspect adnexal masses involves surgery to define the best treatment. Diagnostic choices include a two-stage procedure for histopathology examination (HPE) or intraoperative histological analysis – intraoperative frozen section (IFS) and formalin-fixed and paraffin-soaked tissues (FFPE). Preoperative assessment with ultrasound may also be useful to predict malignancy. We aimed at determining the accuracy of IFS to evaluate adnexal masses stratified by size and morphology having HPE as the diagnostic gold standard.
Methods
A retrospective chart review of 302 patients undergoing IFS of adnexal masses at Hospital de Clínicas de Porto Alegre, between January2005 and September2011 was performed. Data were collected regarding sonographic size (≤10cm or >10cm), characteristics of the lesion, and diagnosis established in IFS and HPE. Eight groups were studied: unilocular lesions; septated/cystic lesions; heterogeneous (solid/cystic) lesions; and solid lesions, divided in two main groups according to the size of lesion, ≤10cm or >10cm. Kappa agreement between IFS and HPE was calculated for each group.
Results
Overall agreement between IFS and HPE was 96.1% for benign tumors, 96.1% for malignant tumors, and 73.3% for borderline tumors. Considering the combination of tumor size and morphology, 100% agreement between IFS and HPE was recorded for unilocular and septated tumors ≤10cm and for solid tumors.
Conclusion
Stratification of adnexal masses according to size and morphology is a good method for preoperative assessment. We should wait for final HPE for staging decision, regardless of IFS results, in heterogeneous adnexal tumors of any size, solid tumors ≤10cm, and all non-solid tumors >10cm.
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. - Clarissa de Andrade Amaral
-
Original Article
Maternal deaths caused by eclampsia in Brazil: a descriptive study from 2000 to 2021
- Victor Hugo Palhares Flávio-Reis ,
- Yago Marcos Pessoa-Gonçalves ,
- Alan de Castro Barbosa ,
- Chamberttan Souza Desidério ,
- Wellington Francisco Rodrigues , [ ... ],
- Carlo José Freire Oliveira
07-26-2024
Summary
Original ArticleMaternal deaths caused by eclampsia in Brazil: a descriptive study from 2000 to 2021
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo65
07-26-2024- Victor Hugo Palhares Flávio-Reis ,
- Yago Marcos Pessoa-Gonçalves ,
- Alan de Castro Barbosa ,
- Chamberttan Souza Desidério ,
- Wellington Francisco Rodrigues ,
- Carlo José Freire Oliveira
Views171See moreAbstract
Objective
Eclampsia is a hypertensive disorder that occurs during pregnancy and can lead to death. The literature has gaps by not providing comprehensive data on the epidemiology of the disease, restricting analysis to limited temporal intervals and geographical locations. This study aims to characterize the epidemiological profile of women who died from eclampsia in Brazil from 2000 to 2021.
Methods
The maternal mortality data were obtained from the Sistema de Informações sobre Mortalidade, with the following variables of interest selected: “Federative Unit,” “Year,” “Age Range,” “Race/Color,” and “Education Level.” The collection of the number of live births for data normalization was conducted in the Sistema de Informações sobre Nascidos Vivos. Statistical analyses were performed using GraphPad Prism, calculating odds ratio for variables and fixing number of deaths per 100,000 live births for calculating maternal mortality ratio (MMR).
Results
There was a downward trend in maternal mortality rate during the study period. Maranhão stood out as the federative unit with the highest MMR (17 deaths per 100.000 live births). Mothers aged between 40 and 49 years (OR = 3.55, CI: 3.11–4.05) presents higher MMR. Additionally, black women showed the highest MMR (OR = 4.67, CI: 4.18–5.22), as well as mothers with no educational background (OR = 5.83, CI: 4.82–7.06).
Conclusion
The epidemiological profile studied is predominantly composed of mothers with little or no formal education, self-declared as Black, residing in needy states and with advanced aged. These data are useful for formulating public policies aimed at combating the issue.
Views171This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleMaternal deaths caused by eclampsia in Brazil: a descriptive study from 2000 to 2021
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo65
07-26-2024- Victor Hugo Palhares Flávio-Reis ,
- Yago Marcos Pessoa-Gonçalves ,
- Alan de Castro Barbosa ,
- Chamberttan Souza Desidério ,
- Wellington Francisco Rodrigues ,
- Carlo José Freire Oliveira
Views171See moreAbstract
Objective
Eclampsia is a hypertensive disorder that occurs during pregnancy and can lead to death. The literature has gaps by not providing comprehensive data on the epidemiology of the disease, restricting analysis to limited temporal intervals and geographical locations. This study aims to characterize the epidemiological profile of women who died from eclampsia in Brazil from 2000 to 2021.
Methods
The maternal mortality data were obtained from the Sistema de Informações sobre Mortalidade, with the following variables of interest selected: “Federative Unit,” “Year,” “Age Range,” “Race/Color,” and “Education Level.” The collection of the number of live births for data normalization was conducted in the Sistema de Informações sobre Nascidos Vivos. Statistical analyses were performed using GraphPad Prism, calculating odds ratio for variables and fixing number of deaths per 100,000 live births for calculating maternal mortality ratio (MMR).
Results
There was a downward trend in maternal mortality rate during the study period. Maranhão stood out as the federative unit with the highest MMR (17 deaths per 100.000 live births). Mothers aged between 40 and 49 years (OR = 3.55, CI: 3.11–4.05) presents higher MMR. Additionally, black women showed the highest MMR (OR = 4.67, CI: 4.18–5.22), as well as mothers with no educational background (OR = 5.83, CI: 4.82–7.06).
Conclusion
The epidemiological profile studied is predominantly composed of mothers with little or no formal education, self-declared as Black, residing in needy states and with advanced aged. These data are useful for formulating public policies aimed at combating the issue.
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. - Victor Hugo Palhares Flávio-Reis
-
Original Article
Effect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut , [ ... ],
- Şevki Çelen
07-26-2024
Summary
Original ArticleEffect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo66
07-26-2024- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut ,
- Cantekin İskender ,
- Şevki Çelen
Views153Abstract
Objective
This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG) levels.
Methods
The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free β-hCG and PAPP-A levels of the groups were compared.
Results
There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free β-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free β-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05).
Conclusion
The level of PAPP-A and free β-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.
Key-words Abortion, threatenedAneuploidybiomarkersChorionic gonadotropinPregnancy trimester, firstPregnancy-associated plasma protein-ASubchorionic hematomaSee moreViews153This 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 ArticleEffect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo66
07-26-2024- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut ,
- Cantekin İskender ,
- Şevki Çelen
Views153Abstract
Objective
This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG) levels.
Methods
The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free β-hCG and PAPP-A levels of the groups were compared.
Results
There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free β-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free β-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05).
Conclusion
The level of PAPP-A and free β-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.
Key-words Abortion, threatenedAneuploidybiomarkersChorionic gonadotropinPregnancy trimester, firstPregnancy-associated plasma protein-ASubchorionic hematomaSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Arife Akay
-
Original Article
Prevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
06-27-2024
Summary
Original ArticlePrevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo51
06-27-2024- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Views136Abstract
Objective
To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.
Methods
We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.
Results
Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.
Conclusion
The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.
Key-words Abortion, habitualAbortion, spontaneousChromosome aberrationsKaryotypeTranslocation, geneticSee moreViews136This 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 ArticlePrevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo51
06-27-2024- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Views136Abstract
Objective
To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.
Methods
We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.
Results
Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.
Conclusion
The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.
Key-words Abortion, habitualAbortion, spontaneousChromosome aberrationsKaryotypeTranslocation, geneticSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Elaine Cristina Fontes de Oliveira
-
Original Article
Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
06-27-2024
Summary
Original ArticleClinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
06-27-2024- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Views163Abstract
Objective
To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.
Methods
This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.
Results
A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).
Conclusion
The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.
Key-words coronavirus infectionsCOVID-19Health information systemsMaternal deathPostpartum periodPregnancySARS-CoV-2See moreViews163This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleClinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
06-27-2024- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Views163Abstract
Objective
To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.
Methods
This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.
Results
A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).
Conclusion
The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.
Key-words coronavirus infectionsCOVID-19Health information systemsMaternal deathPostpartum periodPregnancySARS-CoV-2See moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Gustavo Gonçalves dos Santos
-
Original Article
Risk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares , [ ... ],
- Sue Yazaki Sun
06-27-2024
Summary
Original ArticleRisk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo53
06-27-2024- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares ,
- Camilla Parente Salmeron ,
- João Victor Jacomele Caldas ,
- Nathalia Mello ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Sue Yazaki Sun
Views180Abstract
Objective
To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.
Methods
We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.
Results
There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).
Conclusion
Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.
Key-words Hospitals, maternityPostpartum hemorrhagePostpartum periodPregnancyRisk factorsrobson classificationSee moreViews180This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Original ArticleRisk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo53
06-27-2024- Amanda Botelho ,
- Adriana Luckow Invitti ,
- ,
- Rosiane Mattar ,
- David Baptista da Silva Pares ,
- Camilla Parente Salmeron ,
- João Victor Jacomele Caldas ,
- Nathalia Mello ,
- Alberto Borges Peixoto ,
- Edward Araujo Júnior ,
- Sue Yazaki Sun
Views180Abstract
Objective
To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.
Methods
We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.
Results
There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).
Conclusion
Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.
Key-words Hospitals, maternityPostpartum hemorrhagePostpartum periodPregnancyRisk factorsrobson classificationSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Amanda Botelho
-
Original Article
The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects
- Claruza Braga Holanda Lavor ,
- Francisca Adriele Vieira Neta ,
- Antonio Brazil Viana Júnior ,
- Francisco das Chagas Medeiros
06-27-2024
Summary
Original ArticleThe impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo42
06-27-2024- Claruza Braga Holanda Lavor ,
- Francisca Adriele Vieira Neta ,
- Antonio Brazil Viana Júnior ,
- Francisco das Chagas Medeiros
Views197Abstract
Objective
To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Methods
Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Results
Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Conclusion
Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
Key-words AnxietyDepressionEndometriosisInflammationLaparoscopyLipidsMental healthPelvic painQuality of lifesurveys and questionnairesSee moreViews197This 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 impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo42
06-27-2024- Claruza Braga Holanda Lavor ,
- Francisca Adriele Vieira Neta ,
- Antonio Brazil Viana Júnior ,
- Francisco das Chagas Medeiros
Views197Abstract
Objective
To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Methods
Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Results
Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Conclusion
Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
Key-words AnxietyDepressionEndometriosisInflammationLaparoscopyLipidsMental healthPelvic painQuality of lifesurveys and questionnairesSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Claruza Braga Holanda Lavor
Original Article Archives - Page 3 of 55 - Revista Brasileira de Ginecologia e Obstetrícia
