Review Article Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Review Article

    Ocular Changes During Pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):32-42

    Summary

    Review Article

    Ocular Changes During Pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(1):32-42

    DOI 10.1055/s-0037-1605366

    Views1

    Abstract

    Pregnancy is needed for the perpetuation of the human species, and it leads to physiological adaptations of the various maternal organs and systems. The eye, although a closed space, also undergoes some modifications, most of which are relatively innocuous, but they may occasionally become pathological. For women, pregnancy is a susceptibility period; however, for many obstetricians, their knowledge of the ocular changes that occur during pregnancy tends to be limited. For this reason, this is a important area of study as is necessary the development of guidelines to approach those changes. Of equal importance are the knowledge of the possible therapies for ophthalmological problems in this period and the evaluation of themode of delivery in particular conditions. For this article, an extensive review of the literature was performed, and a summary of the findings is presented.

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    Ocular Changes During Pregnancy
  • Review Article

    Is Ovarian Cancer Prevention Currently Still a recommendation of Our Grandparents?

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):676-685

    Summary

    Review Article

    Is Ovarian Cancer Prevention Currently Still a recommendation of Our Grandparents?

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(12):676-685

    DOI 10.1055/s-0037-1608867

    Views1

    Abstract

    Ovarian cancer is the leading cause of death among gynecologic tumors because in most of the cases (75%), the disease is diagnosed in advanced stages. Screening methods are not available since the disease is rare, and the tested methods, such as ultrasound and CA125, were not able to decrease the mortality rate for this type of cancer. This article discusses the main risk factors for ovarian cancer, and the potential clinical and surgical strategies for the prevention of this disease.

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    Is Ovarian Cancer Prevention Currently Still a recommendation of Our Grandparents?
  • Review Article

    Acute Onset Neurological Disorders during Pregnancy: A Literature Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):560-568

    Summary

    Review Article

    Acute Onset Neurological Disorders during Pregnancy: A Literature Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(10):560-568

    DOI 10.1055/s-0037-1604058

    Views1

    Abstract

    Objectives

    To characterize the most common peripheral and central neurological disorders during pregnancy.

    Methods

    Original research and review of the literature on neurological complications during pregnancy. We searched for keywords related to the topic on different databases.

    Results

    Pregnancy involves physiological changes that can trigger peripheral neurological and/or central nervous system pathologies, which can sometimes be associated with hypertensive disorders. A definitive diagnosis of neurological disorders can be made according to the trimester of pregnancy and the clinical findings. Carpal tunnel syndrome and peripheral facial palsy are common peripheral neurological disorders, more frequent in the second half of pregnancy. Central nervous disorders are more complex and a precise diagnosis must be made in order to improve perinatal outcomes, provide correct management and treatment and to prevent acute and long-term complications.

    Conclusions

    It is possible to achieve a precise diagnosis,management and treatment of neurological disorders during pregnancy, but these require a multidisciplinary approach, crucial to improve perinatal outcomes.

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    Acute Onset Neurological Disorders during Pregnancy: A Literature Review
  • Review Article

    Preeclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512

    Summary

    Review Article

    Preeclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512

    DOI 10.1055/s-0037-1604471

    Views5

    Abstract

    The authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia. The early treatment of acute hypertension, use of magnesium sulfate and early hospitalization in cases of preeclampsia are concepts to pursue the reduction of our pregnant women’s mortality.

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    Preeclampsia
  • Review Article

    Physical Activity during Pregnancy: Recommendations and Assessment Tools

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(8):424-432

    Summary

    Review Article

    Physical Activity during Pregnancy: Recommendations and Assessment Tools

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(8):424-432

    DOI 10.1055/s-0037-1604180

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    Abstract

    The literature that supports and recommends the practice of exercise during pregnancy is extensive.However, although a more complete research on ways to evaluate the physical activity performedby pregnant women has been perfomed, it is found that there is no gold standard and that the articles in the area are inconclusive. Thus, the objective of the present article is to review relevant aspects, such as, technique and applicability of the different methods for the assessment of physical activity during pregnancy to providemore reliable and safe information for health professionals to encourage their pregnant patients to engage in the practice of physical activity. This review concluded that all tools for the analysis of physical activity have limitations. Thus, it is necessary to establish the objectives of evaluation in an appropriate manner, as well as to determine their viability and costeffectiveness for the population under study.

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  • Review Article

    Abnormal Uterine Bleeding

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):358-368

    Summary

    Review Article

    Abnormal Uterine Bleeding

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(7):358-368

    DOI 10.1055/s-0037-1603807

    Views3

    Abstract

    Abnormal uterine bleeding is a frequent condition in Gynecology. It may impact physical, emotional sexual and professional aspects of the lives of women, impairing their quality of life. In cases of acute and severe bleeding, women may need urgent treatment with volumetric replacement and prescription of hemostatic substances. In some specific cases with more intense and prolonged bleeding, surgical treatment may be necessary. The objective of this chapter is to describe the main evidence on the treatment of women with abnormaluterinebleeding, both acuteand chronic.Didactically,thetreatmentoptions were based on the current International Federation of Gynecology and Obstetrics (FIGO) classification system (PALM-COEIN). The etiologies of PALM-COEIN are: uterine Polyp (P), Adenomyosis (A), Leiomyoma (L), precursor and Malignant lesions of the uterine body (M), Coagulopathies (C), Ovulatory dysfunction (O), Endometrial dysfunction (E), Iatrogenic (I), and Not yet classified (N). The articles were selected according to the recommendation grades of the PubMed, Cochrane and Embase databases, and those in which the main objective was the reduction of uterine menstrual bleeding were included. Only studies written in English were included. All editorial or complete papers that were not consistent with abnormal uterine bleeding, or studies in animal models, were excluded. The main objective of the treatment is the reduction of menstrual flow and morbidity and the improvement of quality of life. It is important to emphasize that the treatment in the acute phase aims to hemodynamically stabilize the patient and stop excessive bleeding, while the treatment in the chronic phase is based on correcting menstrual dysfunction according to its etiology and clinical manifestations. The treatment may be surgical or pharmacological, and thelatterisbasedmainlyonhormonaltherapy,anti-inflammatorydrugsandantifibrinolytics.

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    Abnormal Uterine Bleeding
  • Review Article

    Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):128-141

    Summary

    Review Article

    Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(3):128-141

    DOI 10.1055/s-0037-1599094

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    Abstract

    Purpose

    To evaluate the effect of supplementation with omega-3 sources on the fatty acid composition of human milk.

    Methods

    The review consisted of the search for articles published in PubMed, Biblioteca Virtual de Saúde (Virtual Health Library[VHL]) andWeb of Science databases using the following keywords: fatty acids, omega-3, human milk and supplementation; for this purpose, we have used the program of research to integrate the services for the maintenance of autonomy (PRISMA) checklist. The following selection criteria were used: articles in English, Portuguese, Spanish or Italian, published between 2000 and 2015, and about studies performed in humans. We found 710 articles that met the established criteria; however, only 22 of them were selected to be part of this study.

    Results

    All studies found a positive relationship between the consumption of omega- 3 sources and their concentration in humanmilk. The differences in the findings are due to the distinct methods used, such as the specific time of the omega-3 supplementation, the type of omega-3 source offered, as well as the sample size.

    Conclusion

    Although the studies were different in several methodological aspects, it was possible to observe the importance of omega-3 supplementation during gestation and/or the puerperium.

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    Are There Changes in the Fatty Acid Profile of Breast Milk with Supplementation of Omega-3 Sources? A Systematic Review
  • Review Article

    Multidisciplinary Approach to Neoadjuvant Endocrine Therapy in Breast Cancer: A Comprehensive Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(12):615-622

    Summary

    Review Article

    Multidisciplinary Approach to Neoadjuvant Endocrine Therapy in Breast Cancer: A Comprehensive Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2016;38(12):615-622

    DOI 10.1055/s-0036-1597579

    Views0

    ABSTRACT

    Breast cancer is the most common type of cancer and the leading cause of cancer-related death among women worldwide. Hormone receptor-positive (HRþ) tumors represent the most common form of this disease, with more than 70% of breast cancers expressing these receptors. Response and benefit to neoadjuvant chemo-therapy (NCT) varies according to HR expression, with lower responses in luminal tumors as compared with hormone receptor-negative (HR-) and human epidermal growth factor receptor 2-positive (HER2þ) tumors. Neoadjuvant endocrine therapy (NET) is an option for selected patients with HRþ locally advanced breast cancer. Neoadjuvant endocrine therapy has a favorable toxicity profile, and is associated with benefits such as having low cost and being more easily available even for cancer care professionals outside major urban areas or tertiary centers. These factors are particularly relevant, as 70% of breast cancer deaths occur in women from low-income and middle-income countries. Additionally, NET is being increasingly explored, not simply to allow for less extensive surgery, but also as a scientific tool, with the use of biomarkers to predict outcomes in adjuvant trials and for the individual patient. This review details the current and most relevant evidence about NET for breast cancer as well as the future directions of this field.

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