-
Review Article02-12-2006
Hormonal contraception and antiretroviral therapy among HIV-infected women
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(11):680-684
Abstract
Review ArticleHormonal contraception and antiretroviral therapy among HIV-infected women
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(11):680-684
DOI 10.1590/S0100-72032006001100008
Views96There is much controversy regarding the realtionship between the use of hormonal contraceptives and the risk of acquiring human immunodeficiency virus (HIV), and little is known about the effects of hormonal contraception in HIV-infected women (adverse events, menstrual disorders, disease progression, antiretroviral therapy interactions). The aim of the present study was to review available data regarding HIV vulnerability and transmission associated with hormonal contraceptives and the use of these contraceptives by women on antiretroviral therapy, with emphasis on drug interactions. In conclusion, it was not possible to offer evidence-based recommendations for the use of hormonal contraceptives among HIV-infected women under antiretroviral therapy. Infectious disease specialists and gynecologists providing care should be cautious about potential drug interaction leading to increase in adverse events, individualizing contraceptive drugs, route, and dosage, according to the antiretroviral therapy under use.
Key-words Antiretroviral therapy, highly activeContraceptionContraceptives, oral, hormonalHIVHIV infectionsSee moreViews96
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 ArticleHormonal contraception and antiretroviral therapy among HIV-infected women
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(11):680-684
DOI 10.1590/S0100-72032006001100008
Views96There is much controversy regarding the realtionship between the use of hormonal contraceptives and the risk of acquiring human immunodeficiency virus (HIV), and little is known about the effects of hormonal contraception in HIV-infected women (adverse events, menstrual disorders, disease progression, antiretroviral therapy interactions). The aim of the present study was to review available data regarding HIV vulnerability and transmission associated with hormonal contraceptives and the use of these contraceptives by women on antiretroviral therapy, with emphasis on drug interactions. In conclusion, it was not possible to offer evidence-based recommendations for the use of hormonal contraceptives among HIV-infected women under antiretroviral therapy. Infectious disease specialists and gynecologists providing care should be cautious about potential drug interaction leading to increase in adverse events, individualizing contraceptive drugs, route, and dosage, according to the antiretroviral therapy under use.
Key-words Antiretroviral therapy, highly activeContraceptionContraceptives, oral, hormonalHIVHIV infectionsSee 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 Article02-07-2006
Treatment of endometriosis
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(10):612-623
Abstract
Review ArticleTreatment of endometriosis
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(10):612-623
DOI 10.1590/S0100-72032006001000008
Views90Despite a wide heterogeneity of clinical manifestations related to endometriosis, a high prevalence of the disease is observed in infertile women and in those with chronic pelvic pain. This enigmatic condition has a high socioeconomic impact, and the described data regarding efficacy of the therapeutic approaches are quite conflicting. Thus, the purpose of the present study was to describe the available scientific evidence about the applicable therapeutic modalities and to provide recommendations for the treatment of infertility and the chronic pelvic pain related to endometriosis. Although suppression of ovarian function in patients with minimal or mild endometriosis is not effective in improving fertility, ablation of the lesions associated with adhesiolysis seems to be more effective than exclusive diagnostic laparoscopy. There is no sufficient evidence to determine whether surgical excision in cases of moderate or severe disease would improve the pregnancy rates. In vitro fertilization seems to be an adequate approach, especially in cases of coexistence of infertility factors and/or failure of other treatments. The possibility of using GnRH for 3 to 6 months before in vitro fertilization should be considered. Regarding pain relief, suppression of ovarian function for 3 to 6 months in patients with laparoscopically-confirmed disease reduces the pain associated with endometriosis. All studied medication seem to have similar efficacy, differing only in terms of adverse effects and costs. Ablation of endometriotic lesion reduces the pain associated with endometriosis, being less effective in cases of minimal disease. Exeresis of endometriomas with diameter > 4 cm seems to improve the rate of natural fecundity and the rate for ??? obtained after assisted reproduction procedures, in addition to reducing both pain and recurrence risk. Finally, it is important to emphasize that this subject is much controversial and the recommendations herein described should be revised as randomized controlled clinical trials with adequate casuistic generate more concrete and reliable evidence.
Key-words Chronic pelvic painEndometriosiInfertility, femaleReproductionReproductive techniques, assistedSee moreViews90This 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 ArticleTreatment of endometriosis
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(10):612-623
DOI 10.1590/S0100-72032006001000008
Views90Despite a wide heterogeneity of clinical manifestations related to endometriosis, a high prevalence of the disease is observed in infertile women and in those with chronic pelvic pain. This enigmatic condition has a high socioeconomic impact, and the described data regarding efficacy of the therapeutic approaches are quite conflicting. Thus, the purpose of the present study was to describe the available scientific evidence about the applicable therapeutic modalities and to provide recommendations for the treatment of infertility and the chronic pelvic pain related to endometriosis. Although suppression of ovarian function in patients with minimal or mild endometriosis is not effective in improving fertility, ablation of the lesions associated with adhesiolysis seems to be more effective than exclusive diagnostic laparoscopy. There is no sufficient evidence to determine whether surgical excision in cases of moderate or severe disease would improve the pregnancy rates. In vitro fertilization seems to be an adequate approach, especially in cases of coexistence of infertility factors and/or failure of other treatments. The possibility of using GnRH for 3 to 6 months before in vitro fertilization should be considered. Regarding pain relief, suppression of ovarian function for 3 to 6 months in patients with laparoscopically-confirmed disease reduces the pain associated with endometriosis. All studied medication seem to have similar efficacy, differing only in terms of adverse effects and costs. Ablation of endometriotic lesion reduces the pain associated with endometriosis, being less effective in cases of minimal disease. Exeresis of endometriomas with diameter > 4 cm seems to improve the rate of natural fecundity and the rate for ??? obtained after assisted reproduction procedures, in addition to reducing both pain and recurrence risk. Finally, it is important to emphasize that this subject is much controversial and the recommendations herein described should be revised as randomized controlled clinical trials with adequate casuistic generate more concrete and reliable evidence.
Key-words Chronic pelvic painEndometriosiInfertility, femaleReproductionReproductive techniques, assistedSee 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 Article01-18-2006
Placental drug transfer
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(9):557-564
Abstract
Review ArticlePlacental drug transfer
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(9):557-564
DOI 10.1590/S0100-72032006000900009
Views125See morePregnant women may depend on the use of medications to minimize the problems caused by preexisting disease, and pregnancy itself can cause situations that compromise the maternal well-being and that require treatment. The obstetrician should be aware of the placental transfer of drugs and of fetal exposure to teratogenic or toxic agents that might compromise the development of the fetus or even its future life.Transport through the placenta involves the movement of molecules between three compartments: maternal blood, cytoplasm of the syncytiotrophoblast, and fetal blood. This movement can occur through the following mechanisms: simple diffusion, facilitated diffusion, active transport, class P, V, F and large ABC family pumps, and endocytosis. With the use of anticonvulsants the incidence of major malformations in exposed newborns is 4 to 6%, compared to 2 to 4% in the general population. Multidrug treatment is more damaging, especially when valproic acid and hydantoin are part of the combination. The recommendation for epileptic patients who have been clinically asymptomatic for two years is to discontinue the drugs they are taking. However, if seizures occur it is advisable to consult a neurologist to discuss anticonvulsant therapy with better benefits and less side effects.Local anesthetics and opioids are extensively used during the resolution of pregnancy. Lidocaine applied by the perineal route for episiotomy at a fixed dose of 400 mg presents a high concentration in maternal plasma and a high rate of placental transfer at the time of birth, with the need for caution regarding the use of repeated doses. Bupivacaine administered by the epidural route is a safe anesthetic which is present in the racemic form and has a placental transfer of about 30%. Fentanyl, an opioid anesthetic used by the epidural route in resolution of cesarean section at the fixed dose of 0.10 mg, presents high rates of placental transfer of the order of 90%, requiring caution with the use of repeated doses for analgesia during labor.
Views125This 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 ArticlePlacental drug transfer
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(9):557-564
DOI 10.1590/S0100-72032006000900009
Views125See morePregnant women may depend on the use of medications to minimize the problems caused by preexisting disease, and pregnancy itself can cause situations that compromise the maternal well-being and that require treatment. The obstetrician should be aware of the placental transfer of drugs and of fetal exposure to teratogenic or toxic agents that might compromise the development of the fetus or even its future life.Transport through the placenta involves the movement of molecules between three compartments: maternal blood, cytoplasm of the syncytiotrophoblast, and fetal blood. This movement can occur through the following mechanisms: simple diffusion, facilitated diffusion, active transport, class P, V, F and large ABC family pumps, and endocytosis. With the use of anticonvulsants the incidence of major malformations in exposed newborns is 4 to 6%, compared to 2 to 4% in the general population. Multidrug treatment is more damaging, especially when valproic acid and hydantoin are part of the combination. The recommendation for epileptic patients who have been clinically asymptomatic for two years is to discontinue the drugs they are taking. However, if seizures occur it is advisable to consult a neurologist to discuss anticonvulsant therapy with better benefits and less side effects.Local anesthetics and opioids are extensively used during the resolution of pregnancy. Lidocaine applied by the perineal route for episiotomy at a fixed dose of 400 mg presents a high concentration in maternal plasma and a high rate of placental transfer at the time of birth, with the need for caution regarding the use of repeated doses. Bupivacaine administered by the epidural route is a safe anesthetic which is present in the racemic form and has a placental transfer of about 30%. Fentanyl, an opioid anesthetic used by the epidural route in resolution of cesarean section at the fixed dose of 0.10 mg, presents high rates of placental transfer of the order of 90%, requiring caution with the use of repeated doses for analgesia during labor.
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 Article10-20-2006
Fertility preservation
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(6):365-372
Abstract
Review ArticleFertility preservation
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(6):365-372
DOI 10.1590/S0100-72032006000600008
Views87See moreAs therapeutic approaches for oncologic diseases are being improved and an increase in the survival rates are being achieved, long-term complications of these therapies, initially infrequent, assume these days an important place when considering life quality. Among the long term repercussions appears the premature ovarian failure. According to the recommendations of the American Society of Clinical Oncology recently published, the only procedures available nowadays considered to be effective for female fertility preservation are: embryo cryopreservation, conservative gynecological surgery and oophoropexy in cases of local radiotherapy. All the other proposed techniques, surch as: ovarian suppression and oocyte and ovarian tissue cryopreservation, although present promising results, are still considered as experimental options. The best choice for fertility preservation in each specific case depends on patient's age, type of treatment, existence of a partner, time available until chemo- or radiotherapy beginning, and the ovarian metastatic potential of the tumor. In the present manuscript, the available and experimental techniques for fertility preservation are revised and discussed.
Views87This 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 ArticleFertility preservation
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(6):365-372
DOI 10.1590/S0100-72032006000600008
Views87See moreAs therapeutic approaches for oncologic diseases are being improved and an increase in the survival rates are being achieved, long-term complications of these therapies, initially infrequent, assume these days an important place when considering life quality. Among the long term repercussions appears the premature ovarian failure. According to the recommendations of the American Society of Clinical Oncology recently published, the only procedures available nowadays considered to be effective for female fertility preservation are: embryo cryopreservation, conservative gynecological surgery and oophoropexy in cases of local radiotherapy. All the other proposed techniques, surch as: ovarian suppression and oocyte and ovarian tissue cryopreservation, although present promising results, are still considered as experimental options. The best choice for fertility preservation in each specific case depends on patient's age, type of treatment, existence of a partner, time available until chemo- or radiotherapy beginning, and the ovarian metastatic potential of the tumor. In the present manuscript, the available and experimental techniques for fertility preservation are revised and discussed.
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 Article08-29-2006
Molecular forms of human chorionic gonadotropin: characteristics, assays and clinical use
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):251-263
Abstract
Review ArticleMolecular forms of human chorionic gonadotropin: characteristics, assays and clinical use
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):251-263
DOI 10.1590/S0100-72032006000400008
Views103See moreThe human chorionic gonadotropin (hCG) results from a non-covalent linkage of two subunits, alpha (alphahCG) and beta (betahCG), separately synthesized by normal trophoblastic tissue, hydatiform mole, choriocarcinoma, pituitary cells, and tumoral tissues of different histologic types. The peptide chain and its further glycosylation in the secretory cell involves the complex action of different enzymes. This complexity results in the secretion of heterogeneous molecular forms. The different molecules might be found in serum, urine and amniotic fluid of pregnant women; serum, urine, and vesicles of patients with hydatiform mole or choriocarcinoma and in other biological fluids of normal non-pregnant women and men or patients with different embryonary types of cancer. Both the intact hCG molecule and its free subunits and the hyperglycosylated (H-hCG), nicked (N-hCG) and core fragment of betahCG (CF- betahCG) variant forms have relevant clinical use. Depending on the prevalent molecular form or the proportion of the variant form to the intact hCG in a determined clinical situation the measurement of a specific molecule is chosen. This review analyzes the clinical use of hCG and its related molecules in the early detection of ectopic pregnancy or patients with higher risk of abortion, in the identification of an embryo or fetus with chromosomal abnormalities, and in the evaluation of risk for preeclampsia or fetal growth restriction. The review also examines the use of hCG and variant forms as tumor markers. It is concluded that it is useful to measure hCG and/or related molecules in clinical practice, but difficulties in developing and achievement of more sensitive and specific new assays limit their use.
Views103This 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 ArticleMolecular forms of human chorionic gonadotropin: characteristics, assays and clinical use
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(4):251-263
DOI 10.1590/S0100-72032006000400008
Views103See moreThe human chorionic gonadotropin (hCG) results from a non-covalent linkage of two subunits, alpha (alphahCG) and beta (betahCG), separately synthesized by normal trophoblastic tissue, hydatiform mole, choriocarcinoma, pituitary cells, and tumoral tissues of different histologic types. The peptide chain and its further glycosylation in the secretory cell involves the complex action of different enzymes. This complexity results in the secretion of heterogeneous molecular forms. The different molecules might be found in serum, urine and amniotic fluid of pregnant women; serum, urine, and vesicles of patients with hydatiform mole or choriocarcinoma and in other biological fluids of normal non-pregnant women and men or patients with different embryonary types of cancer. Both the intact hCG molecule and its free subunits and the hyperglycosylated (H-hCG), nicked (N-hCG) and core fragment of betahCG (CF- betahCG) variant forms have relevant clinical use. Depending on the prevalent molecular form or the proportion of the variant form to the intact hCG in a determined clinical situation the measurement of a specific molecule is chosen. This review analyzes the clinical use of hCG and its related molecules in the early detection of ectopic pregnancy or patients with higher risk of abortion, in the identification of an embryo or fetus with chromosomal abnormalities, and in the evaluation of risk for preeclampsia or fetal growth restriction. The review also examines the use of hCG and variant forms as tumor markers. It is concluded that it is useful to measure hCG and/or related molecules in clinical practice, but difficulties in developing and achievement of more sensitive and specific new assays limit their use.
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 Article08-28-2006
Beneficial interventions for maternal mortality prevention in the prenatal period
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):310-315
Abstract
Review ArticleBeneficial interventions for maternal mortality prevention in the prenatal period
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):310-315
DOI 10.1590/S0100-72032006000500008
Views127See moreMaternal mortality rate (MM) is a health quality indicator that is directly influenced by the economic, cultural and technological level of a country. Official data of MM in Brazil, although underestimated, point to the lack of quality in pregnancy, childbirth and puerperium care services. This characteristic is common in developing countries, where poorer pregnant women as well as those facing greater difficulty to quality care access are found. Prenatal care cannot prevent major childbirth complications, which are important causes of MM; however, some interventions during the prenatal period can favor maternal prognosis and prevent MM. In this setting, this study brings a scientifically based update concerning effective interventions for maternal mortality prevention during the prenatal period. The most important strategies consist of a tripod with specific interventions related to maternal health promotion, risk prevention and assurance of nutritional support during gestation, in addition to criteria to investigate gestational risk and inclusion of the pregnant woman in the basic component of the prenatal care model. It ends with the definition of priorities in the prevention of MM related to eclampsia/preeclampsia and reinforces the importance of normalization of reference systems for obstetric emergency cases.
Views127This 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 ArticleBeneficial interventions for maternal mortality prevention in the prenatal period
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(5):310-315
DOI 10.1590/S0100-72032006000500008
Views127See moreMaternal mortality rate (MM) is a health quality indicator that is directly influenced by the economic, cultural and technological level of a country. Official data of MM in Brazil, although underestimated, point to the lack of quality in pregnancy, childbirth and puerperium care services. This characteristic is common in developing countries, where poorer pregnant women as well as those facing greater difficulty to quality care access are found. Prenatal care cannot prevent major childbirth complications, which are important causes of MM; however, some interventions during the prenatal period can favor maternal prognosis and prevent MM. In this setting, this study brings a scientifically based update concerning effective interventions for maternal mortality prevention during the prenatal period. The most important strategies consist of a tripod with specific interventions related to maternal health promotion, risk prevention and assurance of nutritional support during gestation, in addition to criteria to investigate gestational risk and inclusion of the pregnant woman in the basic component of the prenatal care model. It ends with the definition of priorities in the prevention of MM related to eclampsia/preeclampsia and reinforces the importance of normalization of reference systems for obstetric emergency cases.
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 Article08-25-2006
Quality of life in breast cancer survivors
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):195-204
Abstract
Review ArticleQuality of life in breast cancer survivors
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):195-204
DOI 10.1590/S0100-72032006000300010
Views106See moreBreast cancer is one of the most common malignancies among women. Its diagnosis and treatment have social, economic, physical, emotional/psychological and sexual repercussions. The main parameters used to assess the results of anticancer therapy are disease-free survival and overall survival. More recently, quality of life (QOL) has been considered an additional parameter. No consensus exists about the definition of QOL. However, most definitions take into account multidimensional and subjective aspects of QOL. The identification of factors related to QOL and comprehension of how these factors contribute to the perception of QOL are reasons for debate, since the concept of QOL is directly related to the social and cultural context in which the individual is inserted. Age at diagnosis, chemotherapy, type of surgery, climacteric symptoms, relationship between the couple, and sexuality are several factors associated with QOL in women with breast cancer. QOL associated with different antineoplastic therapies may help patients and physicians choose the best therapeutic modality. Towards this end, the current article addresses various aspects of QOL of breast cancer women, and presents the state-of-the-art knowledge on the topic.
Views106This 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 ArticleQuality of life in breast cancer survivors
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(3):195-204
DOI 10.1590/S0100-72032006000300010
Views106See moreBreast cancer is one of the most common malignancies among women. Its diagnosis and treatment have social, economic, physical, emotional/psychological and sexual repercussions. The main parameters used to assess the results of anticancer therapy are disease-free survival and overall survival. More recently, quality of life (QOL) has been considered an additional parameter. No consensus exists about the definition of QOL. However, most definitions take into account multidimensional and subjective aspects of QOL. The identification of factors related to QOL and comprehension of how these factors contribute to the perception of QOL are reasons for debate, since the concept of QOL is directly related to the social and cultural context in which the individual is inserted. Age at diagnosis, chemotherapy, type of surgery, climacteric symptoms, relationship between the couple, and sexuality are several factors associated with QOL in women with breast cancer. QOL associated with different antineoplastic therapies may help patients and physicians choose the best therapeutic modality. Towards this end, the current article addresses various aspects of QOL of breast cancer women, and presents the state-of-the-art knowledge on the topic.
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 Article08-16-2006
Sexual violence: recommended procedures and results of emergency care for women victims of rape
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):126-135
Abstract
Review ArticleSexual violence: recommended procedures and results of emergency care for women victims of rape
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):126-135
DOI 10.1590/S0100-72032006000200009
Views98See moreGender-based violence is related to the power imbalance between men and women that is present, to a greater or lesser degree, in all societies. It was recognized as a human rights problem by the UN relatively recently. It includes emotional, physical and sexual violence. Sexual violence is the extreme form of gender violence, usually accompanied by the other types of violence. Its prevalence is difficult to determine, but it most probably affects at least one third of women some time in their life. It has multiple consequences to women's physical and gynecological health, which depends in great part on the quality of the care the woman received immediately after the assault. Unfortunately, most emergency health services, including those in women's hospitals, are rarely prepared to provide the correct care for these women. Care should be multidisciplinary and involves crisis treatment, meticulous clinical examination with complementary auxiliary methods, treatment of physical lesions, prevention of pregnancy and of sexually transmitted infections and AIDS, and follow-up for at least six months after the aggression.
Views98This 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 ArticleSexual violence: recommended procedures and results of emergency care for women victims of rape
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):126-135
DOI 10.1590/S0100-72032006000200009
Views98See moreGender-based violence is related to the power imbalance between men and women that is present, to a greater or lesser degree, in all societies. It was recognized as a human rights problem by the UN relatively recently. It includes emotional, physical and sexual violence. Sexual violence is the extreme form of gender violence, usually accompanied by the other types of violence. Its prevalence is difficult to determine, but it most probably affects at least one third of women some time in their life. It has multiple consequences to women's physical and gynecological health, which depends in great part on the quality of the care the woman received immediately after the assault. Unfortunately, most emergency health services, including those in women's hospitals, are rarely prepared to provide the correct care for these women. Care should be multidisciplinary and involves crisis treatment, meticulous clinical examination with complementary auxiliary methods, treatment of physical lesions, prevention of pregnancy and of sexually transmitted infections and AIDS, and follow-up for at least six months after the aggression.
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 Article Archives - Page 3 of 24 - Revista Brasileira de Ginecologia e Obstetrícia
