Review Article Archives - Page 15 of 15 - Revista Brasileira de Ginecologia e Obstetrícia

  • Review Article

    Analysis of the Role of Female Hormones During Infection by COVID-19

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):940-948

    Summary

    Review Article

    Analysis of the Role of Female Hormones During Infection by COVID-19

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(12):940-948

    DOI 10.1055/s-0041-1740208

    Views7

    Abstract

    Women have metabolic, immunological, and genetic variables that ensure more protection from coronavirus infection. However, the indication of treatment for several pathologies and contraception is determined by hormones that have adverse effects and raise doubts about their use during the COVID-19 pandemic. Therefore, the present study searches women specificities and the relation between female sexual hormones and COVID-19, and reports the main recommendations in this background. To this end, a review of the literature was conducted in the main databases, auxiliary data sources, and official websites. Therefore, considering the hypercoagulability status of COVID-19, the debate about the use of contraceptives due to the relative risk of thromboembolic effects that they impose arises. However, the current available evidence, as well as the recommendations of main health organs around the world, demonstrate that the use of hormonal contraceptives must be maintained during the pandemic.

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    Analysis of the Role of Female Hormones During Infection by COVID-19
  • Review Article

    Can Prenatal and Postnatal Cell Phone Exposure Increase Adverse Maternal, Infant and Child Outcomes?

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(11):870-877

    Summary

    Review Article

    Can Prenatal and Postnatal Cell Phone Exposure Increase Adverse Maternal, Infant and Child Outcomes?

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(11):870-877

    DOI 10.1055/s-0041-1736173

    Views11

    Abstract

    Objective

    To determine the association between maternal mobile phone use and adverse outcomes in infants, children, and mothers.

    Method

    In March 202, we conducted a search on the MEDLINE, Embase, and Scopus databases. Data extraction and an assessment of the quality of the studies were performed by two authors. The quality of the studies was assessed using the checklist of the Newcastle-Ottawa scale.

    Results

    Studies assessing behavioral problems in infants aged 6 to 18 months reported null findings. However, an increased risk of emotional and behavioral disorders was observed in children aged between 7 and 11 years whose mothers had been exposed to cell phones. The findings regarding the association between maternal cell phone exposure and adverse outcomes in children aged 3 to 5 are controversial. A study found a significant association between the call time (p=0.002) or the history of mobile phone use (in months) and speech disorders in the children (p=0.003). However, another study found that maternal cell phone use during pregnancy was not significantly associated with child psychomotor and mental developments. Inconclusive results were observed about the adverse outcomes in fetuses, such as fetal growth restriction or t scores for birth weight in cell phone users as opposed to non-users. On the contrary, the children ofmothers who were cell phone users had a lower risk of scoring low on motor skills. Similar results were observed regarding the adverse outcomes of cell phone use in infants, such as fetal growth restriction or low birth weight, and the risk of preeclampsia was lower among subjects with medium and high cell phone exposure, as opposed to those with low exposure.

    Conclusion

    Studies on behavioral problems have reported different postnatal results, such as null findings among infants and a positive association in children.

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  • Review Article

    Dyspnea and COVID-19: A Review of Confounding Diagnoses during the Postpartum Period

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(11):862-869

    Summary

    Review Article

    Dyspnea and COVID-19: A Review of Confounding Diagnoses during the Postpartum Period

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(11):862-869

    DOI 10.1055/s-0041-1736304

    Views7

    Abstract

    The puerperium is a complex period that begins with placental delivery and lasts for 6 weeks, during which readaptation of the female organism and redistribution of blood volume occur. This period is conducive to the occurrence of thromboembolic events. In the context of the SARS-CoV-2 pandemic, the virus responsible for COVID-19, the attention of the scientific community and health professionals has been focused on obtaining insights on different aspects of this disease, including etiology, transmission, diagnosis, and treatment. Regarding the pregnancy-postpartum cycle, it is opportune to review the clinical conditions that can occur during this period and to investigate dyspnea as a postpartum symptom in order to avoid its immediate association with COVID-19 without further investigation, which can lead to overlooking the diagnosis of other important and occasionally fatal conditions.

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  • Review Article

    Oral Iron Supplementation in Pregnancy: Current Recommendations and Evidence-Based Medicine Suplementação oral de ferro na gravidez: recomendações atuais e medicina baseada na evidência

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):782-788

    Summary

    Review Article

    Oral Iron Supplementation in Pregnancy: Current Recommendations and Evidence-Based Medicine Suplementação oral de ferro na gravidez: recomendações atuais e medicina baseada na evidência

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):782-788

    DOI 10.1055/s-0041-1736144

    Views17

    Abstract

    Objective

    To review the evidence about universal iron supplementation in pregnancy to prevent maternal anemia.

    Methods

    Bibliographic research of randomized and controlled clinical trials, meta-analyses, systematic reviews, and clinical guidelines, published between August 2009 and August 2019, using the MeSH terms: iron; therapeutic use; pregnancy; anemia, prevention and control.

    Results

    We included six clinical guidelines, three meta-analyses and one randomized controlled clinical trial.

    Discussion

    Most articles point to the improvement of hematological parameters and reduction of maternal anemia risk, with supplementary iron. However, they do not correlate this improvement in pregnant women without previous anemia with the eventual improvement of clinical parameters.

    Conclusion

    Universal iron supplementation in pregnancy is controversial, so we attribute a SORT C recommendation strength.

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    Oral Iron Supplementation in Pregnancy: Current Recommendations and Evidence-Based Medicine Suplementação oral de ferro na gravidez: recomendações atuais e medicina baseada na evidência
  • Review Article

    Association of the Maternal Folic Acid Supplementation with the Autism Spectrum Disorder: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):775-781

    Summary

    Review Article

    Association of the Maternal Folic Acid Supplementation with the Autism Spectrum Disorder: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(10):775-781

    DOI 10.1055/s-0041-1736298

    Views14

    Abstract

    Objective

    To analyze the scientific production regarding maternal folic acid (FA) supplementation and its relationship with autistic spectrum disorder (ASD).

    Data Sources

    We performed unrestricted electronic searches in the BIREME virtual bank, Virtual Health Library (VHL) and Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed) databases.

    Selection of Studies

    For sample selection, articles that met the proposed objectives were included, published in English, Spanish and Portuguese, the use of Health Sciences Descriptors (DeCS): autistic OR autism AND autism spectrum disorder AND folic acid, AND, with the use of the Medical Subject Headings (MeSH): autistic OR autism AND autistic spectrum disorder AND folic acid.

    Data Collection

    Data extraction was performed by the reviewers with a preestablished data collection formulary.

    Data Synthesis

    The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) was used based on a checklist with 27 items and a 4-step flowchart.

    Results

    A total of 384 articles was found by the search strategies, of which 17 were eligible following the pre-established criteria. The main findings of the present review point to maternal FA supplementation in the pre-conception period and beginning of pregnancy as a protective effect in relation to ASD, which should be indicated in this period as prevention to the problem.

    Conclusion

    According to the research analyzed, more studies are necessary to know its effects on pregnancy, since the consumption of excessive FA may not be innocuous.

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    Association of the Maternal Folic Acid Supplementation with the Autism Spectrum Disorder: A Systematic Review
  • Review Article

    Supplementation of Vitamin D in the Postdelivery Period of Women with Previous Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis of Randomized Trials

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):699-709

    Summary

    Review Article

    Supplementation of Vitamin D in the Postdelivery Period of Women with Previous Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis of Randomized Trials

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(9):699-709

    DOI 10.1055/s-0041-1734000

    Views4

    Abstract

    Objective

    To evaluate the effects of vitamin D supplementation in the postpartum period of women with previous gestational diabetes mellitus (GDM).

    Methods

    Randomized clinical trials of pregnant women with GDM of any chronological, gestational age and parity, with no history of previous disease who received vitamin D supplementation in the prenatal and/or postpartum period and were evaluated in the postpartum period were included. The PubMed, EMBASE, Cochrane, and LILACS databases were consulted until July 2019. Serum vitamin D concentration (25- hydroxyvitamin D in nmol/L), fasting blood glucose, glycated hemoglobin, serum calcium concentration, homeostatic model assessment of insulin resistance (HOMAIR), quantitative insulin sensitivity check index (QUICKI), parathyroid hormone (PTH) and body mass index (BMI) were evaluated. Similar results in at least two trials were plotted using the RevMan 5; Cochrane Collaboration, Oxford, Reino Unido. The quality of the evidence was generated according to the classification, development, and evaluation of the classification of the recommendations.

    Results

    Four studies were included in the present review (200 women). The findings indicate that there is no difference in the postpartum period in women diagnosed with previous GDM who received vitamin D supplementation in the prenatal and/or in the postpartum period, showing only that there was a significant increase in the concentration of vitamin D (relative risk [RR]: 1.85; 95% confidence interval [CI]: 1.02-2.68).

    Conclusion

    This increase in the concentration of vitamin D should be interpreted with caution, since the assessment of the quality of the evidence was very low. For the other analyzed outcomes, there was no significance between the intervention and control groups, and the outcomes, when analyzed in their strength of evidence, were considered very low and low in their evaluation.

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    Supplementation of Vitamin D in the Postdelivery Period of Women with Previous Gestational Diabetes Mellitus: Systematic Review and Meta-Analysis of Randomized Trials
  • Review Article

    Expectant Versus Interventionist Care in the Management of Severe Preeclampsia Remote from Term: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):627-637

    Summary

    Review Article

    Expectant Versus Interventionist Care in the Management of Severe Preeclampsia Remote from Term: A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(8):627-637

    DOI 10.1055/s-0041-1733999

    Views9

    Abstract

    Objective

    To compare the effects of expectant versus interventionist care in the management of pregnant women with severe preeclampsia remote from term.

    Data sources

    An electronic search was conducted in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), Latin American and Caribbean Health Sciences Literature (LILACS, for its Spanish acronym), World Health Organization’s International Clinical Trials Registry Platform (WHO-ICTRP), and Open- Grey databases. The International Federation of Gynecology and Obstetrics (FIGO, for its French acronym), Royal College of Obstetricians and Gynaecologists (RCOG), American College of Obstetricians and Gynecologists (ACOG), and Colombian Journal of Obstetrics and Gynecology (CJOG) websites were searched for conference proceedings, without language restrictions, up to March 25, 2020.

    Selection of studies

    Randomized clinical trials (RCTs), and non-randomized controlled studies (NRSs) were included. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of the evidence.

    Data collection

    Studies were independently assessed for inclusion criteria, data extraction, and risk of bias. Disagreements were resolved by consensus.

    Data synthesis

    Four RCTs and six NRS were included. Low-quality evidence from the RCTs showed that expectant care may result in a lower incidence of appearance, pulse, grimace, activity, and respiration (Apgar) scores<7 at 5 minutes (risk ratio [RR]: 0.48; 95% confidence interval [95%CI]: 0.23%to 0.99) and a higher average birth weight (mean difference [MD]: 254.7 g; 95%CI: 98.5 g to 410.9 g). Very low quality evidence from the NRSs suggested that expectant care might decrease the rates of neonatal death (RR: 0.42; 95%CI 0.22 to 0.80), hyalinemembrane disease (RR: 0.59; 95%CI: 0.40 to 0.87), and admission to neonatal care (RR: 0.73; 95%CI: 0.54 to 0.99). Nomaternal or fetal differences were found for other perinatal outcomes.

    Conclusion

    Compared with interventionist management, expectant care may improve neonatal outcomes without increasing maternal morbidity and mortality.

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    Expectant Versus Interventionist Care in the Management of Severe Preeclampsia Remote from Term: A Systematic Review
  • Review Article

    Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):560-569

    Summary

    Review Article

    Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature

    Revista Brasileira de Ginecologia e Obstetrícia. 2021;43(7):560-569

    DOI 10.1055/s-0041-1730292

    Views32

    Abstract

    Introduction

    Preeclampsia (PE) is a pregnancy complication associated with increased maternal and perinatal morbidity and mortality. The disease presents with recent onset hypertension (after 20 weeks of gestation) and proteinuria, and can progress to multiple organ dysfunction, with worse outcomes among early onset preeclampsia (EOP) cases (<34 weeks). The placenta is considered the root cause of PE; it represents the interface between the mother and the fetus, and acts as a macromembrane between the two circulations, due to its villous and vascular structures. Therefore, in pathological conditions, macroscopic and microscopic evaluation can provide clinically useful information that can confirm diagnosis and enlighten about outcomes and future therapeutic benefit.

    Objective

    To perform an integrative review of the literature on pathological placental findings associated to preeclampsia (comparing EOP and late onset preeclampsia [LOP]) and its impacts on clinical manifestations.

    Results:

    Cases of EOP presented worse maternal and perinatal outcomes, and pathophysiological and anatomopathological findings were different between EOP and LOP placentas, with less placental perfusion, greater placental pathological changes with less villous volume (villous hypoplasia), greater amount of trophoblastic debris, syncytial nodules, microcalcification, villous infarcts, decidual arteriolopathy in EOP placentas when compared with LOP placentas. Clinically, the use of low doses of aspirin has been shown to be effective in preventing PE, as well asmagnesium sulfate in preventing seizures in cases of severe features.

    Conclusion

    The anatomopathological characteristics between EOP and LOP are significantly different, with large morphological changes in cases of EOP, such as

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    Placental Findings in Preterm and Term Preeclampsia: An Integrative Review of the Literature

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