About the journal
The Revista Brasileira de Ginecologia e Obstetrícia is a scientific publication of the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). It is aimed at gynecologists, obstetricians and professionals in related areas with the purpose to publish research results on relevant topics in the field of Gynecology, Obstetrics and related areas.
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Febrasgo Position Statement
Use of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet.2024;46():-
Summary
Febrasgo Position StatementUse of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet.2024;46():-
Views233See moreKey points
•The risk of venous thromboembolism (VTE) is not increased in women using long-acting reversible contraceptive methods (LARCs) with progestogens.
•Oral contraceptives with levonorgestrel or norgestimate confer half the risk of VTE compared to oral contraceptives containing desogestrel, gestodene or drospirenone.
•Progestogen-only pills do not confer an increased risk of VTE.
•Women using transdermal contraceptive patches and combined oral contraceptives (COCs) are at an approximately eight times greater risk of VTE than non-users of hormonal contraceptives (HCs), corresponding to 9.7 events per 10,000 women/years.
•Vaginal rings increase the risk of VTE by 6.5 times compared to not using HC, corresponding to 7.8 events per 10,000 women/years.
•Several studies have demonstrated an increased risk of VTE in transgender individuals receiving hormone therapy (HT).
•Hormone therapy during menopause increases the risk of VTE by approximately two times, and this risk is increased by obesity, thrombophilia, age over 60 years, surgery and immobilization.
•The route of estrogen administration, the dosage and type of progestogen associated with estrogen may affect the risk of VTE in the climacteric.
•Combined estrogen-progesterone therapy increases the risk of VTE compared to estrogen monotherapy.
•Postmenopausal HT increases the risk of thrombosis at atypical sites.
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Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic
Rev Bras Ginecol Obstet.2024;46():-
Summary
Prevalence and factors associated with anxiety, depression and burnout in gynecology and obstetrics residents during the COVID-19 pandemic
Rev Bras Ginecol Obstet.2024;46():-
Views166Abstract
Objective:
To determine the prevalence of anxiety, depression and burnout in residents of Gynecology and Obstetrics during COVID-19 pandemic in Brazil and its associated factors.
Methods:
Cross-sectional study involving all regions of Brazil, through the application of a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale (HAD) and the Maslach Burnout Inventory (MBI-HSS) instrument. Multivariate analysis was performed after adjusting the Poisson model.
Results:
Among the 719 participating medical residents, screening was positive for anxiety in 75.7% and for depression in 49.8% of cases. Burnout syndrome was evidenced in 41.3% of the physicians studied. Those with depression are more likely to have anxiety (OR 0.797; 95%CI 0.687 – 0.925) and burnout syndrome (OR 0.847 95%CI 0.74 – 0.97). Residents with anxiety (OR 0.805; 95%CI 0.699 – 0.928) and burnout (OR 0.841; 95%CI 0.734 – 0.963) are more likely to have depression.
Conclusion:
High prevalence of anxiety, depression and burnout were found in residents of Gynecology and Obstetrics in Brazil, in addition to important correlations between anxiety-depression and depression-burnout.
Key-words anxietyBrazilBurnout, psychologicalCOVID-19Depressiongynecologyinternship and residencymedical residencyMental healthObstetricspandemicsSee more -
Febrasgo Position Statement
Vulvovaginitis in pregnant women
Rev Bras Ginecol Obstet.2024;46():-
Summary
Febrasgo Position StatementVulvovaginitis in pregnant women
Rev Bras Ginecol Obstet.2024;46():-
Views231See moreKey points
• The balanced vaginal microbiome is the main factor defending the vaginal environment against infections. Lactobacilli play a key role in this regard, maintaining the vaginal pH within the normal range (3.8 to 4.5).
•Hormonal and immune adaptations resulting from pregnancy influence changes in the vaginal microbiome during pregnancy.
•An altered vaginal microbiome predisposes to human immunodeficiency virus (HIV) infection.
•Bacterial vaginosis is the main clinical expression of an imbalanced vaginal microbiome.
•Vulvovaginal candidiasis depends more on the host’s conditions than on the etiological agent.
•Trichomonas vaginalis is a protozoan transmitted during sexual intercourse.
•The use of probiotics is not approved for use in pregnant women.
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Febrasgo Position Statement
Breech birth care: Number 1 – 2024
Rev Bras Ginecol Obstet.2024;46():-
Summary
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Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases
Rev Bras Ginecol Obstet.2024;46():-
Summary
Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases
Rev Bras Ginecol Obstet.2024;46():-
Views153Abstract
Objective:
To present a series of cases with our initial experience and short-term outcomes of a modified vaginal mucosal flap urethroplasty.
Methods:
Patients diagnosed with urethral stricture and operated by the same operative technique between January 2012 and January 2018 were followed for at least 6 months. Uroflowmetry and clinical outcomes were evaluated.
Results:
Nineteen patients were included with an average age of 56.4 years, mean preoperative Qmax of 5.3 ml/s, and PVR of 101.4 mL. After 6 months of the procedure, the mean Qmax improved to 14.7 mL/s (p<0.05), PVR decreased to 47.3 mL (p<0.05), and 84.2% of all patients reported improvement in clinical self-reported symptoms. There was an improvement in symptoms such as voiding effort in 84.2% of patients, weak stream (89.5%), and recurrent urinary tract infection (85.7%). The success rate (absence of symptoms and normal Qmax with no significant PVR) of the procedure was 84.2%.
Conclusion:
The described technique was considered effective for the treatment of female urethra stricture, with a high clinical success rate and an objective improvement of Qmax and decrease in PVR after 6 months of the procedure.
Key-words Urethral strictureUrethroplastyUrinary bladder neck obstructionUrological surgical proceduresSee more -
Original Article
Correlation of pelvic ultrasonography with pubertal development in girls
Rev Bras Ginecol Obstet.2024;46():-
Summary
Original ArticleCorrelation of pelvic ultrasonography with pubertal development in girls
Rev Bras Ginecol Obstet.2024;46():-
Views141See moreAbstract
Objectives:
This study aims to correlate pelvic ultrasound with female puberty and evaluate the usual ultrasound parameters as diagnostic tests for the onset of puberty and, in particular, a less studied parameter: the Doppler evaluation of the uterine arteries.
Methods:
Cross-sectional study with girls aged from one to less than eighteen years old, with normal pubertal development, who underwent pelvic ultrasound examination from November 2020 to December 2021. The presence of thelarche was the clinical criterion to distinguish pubescent from non-pubescent girls. The sonographic parameters were evaluated using the ROC curve and the cutoff point defined through the Youden index (J).
Results:
60 girls were included in the study. Uterine volume ≥ 2.45mL had a sensitivity of 93%, specificity of 90%, PPV of 90%, NPV of 93% and accuracy of 91% (AUC 0.972) for predicting the onset of puberty. Mean ovarian volume ≥ 1.48mL had a sensitivity of 96%, specificity of 90%, PPV of 90%, NPV of 97% and accuracy of 93% (AUC 0.966). Mean PI ≤ 2.75 had 100% sensitivity, 48% specificity, 62% PPV, 100% NPV and 72% accuracy (AUC 0.756) for predicting the onset of puberty.
Conclusion:
Pelvic ultrasound proved to be an excellent tool for female pubertal assessment and uterine and ovarian volume, the best ultrasound parameters for detecting the onset of puberty. The PI of the uterine arteries, in this study, although useful in the pubertal evaluation, showed lower accuracy in relation to the uterine and ovarian volume.
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Translation, cross-cultural adaptation to Brazilian Portuguese and measurement properties of the WaLIDD score
Rev Bras Ginecol Obstet.2024;46():-
Summary
Translation, cross-cultural adaptation to Brazilian Portuguese and measurement properties of the WaLIDD score
Rev Bras Ginecol Obstet.2024;46():-
Views208See moreAbstract
Objective:
Dysmenorrhea is the pain related to menstruation; to screen for the symptoms, a working ability, location, intensity of days of pain, and dysmenorrhea (WaLIDD) score was created. The purpose of this work was to culturally adapt and assess the measurement properties of the WaLIDD score for dysmenorrhea in Brazilian women.
Methods:
In this cross-sectional online study, we evaluated women with and without dysmenorrhea. Criterion validity and construct validity were assessed, respectively, by the Receiver Operator Characteristic (ROC) curve and correlations with the bodily pain and social functioning domains of medical outcomes study 36-item short-form health survey (SF-36), self-report of absenteeism and Stanford Presenteeism Scale for presenteeism. Test-retest reliability and measurement errors were assessed, respectively, by intraclass correlation coefficient (ICC) and Bland and Altman Graph.
Results:
430 women completed the test, 238 (55.4%) women had dysmenorrhea, and 199 (46.3%) answered the questionnaire twice for the retest. The cutoff points ≥4, ≥5, and ≥5 could discriminate between women with and without dysmenorrhea, absenteeism, and presenteeism related to dysmenorrhea, respectively. Correlations between SF-36 – pain and social functioning domains and WaLIDD score were weak to strong and negative. For WaLIDD total Score, ICC was 0.95 and the limits of agreement were −1.54 and 1.62.
Conclusion:
WaLIDD score is a short, valid and reliable instrument to screen and predict dysmenorrhea and could predict absenteeism and presenteeism related to dysmenorrhea in Brazilian women.
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Original Article
Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
Rev Bras Ginecol Obstet.2024;46():-
Summary
Original ArticleGender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
Rev Bras Ginecol Obstet.2024;46():-
Views175Abstract
Objective:
Evaluate histological changes in testicular parameters after hormone treatment in transgender women.
Methods:
Cross-section study with patients who underwent gonadectomy at Hospital de Clínicas de Porto Alegre from 2011 to 2019. Hormone treatment type, route of administration, age at initiation and duration were recorded. Atrophy parameters were observed: testicular volume, tubular diameter, basal membrane length, presence of spermatogonia and spermatids (diploid and haploid spermatozoid precursors).
Results:
Eighty-six patients were included. Duration of hormone treatment is associated with testicular atrophy and spermatogenesis arrest. Other characteristics of hormone treatment such as age of initiation, route of administration and type of treatment were not associated with testicular histological changes. Testicular volume may predict spermatogenesis arrest. Basal membrane length and tubular diameter ratio is an interesting predictor of germ cell presence.
Conclusion:
Cross-sex hormone treatment affects testicular germ cell presence. Basal membrane length and tubular diameter ratio reduces inter variability of measurements and better exemplify how atrophic seminiferous tubules are. Fertility preservation should be addressed by healthcare providers in order to recognize gender affirming treatment impact on transgender health.
Key-words fertilityfertility preservationGonadal steroid hormonesHormone treatmentSpermatogenesisTransgender personsTransgender womenSee more
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Febrasgo Position Statement
Hyperprolactinemia in women: diagnostic approach
Rev Bras Ginecol Obstet.2024;46():-
Summary
Febrasgo Position StatementHyperprolactinemia in women: diagnostic approach
Rev Bras Ginecol Obstet.2024;46():-
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Febrasgo Position Statement
Hyperprolactinemia in women: treatment
Rev Bras Ginecol Obstet.2024;46():-
Summary
Febrasgo Position StatementHyperprolactinemia in women: treatment
Rev Bras Ginecol Obstet.2024;46():-
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Febrasgo Position Statement
Breech birth care: Number 1 – 2024
Rev Bras Ginecol Obstet.2024;46():-
Summary
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Letter to the Editor
Letter to Editor: In response to existence of SARS-CoV-2 in the peritoneal fluid
Rev Bras Ginecol Obstet.2024;46():-
Summary
Letter to the EditorLetter to Editor: In response to existence of SARS-CoV-2 in the peritoneal fluid
Rev Bras Ginecol Obstet.2024;46():-
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The path to elimination: FEBRASGO 2023’s targeted strategies against cervical cancer in Brazil
Rev Bras Ginecol Obstet.2024;46():-
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Breast Imaging Reporting and Data System (BI-RADS®): a success history and particularities of its use in Brazil
Rev Bras Ginecol Obstet.2024;46():-
Summary
Breast Imaging Reporting and Data System (BI-RADS®): a success history and particularities of its use in Brazil
Rev Bras Ginecol Obstet.2024;46():-
Views349See moreAbstract
BI-RADS® is a standardization system for breast imaging reports and results created by the American College of Radiology to initially address the lack of uniformity in mammography reporting. The system consists of a lexicon of descriptors, a reporting structure with final categories and recommended management, and a structure for data collection and auditing. It is accepted worldwide by all specialties involved in the care of breast diseases. Its implementation is related to the Mammography Quality Standards Act initiative in the United States (1992) and breast cancer screening. After its initial creation in 1993, four additional editions were published in 1995, 1998, 2003 and 2013. It is adopted in several countries around the world and has been translated into 6 languages. Successful breast cancer screening programs in high-income countries can be attributed in part to the widespread use of BI-RADS®. This success led to the development of similar classification systems for other organs (e.g., lung, liver, thyroid, ovaries, colon). In 1998, the structured report model was adopted in Brazil. This article highlights the pioneering and successful role of BI-RADS®, created by ACR 30 years ago, on the eve of publishing its sixth edition, which has evolved into a comprehensive quality assurance tool for multiple imaging modalities. And, especially, it contextualizes the importance of recognizing how we are using BI-RADS® in Brazil, from its implementation to the present day, with a focus on breast cancer screening.
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Early and late-onset preeclampsia: effects of DDAH2 polymorphisms on ADMA levels and association with DDAH2 haplotypes
Rev Bras Ginecol Obstet.2024;46():-
Summary
Early and late-onset preeclampsia: effects of DDAH2 polymorphisms on ADMA levels and association with DDAH2 haplotypes
Rev Bras Ginecol Obstet.2024;46():-
Views234Abstract
Objective:
To examine whether the DDAH2 promoter polymorphisms -1415G/A (rs2272592), -1151A/C (rs805304) and -449G/C (rs805305), and their haplotypes, are associated with PE compared with normotensive pregnant women, and whether they affect ADMA levels in these groups.
Methods:
A total of 208 pregnant women were included in the study and classified as early-onset (N=57) or late-onset PE (N =49), and as normotensive pregnant women (N = 102).
Results:
Pregnant with early-onset PE carrying the GC and GG genotypes for the DDAH2 -449G/C polymorphism had increased ADMA levels (P=0.01). No association of DDAH2 polymorphisms with PE in single-locus analysis was found. However, the G-C-G haplotype was associated with the risk for late-onset PE.
Conclusion:
It is suggested that DDAH2 polymorphisms could affect ADMA levels in PE, and that DDAH2 haplotypes may affect the risk for PE.
Key-words Asymmetric dimethylarginineDimethylarginine dimethylaminohydrolase 2 geneGenotypeHaplotypesNitric Oxide SynthaseNitric Oxide Synthase Type III/ geneticsPolymorphism, geneticpre-eclampsiapregnant womenSee more -
Febrasgo Position Statement
Use of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet.2024;46():-
Summary
Febrasgo Position StatementUse of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet.2024;46():-
Views233See moreKey points
•The risk of venous thromboembolism (VTE) is not increased in women using long-acting reversible contraceptive methods (LARCs) with progestogens.
•Oral contraceptives with levonorgestrel or norgestimate confer half the risk of VTE compared to oral contraceptives containing desogestrel, gestodene or drospirenone.
•Progestogen-only pills do not confer an increased risk of VTE.
•Women using transdermal contraceptive patches and combined oral contraceptives (COCs) are at an approximately eight times greater risk of VTE than non-users of hormonal contraceptives (HCs), corresponding to 9.7 events per 10,000 women/years.
•Vaginal rings increase the risk of VTE by 6.5 times compared to not using HC, corresponding to 7.8 events per 10,000 women/years.
•Several studies have demonstrated an increased risk of VTE in transgender individuals receiving hormone therapy (HT).
•Hormone therapy during menopause increases the risk of VTE by approximately two times, and this risk is increased by obesity, thrombophilia, age over 60 years, surgery and immobilization.
•The route of estrogen administration, the dosage and type of progestogen associated with estrogen may affect the risk of VTE in the climacteric.
•Combined estrogen-progesterone therapy increases the risk of VTE compared to estrogen monotherapy.
•Postmenopausal HT increases the risk of thrombosis at atypical sites.
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Review Article
Breastfeeding and the Benefits of Lactation for Women’s Health
Rev Bras Ginecol Obstet.2018;40(6):354-359
Summary
Review ArticleBreastfeeding and the Benefits of Lactation for Women’s Health
Rev Bras Ginecol Obstet.2018;40(6):354-359
Views4See moreAbstract
The offer of the maternal breast to the baby is an unquestionable right of mothers and their children, and all efforts should bemade to promote, follow and maintain exclusive breastfeeding for up to 6months and supplement it until the child completes 2 years of age. Many publications are available in the literature about the qualities of breast milk, its benefits and health repercussions, stimulating the practice of breastfeeding and supporting campaigns for its implementation. However, although it is widely known that breastfeeding is an important step in the reproductive process of women and its practice offers benefits to both mother and child, most of the available information highlights the benefits of breast milk for children, while mention of the effects of breastfeeding on the health of the mother is usually neglected. Thus, the objective of the present study is to highlight the multiple benefits of breastfeeding for the physical and emotional health of the nursing mother. The authors consulted articles published in the databases PubMed, Virtual Health Library andWeb of Science using the keywords breastfeeding, breast milk, lactation and maternal health.
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Original Article
Translation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index
Rev Bras Ginecol Obstet.2008;30(10):504-510
Summary
Original ArticleTranslation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index
Rev Bras Ginecol Obstet.2008;30(10):504-510
DOI 10.1590/S0100-72032008001000005
Views10PURPOSE: to translate from English into Portuguese, adapt culturally and validate the Female Sexual Function Index (FSFI). METHODS: knowing the objectives of this research, two Brazilian translators have prepared a version each from the FSFI into Portuguese. Both versions have then been retro-translated into English by two English translators. After harmonizing the differences, they have been pre-tested in a pilot study. The final versions from the FSFI and from another questionnaire, the Short-Form Health Survey, which had already been translated and published in Portuguese, have then been simultaneously administered to one hundred patients, to test the FSFI psychometric proprieties concerning reliability (internal consistency and testing-retesting) and construct validity. Retesting was done after four weeks from the first interview. RESULTS: the process of cultural adaptation has not altered the Portuguese version of the FSFI, as compared to the original. The FSFI standardized Cronbach alpha was 0.96, and the evaluation by domains has varied from 0.31 to 0.97. As a measure of test-retest confidentiality, it was applied the intra-class coefficient, which has been considered strong and identical (1.0). Pearson’s correlation coefficient between the FSFI and the Short-Form Health Survey was positive, but weak in most of the interrelated domains, varying from 0.017 to 0.036. CONCLUSIONS: the FSFI English version has been translated into Portuguese and culturally adapted, being reliable to evaluate the sexual response of Brazilian women.
Key-words questionnairesReproducibility of resultsSexual dysfunctions, psychologicalTranslationsvalidation studieswomen's healthSee more -
Review Article
Preeclampsia
Rev Bras Ginecol Obstet.2017;39(9):496-512
Summary
Review ArticlePreeclampsia
Rev Bras Ginecol Obstet.2017;39(9):496-512
Views8Abstract
The authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia. The early treatment of acute hypertension, use of magnesium sulfate and early hospitalization in cases of preeclampsia are concepts to pursue the reduction of our pregnant women’s mortality.
Key-words HELLP syndromeHigh-risk pregnancypreeclampsiapregnancy arterial hypertensionPregnancy complicationsSee more -
Review Article
Primary Dysmenorrhea: Assessment and Treatment
Rev Bras Ginecol Obstet.2020;42(8):501-507
Summary
Review ArticlePrimary Dysmenorrhea: Assessment and Treatment
Rev Bras Ginecol Obstet.2020;42(8):501-507
Views4See moreAbstract
Primary dysmenorrhea is defined asmenstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of themenstrual cycle. It hasmajor implications for quality of life, such as limitation of daily activities and psychological stress, being one of themain causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, nonpharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments’ contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.
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Original Article
Coverage of the Pap smear in Brazil and its determining factors: a systematic literature review
Rev Bras Ginecol Obstet.2005;27(8):485-492
Summary
Original ArticleCoverage of the Pap smear in Brazil and its determining factors: a systematic literature review
Rev Bras Ginecol Obstet.2005;27(8):485-492
DOI 10.1590/S0100-72032005000800009
Views0See morePURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE – 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women’s failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women’s failure to submit to the Pap smear.
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Original Article
Pré-natal Care Profile among Public Health Service (“Sistema Único de Saúde”) Users from Caxias do Sul
Rev Bras Ginecol Obstet.2002;24(5):293-299
Summary
Original ArticlePré-natal Care Profile among Public Health Service (“Sistema Único de Saúde”) Users from Caxias do Sul
Rev Bras Ginecol Obstet.2002;24(5):293-299
DOI 10.1590/S0100-72032002000500002
Views4See morePurpose: to study the prenatal care among Public Health Service (“Sistema Único de Saúde”) users from Caxias do Sul – RS. Methods: a transversal study of 702 pregnancies attended at the Hospital Geral -Universidade de Caxias do Sul from March 2000 to March 2001 based on the criteria set by the “Programa Nacional de Humanização do Pré-natal e Nascimento (PNHPN)” of the Brazilian Ministry of Health. Results: the observed prenatal coverage was 95.4%, whereas the average of visits was 6.2. The main reported reason for not following prenatal care was the lack of information about its importance (65.6%). In 51.5% of the cases, prenatal care started in the third month of pregnancy, whereas 44.3% of the pregnant women carried out all the proposed complementary tests. Prenatal care was considered inappropriate in 64.8% and appropriate in 35.2% of the cases. The quality of prenatal attention was significantly associated with the mother’s education, as well as with the number of previous deliveries. The higher the educational level, the better the quality of observed prenatal care (p=0.0148). In addition, the higher number of previous deliveries showed to be associated with a later beginning of prenatal care and a lower number of visits (p=0.0008). Conclusions: the prenatal care available at Caxias do Sul in spite of its good coverage, should be reviewed in terms of quality. Special attention should be given to education in health along the prenatal assistance.
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Original Article
Validation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence
Rev Bras Ginecol Obstet.2005;27(5):235-242
Summary
Original ArticleValidation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence
Rev Bras Ginecol Obstet.2005;27(5):235-242
DOI 10.1590/S0100-72032005000500002
Views2See morePURPOSE: the proposal of the present study was to translate and to validate King’s Health Questionnaire (KHQ) for Brazilian women with urinary incontinence. METHODS: a hundred and thirty-four patients with urinary incontinence, confirmed by urodynamic study, were enrolled from the outpatient clinic of Uroginecology. Initially, we translated the KHQ into the Brazilian Portuguese language in agreement with international criteria. Due to language and cultural differences we performed a cultural, structural, conceptual, and semantic adaptation of the KHQ, in order to make sure that patients were able to fully understand the questions. All patients answered the KHQ twice on the same day, within an interval of 30 min, applied by two different interviewers. After 7 to 14 days, on a second visit, the questionnaire was applied again. Reliability (intra- and interobserver internal consistency), construct and discriminative validity were tested. RESULTS: several cultural adaptations were necessary until we reached the final version. The intra-observer internal consistency (alpha of Cronbach) of the several dimensions varied from moderate to high (0.77-0.90), and the interobserver internal consistency varied from 0.66 to 0.94. Moderate to strong correlation was detected among the specific KHQ urinary incontinence dominions and clinical urinary incontinence manifestations known to affect the quality of life of these patients. CONCLUSION: KHQ was adapted to the Portuguese language and to the Brazilian culture, showing great reliability and validity. It should be included and used in any Brazilian urinary incontinence clinical trial.
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Review Article
Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Rev Bras Ginecol Obstet.2018;40(9):554-562
Summary
Review ArticleMultiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Rev Bras Ginecol Obstet.2018;40(9):554-562
Views2See moreAbstract
Twin pregnancy accounts for 2 to 4% of total births, with a prevalence ranging from 0.9 to 2.4% in Brazil. It is associated with worse maternal and perinatal outcomes. Many conditions, such as severe maternal morbidity (SMM) (potentially life-threatening conditions and maternal near-miss) and neonatal near-miss (NNM) still have not been properly investigated in the literature. The difficulty in determining the conditions associated with twin pregnancy probably lies in its relatively low occurrence and the need for larger population studies. The use of the whole population and of databases from large multicenter studies, therefore, may provide unprecedented results. Since it is a rare condition, it ismore easily evaluated using vital statistics from birth e-registries. Therefore, we have performed a literature review to identify the characteristics of twin pregnancy in Brazil and worldwide. Twin pregnancy has consistently been associated with SMM, maternal near-miss (MNM) and perinatal morbidity, with still worse results for the second twin, possibly due to some characteristics of the delivery, including safety and availability of appropriate obstetric care to women at a high risk of perinatal complications.
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breast (42) breast cancer (42) breast neoplasms (95) Cesarean section (72) endometriosis (66) infertility (56) Maternal mortality (43) menopause (82) obesity (58) postpartum period (40) pregnancy (225) Pregnancy complications (99) Prenatal care (68) prenatal diagnosis (50) Prevalence (41) Quality of life (51) risk factors (94) ultrasonography (79) urinary incontinence (40) women's health (48)
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Aims and Vision
The Brazilian Journal of Gynecology and Obstetrics (RBGO) aims to publish basic and clinical research in gynecology, obstetrics and other related specialties and be a reference to support and promote professional education for residents, researchers and university teachers. As a vision, RBGO aims to become an internationally recognized reference among the main world’s journals in Gynecology and Obstetrics.