Trabalhos Originais Archives - Page 2 of 51 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):13-17
DOI 10.1590/S0100-72032000000100003
Purpose: to determine magnesium sulfate effectiveness to prevent eclamptic seizures in pregnant women diagnosed with preeclampsia. Methods: a case-control study involving 489 pregnant patients admitted to the Hospital de Clínicas de Porto Alegre (HCPA) with the diagnosis of hypertension between January 1990 and January 1997. The patients were divided into two groups: those who received magnesium sulfate (Group I) and those who did not (Group II). All patients were treated according to the hospital's standard protocol for the treatment of hypertensive pregnant women. The following variables were assessed: maternal age, race, number of seizures, number of seizures in patients receiving magnesium sulfate, period of magnesium sulfate administration, before and after delivery, maternal mortality, need of ICU care, need of mechanical ventilation and length of hospital stay after delivery. Data were assessed with Epi-Info 6.0 statistical package, using multivariate analysis. The main outcome measure was magnesium sulfate use. Results: no differences were found between the two groups in terms of maternal age, race or gestational age. Women who received magnesium sulfate had a higher mean systolic and diastolic blood pressure. Women in the intervention group had a longer hospital stay and a greater need of ICU care. Need of mechanical ventilation and maternal mortality were similar in the two groups. Twenty-two out of 353 women had one or more seizures before admission to the hospital. Six women (27.3%) had one or two additional seizures after magnesium sulfate administration. No subjects had three or more seizures after receiving magnesium sulfate. Conclusion: the results show that eclamptic seizures can be prevented by routine prophylactic magnesium sulfate administration.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):13-17
DOI 10.1590/S0100-72032000000100003
Purpose: to determine magnesium sulfate effectiveness to prevent eclamptic seizures in pregnant women diagnosed with preeclampsia. Methods: a case-control study involving 489 pregnant patients admitted to the Hospital de Clínicas de Porto Alegre (HCPA) with the diagnosis of hypertension between January 1990 and January 1997. The patients were divided into two groups: those who received magnesium sulfate (Group I) and those who did not (Group II). All patients were treated according to the hospital's standard protocol for the treatment of hypertensive pregnant women. The following variables were assessed: maternal age, race, number of seizures, number of seizures in patients receiving magnesium sulfate, period of magnesium sulfate administration, before and after delivery, maternal mortality, need of ICU care, need of mechanical ventilation and length of hospital stay after delivery. Data were assessed with Epi-Info 6.0 statistical package, using multivariate analysis. The main outcome measure was magnesium sulfate use. Results: no differences were found between the two groups in terms of maternal age, race or gestational age. Women who received magnesium sulfate had a higher mean systolic and diastolic blood pressure. Women in the intervention group had a longer hospital stay and a greater need of ICU care. Need of mechanical ventilation and maternal mortality were similar in the two groups. Twenty-two out of 353 women had one or more seizures before admission to the hospital. Six women (27.3%) had one or two additional seizures after magnesium sulfate administration. No subjects had three or more seizures after receiving magnesium sulfate. Conclusion: the results show that eclamptic seizures can be prevented by routine prophylactic magnesium sulfate administration.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):33-36
DOI 10.1590/S0100-72032000000100006
Purpose: to evaluate the morphologic and morphometric alterations produced by tamoxifen and conjugated estrogens in the mammary epithelium of rats in persistent estrus. Methods: thirty-three adult female rats in persistent estrus induced with 1.25 mg testosterone propionate were divided at random into three groups: GI -- which received only water, control group (n = 12); GII -- treated with 500 mug tamoxifen daily (n = 10); GIII -- treated with 30 mug conjugated estrogens per day (n = 11). The first inguinal-abdominal pair of mammary glands of the animals was extirpated and processed for morphologic and morphometric study. Data were analyzed statistically by the Kruskal-Wallis rank analysis of variance (p < 0.05). Results: the morphologic study revealed signs of epithelial atrophy and the morphometric study showed a statistically significant reduction in the mean number of ducts and alveoli in groups II (10.1 and 1.9, respectively) and III (11.1 and 3.5, respectively) compared to group I (25.0 and 6.6, respectively). There was no significant difference between groups II and III. Conclusions: the results of this study indicate that tamoxifen as well as conjugated estrogens at the tested doses produced mammary epithelial atrophy in rats in persistent estrus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):33-36
DOI 10.1590/S0100-72032000000100006
Purpose: to evaluate the morphologic and morphometric alterations produced by tamoxifen and conjugated estrogens in the mammary epithelium of rats in persistent estrus. Methods: thirty-three adult female rats in persistent estrus induced with 1.25 mg testosterone propionate were divided at random into three groups: GI -- which received only water, control group (n = 12); GII -- treated with 500 mug tamoxifen daily (n = 10); GIII -- treated with 30 mug conjugated estrogens per day (n = 11). The first inguinal-abdominal pair of mammary glands of the animals was extirpated and processed for morphologic and morphometric study. Data were analyzed statistically by the Kruskal-Wallis rank analysis of variance (p < 0.05). Results: the morphologic study revealed signs of epithelial atrophy and the morphometric study showed a statistically significant reduction in the mean number of ducts and alveoli in groups II (10.1 and 1.9, respectively) and III (11.1 and 3.5, respectively) compared to group I (25.0 and 6.6, respectively). There was no significant difference between groups II and III. Conclusions: the results of this study indicate that tamoxifen as well as conjugated estrogens at the tested doses produced mammary epithelial atrophy in rats in persistent estrus.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):37-41
DOI 10.1590/S0100-72032000000100007
Purpose: to evaluate the effects of tibolone on climacteric symptoms and clinical and metabolic variables. Methods: thirty-four postmenopausal women were treated orally with 2.5 mg tibolone daily for 48 weeks and evaluated as to climacteric complaints, clinical aspects such as weight and blood pressure and lipid profile (total cholesterol, HDL-c, LDL-c, VLDL-c and triglycerides). Results: a significant improvement of climacteric complaints was demonstrated by a significant decrease in the Kupperman index (p<0.001) and the mean number of hot flushes (p<0.001) from the first month of treatment onwards. There was a significant decrease in total cholesterol, triglycerides and VLDL-c (p<0.001). The LDL-c levels presented a slight decrease (not significant). The HDL-c levels showed a significant decrease at week 24. However these levels returned to baseline levels at week 48. With regard to the vital signs no change in body weight and blood pressure was measured. The side effects were mild and temporary, vaginal bleeding, nausea and edema being the most common. Conclusion: tibolone may be considered a safe and efficient option to treat climacteric symptoms in postmenopausal women without significant impact on lipid profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):37-41
DOI 10.1590/S0100-72032000000100007
Purpose: to evaluate the effects of tibolone on climacteric symptoms and clinical and metabolic variables. Methods: thirty-four postmenopausal women were treated orally with 2.5 mg tibolone daily for 48 weeks and evaluated as to climacteric complaints, clinical aspects such as weight and blood pressure and lipid profile (total cholesterol, HDL-c, LDL-c, VLDL-c and triglycerides). Results: a significant improvement of climacteric complaints was demonstrated by a significant decrease in the Kupperman index (p<0.001) and the mean number of hot flushes (p<0.001) from the first month of treatment onwards. There was a significant decrease in total cholesterol, triglycerides and VLDL-c (p<0.001). The LDL-c levels presented a slight decrease (not significant). The HDL-c levels showed a significant decrease at week 24. However these levels returned to baseline levels at week 48. With regard to the vital signs no change in body weight and blood pressure was measured. The side effects were mild and temporary, vaginal bleeding, nausea and edema being the most common. Conclusion: tibolone may be considered a safe and efficient option to treat climacteric symptoms in postmenopausal women without significant impact on lipid profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):7-12
DOI 10.1590/S0100-72032000000100002
Purpose: to compare the capacity of diagnosing oligohy-dramnios by ultrasound using different measures of the maximum pool depth of amniotic fluid in comparison to the amniotic fluid index among normal pregnant women from the 36th to the 42nd week of gestation. Methods: a descriptive study of diagnostic validity was perfomed, on 875 normal pregnant women who were studied through routine obstetric ultrasound examinations, including the measure of the maximum pool depth for the diagnosis of oligohydramnios, using the amniotic fluid index as the gold standard. The data were analyzed through sensitivity and specificity of the maximum pool depth of amniotic fluid using 10, 20 and 30 mm cut-offs, in comparison to the amniotic fluid index values of the normal curve in percentiles 2.5 and 10 for different gestational ages. Results: the maximum pool depth had a poor sensitivity to diagnose oligohydramnios when 10 and 20 mm were used as cut-offs, and good sensitivity and specificity when 30 mm was used, in comparison to the amniotic fluid values in percentiles 2.5 and 10. The best sensitivity and specificity of the maximum pool depth were when found using a 30 mm cut-off in comparison to 2.5 percentile to diagnose oligohydramnios. Conclusions: the capacity to diagnose oligohydramnios by the measure of the maximum pool depth is satisfactory only with the cut-off of 30 mm
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(1):7-12
DOI 10.1590/S0100-72032000000100002
Purpose: to compare the capacity of diagnosing oligohy-dramnios by ultrasound using different measures of the maximum pool depth of amniotic fluid in comparison to the amniotic fluid index among normal pregnant women from the 36th to the 42nd week of gestation. Methods: a descriptive study of diagnostic validity was perfomed, on 875 normal pregnant women who were studied through routine obstetric ultrasound examinations, including the measure of the maximum pool depth for the diagnosis of oligohydramnios, using the amniotic fluid index as the gold standard. The data were analyzed through sensitivity and specificity of the maximum pool depth of amniotic fluid using 10, 20 and 30 mm cut-offs, in comparison to the amniotic fluid index values of the normal curve in percentiles 2.5 and 10 for different gestational ages. Results: the maximum pool depth had a poor sensitivity to diagnose oligohydramnios when 10 and 20 mm were used as cut-offs, and good sensitivity and specificity when 30 mm was used, in comparison to the amniotic fluid values in percentiles 2.5 and 10. The best sensitivity and specificity of the maximum pool depth were when found using a 30 mm cut-off in comparison to 2.5 percentile to diagnose oligohydramnios. Conclusions: the capacity to diagnose oligohydramnios by the measure of the maximum pool depth is satisfactory only with the cut-off of 30 mm
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):209-216
DOI 10.1590/S0100-72032000000400004
Purpose: to observe the circadian pattern of blood pressure variation in normotensive and hypertensive pregnant women, assessing the occurrence of nocturnal blood pressure decrease, as well as the compliance with the method and possible complications. Methods: the blood pressure measurement was carried out in seventeen normotensive and fourteen hypertensive pregnant women at the Hospital das Clínicas of UFMG. Blood pressure was measured on two different occasions during gestation using the oscillometric technique to compare both groups. Results: in both groups nocturnal decrease in blood pressure as well as an increase in pressure levels was observed as pregnancy advanced. No significant complications were seen and they did not interfere with compliance which was 100%. Conclusions: the ambulatory blood pressure measurement is useful to evaluate pressure variation in normotensive and hypertensive pregnant women confirming the gradual increase in blood pressure throughout pregnancy and the nocturnal physiologic decrease which does not depend on maternal pressure levels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):209-216
DOI 10.1590/S0100-72032000000400004
Purpose: to observe the circadian pattern of blood pressure variation in normotensive and hypertensive pregnant women, assessing the occurrence of nocturnal blood pressure decrease, as well as the compliance with the method and possible complications. Methods: the blood pressure measurement was carried out in seventeen normotensive and fourteen hypertensive pregnant women at the Hospital das Clínicas of UFMG. Blood pressure was measured on two different occasions during gestation using the oscillometric technique to compare both groups. Results: in both groups nocturnal decrease in blood pressure as well as an increase in pressure levels was observed as pregnancy advanced. No significant complications were seen and they did not interfere with compliance which was 100%. Conclusions: the ambulatory blood pressure measurement is useful to evaluate pressure variation in normotensive and hypertensive pregnant women confirming the gradual increase in blood pressure throughout pregnancy and the nocturnal physiologic decrease which does not depend on maternal pressure levels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):225-228
DOI 10.1590/S0100-72032000000400006
Purpose: to analyze the frequency of glove perforation during gynecologic surgeries. Methods: a prospective study of 454 gloves used in 65 surgeries by the water pressure method. Results: of a total of 454 gloves, 54 (11.9%) had perforations. Comparison with the control group showed p<0.05 (chi² test), 1 (1.7%) perforation in 60 gloves tested. Of the total of gloves used in 65 surgeries, 29 (44.6%) had perforations, 44 (81%) had one perforation and 10 (19%) had more than one perforation. The two most common sites of perforations were the index finger, 20 (29.5%) and the thumb, 14 (25.9%). Perforation was predominant in the left hand (72.1%). The surgeons were the members of the team with the greatest number of glove perforations. Total hysterectomy was the most frequent surgery in which glove perforations occurred (50% of the cases). Conclusion: the glove perforations occurred with relatively high frequency during gynecologic surgeries. The index finger of the left hand proved to be the most affected region. Among the members of the team, the highest percentage of glove perforations occurred in those of the surgeons. Total hysterectomy had the highest perforation rate.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):225-228
DOI 10.1590/S0100-72032000000400006
Purpose: to analyze the frequency of glove perforation during gynecologic surgeries. Methods: a prospective study of 454 gloves used in 65 surgeries by the water pressure method. Results: of a total of 454 gloves, 54 (11.9%) had perforations. Comparison with the control group showed p<0.05 (chi² test), 1 (1.7%) perforation in 60 gloves tested. Of the total of gloves used in 65 surgeries, 29 (44.6%) had perforations, 44 (81%) had one perforation and 10 (19%) had more than one perforation. The two most common sites of perforations were the index finger, 20 (29.5%) and the thumb, 14 (25.9%). Perforation was predominant in the left hand (72.1%). The surgeons were the members of the team with the greatest number of glove perforations. Total hysterectomy was the most frequent surgery in which glove perforations occurred (50% of the cases). Conclusion: the glove perforations occurred with relatively high frequency during gynecologic surgeries. The index finger of the left hand proved to be the most affected region. Among the members of the team, the highest percentage of glove perforations occurred in those of the surgeons. Total hysterectomy had the highest perforation rate.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):229-233
DOI 10.1590/S0100-72032000000400007
Purpose: to evaluate the effects of hormone replacement therapy on the body mass index of postmenopausal women. Methods: for this purpose, 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM - UNICAMP, where the variations in this parameter were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through chi² test, Student's t test, and Mann-Whitney test. Results: we observed no significant variations in the body mass index, when comparing users and non-users during the three years of observation. Conclusion: hormone replacement therapy did not produce changes in this parameter in women properly assisted during its use.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(4):229-233
DOI 10.1590/S0100-72032000000400007
Purpose: to evaluate the effects of hormone replacement therapy on the body mass index of postmenopausal women. Methods: for this purpose, 166 users and 136 non-users of hormone replacement were evaluated retrospectively during a period of three years. All women were assisted at the Menopause Outpatient Clinic of CAISM - UNICAMP, where the variations in this parameter were evaluated at the end of each year in relation to the initial parameters. The data analysis was performed through chi² test, Student's t test, and Mann-Whitney test. Results: we observed no significant variations in the body mass index, when comparing users and non-users during the three years of observation. Conclusion: hormone replacement therapy did not produce changes in this parameter in women properly assisted during its use.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):101-106
DOI 10.1590/S0100-72032000000200007
Purpose: to evaluate the prevalence of anticardiolipin antibody in women with stillbirth. Patients and Methods: this was a cross-sectional study performed from May 1998 to September 1999 at the Maternity of the University of Campinas and at the Hospital and Maternity Leonor Mendes de Barros, in Brazil, which evaluated 109 pregnant women hospitalized with the diagnosis of intrauterine fetal death and gestational age of 20 or more weeks. These women underwent some laboratory examinations to identify the cause of fetal death, including anticardiolipin antibody evaluation performed through the determination of IgG and IgM serum levels. IgG and IgM results are expressed as GPL and MPL units, respectively, and, in both cases, results above 10 units are considered positive. The statistical procedures used were the mean and standard deviation estimates, Student's t test, Fisher test and chi². Results: the prevalence of anticardiolipin positivity was 18.3%. The women were predominantly young, with a mean age around 27 years. The main identified causes of fetal death were: hypertension (26.1%), hemorrhage during the third trimester (9.9%) and fetal malformation (8.1%). One third of the cases had no identified causes of fetal death. However, considering the 20 positive cases for anticardiolipin antibody, the proportion of unidentified causes decreased to 29%. Conclusions: it is important to investigate the presence of anticardiolipin antibodies among women with intrauterine fetal death with the purpose of clarifying the causes of stillbirth. If the diagnosis of antiphospholipid syndrome is confirmed, it is necessary to counsel and treat these women regarding future pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(2):101-106
DOI 10.1590/S0100-72032000000200007
Purpose: to evaluate the prevalence of anticardiolipin antibody in women with stillbirth. Patients and Methods: this was a cross-sectional study performed from May 1998 to September 1999 at the Maternity of the University of Campinas and at the Hospital and Maternity Leonor Mendes de Barros, in Brazil, which evaluated 109 pregnant women hospitalized with the diagnosis of intrauterine fetal death and gestational age of 20 or more weeks. These women underwent some laboratory examinations to identify the cause of fetal death, including anticardiolipin antibody evaluation performed through the determination of IgG and IgM serum levels. IgG and IgM results are expressed as GPL and MPL units, respectively, and, in both cases, results above 10 units are considered positive. The statistical procedures used were the mean and standard deviation estimates, Student's t test, Fisher test and chi². Results: the prevalence of anticardiolipin positivity was 18.3%. The women were predominantly young, with a mean age around 27 years. The main identified causes of fetal death were: hypertension (26.1%), hemorrhage during the third trimester (9.9%) and fetal malformation (8.1%). One third of the cases had no identified causes of fetal death. However, considering the 20 positive cases for anticardiolipin antibody, the proportion of unidentified causes decreased to 29%. Conclusions: it is important to investigate the presence of anticardiolipin antibodies among women with intrauterine fetal death with the purpose of clarifying the causes of stillbirth. If the diagnosis of antiphospholipid syndrome is confirmed, it is necessary to counsel and treat these women regarding future pregnancies.