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Review Article06-27-2022
Imaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):435-441
Abstract
Review ArticleImaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):435-441
Views165Abstract
Objective
Antenatal recognition of severe cases of congenital diaphragmatic hernia (CDH) by ultrasound (US) and magnetic resonance imaging (MRI) may aid decisions regarding the indication of fetal endoscopic tracheal occlusion.
Methods
An integrative review was performed. Searches in MEDLINE and EMBASE used terms related to CDH, diagnosis, MRI, and US. The inclusion criteria were reviews and guidelines approaching US and MRI markers of severity of CDH published in English in the past 10 years.
Results
The search retrieved 712 studies, out of which 17 publications were included. The US parameters were stomach and liver positions, lung-to-head ratio (LHR), observed/expected LHR (o/e LHR), and quantitative lung index. The MRI parameters were total fetal lung volume (TFLV), observed/expected TFLV, relative fetal or percent predicted lung volumes, liver intrathoracic ratio, and modified McGoon index. None of the parameters was reported to be superior to the others.
Conclusion
The most mentioned parameters were o/e LHR, LHR, liver position, o/e TFLV, and TFLV.
Key-words hernias diaphragmatic congenitalMagnetic resonance Imagingpatient selectionReference standardsUltrasonography, prenatalSee moreViews165
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
Review ArticleImaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):435-441
Views165Abstract
Objective
Antenatal recognition of severe cases of congenital diaphragmatic hernia (CDH) by ultrasound (US) and magnetic resonance imaging (MRI) may aid decisions regarding the indication of fetal endoscopic tracheal occlusion.
Methods
An integrative review was performed. Searches in MEDLINE and EMBASE used terms related to CDH, diagnosis, MRI, and US. The inclusion criteria were reviews and guidelines approaching US and MRI markers of severity of CDH published in English in the past 10 years.
Results
The search retrieved 712 studies, out of which 17 publications were included. The US parameters were stomach and liver positions, lung-to-head ratio (LHR), observed/expected LHR (o/e LHR), and quantitative lung index. The MRI parameters were total fetal lung volume (TFLV), observed/expected TFLV, relative fetal or percent predicted lung volumes, liver intrathoracic ratio, and modified McGoon index. None of the parameters was reported to be superior to the others.
Conclusion
The most mentioned parameters were o/e LHR, LHR, liver position, o/e TFLV, and TFLV.
Key-words hernias diaphragmatic congenitalMagnetic resonance Imagingpatient selectionReference standardsUltrasonography, prenatalSee 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. -
Review Article06-27-2022
Cognitive Behavioral Therapy in Endometriosis, Psychological Based Intervention: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):295-303
Abstract
Review ArticleCognitive Behavioral Therapy in Endometriosis, Psychological Based Intervention: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):295-303
Views378Abstract
Introduction
Endometriosis is an inflammatory disease that affects women of reproductive age, causing pain and the possibility of infertility. Endometriosis was associated to low life quality and research shows the impact of endometriosis in several areas of life, justifying how these patients are more likely to develop depression, anxiety, and stress.
Objective
The aim of the present systematic review was to explore the field of psychology in endometriosis, identifying studies that used the cognitive behavioral therapy technique as a treatment for endometriosis and chronic pelvic pain.
Methods
The keywords used were Endometriosis and Behavioral Therapy; Behavioral Disciplines and Activities; Cognitive Behavioral Therapy; Mental Health; Psychological Techniques; Psychology; Psychotherapy; Mental Health Services; and the search was performed in the following databases: PubMed/Medline, Scielo, Lilacs, and Capes. The study followed the PRISMA guidelines and all studies whose intervention strategy used was related to cognitive-behavioral therapy were considered.
Results
Of the 129 articles found, only 5 were selected, and it was possible to identify that the psychological intervention whose approach brought cognitive-behavioral therapy techniques promoted a decrease in the sensation of pain, improvements in the scores of depression and stress, and significant changes in aspects of quality of life such as vitality, physical and social functioning, emotional well-being, control, and autonomy.
Conclusion
Cognitive-behavioral therapy can be very promising to take care of the emotional side of those who have endometriosis However, the present systematic review highlights the need to develop more structured studies with consistent, clear and replicablemethods to reach a psychological intervention protocol for patients who live with this gynecological-physical-emotional condition.
Key-words Chronic pelvic paincognitive behavioral therapyEndometriosispsychological interventionQuality of lifesystematic reviewsSee moreViews378This 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
Review ArticleCognitive Behavioral Therapy in Endometriosis, Psychological Based Intervention: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(3):295-303
Views378Abstract
Introduction
Endometriosis is an inflammatory disease that affects women of reproductive age, causing pain and the possibility of infertility. Endometriosis was associated to low life quality and research shows the impact of endometriosis in several areas of life, justifying how these patients are more likely to develop depression, anxiety, and stress.
Objective
The aim of the present systematic review was to explore the field of psychology in endometriosis, identifying studies that used the cognitive behavioral therapy technique as a treatment for endometriosis and chronic pelvic pain.
Methods
The keywords used were Endometriosis and Behavioral Therapy; Behavioral Disciplines and Activities; Cognitive Behavioral Therapy; Mental Health; Psychological Techniques; Psychology; Psychotherapy; Mental Health Services; and the search was performed in the following databases: PubMed/Medline, Scielo, Lilacs, and Capes. The study followed the PRISMA guidelines and all studies whose intervention strategy used was related to cognitive-behavioral therapy were considered.
Results
Of the 129 articles found, only 5 were selected, and it was possible to identify that the psychological intervention whose approach brought cognitive-behavioral therapy techniques promoted a decrease in the sensation of pain, improvements in the scores of depression and stress, and significant changes in aspects of quality of life such as vitality, physical and social functioning, emotional well-being, control, and autonomy.
Conclusion
Cognitive-behavioral therapy can be very promising to take care of the emotional side of those who have endometriosis However, the present systematic review highlights the need to develop more structured studies with consistent, clear and replicablemethods to reach a psychological intervention protocol for patients who live with this gynecological-physical-emotional condition.
Key-words Chronic pelvic paincognitive behavioral therapyEndometriosispsychological interventionQuality of lifesystematic reviewsSee 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. -
Review Article06-20-2022
Sentinel Lymph Node Biopsy in Endometrial Cancer – A Systematic Review and Quality Assessment of Meta-Analyses
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):785-789
Abstract
Review ArticleSentinel Lymph Node Biopsy in Endometrial Cancer – A Systematic Review and Quality Assessment of Meta-Analyses
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):785-789
Views172See moreAbstract
Objective
To assess the quality of recent meta-analyses reviewing the diagnostic utility of sentinel node biopsy in endometrial cancer.
Methods
With the MeSH terms endometrial neoplasms and sentinel lymph node biopsy, PubMed and Embase databases were searched on October 21, 2020, and again on November 10, 2021, with meta-analysis and publication date filters set to since 2015. The articles included were classified with the A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) assessment tool.
Results
The database searches found 17, 7 of which, after the screening, were selected for full review by the author, finally extracting six meta-analyzes for quality analysis. The rating with the AMSTAR 2 assessment tool found that overall confidence in their results was critically low.
Conclusion
This study found that the quality of recent meta-analyses on the utility of the staging of endometrial cancer with sentinel node biopsy, evaluated by the AMSTAR 2 assessment tool, is classified as critically low, and, therefore, these meta-analyses are not reliable in the summary of their studies.
Views172This 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
Review ArticleSentinel Lymph Node Biopsy in Endometrial Cancer – A Systematic Review and Quality Assessment of Meta-Analyses
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):785-789
Views172See moreAbstract
Objective
To assess the quality of recent meta-analyses reviewing the diagnostic utility of sentinel node biopsy in endometrial cancer.
Methods
With the MeSH terms endometrial neoplasms and sentinel lymph node biopsy, PubMed and Embase databases were searched on October 21, 2020, and again on November 10, 2021, with meta-analysis and publication date filters set to since 2015. The articles included were classified with the A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) assessment tool.
Results
The database searches found 17, 7 of which, after the screening, were selected for full review by the author, finally extracting six meta-analyzes for quality analysis. The rating with the AMSTAR 2 assessment tool found that overall confidence in their results was critically low.
Conclusion
This study found that the quality of recent meta-analyses on the utility of the staging of endometrial cancer with sentinel node biopsy, evaluated by the AMSTAR 2 assessment tool, is classified as critically low, and, therefore, these meta-analyses are not reliable in the summary of their studies.
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. -
Review Article06-20-2022
Renin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review
- Priscilla Araújo dos Santos
, - Alice Miranda de Oliveira ,
- Caroline Queiroz Alves ,
- Clóvis Figueiredo Souza Filho ,
- Ana Marice Teixeira Ladeia , [ ... ],
- Jefferson Petto
Abstract
Review ArticleRenin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):710-718
- Priscilla Araújo dos Santos ,
- Alice Miranda de Oliveira ,
- Caroline Queiroz Alves ,
- Clóvis Figueiredo Souza Filho ,
- Ana Marice Teixeira Ladeia ,
- Jefferson Petto
Views306See moreAbstract
Objective
To describe the effects of combined oral contraceptives (COC) on the renin-angiotensin-aldosterone system (RAAS).
Conclusion
The findings of this study suggest that the COC promotes greater activation of the RAAS. Supporting the idea that its use is related to an increased risk of cardiovascular events, including systemic arterial hypertension.
Views306This 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
Review ArticleRenin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):710-718
- Priscilla Araújo dos Santos ,
- Alice Miranda de Oliveira ,
- Caroline Queiroz Alves ,
- Clóvis Figueiredo Souza Filho ,
- Ana Marice Teixeira Ladeia ,
- Jefferson Petto
Views306See moreAbstract
Objective
To describe the effects of combined oral contraceptives (COC) on the renin-angiotensin-aldosterone system (RAAS).
Conclusion
The findings of this study suggest that the COC promotes greater activation of the RAAS. Supporting the idea that its use is related to an increased risk of cardiovascular events, including systemic arterial hypertension.
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. - Priscilla Araújo dos Santos
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Review Article06-03-2022
Relation between Selenium and Female Fertility: A Systematic Review
- Luiz Gustavo Lima ,
- André Amaro Mamédio dos Santos ,
- Tiago Daniel Gueiber ,
- Ricardo Zanetti Gomes ,
- Camila Marinelli Martins , [ ... ],
- Andrielle Cristina Chaikoski
Abstract
Review ArticleRelation between Selenium and Female Fertility: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):701-709
- Luiz Gustavo Lima ,
- André Amaro Mamédio dos Santos ,
- Tiago Daniel Gueiber ,
- Ricardo Zanetti Gomes ,
- Camila Marinelli Martins ,
- Andrielle Cristina Chaikoski
Views304See moreAbstract
Objective
To analyze the influence of selenium in female fertility.
Conclusion
Selenium supplementation is promising in women with this micronutrient deficiency to promote improvement of the reproductive efficiency and prevent damage to the pregnancy. Further studies on this theme are still required.
Views304This 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
Review ArticleRelation between Selenium and Female Fertility: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(7):701-709
- Luiz Gustavo Lima ,
- André Amaro Mamédio dos Santos ,
- Tiago Daniel Gueiber ,
- Ricardo Zanetti Gomes ,
- Camila Marinelli Martins ,
- Andrielle Cristina Chaikoski
Views304See moreAbstract
Objective
To analyze the influence of selenium in female fertility.
Conclusion
Selenium supplementation is promising in women with this micronutrient deficiency to promote improvement of the reproductive efficiency and prevent damage to the pregnancy. Further studies on this theme are still required.
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. - Luiz Gustavo Lima
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Review Article05-23-2022
Non-pharmacological Interventions for Improving Sleep Quality During Pregnancy: A Systematic Review and Meta-Analysis
- Daiane Sofia Morais Paulino ,
- Carolina Bicudo Borrelli ,
- Débora Bicudo Faria-Schützer ,
- Luiz Gustavo Oliveira Brito ,
- Fernanda Garanhani Surita
Abstract
Review ArticleNon-pharmacological Interventions for Improving Sleep Quality During Pregnancy: A Systematic Review and Meta-Analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):776-784
- Daiane Sofia Morais Paulino ,
- Carolina Bicudo Borrelli ,
- Débora Bicudo Faria-Schützer ,
- Luiz Gustavo Oliveira Brito ,
- Fernanda Garanhani Surita
Views261Abstract
Objective
To investigate the effect of non-pharmacological interventions to improve sleep quality during pregnancy.
Data sources
A search was made in the NCBI/PubMed, ClinicalTrials.gov, Embase, BVS, and Web of Science databases. There were no limitations regarding language, sample size, and type of non-pharmacological intervention. We have included prospective clinical trials between July 2014 and July 2019.
Selection of studies
This study was registered in the Prospective International Registration of Systematic Reviews (PROSPERO) database was performed. Publication bias was also assessed with funnel plots. the primary outcome was the total score in the Pittsburgh Sleep Quality Index (PSQI) before and after intervention. Risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were used for assessing methodological quality. From the 28 retrieved studies, we have selected 8 for qualitative analysis and 6 for meta-analysis.
Data collection
Two independent reviewers performed the study selection. In the case of disagreement, a third senior reviewer was consulted. The study was initially assessed based on the title, followed by abstract. Lastly, the full text was assessed to be included.
Data Synthesis
A significant improvement on the sleep quality (PSQI score) was observed when all interventions were grouped (MD = -3.03, 95%CI -4.15 to -1.92, n= 623, i2= 84%, p< 0.001). Analysis by subgroup (music listening: MD = -1.96, 95% CI -3.27 to -0.65, n= 207, i2= 67%, p= 0.003 and other interventions: MD = -3.66, 95% CI -4.93 to -2.40, n= 416, i2 = 80%, p< 0.001) showed an improvement, with high heterogeneity. Risk of bias has shown performance and detection bias for almost studies, and GRADE evidence was very low for all analyzed variables.
Conclusion
Non-pharmacological interventions—listening to music, physical exercise, relaxation exercises, lettuce seed, sleep hygiene, and acupressure—are effective for improving sleep quality during pregnancy.
Key-words Meta-analysisnon-pharmacological interventionsPregnant womensleep qualitysystematic reviewSee moreViews261This 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
Review ArticleNon-pharmacological Interventions for Improving Sleep Quality During Pregnancy: A Systematic Review and Meta-Analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(8):776-784
- Daiane Sofia Morais Paulino ,
- Carolina Bicudo Borrelli ,
- Débora Bicudo Faria-Schützer ,
- Luiz Gustavo Oliveira Brito ,
- Fernanda Garanhani Surita
Views261Abstract
Objective
To investigate the effect of non-pharmacological interventions to improve sleep quality during pregnancy.
Data sources
A search was made in the NCBI/PubMed, ClinicalTrials.gov, Embase, BVS, and Web of Science databases. There were no limitations regarding language, sample size, and type of non-pharmacological intervention. We have included prospective clinical trials between July 2014 and July 2019.
Selection of studies
This study was registered in the Prospective International Registration of Systematic Reviews (PROSPERO) database was performed. Publication bias was also assessed with funnel plots. the primary outcome was the total score in the Pittsburgh Sleep Quality Index (PSQI) before and after intervention. Risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were used for assessing methodological quality. From the 28 retrieved studies, we have selected 8 for qualitative analysis and 6 for meta-analysis.
Data collection
Two independent reviewers performed the study selection. In the case of disagreement, a third senior reviewer was consulted. The study was initially assessed based on the title, followed by abstract. Lastly, the full text was assessed to be included.
Data Synthesis
A significant improvement on the sleep quality (PSQI score) was observed when all interventions were grouped (MD = -3.03, 95%CI -4.15 to -1.92, n= 623, i2= 84%, p< 0.001). Analysis by subgroup (music listening: MD = -1.96, 95% CI -3.27 to -0.65, n= 207, i2= 67%, p= 0.003 and other interventions: MD = -3.66, 95% CI -4.93 to -2.40, n= 416, i2 = 80%, p< 0.001) showed an improvement, with high heterogeneity. Risk of bias has shown performance and detection bias for almost studies, and GRADE evidence was very low for all analyzed variables.
Conclusion
Non-pharmacological interventions—listening to music, physical exercise, relaxation exercises, lettuce seed, sleep hygiene, and acupressure—are effective for improving sleep quality during pregnancy.
Key-words Meta-analysisnon-pharmacological interventionsPregnant womensleep qualitysystematic reviewSee 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. - Daiane Sofia Morais Paulino
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Review Article04-28-2022
Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review
- Larissa Bueno Ferreira ,
- Cecília Viana Lobo ,
- Aline Elizabeth da Silva Miranda ,
- Brenda da Cunha Carvalho ,
- Luana Caroline dos Santos
Abstract
Review ArticleDietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):540-547
- Larissa Bueno Ferreira ,
- Cecília Viana Lobo ,
- Aline Elizabeth da Silva Miranda ,
- Brenda da Cunha Carvalho ,
- Luana Caroline dos Santos
Views251See moreAbstract
The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.
Views251This 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
Review ArticleDietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):540-547
- Larissa Bueno Ferreira ,
- Cecília Viana Lobo ,
- Aline Elizabeth da Silva Miranda ,
- Brenda da Cunha Carvalho ,
- Luana Caroline dos Santos
Views251See moreAbstract
The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. - Larissa Bueno Ferreira
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Review Article04-25-2022
Diagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
- Maria Laura Costa ,
- Ricardo de Carvalho Cavalli ,
- Henri Augusto Korkes ,
- Edson Vieira da Cunha Filho ,
- José Carlos Peraçoli
Abstract
Review ArticleDiagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
- Maria Laura Costa ,
- Ricardo de Carvalho Cavalli ,
- Henri Augusto Korkes ,
- Edson Vieira da Cunha Filho ,
- José Carlos Peraçoli
Views242Abstract
Objective
It is a challenge to consider preeclampsia (PE) diagnosis and management in low and middle-income settings, where it represents a major public health concern. The placenta is the underlying cause of disease, and the plasma concentrations of proangiogenic and antiangiogenic factors released by the placenta can reflect the risks of disease progression. Antiangiogenic proteins, such as soluble fms-like tyrosine kinase 1 (sFlt-1), and proangiogenic, like placental growth factors (PlGF), are directly and inversely correlated with the disease onset, respectively.
Methods
Narrative review on the use of biomarkers (sFlt-1 to PlGF ratio) with a suggested guidance protocol.
Results
Key considerations on the use of biomarkers: the sFlt-1/PlGF ratio is mainly relevant to rule out PE between 20 and 36 6/7 weeks in cases of suspected PE; however, it should not replace the routine exams for the diagnosis of PE. The sFlt-1/PlGF ratio should not be performed after confirmed PE diagnosis (only in research settings). In women with suspected PE, sFlt-1/PlGF ratio < 38 can rule out the diagnosis of PE for 1 week (VPN = 99.3) and up to 4 weeks (VPN= 94.3); sFlt-1/PlGF ratio > 38 does not confirm the diagnosis of PE; however, it can assist clinical management. In cases of severe hypertension and/or symptoms (imminent eclampsia), hospitalization is imperative, regardless of the result of the sFlt-1/PlGF ratio.
Conclusion
The use of biomarkers can help support clinical decisions on the management of suspected PE cases, especially to rule out PE diagnosis, thus avoiding unnecessary interventions, especially hospitalizations and elective prematurity
Key-words Hypertensionplacental growth factorPreeclampsiapreterm preeclampsiasoluble fms-like tyrosine kinase 1See moreViews242This 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
Review ArticleDiagnosis and Management of Preeclampsia: Suggested Guidance on the Use of Biomarkers
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(9):878-883
- Maria Laura Costa ,
- Ricardo de Carvalho Cavalli ,
- Henri Augusto Korkes ,
- Edson Vieira da Cunha Filho ,
- José Carlos Peraçoli
Views242Abstract
Objective
It is a challenge to consider preeclampsia (PE) diagnosis and management in low and middle-income settings, where it represents a major public health concern. The placenta is the underlying cause of disease, and the plasma concentrations of proangiogenic and antiangiogenic factors released by the placenta can reflect the risks of disease progression. Antiangiogenic proteins, such as soluble fms-like tyrosine kinase 1 (sFlt-1), and proangiogenic, like placental growth factors (PlGF), are directly and inversely correlated with the disease onset, respectively.
Methods
Narrative review on the use of biomarkers (sFlt-1 to PlGF ratio) with a suggested guidance protocol.
Results
Key considerations on the use of biomarkers: the sFlt-1/PlGF ratio is mainly relevant to rule out PE between 20 and 36 6/7 weeks in cases of suspected PE; however, it should not replace the routine exams for the diagnosis of PE. The sFlt-1/PlGF ratio should not be performed after confirmed PE diagnosis (only in research settings). In women with suspected PE, sFlt-1/PlGF ratio < 38 can rule out the diagnosis of PE for 1 week (VPN = 99.3) and up to 4 weeks (VPN= 94.3); sFlt-1/PlGF ratio > 38 does not confirm the diagnosis of PE; however, it can assist clinical management. In cases of severe hypertension and/or symptoms (imminent eclampsia), hospitalization is imperative, regardless of the result of the sFlt-1/PlGF ratio.
Conclusion
The use of biomarkers can help support clinical decisions on the management of suspected PE cases, especially to rule out PE diagnosis, thus avoiding unnecessary interventions, especially hospitalizations and elective prematurity
Key-words Hypertensionplacental growth factorPreeclampsiapreterm preeclampsiasoluble fms-like tyrosine kinase 1See 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. - Maria Laura Costa
Review Article Archives - Revista Brasileira de Ginecologia e Obstetrícia
