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Original Article07-26-2024
Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
- Jaqueline Brandão Mazzola
, - Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal , [ ... ],
- Luciano Marcondes Machado Nardozza
Abstract
Original ArticleMode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views202Abstract
Objective
To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.
Methods
Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).
Results
Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).
Conclusion
Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson classificationSee moreViews202
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleMode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30
- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views202Abstract
Objective
To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.
Methods
Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).
Results
Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).
Conclusion
Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson 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. - Jaqueline Brandão Mazzola
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Original Article07-26-2024
Association of insulin-like growth factor II mrna-binding protein 3 (IMP3) expression with prognostic and morphological factors in endometrial cancer
- Silas Otero Reis Salum ,
- Eduardo Batista Candido ,
- Maria Aparecida Custódio Domingues ,
- Elida Paula Benquique Ojopi ,
- Ângela Favorito Santarem Tonon , [ ... ],
- Agnaldo Lopes da Silva-Filho
Abstract
Original ArticleAssociation of insulin-like growth factor II mrna-binding protein 3 (IMP3) expression with prognostic and morphological factors in endometrial cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo61
- Silas Otero Reis Salum ,
- Eduardo Batista Candido ,
- Maria Aparecida Custódio Domingues ,
- Elida Paula Benquique Ojopi ,
- Ângela Favorito Santarem Tonon ,
- Agnaldo Lopes da Silva-Filho
Views162See moreAbstract
Objective
Endometrial cancer (EC) is a heterogeneous disease with recurrence rates ranging from 15 to 20%. The discrimination of cases with a worse prognosis aims, in part, to reduce the length of surgical staging in cases with a better prognosis. This study aimed to evaluate the association between Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression and prognostic and morphological factors in EC.
Methods
This retrospective, cross-sectional, analytical study included 79 EC patients - 70 endometrioid carcinoma (EEC) and 9 serous carcinoma (SC) - and 74 benign endometrium controls. IMP3 expression was evaluated by immunohistochemistry-based TMA (Tissue Microarray), and the results were associated with morphological and prognostic factors, including claudins 3 and 4, estrogen and progesterone receptors, TP53, and KI67.
Results
IMP3 expression was significantly higher in SC compared to EEC in both extent (p<0.001) and intensity (p=0.044). It was also significantly associated with worse prognostic factors, including degree of differentiation (p=0.024, p<0.001), staging (p<0.001; p<0.001) and metastasis (p=0.002; p<0.001). IMP3 expression was also significant in extent (p=0.002) in endometrial tumors compared with controls. In addition, protein TP53 and KI67 showed significant associations in extent and intensity, respectively.
Conclusion
IMP3 expression was associated with worse prognostic factors studied. These findings suggest that IMP3 may be a potential biomarker for EC poorer prognosis.
Views162This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleAssociation of insulin-like growth factor II mrna-binding protein 3 (IMP3) expression with prognostic and morphological factors in endometrial cancer
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo61
- Silas Otero Reis Salum ,
- Eduardo Batista Candido ,
- Maria Aparecida Custódio Domingues ,
- Elida Paula Benquique Ojopi ,
- Ângela Favorito Santarem Tonon ,
- Agnaldo Lopes da Silva-Filho
Views162See moreAbstract
Objective
Endometrial cancer (EC) is a heterogeneous disease with recurrence rates ranging from 15 to 20%. The discrimination of cases with a worse prognosis aims, in part, to reduce the length of surgical staging in cases with a better prognosis. This study aimed to evaluate the association between Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression and prognostic and morphological factors in EC.
Methods
This retrospective, cross-sectional, analytical study included 79 EC patients - 70 endometrioid carcinoma (EEC) and 9 serous carcinoma (SC) - and 74 benign endometrium controls. IMP3 expression was evaluated by immunohistochemistry-based TMA (Tissue Microarray), and the results were associated with morphological and prognostic factors, including claudins 3 and 4, estrogen and progesterone receptors, TP53, and KI67.
Results
IMP3 expression was significantly higher in SC compared to EEC in both extent (p<0.001) and intensity (p=0.044). It was also significantly associated with worse prognostic factors, including degree of differentiation (p=0.024, p<0.001), staging (p<0.001; p<0.001) and metastasis (p=0.002; p<0.001). IMP3 expression was also significant in extent (p=0.002) in endometrial tumors compared with controls. In addition, protein TP53 and KI67 showed significant associations in extent and intensity, respectively.
Conclusion
IMP3 expression was associated with worse prognostic factors studied. These findings suggest that IMP3 may be a potential biomarker for EC poorer prognosis.
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. - Silas Otero Reis Salum
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Original Article07-26-2024
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
Abstract
Original ArticleStudy of 138 vulvar lichen sclerosus patients and the malignant risk transformation
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo62
- 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
Views185See 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.
Views185This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleStudy of 138 vulvar lichen sclerosus patients and the malignant risk transformation
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo62
- 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
Views185See 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
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Original Article07-26-2024
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
Abstract
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
- 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
Views177See 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.
Views177This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original 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
- 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
Views177See 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
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Original Article07-26-2024
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
Abstract
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
- Victor Hugo Palhares Flávio-Reis ,
- Yago Marcos Pessoa-Gonçalves ,
- Alan de Castro Barbosa ,
- Chamberttan Souza Desidério ,
- Wellington Francisco Rodrigues ,
- Carlo José Freire Oliveira
Views234See 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.
Views234This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleMaternal deaths caused by eclampsia in Brazil: a descriptive study from 2000 to 2021
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo65
- Victor Hugo Palhares Flávio-Reis ,
- Yago Marcos Pessoa-Gonçalves ,
- Alan de Castro Barbosa ,
- Chamberttan Souza Desidério ,
- Wellington Francisco Rodrigues ,
- Carlo José Freire Oliveira
Views234See 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
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Original Article07-26-2024
Effect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut , [ ... ],
- Şevki Çelen
Abstract
Original ArticleEffect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo66
- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut ,
- Cantekin İskender ,
- Şevki Çelen
Views216Abstract
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 moreViews216This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleEffect of subchorionic hematoma on first-trimester maternal serum free β-hCG and PAPP-A levels
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo66
- Arife Akay ,
- Yıldız Akdaş Reis ,
- Büşra Şahin ,
- Asya Kalaycı Öncü ,
- Mehmet Obut ,
- Cantekin İskender ,
- Şevki Çelen
Views216Abstract
Objective
This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free β-human chorionic gonadotropin (β-hCG) levels.
Methods
The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free β-hCG and PAPP-A levels of the groups were compared.
Results
There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free β-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free β-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05).
Conclusion
The level of PAPP-A and free β-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.
Key-words Abortion, threatenedAneuploidybiomarkersChorionic gonadotropinPregnancy trimester, firstPregnancy-associated plasma protein-ASubchorionic hematomaSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Arife Akay
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Original Article06-27-2024
Prevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Abstract
Original ArticlePrevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo51
- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Views170Abstract
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 moreViews170This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticlePrevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo51
- Elaine Cristina Fontes de Oliveira ,
- Ines Katerina Damasceno Cavallo Cruzeiro ,
- Cezar Antônio Abreu de Souza ,
- Fernando Marcos Reis
Views170Abstract
Objective
To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.
Methods
We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.
Results
Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.
Conclusion
The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.
Key-words Abortion, habitualAbortion, spontaneousChromosome aberrationsKaryotypeTranslocation, geneticSee moreThis is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Elaine Cristina Fontes de Oliveira
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Original Article06-27-2024
Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Abstract
Original ArticleClinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Views210Abstract
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 moreViews210This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract
Original ArticleClinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo52
- Gustavo Gonçalves dos Santos ,
- Anderson Lima Cordeiro da Silva ,
- Edson Silva do Nascimento ,
- Luis Henrique de Andrade
Views210Abstract
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 Archives - Page 3 of 201 - Revista Brasileira de Ginecologia e Obstetrícia
