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Review Article
Thromboprophylaxis during the Pregnancy-Puerperal Cycle – Literature Review
- Suzanna Maria Viana Sanches
, - Monique Magnavita Borba da Fonseca Cerqueira ,
- Patrícia Lima Junqueira ,
- Miriam Takayanagi Gomez
05-18-2020
Summary
Review ArticleThromboprophylaxis during the Pregnancy-Puerperal Cycle – Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):218-227
05-18-2020- Suzanna Maria Viana Sanches ,
- Monique Magnavita Borba da Fonseca Cerqueira ,
- Patrícia Lima Junqueira ,
- Miriam Takayanagi Gomez
Views140See moreAbstract
Objective
To identify current strategies and recommendations for venous thromboembolism prophylaxis associated with the pregnancy-puerperal cycle, a condition of high morbidity and mortality among women.
Methods
The literature search was performed between May and October 2019, using the PubMed database, including papers published in Portuguese, English and Spanish. The terms thromboembolism (Mesh) AND pregnancy (Mesh) OR postpartum (Mesh) were used as descriptors, including randomized controlled trials, meta-analyses, systematic reviews and guidelines published from 2009 to 2019, presenting strategies for prevention of thromboembolism during pregnancy and the postpartum.
Results
Eight articles met the inclusion criteria. Many studies evaluated were excluded because they did not address prevention strategies. We compiled the recommendations from the American Society of Hematologists, the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada, the American College of Chest Physicians and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Conclusion:
There are some gaps in the research, and clinical studies with appropriate methodology are needed to support decisions made regarding the risk of thromboembolism in the perigestational period. Thus, the attention of the professionals involved in the care of pregnant and postpartum women is crucial, as it is a condition associated with high morbidity and mortality.
Views140
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleThromboprophylaxis during the Pregnancy-Puerperal Cycle – Literature Review
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):218-227
05-18-2020- Suzanna Maria Viana Sanches ,
- Monique Magnavita Borba da Fonseca Cerqueira ,
- Patrícia Lima Junqueira ,
- Miriam Takayanagi Gomez
Views140See moreAbstract
Objective
To identify current strategies and recommendations for venous thromboembolism prophylaxis associated with the pregnancy-puerperal cycle, a condition of high morbidity and mortality among women.
Methods
The literature search was performed between May and October 2019, using the PubMed database, including papers published in Portuguese, English and Spanish. The terms thromboembolism (Mesh) AND pregnancy (Mesh) OR postpartum (Mesh) were used as descriptors, including randomized controlled trials, meta-analyses, systematic reviews and guidelines published from 2009 to 2019, presenting strategies for prevention of thromboembolism during pregnancy and the postpartum.
Results
Eight articles met the inclusion criteria. Many studies evaluated were excluded because they did not address prevention strategies. We compiled the recommendations from the American Society of Hematologists, the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada, the American College of Chest Physicians and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Conclusion:
There are some gaps in the research, and clinical studies with appropriate methodology are needed to support decisions made regarding the risk of thromboembolism in the perigestational period. Thus, the attention of the professionals involved in the care of pregnant and postpartum women is crucial, as it is a condition associated with high morbidity and mortality.
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. - Suzanna Maria Viana Sanches
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Review Article
Omega-3 Fatty Acids and Fecundation, Pregnancy and Breastfeeding
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(3):160-164
04-22-2020
Summary
Review ArticleOmega-3 Fatty Acids and Fecundation, Pregnancy and Breastfeeding
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(3):160-164
04-22-2020Views142See moreAbstract
Long-chain omega-3 (n-3) polyunsaturated fatty acids (PUFAs), such as the eicosapentaenoic and docosahexaenoic acids, have been linked to human health in all stages of life, from fetal development to aging. These PUFAs act as precursors for various metabolites involved in the prevention of certain diseases. The recognizable effects of these supplements prior to pregnancy (oocyte maturation), during pregnancy (improvement in the risk of premature delivery, among others) and in the offspring (in terms of cognitive function and the approach to neurodevelopmental disorders) are described in the present narrative review. We concluded that the diffusion of these supplements may improve the prognosis of these patients in a simple, effective way, and with high safety rates.
Views142This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleOmega-3 Fatty Acids and Fecundation, Pregnancy and Breastfeeding
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(3):160-164
04-22-2020Views142See moreAbstract
Long-chain omega-3 (n-3) polyunsaturated fatty acids (PUFAs), such as the eicosapentaenoic and docosahexaenoic acids, have been linked to human health in all stages of life, from fetal development to aging. These PUFAs act as precursors for various metabolites involved in the prevention of certain diseases. The recognizable effects of these supplements prior to pregnancy (oocyte maturation), during pregnancy (improvement in the risk of premature delivery, among others) and in the offspring (in terms of cognitive function and the approach to neurodevelopmental disorders) are described in the present narrative review. We concluded that the diffusion of these supplements may improve the prognosis of these patients in a simple, effective way, and with high safety rates.
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
Antiphospholipid Antibody Syndrome and Infertility
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(10):621-627
11-07-2019
Summary
Review ArticleAntiphospholipid Antibody Syndrome and Infertility
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(10):621-627
11-07-2019Views156See moreAbstract
Antiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. The objective of the present study was to review the pathophysiology of APS and its association with female infertility. A bibliographic review of articles of the past 20 yearswas performed at the PubMed, Scielo, and Bireme databases. Antiphospholipid antibody syndrome may be associated with primary infertility, interfering with endometrial decidualization and with decreased ovarian reserve. Antiphospholipid antibodies also have direct negative effects on placentation, when they bind to the trophoblast, reducing their capacity for invasion, and proinflammatory effects, such as complement activation and neutrophil recruitment, contributing to placental insufficiency, restricted intrauterine growth, and fetal loss. In relation to thrombosis, APS results in a diffuse thrombotic diathesis, with global and diffuse dysregulation of the homeostatic balance. Knowing the pathophysiology of APS, which is closely linked to female infertility, is essential for new therapeutic approaches, specialized in immunomodulation andinflammatory signaling pathways, to provide important advances in its treatment.
Views156This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleAntiphospholipid Antibody Syndrome and Infertility
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(10):621-627
11-07-2019Views156See moreAbstract
Antiphospholipid antibody syndrome (APS) is a systemic, autoimmune, prothrombotic disease characterized by persistent antiphospholipid antibodies (aPLs), thrombosis, recurrent abortion, complications during pregnancy, and occasionally thrombocytopenia. The objective of the present study was to review the pathophysiology of APS and its association with female infertility. A bibliographic review of articles of the past 20 yearswas performed at the PubMed, Scielo, and Bireme databases. Antiphospholipid antibody syndrome may be associated with primary infertility, interfering with endometrial decidualization and with decreased ovarian reserve. Antiphospholipid antibodies also have direct negative effects on placentation, when they bind to the trophoblast, reducing their capacity for invasion, and proinflammatory effects, such as complement activation and neutrophil recruitment, contributing to placental insufficiency, restricted intrauterine growth, and fetal loss. In relation to thrombosis, APS results in a diffuse thrombotic diathesis, with global and diffuse dysregulation of the homeostatic balance. Knowing the pathophysiology of APS, which is closely linked to female infertility, is essential for new therapeutic approaches, specialized in immunomodulation andinflammatory signaling pathways, to provide important advances in its treatment.
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
Pharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review
- Cristina Laguna Benetti-Pinto ,
- Ticiana Aparecida Alves de Mira,
- Daniela Angerame Yela,
- Cassia Raquel Teatin-Juliato,
- Luiz Gustavo Oliveira Brito
09-30-2019
Summary
Review ArticlePharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):564-574
09-30-2019- Cristina Laguna Benetti-Pinto ,
- Ticiana Aparecida Alves de Mira,
- Daniela Angerame Yela,
- Cassia Raquel Teatin-Juliato,
- Luiz Gustavo Oliveira Brito
Views156See moreAbstract
Objective
To assess the efficacy of non-surgical treatment for adenomyosis.
Data Sources
A search was performed by two authors in the Pubmed, Scopus, and Scielo databases and in the grey literature from inception to March 2018, with no language restriction.
Selection of Studies
We have included prospective randomized studies for treating symptomaticwomen with adenomyosis (abnormal uterine bleeding and/or pelvic pain) diagnosed by ultrasound or magnetic resonance imaging.
Data Collection
Studies were primarily selected by title and abstract. The articles that were eligible for inclusion were evaluated in their entirety, and their data was extracted for further processing and analysis.
Data Synthesis
From567retrieved records only 5 remained for analysis. The intervention groups were: levonorgestrel intrauterine system (LNG-IUS)(n= 2), dienogest (n= 2), and letrozole (n= 1). Levonorgestrel intrauterine system was effective to control bleeding when compared to hysterectomy or combined oral contraceptives (COCs). One study assessed chronic pelvic pain and reported that LNG-IUS was superior to COC to reduce symptoms. Regarding dienogest, it was efficient to reduce pelvic pain when compared to placebo or goserelin, but less effective to control bleeding than gonadotropin-releasing hormone (GnRH) analog. Letrozolewas as efficient asGnRHanalog to relieve dysmenorrhea and dyspareunia, but not for chronic pelvic pain. Reduction of uterine volumewas seen with aromatase inhibitors, GnRH analog, and LGN-IUD.
Conclusion
Levonorgestrel intrauterine system and dienogest have significantly improved the control of bleeding and pelvic pain, respectively, in women with adenomyosis. However, there is insufficient data from the retrieved studies to endorse eachmedication for this disease. Further randomized control tests (RCTs) are needed to address pharmacological treatment of adenomyosis.
Views156This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticlePharmacological Treatment for Symptomatic Adenomyosis: A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):564-574
09-30-2019- Cristina Laguna Benetti-Pinto ,
- Ticiana Aparecida Alves de Mira,
- Daniela Angerame Yela,
- Cassia Raquel Teatin-Juliato,
- Luiz Gustavo Oliveira Brito
Views156See moreAbstract
Objective
To assess the efficacy of non-surgical treatment for adenomyosis.
Data Sources
A search was performed by two authors in the Pubmed, Scopus, and Scielo databases and in the grey literature from inception to March 2018, with no language restriction.
Selection of Studies
We have included prospective randomized studies for treating symptomaticwomen with adenomyosis (abnormal uterine bleeding and/or pelvic pain) diagnosed by ultrasound or magnetic resonance imaging.
Data Collection
Studies were primarily selected by title and abstract. The articles that were eligible for inclusion were evaluated in their entirety, and their data was extracted for further processing and analysis.
Data Synthesis
From567retrieved records only 5 remained for analysis. The intervention groups were: levonorgestrel intrauterine system (LNG-IUS)(n= 2), dienogest (n= 2), and letrozole (n= 1). Levonorgestrel intrauterine system was effective to control bleeding when compared to hysterectomy or combined oral contraceptives (COCs). One study assessed chronic pelvic pain and reported that LNG-IUS was superior to COC to reduce symptoms. Regarding dienogest, it was efficient to reduce pelvic pain when compared to placebo or goserelin, but less effective to control bleeding than gonadotropin-releasing hormone (GnRH) analog. Letrozolewas as efficient asGnRHanalog to relieve dysmenorrhea and dyspareunia, but not for chronic pelvic pain. Reduction of uterine volumewas seen with aromatase inhibitors, GnRH analog, and LGN-IUD.
Conclusion
Levonorgestrel intrauterine system and dienogest have significantly improved the control of bleeding and pelvic pain, respectively, in women with adenomyosis. However, there is insufficient data from the retrieved studies to endorse eachmedication for this disease. Further randomized control tests (RCTs) are needed to address pharmacological treatment of adenomyosis.
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. 
- Cristina Laguna Benetti-Pinto
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Review Article
Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
- Júlia Ferreira Fante,
- Thais Daniel Silva,
- Elaine Cristine Lemes Mateus-Vasconcelos,
- Cristine Homsi Jorge Ferreira,
- Luiz Gustavo Oliveira Brito
09-16-2019
Summary
Review ArticleDo Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519
09-16-2019- Júlia Ferreira Fante,
- Thais Daniel Silva,
- Elaine Cristine Lemes Mateus-Vasconcelos,
- Cristine Homsi Jorge Ferreira,
- Luiz Gustavo Oliveira Brito
Views198See moreAbstract
Objective
We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence - UI, fecal incontinence - FI, and pelvic organ prolapse - POP).
Data
sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies.
Data collection
Two authors performed data extraction into a standardized spreadsheet.
Data synthesis
Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n= 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n= 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n= 3), low educational level (n= 4), low access to information (n= 5) and socioeconomic status (n= 3).
Conclusion
Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.
Views198This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleDo Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519
09-16-2019- Júlia Ferreira Fante,
- Thais Daniel Silva,
- Elaine Cristine Lemes Mateus-Vasconcelos,
- Cristine Homsi Jorge Ferreira,
- Luiz Gustavo Oliveira Brito
Views198See moreAbstract
Objective
We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence - UI, fecal incontinence - FI, and pelvic organ prolapse - POP).
Data
sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies.
Data collection
Two authors performed data extraction into a standardized spreadsheet.
Data synthesis
Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n= 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n= 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n= 3), low educational level (n= 4), low access to information (n= 5) and socioeconomic status (n= 3).
Conclusion
Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.
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
New Approaches to Fetal Growth Restriction: The Time for Metabolomics Has Come
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(7):454-462
08-15-2019
Summary
Review ArticleNew Approaches to Fetal Growth Restriction: The Time for Metabolomics Has Come
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(7):454-462
08-15-2019Views128See moreAbstract
Fetal growth restriction (FGR) diagnosis is often made by fetal biometric ultrasound measurements orDoppler evaluation, but most babies are only diagnosed after birth, using the birth weight as a proxy for intrauterine development. The higher risks of neurodevelopmental delay, metabolic syndrome, and cardiovascular illness associated with FGR impose a shift on the focus during pregnancy. New methodological approaches, like metabolomics, can provide novel biomarkers for intrauterine fetal development. Recent evidence on metabolites involved with fetal growth and weight show a consistent role played by lipids (especially fatty acids), amino acids, vitamin D and folic acid. Fetal energy source andmetabolism, structural functions, and nervous system functioning need further evaluations in different populations. In the near future, the establishment of a core set of outcomes for FGR studies may improve the identification of the role of each metabolite in its development. Thus, we will concretely progress with the perspective of a translational capacity of metabolomics for this condition.
Views128This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleNew Approaches to Fetal Growth Restriction: The Time for Metabolomics Has Come
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(7):454-462
08-15-2019Views128See moreAbstract
Fetal growth restriction (FGR) diagnosis is often made by fetal biometric ultrasound measurements orDoppler evaluation, but most babies are only diagnosed after birth, using the birth weight as a proxy for intrauterine development. The higher risks of neurodevelopmental delay, metabolic syndrome, and cardiovascular illness associated with FGR impose a shift on the focus during pregnancy. New methodological approaches, like metabolomics, can provide novel biomarkers for intrauterine fetal development. Recent evidence on metabolites involved with fetal growth and weight show a consistent role played by lipids (especially fatty acids), amino acids, vitamin D and folic acid. Fetal energy source andmetabolism, structural functions, and nervous system functioning need further evaluations in different populations. In the near future, the establishment of a core set of outcomes for FGR studies may improve the identification of the role of each metabolite in its development. Thus, we will concretely progress with the perspective of a translational capacity of metabolomics for this condition.
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
The Impact on Ovarian Reserve of Different Hemostasis Methods in Laparoscopic Cystectomy: A Systematic Review and Meta-analysis
- Clara Micalli Ferruzzi Baracat ,
- Helizabet Salomão Ayroza Abdalla-Ribeiro,
- Raquel Silveira da Cunha Araujo,
- Wanderley Marques Bernando,
- Paulo Ayroza Ribeiro
07-22-2019
Summary
Review ArticleThe Impact on Ovarian Reserve of Different Hemostasis Methods in Laparoscopic Cystectomy: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(6):400-408
07-22-2019- Clara Micalli Ferruzzi Baracat ,
- Helizabet Salomão Ayroza Abdalla-Ribeiro,
- Raquel Silveira da Cunha Araujo,
- Wanderley Marques Bernando,
- Paulo Ayroza Ribeiro
Views156See moreAbstract
Objective
The objective of this review was to analyze the impact on ovarian reserve of the different hemostatic methods used during laparoscopic cystectomy.
Data Sources
The studies were identified by searching electronic databases (MEDLINE, Embase, Cochrane, LILACS) and scanning reference lists of articles.
Methods of Study Selection
We selected clinical trials that assessed the influence of hemostatic techniques on ovarian reserve in patients with ovarian cysts with benign sonographic appearance submitted to laparoscopic cystectomy by stripping technique. The included trials compared different laparoscopic hemostatic techniques: suture, bipolar electrocoagulation, ultrasonic energy and hemostatic sealants. The outcomes evaluated were level of serum anti-Mullerian hormone (AMH) and antral follicle count (AFC). The possibility of publication bias was evaluated by funnel plots.
Tabulation, Integration and Results
Twelve trials involving 1,047 patients were evaluated. Laparoscopic suturewas superior to bipolar coagulationwhen evaluating serum AMHand AFC, in the 1st, 3rd, 6th and 12thmonth after surgery. In the comparison between bipolar and hemostatic sealants, the results favored the use of hemostatic agents. The use of ultrasonic energy was not superior to the use of bipolar energy.
Conclusion
We recommend suture for hemostasis during laparoscopic cystectomy.
Views156This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleThe Impact on Ovarian Reserve of Different Hemostasis Methods in Laparoscopic Cystectomy: A Systematic Review and Meta-analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(6):400-408
07-22-2019- Clara Micalli Ferruzzi Baracat ,
- Helizabet Salomão Ayroza Abdalla-Ribeiro,
- Raquel Silveira da Cunha Araujo,
- Wanderley Marques Bernando,
- Paulo Ayroza Ribeiro
Views156See moreAbstract
Objective
The objective of this review was to analyze the impact on ovarian reserve of the different hemostatic methods used during laparoscopic cystectomy.
Data Sources
The studies were identified by searching electronic databases (MEDLINE, Embase, Cochrane, LILACS) and scanning reference lists of articles.
Methods of Study Selection
We selected clinical trials that assessed the influence of hemostatic techniques on ovarian reserve in patients with ovarian cysts with benign sonographic appearance submitted to laparoscopic cystectomy by stripping technique. The included trials compared different laparoscopic hemostatic techniques: suture, bipolar electrocoagulation, ultrasonic energy and hemostatic sealants. The outcomes evaluated were level of serum anti-Mullerian hormone (AMH) and antral follicle count (AFC). The possibility of publication bias was evaluated by funnel plots.
Tabulation, Integration and Results
Twelve trials involving 1,047 patients were evaluated. Laparoscopic suturewas superior to bipolar coagulationwhen evaluating serum AMHand AFC, in the 1st, 3rd, 6th and 12thmonth after surgery. In the comparison between bipolar and hemostatic sealants, the results favored the use of hemostatic agents. The use of ultrasonic energy was not superior to the use of bipolar energy.
Conclusion
We recommend suture for hemostasis during laparoscopic cystectomy.
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. - Clara Micalli Ferruzzi Baracat
-
Review Article
Maternal Exposure to Alcohol and Low Birthweight: A Systematic Review and Meta-Analysis
- Priscilla Perez da Silva Pereira ,
- Fabiana Araújo Figueiredo Da Mata,
- Ana Claudia Morais Godoy Figueiredo,
- Roberta Borges Silva,
- Maurício Gomes Pereira
06-27-2019
Summary
Review ArticleMaternal Exposure to Alcohol and Low Birthweight: A Systematic Review and Meta-Analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):333-347
06-27-2019- Priscilla Perez da Silva Pereira ,
- Fabiana Araújo Figueiredo Da Mata,
- Ana Claudia Morais Godoy Figueiredo,
- Roberta Borges Silva,
- Maurício Gomes Pereira
Views142See moreAbstract
Objective
To investigate the relationship between maternal exposure to alcohol and low birthweight (LBW).
Methods
The literature search was performed in January 2017 using the following electronic databases: Medline, Embase, LILACS, SciELO, Web of Science, Scopus, CINHAL, Proquest, and PsychInfo. The search strategy used the following terms: alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol addiction/ use/abuse/consumption, light/moderate/social/low drinking, low birthweight, case-control studies, retrospective studies, and cohort studies. No restrictions regarding language or publication date were considered. The literature search yielded 2,383 articles, and after screening and eligibility assessment, 39 articles were included in the systematic review, and 38 studies were included in the meta-analysis.
Results
Maternal alcohol consumption was associated with LBWamong retrospective cohort studies (relative risk [RR] = 1.37; 95%CI [confidence interval]:1.10-1.77; I2 = 98.4%; p < 0.01). Prospective cohort studies (RR = 1.11; 95%CI: 0.98-1.25; I2 = 81.5%; p < 0.01), and case-control studies (odds ration [OR] = 1.16; 95%CI: 0.68-1.97; I2 = 61.2%; p = 0.05) showed no association between alcohol and LBW.No publication bias was identified, and the meta-regression showed that the sample size influenced the high heterogeneity among retrospective cohort studies. The subgroup analysis showed differences in association between groups when compared by sample size, type of adjustment, or crude measures and publication year.
Conclusions
We have not found an association between alcohol consumption during gestation and LBW in the analysis in all of the subgroups. In addition, we have found a high heterogeneity between the primary studies, which is related to methodological differences in the conduction of these studies.
Views142This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Summary
Review ArticleMaternal Exposure to Alcohol and Low Birthweight: A Systematic Review and Meta-Analysis
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):333-347
06-27-2019- Priscilla Perez da Silva Pereira ,
- Fabiana Araújo Figueiredo Da Mata,
- Ana Claudia Morais Godoy Figueiredo,
- Roberta Borges Silva,
- Maurício Gomes Pereira
Views142See moreAbstract
Objective
To investigate the relationship between maternal exposure to alcohol and low birthweight (LBW).
Methods
The literature search was performed in January 2017 using the following electronic databases: Medline, Embase, LILACS, SciELO, Web of Science, Scopus, CINHAL, Proquest, and PsychInfo. The search strategy used the following terms: alcohol drinking, binge drinking, alcohol-related disorders, alcoholism, alcohol addiction/ use/abuse/consumption, light/moderate/social/low drinking, low birthweight, case-control studies, retrospective studies, and cohort studies. No restrictions regarding language or publication date were considered. The literature search yielded 2,383 articles, and after screening and eligibility assessment, 39 articles were included in the systematic review, and 38 studies were included in the meta-analysis.
Results
Maternal alcohol consumption was associated with LBWamong retrospective cohort studies (relative risk [RR] = 1.37; 95%CI [confidence interval]:1.10-1.77; I2 = 98.4%; p < 0.01). Prospective cohort studies (RR = 1.11; 95%CI: 0.98-1.25; I2 = 81.5%; p < 0.01), and case-control studies (odds ration [OR] = 1.16; 95%CI: 0.68-1.97; I2 = 61.2%; p = 0.05) showed no association between alcohol and LBW.No publication bias was identified, and the meta-regression showed that the sample size influenced the high heterogeneity among retrospective cohort studies. The subgroup analysis showed differences in association between groups when compared by sample size, type of adjustment, or crude measures and publication year.
Conclusions
We have not found an association between alcohol consumption during gestation and LBW in the analysis in all of the subgroups. In addition, we have found a high heterogeneity between the primary studies, which is related to methodological differences in the conduction of these 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. - Priscilla Perez da Silva Pereira
Review Article Archives - Page 4 of 16 - Revista Brasileira de Ginecologia e Obstetrícia
