Trabalhos Originais Archives - Page 2 of 51 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(5):287-290
DOI 10.1590/S0100-72031999000500007
Purpose: to evaluate the knowledge and practice of breast self-examination among medical students and to determine possible factors associated with this practice. Method: the authors used a questionnaire to gather information about the students and their knowledge of this self-examination. This questionnaire also allowed the authors to verify the frequency with which the female students performed breast self-examination. The chi² test and Student's "t" test were used, when applicable, to check the association of certain factors. Results: of the 348 questionnaires which were answered, 16% (55) were submitted by 5th year medical students, who had already attended the Gynecology course; 43% were answered by females, 62% of the students had medical doctors among their relatives, and 17% had a family history of breast cancer. In terms of breast self-examination, 95% knew about the method. Of the 149 females who answered the questionnaire, only 64% checked their breasts regularly. The reasons given for not performing self-examination varied: 24% considered themselves to be too young, 4% thought they would not have cancer, 9% listed fear as the reason, 19% reported they were too lazy, and 44% of the female students had no clear reason for not performing breast self-examination. Neither the knowledge nor the practice of the breast self-examination were associated with the subjects the students had or had not yet taken in medical school, with a family history of breast cancer or with the fact that one or more relatives were medical doctors. Conclusion: breast self-examination is known by practically all the medical students; nevertheless, only one third of the female students performed it regularly. This fact highlights the importance of emphasizing breast self-examination among medical students, so that they can help to disseminate this practice among the general population, rather than delegating this responsibility to the midia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(5):287-290
DOI 10.1590/S0100-72031999000500007
Purpose: to evaluate the knowledge and practice of breast self-examination among medical students and to determine possible factors associated with this practice. Method: the authors used a questionnaire to gather information about the students and their knowledge of this self-examination. This questionnaire also allowed the authors to verify the frequency with which the female students performed breast self-examination. The chi² test and Student's "t" test were used, when applicable, to check the association of certain factors. Results: of the 348 questionnaires which were answered, 16% (55) were submitted by 5th year medical students, who had already attended the Gynecology course; 43% were answered by females, 62% of the students had medical doctors among their relatives, and 17% had a family history of breast cancer. In terms of breast self-examination, 95% knew about the method. Of the 149 females who answered the questionnaire, only 64% checked their breasts regularly. The reasons given for not performing self-examination varied: 24% considered themselves to be too young, 4% thought they would not have cancer, 9% listed fear as the reason, 19% reported they were too lazy, and 44% of the female students had no clear reason for not performing breast self-examination. Neither the knowledge nor the practice of the breast self-examination were associated with the subjects the students had or had not yet taken in medical school, with a family history of breast cancer or with the fact that one or more relatives were medical doctors. Conclusion: breast self-examination is known by practically all the medical students; nevertheless, only one third of the female students performed it regularly. This fact highlights the importance of emphasizing breast self-examination among medical students, so that they can help to disseminate this practice among the general population, rather than delegating this responsibility to the midia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(5):291-295
DOI 10.1590/S0100-72031999000500008
Purpose: to verify changes in amnion epithelia after neovaginoplasty and the presence of estrogen receptor in this tissue using electron microscopy (TEM). Methods: a group consisting of 33 young patients with vaginal agenesy, most of them amenorreic, either incapable or having difficulty to adequately perform sexual activity, underwent surgical correction of the anomaly by the McIndoe-Banister technique. In each woman, a cavity was created through an opening of the vesicorectal space. A mold made of artificial sponge with a condom recovered by amniotic membrane was introduced into the cavity. After eight days, the mold was removed, leaving a developing neoepithelium from the amniotic membrane. Results: The TEM conducted in samples of tissue obtained from neovaginas showed similar results in all three layers of these epithelia, either in the cytoplasm or the cellular microstructures in comparison with normal women. The intensity of staining of the estrogen receptors on the vaginal neoepithelium of the group of women who underwent the surgical procedure was similar to that of normal women. The estrogen receptors were heterogeneously distributed in the three layers of the tissue in all women. The analysis of the vaginal neoepithelium obtained from amniotic membrane revealed, through the TEM, all the characteristics of a regular vaginal epithelium.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(5):291-295
DOI 10.1590/S0100-72031999000500008
Purpose: to verify changes in amnion epithelia after neovaginoplasty and the presence of estrogen receptor in this tissue using electron microscopy (TEM). Methods: a group consisting of 33 young patients with vaginal agenesy, most of them amenorreic, either incapable or having difficulty to adequately perform sexual activity, underwent surgical correction of the anomaly by the McIndoe-Banister technique. In each woman, a cavity was created through an opening of the vesicorectal space. A mold made of artificial sponge with a condom recovered by amniotic membrane was introduced into the cavity. After eight days, the mold was removed, leaving a developing neoepithelium from the amniotic membrane. Results: The TEM conducted in samples of tissue obtained from neovaginas showed similar results in all three layers of these epithelia, either in the cytoplasm or the cellular microstructures in comparison with normal women. The intensity of staining of the estrogen receptors on the vaginal neoepithelium of the group of women who underwent the surgical procedure was similar to that of normal women. The estrogen receptors were heterogeneously distributed in the three layers of the tissue in all women. The analysis of the vaginal neoepithelium obtained from amniotic membrane revealed, through the TEM, all the characteristics of a regular vaginal epithelium.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):371-376
DOI 10.1590/S0100-72031999000700002
Purpose: to evaluate the possible value of pulsed and color Doppler of ductus venosus blood flow in the screening for chromosomal abnormalities at 10-14 weeks of gestation. Methods: the ductus venosus flow velocity waveforms and the nuchal translucency (NT) thickness were obtained immediately before the chorionic villus sample in 26 pregnancies. We employed the following criteria for the suspicion of chromosomal defects: reverse or absent flow during atrial contraction and NT greater or equal to 3 mm. We calculated the sensitivity, the specificity, the negative and positive predictive value for each of the above items. Results: there were 9 chromosomal abnormalities (3 cases of trisomy 21, 2 cases of trisomy 13, 1 case of trisomy 9, 1 case of trisomy 22, 1 triploidy and 1 monosomy X). Abnormal ductus venosus flow was observed in all cases (sensitivity of 100%). In the normal fetuses (17 cases) only 1 had abnormal flow (specificity of 94%). Concerning NT, the sensitivity and the specificity were 88% and 76%, respectively. Conclusion: our preliminary results suggest that the presence of chromosomal abnormalities may be strongly suspected when an increased NT thickness is associated with an absent or reverse flow in the ductus venosus. We speculated that both methods are valid in the screening of chromosomal defects.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):371-376
DOI 10.1590/S0100-72031999000700002
Purpose: to evaluate the possible value of pulsed and color Doppler of ductus venosus blood flow in the screening for chromosomal abnormalities at 10-14 weeks of gestation. Methods: the ductus venosus flow velocity waveforms and the nuchal translucency (NT) thickness were obtained immediately before the chorionic villus sample in 26 pregnancies. We employed the following criteria for the suspicion of chromosomal defects: reverse or absent flow during atrial contraction and NT greater or equal to 3 mm. We calculated the sensitivity, the specificity, the negative and positive predictive value for each of the above items. Results: there were 9 chromosomal abnormalities (3 cases of trisomy 21, 2 cases of trisomy 13, 1 case of trisomy 9, 1 case of trisomy 22, 1 triploidy and 1 monosomy X). Abnormal ductus venosus flow was observed in all cases (sensitivity of 100%). In the normal fetuses (17 cases) only 1 had abnormal flow (specificity of 94%). Concerning NT, the sensitivity and the specificity were 88% and 76%, respectively. Conclusion: our preliminary results suggest that the presence of chromosomal abnormalities may be strongly suspected when an increased NT thickness is associated with an absent or reverse flow in the ductus venosus. We speculated that both methods are valid in the screening of chromosomal defects.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):381-384
DOI 10.1590/S0100-72031999000700003
Purpose: to study the correlation between fetal oxygen saturation measured by pulse oximetry during second stage of labor and umbilical artery pH at birth. Patients and Methods: fetal oxygen saturation (FSpO2) was monitored by pulse oximetry during the second stage of labor in 64 singleton pregnancies at term, with vertex presentation. Umbilical blood was sampled immediately after delivery for subsequent measurement of venous and arterial blood gases and pH. All fetuses maintained FSpO2 > or = 30% through the first stage of labor, until the start of second stage. Results: the mean FSpO2 at the second stage of labor correlated significantly with umbilical artery pH at birth (n = 64, r = 0.79, p <0.001). There was no significant corre-lation between FSpO2 at the second stage of labor and umbilical artery oxygen saturation at birth. Conclusion: fetal oxygen saturation measured by pulse oximetry during second stage of labor has a good correlation with umbilical artery pH at birth.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):381-384
DOI 10.1590/S0100-72031999000700003
Purpose: to study the correlation between fetal oxygen saturation measured by pulse oximetry during second stage of labor and umbilical artery pH at birth. Patients and Methods: fetal oxygen saturation (FSpO2) was monitored by pulse oximetry during the second stage of labor in 64 singleton pregnancies at term, with vertex presentation. Umbilical blood was sampled immediately after delivery for subsequent measurement of venous and arterial blood gases and pH. All fetuses maintained FSpO2 > or = 30% through the first stage of labor, until the start of second stage. Results: the mean FSpO2 at the second stage of labor correlated significantly with umbilical artery pH at birth (n = 64, r = 0.79, p <0.001). There was no significant corre-lation between FSpO2 at the second stage of labor and umbilical artery oxygen saturation at birth. Conclusion: fetal oxygen saturation measured by pulse oximetry during second stage of labor has a good correlation with umbilical artery pH at birth.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):389-392
DOI 10.1590/S0100-72031999000700004
Purpose: to report the personal experience with the use of the amnioinfusion technique in patients in labor presenting meconial amniotic fluid, and the incidence of complications, the meconium aspiration syndrome and of cesarean sections. Method: twenty patients at term and in labor with meconial amniotic fluid were evaluated retrospectively, at the delivery ward at two public institutions of Rio Grande do Sul. An initial infusion of 1.000 ml of normal saline solution at room temperature, at an infusion rate of 20-30 ml per minute was initiated and then reduced to 3 ml per minute. The liquid was drained by elevating the cephalic pole. Results: the procedure was feasible when a nasogastric catheter was used. None of the patients presented major complications related to the procedure. None of the neonates presented meconium below their vocal cords. The cesarean section rate was 3/20 (15%). Conclusion: the amnioinfusion is a low-cost and feasible technique that did not show any complication in this study.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):389-392
DOI 10.1590/S0100-72031999000700004
Purpose: to report the personal experience with the use of the amnioinfusion technique in patients in labor presenting meconial amniotic fluid, and the incidence of complications, the meconium aspiration syndrome and of cesarean sections. Method: twenty patients at term and in labor with meconial amniotic fluid were evaluated retrospectively, at the delivery ward at two public institutions of Rio Grande do Sul. An initial infusion of 1.000 ml of normal saline solution at room temperature, at an infusion rate of 20-30 ml per minute was initiated and then reduced to 3 ml per minute. The liquid was drained by elevating the cephalic pole. Results: the procedure was feasible when a nasogastric catheter was used. None of the patients presented major complications related to the procedure. None of the neonates presented meconium below their vocal cords. The cesarean section rate was 3/20 (15%). Conclusion: the amnioinfusion is a low-cost and feasible technique that did not show any complication in this study.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):393-397
DOI 10.1590/S0100-72031999000700005
Purpose: to evaluate a possible relationship between fetal malformations (FM) and the use of sulfonylureas (SF) by diabetic pregnant women. Methods: we retrospectively studied 35 type 2 diabetic pregnant women followed at the Pathological Prenatal Care Outpatient Clinic of the University Hospital, Faculty of Medicine of Ribeirão Preto, from 1993 to 1995. Twenty-two of these women had been inadvertently using sulfonylureas during the 1st trimester of gestation (SF group). We determined their prevalence of FM and compared it to that observed for pregnant diabetic women who were only on diet or insulin therapy (group C). We also analyzed other variables such as time of disease, age, metabolic control, and prenatal care. Results: there was no significant difference between groups in terms of age range, duration of diabetes, glycemic control, or early start of prenatal care, with the prevalence of FM being similar for the two groups (8.3% in group C and 13.6% in group SF). The malformations observed in group SF were: renal agenesis, pulmonary hypoplasia and ribbon gonads (patient 1); short limbs and abnormally implanted toes (patient 2); cleft palate, low implanted ears, neck webbing and saddle nose (patient 3), and micrognathia, dysplastic ears, imperforate anus, hypospadia, polydactily, ventricular septal defect and atrial septal defect (patient 4) in group C. Conclusions: these data do not allow us to attribute the malformations detected in group SF to the use of sulfonylureas, although not usually described alterations in diabetic embryopathy occurred in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):393-397
DOI 10.1590/S0100-72031999000700005
Purpose: to evaluate a possible relationship between fetal malformations (FM) and the use of sulfonylureas (SF) by diabetic pregnant women. Methods: we retrospectively studied 35 type 2 diabetic pregnant women followed at the Pathological Prenatal Care Outpatient Clinic of the University Hospital, Faculty of Medicine of Ribeirão Preto, from 1993 to 1995. Twenty-two of these women had been inadvertently using sulfonylureas during the 1st trimester of gestation (SF group). We determined their prevalence of FM and compared it to that observed for pregnant diabetic women who were only on diet or insulin therapy (group C). We also analyzed other variables such as time of disease, age, metabolic control, and prenatal care. Results: there was no significant difference between groups in terms of age range, duration of diabetes, glycemic control, or early start of prenatal care, with the prevalence of FM being similar for the two groups (8.3% in group C and 13.6% in group SF). The malformations observed in group SF were: renal agenesis, pulmonary hypoplasia and ribbon gonads (patient 1); short limbs and abnormally implanted toes (patient 2); cleft palate, low implanted ears, neck webbing and saddle nose (patient 3), and micrognathia, dysplastic ears, imperforate anus, hypospadia, polydactily, ventricular septal defect and atrial septal defect (patient 4) in group C. Conclusions: these data do not allow us to attribute the malformations detected in group SF to the use of sulfonylureas, although not usually described alterations in diabetic embryopathy occurred in this group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):401-405
DOI 10.1590/S0100-72031999000700006
Purpose: to investigate if the addition of a cotton "swab" to the Ayre spatula and its previous moistening with physiologic saline solution increase the obtention of endocervical cells in colpocytologic smears. Methods: a random and single-blind diagnostic study was performed, involving three techniques of collection (Ayre spatula, combination of Ayre-dry cotton swab spatula and combination of Ayre-moist cotton swab spatula). A total of 307 smears prepared by Medicine students and residents of Gynecology and Obstetrics were evaluated. Results: there was no significant increase in the number of endocervical cells (columnar and/or metaplastic), obtained with the addition of dry swab (p = 0.2) or with the addition of a moistened swab (p = 0.8). Conclusions: the author concluded that mainly when the collections were performed by trainee professionals and in the absence of other more effective endocervical collecting device, it is more economical to use only the Ayre spatula to prepare the smear.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):401-405
DOI 10.1590/S0100-72031999000700006
Purpose: to investigate if the addition of a cotton "swab" to the Ayre spatula and its previous moistening with physiologic saline solution increase the obtention of endocervical cells in colpocytologic smears. Methods: a random and single-blind diagnostic study was performed, involving three techniques of collection (Ayre spatula, combination of Ayre-dry cotton swab spatula and combination of Ayre-moist cotton swab spatula). A total of 307 smears prepared by Medicine students and residents of Gynecology and Obstetrics were evaluated. Results: there was no significant increase in the number of endocervical cells (columnar and/or metaplastic), obtained with the addition of dry swab (p = 0.2) or with the addition of a moistened swab (p = 0.8). Conclusions: the author concluded that mainly when the collections were performed by trainee professionals and in the absence of other more effective endocervical collecting device, it is more economical to use only the Ayre spatula to prepare the smear.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):409-414
DOI 10.1590/S0100-72031999000700007
Purpose: to determine whether the transfer day or the stage that the embryo is transferred interferes in pregnancy and implantation rates. Methods: oocytes we recovered from 107 patients and submitted to in vitro fertilization. The embryos were cocultured on Vero cells and transferred on day 3 or day 5 post-fertilization, after morphological assessment. Results: the implantation rate of the transferred embryos on day 5 was significantly higher than when the embryos were transferred on day 3, but the pregnacy rates did not change. However, a significant difference was observed in the pregnancy rates for embryos transferred at the expanded blastocyst stage (70.6% of pregnancy) when compared to 20.0% and 10.5% at the earlier blastocyst and morula stages, respectively. Conclusions: the implantation and pregnancy rates were significantly increased when the embryos were transferred at the expanded blastocyst stage, but the culture media and culture conditions now available are not able to provide a satisfactory rate at this stage.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(7):409-414
DOI 10.1590/S0100-72031999000700007
Purpose: to determine whether the transfer day or the stage that the embryo is transferred interferes in pregnancy and implantation rates. Methods: oocytes we recovered from 107 patients and submitted to in vitro fertilization. The embryos were cocultured on Vero cells and transferred on day 3 or day 5 post-fertilization, after morphological assessment. Results: the implantation rate of the transferred embryos on day 5 was significantly higher than when the embryos were transferred on day 3, but the pregnacy rates did not change. However, a significant difference was observed in the pregnancy rates for embryos transferred at the expanded blastocyst stage (70.6% of pregnancy) when compared to 20.0% and 10.5% at the earlier blastocyst and morula stages, respectively. Conclusions: the implantation and pregnancy rates were significantly increased when the embryos were transferred at the expanded blastocyst stage, but the culture media and culture conditions now available are not able to provide a satisfactory rate at this stage.