Você pesquisou por y?yr=1999 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):13-17
DOI 10.1590/S0100-72031999000100003
Purpose: to evaluate if the nipple stimulation performed by primigravidae, at 40 weeks, modifies Bishop index. Method: 64 primigravidae, without clinical or obstetrical complications were studied, in two groups. One group, called nipple stimulation group (N.S.G.) had 29 pregnant women. The other, named control group (C.G.) included 35 pregnant women. The N.S.G. performed the nipple stimulation test, bilaterally, from left to right, for two minutes followed by five minutes of rest, during thirty minutes. The test was done three times a day up to 41 weeks of pregnancy or beginning of labor. Statistical analysis of the results was performed using Student's t test, with 5 % significance. Results: once nipple stimulation was completed in the N.S.G., it was compared with the C.G. considering time of delivery. The results showed no significant differences between the groups regarding cervix modification, according to the Bishop index. Conclusions: there were no differences of the Bishop index in primigravidae, with more than 40 weeks of pregnancy, who performed nipple stimulation test, when compared with pregnant women of the control group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):13-17
DOI 10.1590/S0100-72031999000100003
Purpose: to evaluate if the nipple stimulation performed by primigravidae, at 40 weeks, modifies Bishop index. Method: 64 primigravidae, without clinical or obstetrical complications were studied, in two groups. One group, called nipple stimulation group (N.S.G.) had 29 pregnant women. The other, named control group (C.G.) included 35 pregnant women. The N.S.G. performed the nipple stimulation test, bilaterally, from left to right, for two minutes followed by five minutes of rest, during thirty minutes. The test was done three times a day up to 41 weeks of pregnancy or beginning of labor. Statistical analysis of the results was performed using Student's t test, with 5 % significance. Results: once nipple stimulation was completed in the N.S.G., it was compared with the C.G. considering time of delivery. The results showed no significant differences between the groups regarding cervix modification, according to the Bishop index. Conclusions: there were no differences of the Bishop index in primigravidae, with more than 40 weeks of pregnancy, who performed nipple stimulation test, when compared with pregnant women of the control group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):18-24
DOI 10.1590/S0100-72031999000100004
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):18-24
DOI 10.1590/S0100-72031999000100004
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):25-31
DOI 10.1590/S0100-72031999000100005
Purpose: This epidemiological census on health conditions of women ranging from 20 to 49 years of age was carried out at Vila Santos Dumont, Pelotas, RS, in order to quantify actions to reorganize the service developed at the local health center. Methods: Information was collected regarding age, level of education, if living with a partner, health service utilization, antenatal care characteristics, cervical cancer screening, physical breast examination and contraceptive methods used. Results: Among the 411 women, 343 (83.5%) had a medical visit during the last year. There were 18 (4.4%) pregnant women. Eighty percent of the women had a cervical smear in the past three years. We found that 47.4% of the women had their breast examined in the last year. Among the 279 women currently using some contraceptive method, 62.4% used the pill, 14.0% had performed surgical sterilization and 7.9% used IUD. Conclusions: This study was women's health diagnosis. It became possible to incorporate the epidemiological method in the health center care planning. We discuss some health actions developed to improve the community care.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):25-31
DOI 10.1590/S0100-72031999000100005
Purpose: This epidemiological census on health conditions of women ranging from 20 to 49 years of age was carried out at Vila Santos Dumont, Pelotas, RS, in order to quantify actions to reorganize the service developed at the local health center. Methods: Information was collected regarding age, level of education, if living with a partner, health service utilization, antenatal care characteristics, cervical cancer screening, physical breast examination and contraceptive methods used. Results: Among the 411 women, 343 (83.5%) had a medical visit during the last year. There were 18 (4.4%) pregnant women. Eighty percent of the women had a cervical smear in the past three years. We found that 47.4% of the women had their breast examined in the last year. Among the 279 women currently using some contraceptive method, 62.4% used the pill, 14.0% had performed surgical sterilization and 7.9% used IUD. Conclusions: This study was women's health diagnosis. It became possible to incorporate the epidemiological method in the health center care planning. We discuss some health actions developed to improve the community care.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):33-37
DOI 10.1590/S0100-72031999000100006
Purpose: to evaluate the agreement between the urodynamic and ultrasonography diagnoses of urinary incontinence, as well as to correlate the variables of both examinations. Methodology: three hundred eighty-one patients with urine loss were selected, from the Sectior of Urogynecology and Vaginal Surgery of the Division of Gynecology, Escola Paulista de Medicina - Federal University of São Paulo. All of them were submitted to urodynamic study, according to the standardization of the International Society of Continence, and to ultrasonography of the bladder neck, with a 6 MHz trasvaginal transducer. We analyzed the maximum closing urethral pressure (MCUP) and the etiological diagnosis of the urine loss. In the ultrasonography, the position of the bladder neck was evaluated in relation to the inferior border of the pubic symphysis, and its mobility as well as the diameter of the urethra and bladder neck. The women were categoriaed according to the urodynamic study in to stress urinary incontinence, detrusor instability and mixed urinary incontinence. Results: 1) the bladder neck, at rest was most frequently above the inferior border of the pubic symphysis and, during effort, below or at the height of the bony reference, in the three groups; 2) the mobility of the bladder neck was similar in the groups; 3) there was no significant correlation between MCUP and the diameter of the urethra and of the bladder neck. Conclusion: we deem that ultrasonography of the bladder neck is always a complement to the clinical evaluation and the urodymanic study.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):33-37
DOI 10.1590/S0100-72031999000100006
Purpose: to evaluate the agreement between the urodynamic and ultrasonography diagnoses of urinary incontinence, as well as to correlate the variables of both examinations. Methodology: three hundred eighty-one patients with urine loss were selected, from the Sectior of Urogynecology and Vaginal Surgery of the Division of Gynecology, Escola Paulista de Medicina - Federal University of São Paulo. All of them were submitted to urodynamic study, according to the standardization of the International Society of Continence, and to ultrasonography of the bladder neck, with a 6 MHz trasvaginal transducer. We analyzed the maximum closing urethral pressure (MCUP) and the etiological diagnosis of the urine loss. In the ultrasonography, the position of the bladder neck was evaluated in relation to the inferior border of the pubic symphysis, and its mobility as well as the diameter of the urethra and bladder neck. The women were categoriaed according to the urodynamic study in to stress urinary incontinence, detrusor instability and mixed urinary incontinence. Results: 1) the bladder neck, at rest was most frequently above the inferior border of the pubic symphysis and, during effort, below or at the height of the bony reference, in the three groups; 2) the mobility of the bladder neck was similar in the groups; 3) there was no significant correlation between MCUP and the diameter of the urethra and of the bladder neck. Conclusion: we deem that ultrasonography of the bladder neck is always a complement to the clinical evaluation and the urodymanic study.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):41-45
DOI 10.1590/S0100-72031999000100007
Purpose: to demonstrate a new approach to treatment of endometrial cancer. Methods: Between February, 1996 and February, 1998, twelve patients with endometrial cancer, diagnosed by hysteroscopy and biopsy, were submitted to pelvic lymphadenectomy and hysterectomy with salpingo-oophorectomy by laparoscopy. The mean age was 58.1 years, the mean number of gestations was 2.3 and the mean body mass index was 28.6. Results: the mean length of anesthesia was 4.8 hours. The mean time of hospital stay was 3.3 days. The total of lymph nodes obtained was 176, 104 (59.1%) being from the right side and 72 (40.9%) from the left side. The mean of lymph nodes per patient was 18.5. We observed two complications: in one case the laparoscopic procedure had to be abandoned because the patient presented a dangerous increase in intratracheal pressure and in the other case a granuloma in the vagina was observed. Conclusions: the initial evaluation of the laparoscopic hysterectomy and laparoscopy shows that we achieved good results regarding the accuracy of staging, the number of nodes and a small number (3) of complications.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):41-45
DOI 10.1590/S0100-72031999000100007
Purpose: to demonstrate a new approach to treatment of endometrial cancer. Methods: Between February, 1996 and February, 1998, twelve patients with endometrial cancer, diagnosed by hysteroscopy and biopsy, were submitted to pelvic lymphadenectomy and hysterectomy with salpingo-oophorectomy by laparoscopy. The mean age was 58.1 years, the mean number of gestations was 2.3 and the mean body mass index was 28.6. Results: the mean length of anesthesia was 4.8 hours. The mean time of hospital stay was 3.3 days. The total of lymph nodes obtained was 176, 104 (59.1%) being from the right side and 72 (40.9%) from the left side. The mean of lymph nodes per patient was 18.5. We observed two complications: in one case the laparoscopic procedure had to be abandoned because the patient presented a dangerous increase in intratracheal pressure and in the other case a granuloma in the vagina was observed. Conclusions: the initial evaluation of the laparoscopic hysterectomy and laparoscopy shows that we achieved good results regarding the accuracy of staging, the number of nodes and a small number (3) of complications.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):47-54
DOI 10.1590/S0100-72031999000100008
Purpose: to evaluate clinical and ultrasonic findings in patients with pelvic tumors at postmenopause and to correlate them with the final diagnosis. Patients and Methods: thirty-six postmenopausal women with pelvic tumor diagnosis were prospectively evaluated through clinical examination and endovaginal ultrasonography. Clinical follow-up with no surgical procedures was indicated for anechoic cystic tumors with or without thin unique septation and volume under 50 cm³. Needle aspiration was indicated for tumors with the same aspect, and volume of 50 to 100 cm³, whereas exploratory laparotomy was performed in the remaining patients. Diagnosis defined two groups of patients: benign (28) and malignant (8) pathologies. Results: anechoic cystic tumor with or without a thin septum indicates benignity (p = 0.0091). Tumors with solid areas indicate malignancy (p = 0.0024). Ascites correlates with malignancy (p = 0.0278). Heterogeneity, thick capsule, thick septa, and papillary projections predominated in malignancies but without no statistical significance (p > 0,05). Tumor volume indicates malignancy, with a median of 85.2 cm³ in benign tumors and 452.5 cm³ in malignancies (p = 0.0048), with a cutoff at 295 cm³ (sensitivity = 83.3% and specificity = 85.2%). Following this protocol, all malignancies were submitted to surgery and 11 benign tumor patients were treated with a conservative protocol (39.3% of all benign patients). Conclusion: conservative management is an adequate protocol for women with anechoic pelvic tumors with low volume, with or without single thin septum and without ascites. Differentiation between benign and malignant of complex and/or high volume tumors requires complementary investigation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):47-54
DOI 10.1590/S0100-72031999000100008
Purpose: to evaluate clinical and ultrasonic findings in patients with pelvic tumors at postmenopause and to correlate them with the final diagnosis. Patients and Methods: thirty-six postmenopausal women with pelvic tumor diagnosis were prospectively evaluated through clinical examination and endovaginal ultrasonography. Clinical follow-up with no surgical procedures was indicated for anechoic cystic tumors with or without thin unique septation and volume under 50 cm³. Needle aspiration was indicated for tumors with the same aspect, and volume of 50 to 100 cm³, whereas exploratory laparotomy was performed in the remaining patients. Diagnosis defined two groups of patients: benign (28) and malignant (8) pathologies. Results: anechoic cystic tumor with or without a thin septum indicates benignity (p = 0.0091). Tumors with solid areas indicate malignancy (p = 0.0024). Ascites correlates with malignancy (p = 0.0278). Heterogeneity, thick capsule, thick septa, and papillary projections predominated in malignancies but without no statistical significance (p > 0,05). Tumor volume indicates malignancy, with a median of 85.2 cm³ in benign tumors and 452.5 cm³ in malignancies (p = 0.0048), with a cutoff at 295 cm³ (sensitivity = 83.3% and specificity = 85.2%). Following this protocol, all malignancies were submitted to surgery and 11 benign tumor patients were treated with a conservative protocol (39.3% of all benign patients). Conclusion: conservative management is an adequate protocol for women with anechoic pelvic tumors with low volume, with or without single thin septum and without ascites. Differentiation between benign and malignant of complex and/or high volume tumors requires complementary investigation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):55-58
DOI 10.1590/S0100-72031999000100009
The aim of this report is to present one case of gestational trophoblastic disease with pulmonary metastases apparently persisting despite the return of beta-human chorionic gonadotropin (beta-hCG) to normal levels after five cycles of chemotherapy (20 mg methotrexate/day for 5 days). The patient was submitted to a video-assisted thoracoscopy and the nodules were excised. Histological examination showed tissue necrosis without evidence of residual tumor. It is important to recognize that persistent nodules in the lungs of patients with metastatic gestational disease after treatment and normal beta-hCG titers may not represent viable tumor but rather necrosis and/or fibrosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):55-58
DOI 10.1590/S0100-72031999000100009
The aim of this report is to present one case of gestational trophoblastic disease with pulmonary metastases apparently persisting despite the return of beta-human chorionic gonadotropin (beta-hCG) to normal levels after five cycles of chemotherapy (20 mg methotrexate/day for 5 days). The patient was submitted to a video-assisted thoracoscopy and the nodules were excised. Histological examination showed tissue necrosis without evidence of residual tumor. It is important to recognize that persistent nodules in the lungs of patients with metastatic gestational disease after treatment and normal beta-hCG titers may not represent viable tumor but rather necrosis and/or fibrosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):59-59
DOI 10.1590/S0100-72031999000100011
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):59-59
DOI 10.1590/S0100-72031999000100011