Você pesquisou por y?yr=2001 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):619-619
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):619-619
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):621-626
DOI 10.1590/S0100-72032001001000002
Purpose: to compare bone mineral density (BMD) of postmenopausal women with and without the antecedent of tubal ligation, as well as to evaluate the associated factors that affect the bone mineral density of femur and lumbar spine of both groups. Methods: 70 postmenopausal women in each group were analyzed at CAISM-UNICAMP, during the year of 1998. All women answered a questionnaire about some clinical and reproductive characteristics and underwent bone densitometry (Lunar DPX) to measure bone mineral density of the femur and lumbar spine. Statistical analyses were performed using Student's t-test, Fisher`s exact test, Pearson c² test, Bonferroni`s test and multiple regression analysis. Results: mean age of patients was 53.2 years and for controls it was 52.6 years. Mean age of 48 years at menopause was similar in both groups. Mean age at tubal ligation surgery was 33.7 years and time since surgery was 18 years. The multiple comparison of the average bone mineral density of femur and lumbar spine did not show statistical differences between the groups. The percentage distribution of the T-score categories of femur and lumbar spine, classified into normal and altered, also did not show statistical differences between both groups. Multiple regression analysis showed that bone mineral density of femur was directly associated with body mass index, but age was indirectly associated. The variables dark skin, parity, age at menopause, educational level and body mass index were directly associated with bone mineral density of lumbar spine, but age at menarche was inversely associated. Conclusion: these findings suggest that tubal ligation does not seem to cause an additional reduction in bone mineral density when evaluated in postmenopause.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):621-626
DOI 10.1590/S0100-72032001001000002
Purpose: to compare bone mineral density (BMD) of postmenopausal women with and without the antecedent of tubal ligation, as well as to evaluate the associated factors that affect the bone mineral density of femur and lumbar spine of both groups. Methods: 70 postmenopausal women in each group were analyzed at CAISM-UNICAMP, during the year of 1998. All women answered a questionnaire about some clinical and reproductive characteristics and underwent bone densitometry (Lunar DPX) to measure bone mineral density of the femur and lumbar spine. Statistical analyses were performed using Student's t-test, Fisher`s exact test, Pearson c² test, Bonferroni`s test and multiple regression analysis. Results: mean age of patients was 53.2 years and for controls it was 52.6 years. Mean age of 48 years at menopause was similar in both groups. Mean age at tubal ligation surgery was 33.7 years and time since surgery was 18 years. The multiple comparison of the average bone mineral density of femur and lumbar spine did not show statistical differences between the groups. The percentage distribution of the T-score categories of femur and lumbar spine, classified into normal and altered, also did not show statistical differences between both groups. Multiple regression analysis showed that bone mineral density of femur was directly associated with body mass index, but age was indirectly associated. The variables dark skin, parity, age at menopause, educational level and body mass index were directly associated with bone mineral density of lumbar spine, but age at menarche was inversely associated. Conclusion: these findings suggest that tubal ligation does not seem to cause an additional reduction in bone mineral density when evaluated in postmenopause.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):627-631
DOI 10.1590/S0100-72032001001000003
Purpose: to analyze the pregnancy rates after laparoscopic and microsurgical treatment of hydrosalpinx. Methods: from July 1996 to May 1999 thirty-nine infertile patients with hydrosalpinx were treated according to a previously approved research protocol. They were randomly divided into two groups, according to the previously proposed surgical approach: laparoscopic or open microsurgical salpingostomy. To analyze the results, patients were stratified according to tubal damage, and pregnancy rates in both groups were determined for 24 months. Results: pregnancy rates in our series were 35.3 and 33.3% after laparoscopic and microsurgical salpingostomy, respectively. According to the severity of tubal damage, patients with mildly and moderately damaged tubes got pregnant in 66.7 and 21.7% of the cases, respectively. Cumulative pregnancy rates in one and two years were 25.0 and 34.4%, respectively. There was a single case of ectopic pregnancy, corresponding to 9.1% of all pregnancies. Conclusion: patients with mild and moderate lesions may be initially treated with surgery, and conception success is inversely proportional to the degree of tubal damage.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):627-631
DOI 10.1590/S0100-72032001001000003
Purpose: to analyze the pregnancy rates after laparoscopic and microsurgical treatment of hydrosalpinx. Methods: from July 1996 to May 1999 thirty-nine infertile patients with hydrosalpinx were treated according to a previously approved research protocol. They were randomly divided into two groups, according to the previously proposed surgical approach: laparoscopic or open microsurgical salpingostomy. To analyze the results, patients were stratified according to tubal damage, and pregnancy rates in both groups were determined for 24 months. Results: pregnancy rates in our series were 35.3 and 33.3% after laparoscopic and microsurgical salpingostomy, respectively. According to the severity of tubal damage, patients with mildly and moderately damaged tubes got pregnant in 66.7 and 21.7% of the cases, respectively. Cumulative pregnancy rates in one and two years were 25.0 and 34.4%, respectively. There was a single case of ectopic pregnancy, corresponding to 9.1% of all pregnancies. Conclusion: patients with mild and moderate lesions may be initially treated with surgery, and conception success is inversely proportional to the degree of tubal damage.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):641-646
DOI 10.1590/S0100-72032001001000005
Purpose: to evaluate the prevalence of bacterial vaginosis (BV) in menopausal and in infertile outpatients and to analyze the current clinical diagnostic methods. Methods: we evaluated retrospectively 104 menopausal women and 86 with infertility. Characteristic vaginal discharge on gynecological examination, pH >4.5, positive KOH whiff test, and bacterial vaginosis by Gram test were considered positive. BV was established when at least 3 out of 4 criteria were found. Results: among the menopausal women, 29 patients (28.1%) were clinically positive for BV, 10 (9.6%) had positive whiff test, 68 (65.4%) vaginal pH >4.5, and 34 (32.7%) positive Gram test. For the infertile patients the figures were 20 (23.2%), 13 (15.1%), 61 (70.9%) and 26 (30.2%), respectively. According to our established criteria, BV was diagnosed in 14 menopausal (13.5%) and 15 infertile (17.4%) women. Conclusion: bacterial vaginosis prevalence was similar in both groups of patients. In addition, all diagnostic criteria should be followed in order to avoid underdiagnosing this pathology or treating an otherwise normal vaginal flora.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):641-646
DOI 10.1590/S0100-72032001001000005
Purpose: to evaluate the prevalence of bacterial vaginosis (BV) in menopausal and in infertile outpatients and to analyze the current clinical diagnostic methods. Methods: we evaluated retrospectively 104 menopausal women and 86 with infertility. Characteristic vaginal discharge on gynecological examination, pH >4.5, positive KOH whiff test, and bacterial vaginosis by Gram test were considered positive. BV was established when at least 3 out of 4 criteria were found. Results: among the menopausal women, 29 patients (28.1%) were clinically positive for BV, 10 (9.6%) had positive whiff test, 68 (65.4%) vaginal pH >4.5, and 34 (32.7%) positive Gram test. For the infertile patients the figures were 20 (23.2%), 13 (15.1%), 61 (70.9%) and 26 (30.2%), respectively. According to our established criteria, BV was diagnosed in 14 menopausal (13.5%) and 15 infertile (17.4%) women. Conclusion: bacterial vaginosis prevalence was similar in both groups of patients. In addition, all diagnostic criteria should be followed in order to avoid underdiagnosing this pathology or treating an otherwise normal vaginal flora.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):647-652
DOI 10.1590/S0100-72032001001000006
Purpose: to study the prevalence of congenital syphilis in a universitary hospital of the south of Brazil, emphasizing its role as a prenatal care marker. Patients and Method: a descriptive study of the congenital syphilis cases which occurred at the Hospital Geral (HG-UCS) from June 1st, 2000 to May 31st, 2001, based on the diagnosis criteria proposed by the Center for Disease Control and Prevention (CDC, 1998). Results: The prevalence of congenital syphilis was 1.5 (27 cases in 1739 births). The coefficient of congenital syphilis observed was 15.5/1000 newborns. Twenty-three pregnant women (85.2%) received prenatal care; however, the maternal infection with syphilis was diagnosed before the delivery in only 16 (69.6%) cases. Only 4 pregnant women reported an appropriate prenatal treatment of syphilis. In 8 (29.6%) cases an association of maternal syphilis with other sexually transmissible diseases was observed. The coefficient of perinatal mortality was 1.15/1000 births (two perinatal deaths). Conclusions: The authors reaffirm the importance of congenital syphilis as an indicator of perinatal health, since it is a disease that may be completely prevented by prenatal care. In addition, a high prevalence of congenital syphilis allows one to question the quality of the prenatal care, which was available to the studied group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):647-652
DOI 10.1590/S0100-72032001001000006
Purpose: to study the prevalence of congenital syphilis in a universitary hospital of the south of Brazil, emphasizing its role as a prenatal care marker. Patients and Method: a descriptive study of the congenital syphilis cases which occurred at the Hospital Geral (HG-UCS) from June 1st, 2000 to May 31st, 2001, based on the diagnosis criteria proposed by the Center for Disease Control and Prevention (CDC, 1998). Results: The prevalence of congenital syphilis was 1.5 (27 cases in 1739 births). The coefficient of congenital syphilis observed was 15.5/1000 newborns. Twenty-three pregnant women (85.2%) received prenatal care; however, the maternal infection with syphilis was diagnosed before the delivery in only 16 (69.6%) cases. Only 4 pregnant women reported an appropriate prenatal treatment of syphilis. In 8 (29.6%) cases an association of maternal syphilis with other sexually transmissible diseases was observed. The coefficient of perinatal mortality was 1.15/1000 births (two perinatal deaths). Conclusions: The authors reaffirm the importance of congenital syphilis as an indicator of perinatal health, since it is a disease that may be completely prevented by prenatal care. In addition, a high prevalence of congenital syphilis allows one to question the quality of the prenatal care, which was available to the studied group.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):653-657
DOI 10.1590/S0100-72032001001000007
Purpose: to verify if there is an association between the mean blood velocity in the descending thoracic aorta and fetal anemia diagnosis. Methods: this is a prospective, cross-sectional study in which the mean blood velocities in the fetal aorta, in 66 fetuses at risk for severe anemia due to severe Rh immunization, and cord blood hemoglobin levels were analyzed comparatively. The hemoglobin level was obtained by cordocentesis if an intravascular transfusion was performed for severe anemia, however, if the fetus received an intrauterine transfusion by the intraperitoneal route or if the fetus did not receive a transfusion at all, hemoglobin level was measured at the time of pregnancy termination by umbilical cord puncture. The authors made a statistical association between the mean blood velocity in fetal descending thoracic aorta and the diagnosis of fetal anemia. The c² test was used for statistical analysis and a p value <0,05 was used to indicate significance. Results: there was a significant and indirect association between the mean blood velocity in the descending thoracic aorta and the detection of fetal anemia. The mean blood velocity in fetal thoracic aorta had a sensitivity of 47.4% for the diagnosis of moderate fetal anemia (Hg<10.0 g/dL), with a p value <0.01 by the Fisher exact test, and a sensitivity of 54.5% for severe Rh isoimmunization (Hg<7.0 g/dL), with a p value =0.01. Conclusion: this study revealed a significant indirect correlation between mean blood velocity in the descending thoracic aorta and the detection of fetal anemia due to Rh isoimmunization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):653-657
DOI 10.1590/S0100-72032001001000007
Purpose: to verify if there is an association between the mean blood velocity in the descending thoracic aorta and fetal anemia diagnosis. Methods: this is a prospective, cross-sectional study in which the mean blood velocities in the fetal aorta, in 66 fetuses at risk for severe anemia due to severe Rh immunization, and cord blood hemoglobin levels were analyzed comparatively. The hemoglobin level was obtained by cordocentesis if an intravascular transfusion was performed for severe anemia, however, if the fetus received an intrauterine transfusion by the intraperitoneal route or if the fetus did not receive a transfusion at all, hemoglobin level was measured at the time of pregnancy termination by umbilical cord puncture. The authors made a statistical association between the mean blood velocity in fetal descending thoracic aorta and the diagnosis of fetal anemia. The c² test was used for statistical analysis and a p value <0,05 was used to indicate significance. Results: there was a significant and indirect association between the mean blood velocity in the descending thoracic aorta and the detection of fetal anemia. The mean blood velocity in fetal thoracic aorta had a sensitivity of 47.4% for the diagnosis of moderate fetal anemia (Hg<10.0 g/dL), with a p value <0.01 by the Fisher exact test, and a sensitivity of 54.5% for severe Rh isoimmunization (Hg<7.0 g/dL), with a p value =0.01. Conclusion: this study revealed a significant indirect correlation between mean blood velocity in the descending thoracic aorta and the detection of fetal anemia due to Rh isoimmunization.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):659-665
DOI 10.1590/S0100-72032001001000008
Purpose: evaluation of perinatal outcome of brain-sparing effect detected by color Doppler. Methods: brain-sparing effect was detected in 32 fetuses at the Ultrasound Service of the Center for Integral Attention to Women's Health at Campinas State University (UNICAMP). The diagnosis of brain-sparing effect was made when the ratio between middle cerebral artery and umbilical artery pulsatility indexes was below one (IPACM/IPAU <1). The measurement was obtained with color Doppler equipment Toshiba SSH-140A. Results: admission to neonatal intensive care unit (ICU) was necessary in 26 fetuses (89.6%). The number of days in ICU varied from 1 to 83 days, with a mean of 22 days. Fetal mortality rate was 3 in 32 (9.4%) and perinatal mortality was 9 in 29 (31%). Considering the gestational age by the Capurro method, the incidence of birth below 36 weeks was 21 in 32 (65.6%). Intrauterine growth restriction occurred in 71.8% of the cases and hypoglycemia in 44.8%. Conclusions: brain-sparing effect is a condition in which the fetus is at serious risk of adverse perinatal outcome and Doppler studies might be helpful in the obstetric management.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):659-665
DOI 10.1590/S0100-72032001001000008
Purpose: evaluation of perinatal outcome of brain-sparing effect detected by color Doppler. Methods: brain-sparing effect was detected in 32 fetuses at the Ultrasound Service of the Center for Integral Attention to Women's Health at Campinas State University (UNICAMP). The diagnosis of brain-sparing effect was made when the ratio between middle cerebral artery and umbilical artery pulsatility indexes was below one (IPACM/IPAU <1). The measurement was obtained with color Doppler equipment Toshiba SSH-140A. Results: admission to neonatal intensive care unit (ICU) was necessary in 26 fetuses (89.6%). The number of days in ICU varied from 1 to 83 days, with a mean of 22 days. Fetal mortality rate was 3 in 32 (9.4%) and perinatal mortality was 9 in 29 (31%). Considering the gestational age by the Capurro method, the incidence of birth below 36 weeks was 21 in 32 (65.6%). Intrauterine growth restriction occurred in 71.8% of the cases and hypoglycemia in 44.8%. Conclusions: brain-sparing effect is a condition in which the fetus is at serious risk of adverse perinatal outcome and Doppler studies might be helpful in the obstetric management.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):667-673
DOI 10.1590/S0100-72032001001000009
Purpose: the repetitive use of antenatal corticosteroid therapy for acceleration of fetal lung maturation has been common in cases at risk of preterm delivery. We studied the corticosterone levels at term and the morphologic aspects in the maternal and fetal adrenal glands submitted to the effect of betamethasone in the second half of rat pregnancy in order to verify its consequences. Methods: thirty female pregnant rats were divided into three groups of ten animals each. Group I received betamethasone on the 11th, 12th, 18th and 19th day of pregnancy. Group II received distilled water on the same days (control group). Group III did not receive any drug (stress control group). All rats were sacrificed on the 20th day of pregnancy when plasma corticosterone levels of dams were assessed and the maternal and fetal adrenal glands were studied by light microscopy. Results: plasma corticosterone level of dams was lower in the group treated with betamethasone (4.8 mg/dL) when compared with the control groups (17.7 and 26.8 mg/dL). The light microscopy study revealed cytoplasmatic vacuolation in the fasciculate zone in the maternal and fetal adrenal glands, which indicates adrenal suppression. Conclusions: the antenatal repetitive and prolonged use of corticosteroids in pregnant rats for acceleration of lung fetal maturation causes maternal and fetal adrenal suppression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2001;23(10):667-673
DOI 10.1590/S0100-72032001001000009
Purpose: the repetitive use of antenatal corticosteroid therapy for acceleration of fetal lung maturation has been common in cases at risk of preterm delivery. We studied the corticosterone levels at term and the morphologic aspects in the maternal and fetal adrenal glands submitted to the effect of betamethasone in the second half of rat pregnancy in order to verify its consequences. Methods: thirty female pregnant rats were divided into three groups of ten animals each. Group I received betamethasone on the 11th, 12th, 18th and 19th day of pregnancy. Group II received distilled water on the same days (control group). Group III did not receive any drug (stress control group). All rats were sacrificed on the 20th day of pregnancy when plasma corticosterone levels of dams were assessed and the maternal and fetal adrenal glands were studied by light microscopy. Results: plasma corticosterone level of dams was lower in the group treated with betamethasone (4.8 mg/dL) when compared with the control groups (17.7 and 26.8 mg/dL). The light microscopy study revealed cytoplasmatic vacuolation in the fasciculate zone in the maternal and fetal adrenal glands, which indicates adrenal suppression. Conclusions: the antenatal repetitive and prolonged use of corticosteroids in pregnant rats for acceleration of lung fetal maturation causes maternal and fetal adrenal suppression.
