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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Original Article
Correlation of pelvic ultrasonography with pubertal development in girls
Rev Bras Ginecol Obstet. 2024;46:e-rbgo5
Summary
Original ArticleCorrelation of pelvic ultrasonography with pubertal development in girls
Rev Bras Ginecol Obstet. 2024;46:e-rbgo5
Views156See 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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Febrasgo Position Statement
Use of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet. 2024;46:e-FPS02
Summary
Febrasgo Position StatementUse of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet. 2024;46:e-FPS02
Views247See 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:e-rbgo17
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:e-rbgo17
Views171Abstract
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:e-FPS03
Summary
Febrasgo Position StatementVulvovaginitis in pregnant women
Rev Bras Ginecol Obstet. 2024;46:e-FPS03
Views252See 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:e-rbgofps1
Summary
Febrasgo Position StatementBreech birth care: Number 1 – 2024
Rev Bras Ginecol Obstet. 2024;46:e-rbgofps1
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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:e-rbgo20
Summary
Outcomes of urethral meatal preservation ventral urethroplasty for female urethral stricture: a series of cases
Rev Bras Ginecol Obstet. 2024;46:e-rbgo20
Views155Abstract
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 -
Association of placental histopathological findings with COVID-19 and its predictive factors
Rev Bras Ginecol Obstet. 2024;46:e-rbgo3
Summary
Association of placental histopathological findings with COVID-19 and its predictive factors
Rev Bras Ginecol Obstet. 2024;46:e-rbgo3
Views195See moreAbstract
Objective:
The aims of the study are to describe the association of coronavirus disease (COVID-19) with the abnormal histopathological findings in human placenta and to highlight the potential predictors of these histopathological findings.
Methods:
A retrospective cohort study, held in two obstetric units from January 2021- 2022, 34 patients who were confirmed cases of COVID- 19 were followed up till the time of delivery as their placenta were sent for histopathology. Patients diagnosed with other viral infections, chorioamnionitis, or were known case of as pre-term or term pre labour rupture of membrans (PROM) were excluded as well as pre exisiting diabetes mellitus or pre-eclampsia. Data analysis were performed using STATA software version 16.
Result:
Specific histopatological findings (fetal vascular malperfusion, maternal vascular malperfusion, inflammatory pathology and thrombotic finding) were significantly high among 13 (38.2%) of the study group who got infected earlier in pregnancy (P<0.001). The period between the diagnosis of COVID-19 and the delivery significantly increases the odds of the presence of pathological findings by 2.75 times for each week the patients getting infected earlier.
Conclusion:
Association of abnormal placental histopathological findings with COVID-19 infection in pregnancy and the potential predictor for the occurrence of placental findings is the longer duration between the diagnosis of the infection and the delivery.
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Non-RhD alloimmunization in pregnancy: an updated review
Rev Bras Ginecol Obstet. 2024;46:e-rbgo22
Summary
Non-RhD alloimmunization in pregnancy: an updated review
Rev Bras Ginecol Obstet. 2024;46:e-rbgo22
Views198Abstract
RhD alloimmunization in pregnancy is still the main cause of hemolytic disease of the fetus and neonate (HDFN). Nevertheless, there are other antigens that may be associated with the occurrence of this phenomenon and that have been growing in proportion, given that current prevention strategies focus only on anti-RhD antibodies. Although not widespread, the screening and diagnostic management of the disease caused by these antibodies has recommendations in the literature. For this reason, the following review was carried out with the objective of listing the main red blood cell antigen groups described — such as Rh, ABO, Kell, MNS, Duffy, Kidd, among others — addressing the clinical importance of each one, prevalence in different countries, and recommended management when detecting such antibodies during pregnancy.
Key-words Blood group antigensErythroblastosisfetalFetal diseasesNon-Rh alloimmunizationpregnancyPrevalenceRH IsoimmunizationSee more
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Febrasgo Position Statement
Hyperprolactinemia in women: diagnostic approach
Rev Bras Ginecol Obstet. 2024;46:e-FPS04
Summary
Febrasgo Position StatementHyperprolactinemia in women: diagnostic approach
Rev Bras Ginecol Obstet. 2024;46:e-FPS04
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Febrasgo Position Statement
Hyperprolactinemia in women: treatment
Rev Bras Ginecol Obstet. 2024;46:e-FPS05
Summary
Febrasgo Position StatementHyperprolactinemia in women: treatment
Rev Bras Ginecol Obstet. 2024;46:e-FPS05
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Febrasgo Position Statement
Breech birth care: Number 1 – 2024
Rev Bras Ginecol Obstet. 2024;46:e-rbgofps1
Summary
Febrasgo Position StatementBreech birth care: Number 1 – 2024
Rev Bras Ginecol Obstet. 2024;46:e-rbgofps1
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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:e-rbgo24
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:e-rbgo24
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The path to elimination: FEBRASGO 2023’s targeted strategies against cervical cancer in Brazil
Rev Bras Ginecol Obstet. 2024;46:e-rbgoedt2
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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:e-rbgo6
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:e-rbgo6
Views373See 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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Febrasgo Position Statement
Use of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet. 2024;46:e-FPS02
Summary
Febrasgo Position StatementUse of hormones and risk of venous thromboembolism
Rev Bras Ginecol Obstet. 2024;46:e-FPS02
Views247See 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.
-
Febrasgo Position Statement
Vulvovaginitis in pregnant women
Rev Bras Ginecol Obstet. 2024;46:e-FPS03
Summary
Febrasgo Position StatementVulvovaginitis in pregnant women
Rev Bras Ginecol Obstet. 2024;46:e-FPS03
Views252See 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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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
Views5See 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
Views12PURPOSE: 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
Views5See 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.