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Trabalhos Originais
Adequacy of the prenatal care process among users of the Unified Health Care System in Juiz de Fora-MG
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):717-724
04-13-2003
Summary
Trabalhos OriginaisAdequacy of the prenatal care process among users of the Unified Health Care System in Juiz de Fora-MG
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):717-724
04-13-2003DOI 10.1590/S0100-72032003001000004
Views40See morePURPOSE: to evaluate the adequacy of the prenatal care process offered to users of the Unified Health Care System (SUS) in Juiz de Fora-MG and to compare the municipal services. METHODS: a transversal study with auditing was carried out on the records of 370 pregnant women, selected by systematic sampling among women who carried their pregnancies to term and gave birth using SUS services in the first semester of 2002, with prenatal care given in Juiz de Fora. For statistical analysis the c² test was used to compare the municipal services (level of significance: 5%). The evaluation followed a three-tiered complementary sequence, using: the utilization of prenatal care (Kessner index: beginning and frequency of care) at level 1; the utilization of prenatal care and basic laboratory tests, according to the Humanization Program of Prenatal Care and Birth (ABO-Rh, hemoglobin/hematocrit, VDRL, glycemia and urinalysis), at level 2; and the utilization of prenatal care, the basic laboratory tests and the obligatory clinical-obstetric procedures during a prenatal visit (assessment of blood pressure, weight, edema, uterine fundal height, gestational age, fetal heart rate and fetal presentation), at level 3. RESULTS: the observed adequacy of the process was only 26.7% (level 1), 1.9% (level 2) and 1.1% (level 3). We also observed a prenatal coverage of 99.04%, an average of 6.4 visits per pregnant woman, and an average gestational age of 17.4 weeks at the time of the first prenatal visit. There were no significant differences between the municipal services. CONCLUSIONS: prenatal care offered to SUS users in Juiz de Fora should be reviewed from a qualitative standpoint, and periodic evaluations as necessary instruments of improvement are recommendable. Managers and professionals should undertake actions aimed at increasing compliance with norms/routines of the program - principally the request/recording of basic complementary tests - and which guarantee increased utilization of prenatal care.
Views40
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
Trabalhos OriginaisAdequacy of the prenatal care process among users of the Unified Health Care System in Juiz de Fora-MG
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):717-724
04-13-2003DOI 10.1590/S0100-72032003001000004
Views40See morePURPOSE: to evaluate the adequacy of the prenatal care process offered to users of the Unified Health Care System (SUS) in Juiz de Fora-MG and to compare the municipal services. METHODS: a transversal study with auditing was carried out on the records of 370 pregnant women, selected by systematic sampling among women who carried their pregnancies to term and gave birth using SUS services in the first semester of 2002, with prenatal care given in Juiz de Fora. For statistical analysis the c² test was used to compare the municipal services (level of significance: 5%). The evaluation followed a three-tiered complementary sequence, using: the utilization of prenatal care (Kessner index: beginning and frequency of care) at level 1; the utilization of prenatal care and basic laboratory tests, according to the Humanization Program of Prenatal Care and Birth (ABO-Rh, hemoglobin/hematocrit, VDRL, glycemia and urinalysis), at level 2; and the utilization of prenatal care, the basic laboratory tests and the obligatory clinical-obstetric procedures during a prenatal visit (assessment of blood pressure, weight, edema, uterine fundal height, gestational age, fetal heart rate and fetal presentation), at level 3. RESULTS: the observed adequacy of the process was only 26.7% (level 1), 1.9% (level 2) and 1.1% (level 3). We also observed a prenatal coverage of 99.04%, an average of 6.4 visits per pregnant woman, and an average gestational age of 17.4 weeks at the time of the first prenatal visit. There were no significant differences between the municipal services. CONCLUSIONS: prenatal care offered to SUS users in Juiz de Fora should be reviewed from a qualitative standpoint, and periodic evaluations as necessary instruments of improvement are recommendable. Managers and professionals should undertake actions aimed at increasing compliance with norms/routines of the program - principally the request/recording of basic complementary tests - and which guarantee increased utilization of prenatal care.
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. -
Trabalhos Originais
Perinatal outcome of fetuses with congenital uropathies
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):725-730
04-13-2003
Summary
Trabalhos OriginaisPerinatal outcome of fetuses with congenital uropathies
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):725-730
04-13-2003DOI 10.1590/S0100-72032003001000005
Views87See morePURPOSE: to evaluate the perinatal outcome of fetuses with congenital anomalies of the urinary tract. METHODS: we reviewed the perinatal outcome of 35 fetuses with congenital anomalies of the urinary tract. The following characteristics related to the uropathy were analyzed: type (hydronephrosis, dysplasia and renal agenesis), side of lesion (bilateral or unilateral), and level of the obstruction (high or low, in hydronephrosis). The perinatal outcome was evaluated according to these characteristics. The data were analyzed by the c² test and by the exact Fisher test. The level of significance was 0.05. RESULTS: the incidence of hydronephrosis was 68.6%. Half of the fetuses had unilateral hydronephrosis. Renal dysplasia occurred in 17.1% of the cases; 83.3% of these were bilateral and 16.7%, unilateral. The incidence of renal agenesis was 14.3%, all bilateral. The fetuses with dysplasia/agenesis had a 91% incidence of oligohydramnios, preterm birth, low birth weight, and death. In the group with bilateral disease the presence of oligohydramnios, preterm birth, low birth weight, death, urinary tract infections, and the need of hospitalization for a period greater than 7 days was significant when compared to the group with unilateral disease. The need of hospitalization for a period greater than 7 days in patients with low obstruction was significantly higher when compared to the patients with high obstruction. CONCLUSIONS: hydronephrosis, bilateral disease, and lower obstruction were the most frequent uropathies. The dysplasia/agenesis group had a worse prognosis when compared with the hydronephrosis group. Bilateral disease had a worse prognosis when compared with the unilateral disease group. In the low obstruction group, the need for a period of hospitalization greater than seven days was higher than in the high obstruction group.
Views87This 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
Trabalhos OriginaisPerinatal outcome of fetuses with congenital uropathies
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):725-730
04-13-2003DOI 10.1590/S0100-72032003001000005
Views87See morePURPOSE: to evaluate the perinatal outcome of fetuses with congenital anomalies of the urinary tract. METHODS: we reviewed the perinatal outcome of 35 fetuses with congenital anomalies of the urinary tract. The following characteristics related to the uropathy were analyzed: type (hydronephrosis, dysplasia and renal agenesis), side of lesion (bilateral or unilateral), and level of the obstruction (high or low, in hydronephrosis). The perinatal outcome was evaluated according to these characteristics. The data were analyzed by the c² test and by the exact Fisher test. The level of significance was 0.05. RESULTS: the incidence of hydronephrosis was 68.6%. Half of the fetuses had unilateral hydronephrosis. Renal dysplasia occurred in 17.1% of the cases; 83.3% of these were bilateral and 16.7%, unilateral. The incidence of renal agenesis was 14.3%, all bilateral. The fetuses with dysplasia/agenesis had a 91% incidence of oligohydramnios, preterm birth, low birth weight, and death. In the group with bilateral disease the presence of oligohydramnios, preterm birth, low birth weight, death, urinary tract infections, and the need of hospitalization for a period greater than 7 days was significant when compared to the group with unilateral disease. The need of hospitalization for a period greater than 7 days in patients with low obstruction was significantly higher when compared to the patients with high obstruction. CONCLUSIONS: hydronephrosis, bilateral disease, and lower obstruction were the most frequent uropathies. The dysplasia/agenesis group had a worse prognosis when compared with the hydronephrosis group. Bilateral disease had a worse prognosis when compared with the unilateral disease group. In the low obstruction group, the need for a period of hospitalization greater than seven days was higher than in the high obstruction group.
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. -
Trabalhos Originais
Iron deficiency anemia in pregnant adolescents: comparison between laboratory tests
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):731-738
04-13-2003
Summary
Trabalhos OriginaisIron deficiency anemia in pregnant adolescents: comparison between laboratory tests
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):731-738
04-13-2003DOI 10.1590/S0100-72032003001000006
Views71See morePURPOSE: to evaluate, in pregnant adolescents, the incidence of iron deficiency, using the following blood tests: hemoglobin, ferritin, serum iron, transferrin saturation rate and serum transferrin receptor, and their relationships. METHODS: a total of 56 adolescents were included at the first prenatal evaluation between the 12th and the 20th week of gestation. The normal values for each test were: above 11 mg/dL for hemoglobin, 12 µg/dL for ferritin, 50 mg/L for serum iron, 16% for transferrin saturation rate and below 28.1 nmol/L for serum transferrin receptor. Each result was evaluated using percentages and the McNemar test was used to compare the results. RESULTS: incidence of anemia using the hemoglobin concentration test was 21.4%. All pregnant women presented mild anemia. In the present study, 21.4% of the patients had iron deficiency with a ferritin concentration <12 mug/dL. Serum iron concentration was reduced in 3.6% of the adolescents and transferrin saturation rate in 26.8% of the sample. The value obtained by the transferrin receptor test was unclear, due to the lack of international standardization regarding measure unit. Comparing the hemoglobin concentration test to the other iron deficiency tests, it was found that the latter do not show a better evaluation than the hemoglobin concentration test in patients with hypoferremia. CONCLUSIONS: the hemoglobin concentration test in patients with mild anemia was effective to identify iron deficiency.
Views71This 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
Trabalhos OriginaisIron deficiency anemia in pregnant adolescents: comparison between laboratory tests
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):731-738
04-13-2003DOI 10.1590/S0100-72032003001000006
Views71See morePURPOSE: to evaluate, in pregnant adolescents, the incidence of iron deficiency, using the following blood tests: hemoglobin, ferritin, serum iron, transferrin saturation rate and serum transferrin receptor, and their relationships. METHODS: a total of 56 adolescents were included at the first prenatal evaluation between the 12th and the 20th week of gestation. The normal values for each test were: above 11 mg/dL for hemoglobin, 12 µg/dL for ferritin, 50 mg/L for serum iron, 16% for transferrin saturation rate and below 28.1 nmol/L for serum transferrin receptor. Each result was evaluated using percentages and the McNemar test was used to compare the results. RESULTS: incidence of anemia using the hemoglobin concentration test was 21.4%. All pregnant women presented mild anemia. In the present study, 21.4% of the patients had iron deficiency with a ferritin concentration <12 mug/dL. Serum iron concentration was reduced in 3.6% of the adolescents and transferrin saturation rate in 26.8% of the sample. The value obtained by the transferrin receptor test was unclear, due to the lack of international standardization regarding measure unit. Comparing the hemoglobin concentration test to the other iron deficiency tests, it was found that the latter do not show a better evaluation than the hemoglobin concentration test in patients with hypoferremia. CONCLUSIONS: the hemoglobin concentration test in patients with mild anemia was effective to identify iron deficiency.
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. -
Trabalhos Originais
The influence of maternal age, parity, twin pregnancy, hypertensive syndrome and premature rupture of membranes on the indication for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):739-744
04-13-2003
Summary
Trabalhos OriginaisThe influence of maternal age, parity, twin pregnancy, hypertensive syndrome and premature rupture of membranes on the indication for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):739-744
04-13-2003DOI 10.1590/S0100-72032003001000007
Views55See morePURPOSE: to verify the contribution of maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes as risk factors for cesarean section. METHODS: after approval by the Ethics in Research Committee of the "Maternidade Professor Monteiro de Morais" - Recife, PE - Brazil, for a case control study, the authors analyzed data from 3919 pregnant women, without two or more prior cesarean sections, who gave birth to alive newborns with gestational age equal to or more than 28 weeks, weighing at least 1,000 g, on cephalic presentation, from September 1, 1999 to August 31, 2000. The case group included women submitted to cesarean section and the control group included women submitted to vaginal delivery. With the data collected from obstetric and neonatal reports, the authors performed multivariate analysis by logistic regression to determine a mathematical equation that associates cesarean probability due to more than one independent variable acting as risk factor, determining odds ratio with a confidence interval of 95% (95% CI), for the variables: maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes. RESULTS: the chances for cesarean section significantly increased 8.3 times in twin pregnancy (OR = 8.3; 95% CI: 3.7-19.1), 3.4 in hypertensive syndrome (OR = 3.4; 95% CI: 2.9-4.0), 1.9 in primiparity (OR = 1.9; 95% CI: 1.8-2.0), 1.5 in maternal age over 34 years (OR = 1.5; 95% CI: 1.2-1.8), and 1.2 in the presence of premature rupture of membranes (OR = 1.2; 95 %CI: 1.0-1.4). CONCLUSIONS: the risk for cesarean section was greater in the presence of premature rupture of membranes, maternal age greater than 34 years, primiparity, hypertensive syndrome, and twin pregnancy.
Views55This 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
Trabalhos OriginaisThe influence of maternal age, parity, twin pregnancy, hypertensive syndrome and premature rupture of membranes on the indication for cesarean section
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(10):739-744
04-13-2003DOI 10.1590/S0100-72032003001000007
Views55See morePURPOSE: to verify the contribution of maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes as risk factors for cesarean section. METHODS: after approval by the Ethics in Research Committee of the "Maternidade Professor Monteiro de Morais" - Recife, PE - Brazil, for a case control study, the authors analyzed data from 3919 pregnant women, without two or more prior cesarean sections, who gave birth to alive newborns with gestational age equal to or more than 28 weeks, weighing at least 1,000 g, on cephalic presentation, from September 1, 1999 to August 31, 2000. The case group included women submitted to cesarean section and the control group included women submitted to vaginal delivery. With the data collected from obstetric and neonatal reports, the authors performed multivariate analysis by logistic regression to determine a mathematical equation that associates cesarean probability due to more than one independent variable acting as risk factor, determining odds ratio with a confidence interval of 95% (95% CI), for the variables: maternal age, parity, twin pregnancy, hypertensive syndrome, and premature rupture of membranes. RESULTS: the chances for cesarean section significantly increased 8.3 times in twin pregnancy (OR = 8.3; 95% CI: 3.7-19.1), 3.4 in hypertensive syndrome (OR = 3.4; 95% CI: 2.9-4.0), 1.9 in primiparity (OR = 1.9; 95% CI: 1.8-2.0), 1.5 in maternal age over 34 years (OR = 1.5; 95% CI: 1.2-1.8), and 1.2 in the presence of premature rupture of membranes (OR = 1.2; 95 %CI: 1.0-1.4). CONCLUSIONS: the risk for cesarean section was greater in the presence of premature rupture of membranes, maternal age greater than 34 years, primiparity, hypertensive syndrome, and twin pregnancy.
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. -
Trabalhos Originais
Nonpalpable infiltrative breast cancer: concomitant use of radioguided occult lesion localization and sentinel lymph node biopsy
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):655-659
01-19-2003
Summary
Trabalhos OriginaisNonpalpable infiltrative breast cancer: concomitant use of radioguided occult lesion localization and sentinel lymph node biopsy
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):655-659
01-19-2003DOI 10.1590/S0100-72032003000900006
Views50See morePURPOSE: to assess the simultaneous approach of radioguided occult lesion localization and sentinel lymph node biopsy in women with breast cancer. METHOD: forty-five patients with nonpalpable breast cancer were enrolled in a prospective study. The employed radiocolloid was 99mTc-labelled dextran. The injection was performed peritumorally under sonographic or stereotactic guidance using a 18 gauge needle. Lymphoscintigraph images for the visualization of both the site of injection and sentinel lymph node were obtained in a conventional gamma-camera, with the ipsilateral arm positioned in a 90º angle. Excision biopsy of the tumor and sentinel lymph node were performed with a gamma-detecting probe. RESULTS: the procedure was always successful in permitting the localization of occult breast lesions. It was necessary to enlarge surgical margins in five cases. Concerning the sentinel lymph node we achieved localization in 93% of the cases. No complications were observed. CONCLUSION: the results seems to demonstrate that a combined radioguided occult lesion localization and sentinel lymph node biopsy using the same radiopharmaceutical represents a useful and practicable strategy in the management of early breast cancer.
Views50This 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
Trabalhos OriginaisNonpalpable infiltrative breast cancer: concomitant use of radioguided occult lesion localization and sentinel lymph node biopsy
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):655-659
01-19-2003DOI 10.1590/S0100-72032003000900006
Views50See morePURPOSE: to assess the simultaneous approach of radioguided occult lesion localization and sentinel lymph node biopsy in women with breast cancer. METHOD: forty-five patients with nonpalpable breast cancer were enrolled in a prospective study. The employed radiocolloid was 99mTc-labelled dextran. The injection was performed peritumorally under sonographic or stereotactic guidance using a 18 gauge needle. Lymphoscintigraph images for the visualization of both the site of injection and sentinel lymph node were obtained in a conventional gamma-camera, with the ipsilateral arm positioned in a 90º angle. Excision biopsy of the tumor and sentinel lymph node were performed with a gamma-detecting probe. RESULTS: the procedure was always successful in permitting the localization of occult breast lesions. It was necessary to enlarge surgical margins in five cases. Concerning the sentinel lymph node we achieved localization in 93% of the cases. No complications were observed. CONCLUSION: the results seems to demonstrate that a combined radioguided occult lesion localization and sentinel lymph node biopsy using the same radiopharmaceutical represents a useful and practicable strategy in the management of early breast cancer.
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. -
Trabalhos Originais
The most frequent gynecological problems in HIV-infected women
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):661-666
01-19-2003
Summary
Trabalhos OriginaisThe most frequent gynecological problems in HIV-infected women
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):661-666
01-19-2003DOI 10.1590/S0100-72032003000900007
Views97See morePURPOSE: to present the most frequent gynecologic results in a cohort of 300 outpatient HIV-infected women. METHODS: this is a prospective and descriptive study of HIV-infected women that have been followed up at the gynecological clinic from November 1996 to December 2002. These patients were subjected to a specific protocol which included an interview, a gynecological evaluation and a collecting cervical sample for Pap smear, research of HPV (PCR) and colposcopy. Cervical biopsy was performed when necessary. Data were stored and analyzed by Epi-Info, version 6.0. RESULTS: the mean age was 34.5 years. The small number of sexual partners, average of three partners, and the predominance of heterosexual contagion should be mentioned: 271 (90.6%) patients were contaminated through sexual contact with their partners. There was a high prevalence of cervical intraepithelial neoplasia (CIN) representing 21.7% of the total group. Of 109 patients subjected to PCR, 89 (81.7%) were found to have some HPV genotype. An inflammatory smear was present in 69% of the patients. CONCLUSIONS: there is a high frequency of CIN and genital infectious diseases among HIV-infected women, mainly HPV.
Views97This 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
Trabalhos OriginaisThe most frequent gynecological problems in HIV-infected women
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):661-666
01-19-2003DOI 10.1590/S0100-72032003000900007
Views97See morePURPOSE: to present the most frequent gynecologic results in a cohort of 300 outpatient HIV-infected women. METHODS: this is a prospective and descriptive study of HIV-infected women that have been followed up at the gynecological clinic from November 1996 to December 2002. These patients were subjected to a specific protocol which included an interview, a gynecological evaluation and a collecting cervical sample for Pap smear, research of HPV (PCR) and colposcopy. Cervical biopsy was performed when necessary. Data were stored and analyzed by Epi-Info, version 6.0. RESULTS: the mean age was 34.5 years. The small number of sexual partners, average of three partners, and the predominance of heterosexual contagion should be mentioned: 271 (90.6%) patients were contaminated through sexual contact with their partners. There was a high prevalence of cervical intraepithelial neoplasia (CIN) representing 21.7% of the total group. Of 109 patients subjected to PCR, 89 (81.7%) were found to have some HPV genotype. An inflammatory smear was present in 69% of the patients. CONCLUSIONS: there is a high frequency of CIN and genital infectious diseases among HIV-infected women, mainly HPV.
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. -
Trabalhos Originais
Comparison between hysterosonography, hysteroscopy and histopathology in the evaluation of postmenopausal woman uterine cavity
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):667-672
01-19-2003
Summary
Trabalhos OriginaisComparison between hysterosonography, hysteroscopy and histopathology in the evaluation of postmenopausal woman uterine cavity
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):667-672
01-19-2003DOI 10.1590/S0100-72032003000900008
Views47See morePURPOSE: to compare the results of hysterosonography with those of hysteroscopy and the histopathologic study in postmenopausal women. METHODS: hysterosonography, hysteroscopy and endometrial biopsy were performed in 59 women who had an endometrial echo over 4 mm, age above 40 years and amenorrhea over one year, and whose follicle-stimulating hormone levels were over 35 mIU/mL. Patients using hormones were excluded, as well those in whom it was impossible to perform histerosonography, histeroscopy or endometrial biopsy. The statistical analysis was performed using the nonparametric "G"-Cochran and McNemar tests. In addition, sensitivity and specificity, as well as positive and negative predictive values were determined. The value of 0.05 or 5% for rejection level of the null hypothesis was applied. RESULTS: the agreement rates of hysterosonographic results compared to hysteroscopy and histopatology were 94.8 ande 77.6%, respectively. Sensitivity and specificity of hysterosonographic evaluation of the abnormal endometrial cavity were 98 and 75%, respectively, when compared to hysteroscopy. In addittion, positive and negative predictive values of hysterosonography were 96 and 86%, respectively. When the histopathologic study was used as the gold standard, sensitivity and specificity were 98 and 33%, with positive predictive value of 76% and negative predictive value of 86%, for the detection of the endometrial cavitary changes. One great concern were the histopathologic results of two patients with uterine synechia who showed endometrial hyperplasia. Also, one patient was diagnosed as normal using histerosonography and the histopatological result showed simple hyperplasia. CONCLUSIONS: our data suggest that hysterosonography presented good sensitivity as compared with hysteroscopy. However, uterine synechia is the great limitation of this method as compared with histopathology.
Views47This 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
Trabalhos OriginaisComparison between hysterosonography, hysteroscopy and histopathology in the evaluation of postmenopausal woman uterine cavity
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):667-672
01-19-2003DOI 10.1590/S0100-72032003000900008
Views47See morePURPOSE: to compare the results of hysterosonography with those of hysteroscopy and the histopathologic study in postmenopausal women. METHODS: hysterosonography, hysteroscopy and endometrial biopsy were performed in 59 women who had an endometrial echo over 4 mm, age above 40 years and amenorrhea over one year, and whose follicle-stimulating hormone levels were over 35 mIU/mL. Patients using hormones were excluded, as well those in whom it was impossible to perform histerosonography, histeroscopy or endometrial biopsy. The statistical analysis was performed using the nonparametric "G"-Cochran and McNemar tests. In addition, sensitivity and specificity, as well as positive and negative predictive values were determined. The value of 0.05 or 5% for rejection level of the null hypothesis was applied. RESULTS: the agreement rates of hysterosonographic results compared to hysteroscopy and histopatology were 94.8 ande 77.6%, respectively. Sensitivity and specificity of hysterosonographic evaluation of the abnormal endometrial cavity were 98 and 75%, respectively, when compared to hysteroscopy. In addittion, positive and negative predictive values of hysterosonography were 96 and 86%, respectively. When the histopathologic study was used as the gold standard, sensitivity and specificity were 98 and 33%, with positive predictive value of 76% and negative predictive value of 86%, for the detection of the endometrial cavitary changes. One great concern were the histopathologic results of two patients with uterine synechia who showed endometrial hyperplasia. Also, one patient was diagnosed as normal using histerosonography and the histopatological result showed simple hyperplasia. CONCLUSIONS: our data suggest that hysterosonography presented good sensitivity as compared with hysteroscopy. However, uterine synechia is the great limitation of this method as compared with histopathology.
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. -
Trabalhos Originais
Uterine volume in teenagers evaluated by ultrasound
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):673-678
01-19-2003
Summary
Trabalhos OriginaisUterine volume in teenagers evaluated by ultrasound
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):673-678
01-19-2003DOI 10.1590/S0100-72032003000900009
Views48See morePURPOSE: to evaluate the uterine volume in women between 10 and 40 years in order to observe if the uterine volume in adolescents is smaller than the uterine volume in women between 20 and 40 years. We intend to emphasize the differences between the uterine volume of adolescents and that of adult women and to correlate with the immaturity of the genital tract of adolescents regarding gestation and delivery. METHOD: a cross-sectional study, which included 828 patients between 10 and 40 years old divided into two groups and examined using abdominal ultrasound to obtain the uterine volume measure. The first group consisted of 477 (57.7%) adolescents, and the second group of 351 (42.3%) adult women between 20 and 40 years old. In the adolescent group, ultrasound examination was performed by a single observer and in the group of adult women ultrasound examination was performed by a group of observers who used the same methodology as that of group 1. Image Point HX (Hewlett Packard) and Hitachi 525 ultrasound equipment were used with a multiple frequency probe. For the calculation of the uterine volume we used the longitudinal diameter (LD), anteroposterior diameter (APD) and transverse diameter (TD) with the (LD x APD x TD) x 0.45 formula. RESULTS: adolescents aged 10 to 17 years had a smaller uterine volume than women aged 20 to 40 years (p<0.05). Adolescents who delivered twice had a uterine volume similar to that of the patients between 20 and 40 years old with respective mean values of 62.6 ± 20.6 and 69.0±22.9 (p>0.05). CONCLUSION: adolescents less than 18 years old or primiparous have a smaller uterine volume than women between 20 to 40 years old. However, adolescents aged 18 years or older, or secundipara, have a uterine volume similar to that of women aged 20 to 40 years.
Views48This 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
Trabalhos OriginaisUterine volume in teenagers evaluated by ultrasound
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):673-678
01-19-2003DOI 10.1590/S0100-72032003000900009
Views48See morePURPOSE: to evaluate the uterine volume in women between 10 and 40 years in order to observe if the uterine volume in adolescents is smaller than the uterine volume in women between 20 and 40 years. We intend to emphasize the differences between the uterine volume of adolescents and that of adult women and to correlate with the immaturity of the genital tract of adolescents regarding gestation and delivery. METHOD: a cross-sectional study, which included 828 patients between 10 and 40 years old divided into two groups and examined using abdominal ultrasound to obtain the uterine volume measure. The first group consisted of 477 (57.7%) adolescents, and the second group of 351 (42.3%) adult women between 20 and 40 years old. In the adolescent group, ultrasound examination was performed by a single observer and in the group of adult women ultrasound examination was performed by a group of observers who used the same methodology as that of group 1. Image Point HX (Hewlett Packard) and Hitachi 525 ultrasound equipment were used with a multiple frequency probe. For the calculation of the uterine volume we used the longitudinal diameter (LD), anteroposterior diameter (APD) and transverse diameter (TD) with the (LD x APD x TD) x 0.45 formula. RESULTS: adolescents aged 10 to 17 years had a smaller uterine volume than women aged 20 to 40 years (p<0.05). Adolescents who delivered twice had a uterine volume similar to that of the patients between 20 and 40 years old with respective mean values of 62.6 ± 20.6 and 69.0±22.9 (p>0.05). CONCLUSION: adolescents less than 18 years old or primiparous have a smaller uterine volume than women between 20 to 40 years old. However, adolescents aged 18 years or older, or secundipara, have a uterine volume similar to that of women aged 20 to 40 years.
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Trabalhos Originais Archives - Page 8 of 51 - Revista Brasileira de Ginecologia e Obstetrícia
