Trabalhos Originais Archives - Page 11 of 50 - Revista Brasileira de Ginecologia e Obstetrícia

  • Trabalhos Originais

    Route of delivery in successive gestations in adolescents: study of 714 cases

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):703-707

    Summary

    Trabalhos Originais

    Route of delivery in successive gestations in adolescents: study of 714 cases

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):703-707

    DOI 10.1590/S0100-72032004000900005

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    PURPOSE: to analyze the association between modes of consecutive deliveries of 714 adolescents attended at the Maternity sector of the Hospital das Clínicas da Universidade Federal de Pernambuco (Federal University of Pernambuco), from January to December 2001. PATIENTS AND METHODS: according to a prospective, analytic, transversal, and incidence type study, the sequence of delivery modes was analyzed from the first to the fourth parturition of 714 pregnant adolescents, aged from 13 to 19 years (mean17.2±1.5 years). Every day, after identifying the adolescents who delivered, by the parturition room register, they were invited to participate in this study. Those who agreed, after signing a free informed consent answered a structured questionnaire with 65 direct questions with precodified closed options, among which were delivery mode and number of gestations. RESULTS: it was found that 527 (73.8%) adolescents had only one delivery, 149 (20.9%) two deliveries, 35 (4.9%) three deliveries, and 3 (0.4%) had had four deliveries. Among the 273 cesarean sections, 207 (75.8%) occurred in primiparae, 65 (23.8%) in secundiparae and one (0.4%) in a multipara. There was a statistically significant association between the first and the second deliveries for 83 (55.7%) adolescents who had transvaginal delivery, as well as for 41 (27.5%) by cesarean section. There was also coincidence about the second and third deliveries, regarding transvaginal delivery of 23 (65.7%) adolescents, as well as cesarean section of 10 (28.6%) adolescents. CONCLUSION: a tendency to coincidence of subsequent delivery modes was identified for adolescents until the third parturition.

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  • Trabalhos Originais

    Perinatal results in pregnant women with more than 35 years: a controlled study

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):697-701

    Summary

    Trabalhos Originais

    Perinatal results in pregnant women with more than 35 years: a controlled study

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):697-701

    DOI 10.1590/S0100-72032004000900004

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    PURPOSE: to evaluate perinatal results in pregnant women over 35 years old and to check differences between two groups: 35 to 39-year-old women and women older than 40. METHODS: a retrospective survey was made during the period between January/2000 and July/2003, through the analysis of obstetric charts of 3,093 pregnant women who delivered in the "Hospital do Servidor Público Estadual - Francisco Morato de Oliveira", excluding 933 patients. The patients were divided into 3 groups: 18 to 29 years old (control group), 35 to 39 years old, and over 40 years old. Data collection was done with standardized forms, and the data were transferred to an electronic spreadsheet (Excel - Microsoft Office 2000). Statistical analysis was performed using the chi2 test and the Fisher test. The alpha risk was less or equal to 5% and the confidence interval 95%. RESULTS: cesarean section was the most used method not only in the 35 to 39-year-old group (438/792; 55.3%) but also in the group of women over 40 (153/236; 64.8%). The rates of prematurity (39/236; 16.5%), low weight (37/236; 15.7%), and restriction of fetal growth (38/236; 16.1%) were significantly higher in the group of women over 40, when compared to the other groups. Concerning fetal death, a five times higher incidence was observed in the group over 40 years old, as compared to the other groups, a statistically significant difference. CONCLUSION: the only difference between the 35 to 39-year-old group and the control group was the cesarean section rate. This allows us to suggest a differentiated prenatal attendance for pregnant women over 40.

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  • Trabalhos Originais

    Association between anthropometry and circulating leptin in maternal, fetal and placental compartments, in healthy pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):691-695

    Summary

    Trabalhos Originais

    Association between anthropometry and circulating leptin in maternal, fetal and placental compartments, in healthy pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):691-695

    DOI 10.1590/S0100-72032004000900003

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    PURPOSE: to evaluate the importance of circulating maternal and fetal leptin in the healthy gestation, using its association with maternal, placental and fetal anthropometric variables, obtained at birth, and the relationship between the evaluated compartments. METHODS: in a transversal study a population of 33 single, healthy and term gestations was studied. The evaluated variables were maternal age, maternal weight, body mass index (BMF), weight of the newborn, placental weight, and placental index. Samples of maternal blood were immediately obtained before birth and from fetal umbilical cord blood at birth. Determination of serum leptin was performed using conventional radioimmunoassay. The relationships between serum leptin concentrations in maternal blood, umbilical artery and vein and the studied variables were assessed through linear regression. RESULTS: leptin levels were detected in the blood of all 33 pregnant women and their respective newborns, with maternal blood concentration (17.1±1.77 ng/mL) higher than that of umbilical vessels (vein: 9.0±1.16 ng/mL; artery: 8.23±1.02 ng/mL), p<0.0001. Leptin concentrations in the maternal blood were correlated with leptin concentrations in fetal blood (artery: coef. 0.63, p=0.037; vein: coef. 0.72, p=0.006). Regarding the anthropometric variables, leptin measured in the maternal blood was associated with initial and final maternal BMF (coef. 1.13; p=0.002; coef. 1,18, p=0.001) and cord leptin levels were correlated with the fetal weight at birth (vein: coef. 0.007, p=0.02; artery: coef. 0.006, p=0.02). CONCLUSION: there was a correlation between maternal and fetal leptin production and probably by the action of similar stimuli during gestation. Serum leptin was associated with the weight of the compartment where it circulates.

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  • Trabalhos Originais

    Behavior of heart rate, blood pressure, and hydrostatic weight of pregnant women at different immersion depths

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):685-690

    Summary

    Trabalhos Originais

    Behavior of heart rate, blood pressure, and hydrostatic weight of pregnant women at different immersion depths

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):685-690

    DOI 10.1590/S0100-72032004000900002

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    PURPOSE: to identify the responses of heart rate (HR), blood pressure (BP), and hydrostatic weight (HW) in pregnant women immersed up to different anatomic points as far as the xiphoid process. METHODS: eleven pregnant women underwent the following experimental procedure: 10 minutes in recumbent position for evaluation of HR and BP at rest; 2 minutes in standing position for evaluation of initial measures of HR, BP and mass, and one minute for each immersion depth. HR, BP and HW were measured after immersion up to the level of the ankle, knee, hip, navel, and xiphoid process, respectively. Descriptive statistics, test of normality (Shapiro-Wilks), homogeneity of variance test (Levene), one-way ANOVA and the Bonferroni test (SPSS version 8.0) were used, with significance at p<0.05. RESULTS: significant differences were found for HR, diastolic BP and mean BP starting from the xiphoid process (79.1±5.1 bpm; 53.3±6.7 mmHg and 63.9±6.2 mmHg, respectively) and for the systolic BP starting from the navel (92.7±11.1 mmHg). Significant differences were seen in all measurements of percent HW reduction, as in previous studies carried out with non-pregnant women. CONCLUSION: the obtained results showed a decrease in HR and BP on water immersion when compared non-immersion, as well as decreases in HW, which were proportional to the depth of immersion. The decrease in HW was found to influence the decrease in mechanical load imposed on the lower limb joints, since the mechanical load depends on both the vertical force (hydrostatic weight) and on the acceleration with which the body touches the ground. As a result, it is concluded that water is a healthy environment for the population under study, and may be adequate for the practice of physical activities.

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  • Trabalhos Originais

    Can polycystic ovary syndrome interfere with the outcome of in vitro fertilization?

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):727-733

    Summary

    Trabalhos Originais

    Can polycystic ovary syndrome interfere with the outcome of in vitro fertilization?

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):727-733

    DOI 10.1590/S0100-72032004000900009

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    PURPOSE: to evaluate the results of ovulation hyperinduction followed by in vitro fertilization (IVF) in women with polycystic ovary syndrome (POS), as compared to normal cycle women. METHODS: a controlled retrospective study conducted on 36 women with POS (POS group) and on 44 women with infertility due to mild male factor (control group), submitted to IVF from 1997 to 2003. Subject ages ranged from 18 to 36 years. Ovulation hyperinduction was obtained with recombinant follicle-stimulating hormone and a gonadotrophin-releasing hormone agonist. The analyzed variables were the follicles with a mean diameter of 14 to 17 mm and the follicles with diameters of 18 mm or above on the day of human chorionic gonadotrophin administration, percentage of follicles >18 mm, the number of retrieved oocytes, fertilization rate, cleavage rate, incidence of ovarian hyperstimulation syndrome (OHS), clinical pregnancy rate, and abortion rate. The variables were analyzed by the unpaired t test, Fisher exact test and Mann-Whitney test, with level of significance set at p<0.05. RESULTS: the POS group presented a larger number of retrieved follicles, most of them measuring 14 to 17 mm in diameter, compared to the control group (64.8 vs 53.9%), a lower fertilization rate (59.43 vs 79.57%) and a higher incidence of OHS (38.9 vs 9.1%). The number of retrieved oocytes, cleavage rates, pregnancy rates per embryo transfer, abortion rates and live born rates did not differ between groups. CONCLUSION: the success of IVF is impaired in women with POS due to their larger number of retrieved follicles of reduced diameter, reduced fertilization rate and high OHS rates.

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  • Trabalhos Originais

    Bacterial vaginosis and high-risk HPV-DNA in women submitted to diathermic conization for the treatment of high-grade cervical intra-epithelial neoplasia

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):721-725

    Summary

    Trabalhos Originais

    Bacterial vaginosis and high-risk HPV-DNA in women submitted to diathermic conization for the treatment of high-grade cervical intra-epithelial neoplasia

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):721-725

    DOI 10.1590/S0100-72032004000900008

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    PURPOSE: to analyze the association between bacterial vaginosis (BV), high-risk HPV DNA, and Pap smear abnormalities in women submitted to diathermic conization for the treatment of high-grade cervical intraepithelial neoplasia (CIN 2 or 3). METHODS: a descriptive clinical study with 81 women submitted to diathermic conization for the treatment of CIN 2 or 3. Initial Pap smear was performed by the time of the biopsy and was also used to verify the presence of BV. Prior to conization, samples for the detection of high-risk HPV DNA through hybrid capture II (HC II) were collected. A control visit was scheduled for four months after the conization to repeat these tests. Twenty-seven women were found to have BV and 54 were not. Statistical analysis comprised odds ratios (OR) to assess the correlations between BV and HPV detection before and after diathermic conization and cytological abnormalities. All analyses were performed with a 95% confidence interval (95% CI). RESULTS: high-risk HPV DNA detection before conization was identical in both groups (89%). After conization, HPV DNA detection decreased to 26 and 18% in the groups with and without BV, respectively (OR=1.5; 95% CI 0.5 to 4.6). In addition, 41% of the women with BV and 20% without BV showed Pap smear abnormalities (OR=2.7; 95% CI 1.0 to 7.4). Regarding these 22 women with Pap smear abnormalities approximately four months after the diathermic conization, 83% of the BV group tested positive for HPV DNA compared with 50% in the group without BV (OR=5.0; IC 95% 0.5 a 52.9). CONCLUSION: women with BV presented more Pap smear abnormalities after conization when compared to the women without BV, although this was not statistically significant. This association was not related to high-risk HPV DNA.

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  • Trabalhos Originais

    Experimental endometriosis model in rabbits with follow-up of the lesions

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):715-719

    Summary

    Trabalhos Originais

    Experimental endometriosis model in rabbits with follow-up of the lesions

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):715-719

    DOI 10.1590/S0100-72032004000900007

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    PURPOSE: development of a new experimental model of endometriosis induction in rabbits evaluating its temporal evolution both macro-and microscopically. METHODS: thirty female rabbits were submitted to endometriosis induction through the fixation of a piece of the left uterine horn to the abdominal peritoneum. After four or eight weeks the viability of the lesions was verified by laparoscopy. The lesions were observed endoscopically. The implants were measured and histological analyses were made. The groups were compared for the presence of endometriotic lesion on laparoscopy, presence of adhesions, implant size and histological aspects. For statistical analyses we utilized Student's t and Mann-Whitney's tests, with a statistical significance of 5%. RESULTS: endometriotic lesions were identified in all cases submitted to laparoscopy after 4 weeks of induction, 64% of them cystic, and in 80% of the rabbits after eight weeks, 66% of which cystic. The adhesions were present in 71% of the rabbits after 4 weeks (none in the implants) and in 80% of the rabbits after 8 weeks (13% in the implants). The lesions were significantly larger after 8 weeks (p<0,0001). The histological analyses showed 100% of endometrial tissue in both groups. CONCLUSION: this experimental model showed that it is possible to simulate endometriosis in rabbits with a viable and simple technique, also allowing to record the characteristics and development of the implants macro-and microscopically. Although the histological aspects were similar, the lesions after eight weeks were larger than after four, making their manipulation easier.

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    Experimental endometriosis model in rabbits with follow-up of the lesions
  • Trabalhos Originais

    Previous cesarean section as a risk factor for abruptio placentae

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):709-714

    Summary

    Trabalhos Originais

    Previous cesarean section as a risk factor for abruptio placentae

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(9):709-714

    DOI 10.1590/S0100-72032004000900006

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    PURPOSE: to study the relationship between previous cesarean section and abruptio placentae. METHODS: a retrospective study reviewed 6495 deliveries between April 2001 and January 2004. The adopted inclusion criteria were: clinical diagnosis of abruptio placentae confirmed by placental examination after delivery, single pregnancy, birth weight >500 g, gestational age >22 weeks and no history of abdominal trauma. Five controls were selected for each abruptio placentae case and were matched for the following parameters: parity, gestational age (< or > 30 weeks), maternal arterial hypertension during pregnancy, presence of nonobstetrical uterine scar, premature rupture of membranes and polyhydramnios. Statistical analysis of continuous variables was perfomed by Student's t test. Statistical significance of the comparisons of categorical variables was evaluated by the chi2 test or by the Fisher exact test. p values <0.05 were considered to be significant. RESULTS: thirty-four cases of abruptio placentae were included (incidence 0.52%). The control group included 170 cases that fulfilled the matching criteria. The incidence of previous cesarean section in the abruptio placentae group was 26.5% (9 cases) and in the control group it was 21.2% (36 cases). No significant difference was found between the groups (p=0.65, OR=1.34, CI 95%=0.53-3.34). CONCLUSION: the present study was not able to demonstrate association between abruptio placentae and previous cesarean section.

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