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9 articles
  • Editorial

    Differences in the Diagnosis and Treatment of Rectocele: Time for Standardization

    Rev Bras Ginecol Obstet. 2016;38(11):529-530

    Summary

    Editorial

    Differences in the Diagnosis and Treatment of Rectocele: Time for Standardization

    Rev Bras Ginecol Obstet. 2016;38(11):529-530

    DOI 10.1055/s-0036-1592154

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    Female Pelvic and Reconstructive Surgery (FPRS) is a multidisciplinary subspecialty that combines the efforts of different professionals to benefit women with pelvic floor disorders. Gynecologists, urologists and colorectal surgeons are working simultaneously and trying to offer the best treatment to their patients. However, each medical specialty presents different backgrounds, and this leads to different points […]
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  • Original Article

    Analysis of the Construct Validity and Internal Consistency of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) Scale for Pregnant Women during Labor

    Rev Bras Ginecol Obstet. 2016;38(11):531-537

    Summary

    Original Article

    Analysis of the Construct Validity and Internal Consistency of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) Scale for Pregnant Women during Labor

    Rev Bras Ginecol Obstet. 2016;38(11):531-537

    DOI 10.1055/s-0036-1593894

    Views2

    Abstract

    Purpose

    To analyze the internal consistency and the construct validity of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) scale for pregnant women during labor.

    Method

    A study of measurement property including 150 pregnant women aged between 15 and 45 years old, during the first period of labor and with term pregnancies. The questionnaire used was the STAI S-Anxiety scale. In order to assess the internal consistency, Cronbach’s α was calculated through an exploratory factor analysis. The correlation between the factors was calculated using the Pearson coefficient. The state of significance used for this analysis was 0.05.

    Results

    The STAI S-Anxiety scale used in the context of labor showed two factors represented as the absence (factor 1) and the presence of anxiety (factor 2); item 4 (“I regret it”) did not show a representative value. Both factors showed high indications of Cronbach’s α, varying from 0.830 for factor 1, and 0.723 for factor 2. In the results of the Pearson coefficient between the two factors, a significant but weak correlation was observed (r = -0.188; p = 0.021).

    Conclusion

    The STAI S-Anxiety scale used in pregnant women during labor presented appropriate values of internal consistency; however, item 3 did not show a significant factorial value. Therefore, this questionnaire must be applied cautiously and carefully without the use of the item 4 in the clinical practice and in researches about labor.

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    Analysis of the Construct Validity and Internal Consistency of the State-Trait Anxiety Inventory (STAI) State-Anxiety (S-Anxiety) Scale for Pregnant Women during Labor
  • Original Article

    Evaluation of Pregnant and Postpartum Women’s Knowledge about Toxoplasmosis in Rio Grande – RS, Brazil

    Rev Bras Ginecol Obstet. 2016;38(11):538-544

    Summary

    Original Article

    Evaluation of Pregnant and Postpartum Women’s Knowledge about Toxoplasmosis in Rio Grande – RS, Brazil

    Rev Bras Ginecol Obstet. 2016;38(11):538-544

    DOI 10.1055/s-0036-1593970

    Views4

    Abstract

    Introduction

    Toxoplasmosis a parasitic zoonosis of global distribution, responsible for disorders during gestation can cause fetal death or congenital anomalies.

    Objective

    To evaluate the knowledge of toxoplasmosis among pregnant and postpartum women treated at the University Hospital of the city of Rio Grande, Rio Grande do Sul, Brazil.

    Methods

    This was a cross-sectional study of 100 pregnant and postpartum women at the University Hospital. Participants answered a self-administered questionnaire and gave consent for data relating to serological examinations to be abstracted from their medical records.

    Results

    The proportion of women who received information about toxoplasmosis was higher among those who received care in the private health care system (52.9%) than among those cared for in the public health care system (25.0%). Only 55.7% of women reported having some knowledge about toxoplasmosis. Of these, 53.7% received information during the prenatal period. However, most participants were unable to answer questions about preventive measures and modes of infection. Of the 100 patients in the study, only 46 underwent serologic testing for toxoplasmosis, 65.2% of whom tested negative (IgG).

    Conclusion

    Findings from this study are relevant to the training of health professionals regarding toxoplasmosis education and prevention. Improved education for health care providers and patients can lead to earlier diagnoses and reductions in adverse outcomes.

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  • Original Article

    Adolescent Contraception Before and After Pregnancy-Choices and Challenges for the Future

    Rev Bras Ginecol Obstet. 2016;38(11):545-551

    Summary

    Original Article

    Adolescent Contraception Before and After Pregnancy-Choices and Challenges for the Future

    Rev Bras Ginecol Obstet. 2016;38(11):545-551

    DOI 10.1055/s-0036-1593971

    Views1

    Abstract

    Objective

    To determine methods of contraception used by adolescents before and after pregnancy.

    Methods

    A cross-sectional study was performed, and data were collected from medical records of all teens in puerperal consultation at the Hospital da Mulher - José Aristodemo Pinotti (Caism), Universidade Estadual de Campinas (CAISM), São Paulo, Brazil, between July 2011 and September 2013. The inclusion criterionwas being 10 to 19 years old, and the exclusion criterion was having a first consultation 90 days after childbirth. Statistical analyseswere performed with averages, standard deviations, percentages, correlations and Fisher's exact tests using the SAS program, version 9.4.

    Results

    A total of 196 adolescents in postpartum consultation were included (44 days after childbirth on average). The majority was older than 14 years (89%), with an average age of 16.2 years, and the most were exclusively breast-feeding (70%). Before pregnancy, the use of any contraceptive methods was mentioned by 74% adolescents; the most frequent use was combined oral contraceptive followed by condom. The main reason for abandoning the use of contraception was the occurrence of an unintended pregnancy (41%), followed by reports of side effects (22%), behavior issues (18%) and desire for pregnancy (16%). A positive correlation was found between the age of the adolescent at the moment of childbirth, the age of menarche (r = 0.3), and the first sexual intercourse (r = 0.419). Vaginal delivery occurred in 76% of the cases. After birth, depot medroxyprogesterone acetate (DMPA) was the contraception method most frequently used (71%), followed by oral contraceptives (11.8%) and intrauterine devices (IUDs, 11.2%).

    Conclusions

    The most prescribed contraceptive method before pregnancy in adolescents who had childbirth was combined oral contraceptives. Many of the study participants had an unintended pregnancy. After childbirth, the most used contraceptive method was DMPA. To improve contraception and reduce the chance of unintended pregnancies among adolescents, we should promote the use of long-acting reversible contraceptives (LARCS).

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  • Original Article

    Subclinical Hypothyroidism and Intracytoplasmic Sperm Injection Outcomes

    Rev Bras Ginecol Obstet. 2016;38(11):552-558

    Summary

    Original Article

    Subclinical Hypothyroidism and Intracytoplasmic Sperm Injection Outcomes

    Rev Bras Ginecol Obstet. 2016;38(11):552-558

    DOI 10.1055/s-0036-1593986

    Views2

    Abstract

    Purpose

    Whether preconception elevated concentrations of thyroid-stimulating hormone (TSH) compromises reproductive outcomes in patients undergoing assisted reproduction techniques (ARTs) remains unclear. This study therefore compared the reproductive outcomes in patients with TSH concentrations of < 2.5 mIU/L, 2.5-4.0 mIU/L, and 4.0-10.0mIU/L undergoing controlled ovarian stimulation (COS) for in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

    Methods

    This retrospective cohort study evaluated the medical records of all women with measured TSH concentrations who underwent IVF/ICSI between January 2011 and December 2012. The patients were divided into three groups: TSH < 2.5mIU/L (group 1); THS ≥2.5 and < 4.0 mIU/L (group 2); and THS ≥4 mIU/L and < 10.0 mIU/L (group 3). Patients who were administered levothyroxine for treating hypothyroidism were excluded from the analysis. The primary endpoints were clinical pregnancy,miscarriage, live birth and multiple pregnancy rates.

    Results

    During the study period, 787 women underwent IVF/ICSI. Sixty were excluded because their TSH concentrations were unavailable, and 77 were excluded due to their use of levothyroxine. The prevalence of patients presenting elevated concentrations of TSHwas of 5.07% (using a TSH threshold of 4.0 mIU/L) and of 29.99% (using a TSH threshold of 2.5 mIU/L). Patient characteristics, type of COS, and response to COS did not differ among the three groups, and there were no differences in clinical pregnancy (24.4% versus 25.9% versus 24.2%, p = 0.93); miscarriage (17.1% versus 14.3% versus 12.5%, p = 0.93); live birth (20.2% versus 22.2% versus 21.2%, p = 0.86); and multiple pregnancy rates (27.0% versus 21.4% versus 25.0%, p = 0.90) respectively.

    Conclusion

    Response to COS, live birth, and miscarriage rates were not altered in women with elevated concentrations of TSH undergoing IVF/ICSI, regardless of using a TSH threshold of 2.5mIU/L or 4.0mIU/L. These findings reinforce the uncertainties related to the impact of subclinical hypothyroidism on reproductive outcomes in women undergoing COS for ARTs.

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  • Original Article

    Prevalence of Sexual Dysfunction among Expectant Women

    Rev Bras Ginecol Obstet. 2016;38(11):559-563

    Summary

    Original Article

    Prevalence of Sexual Dysfunction among Expectant Women

    Rev Bras Ginecol Obstet. 2016;38(11):559-563

    DOI 10.1055/s-0036-1594306

    Views6

    Abstract

    Purpose

    To identify pregnancy as a causative factor of sexual dysfunction among expectant women.

    Methods

    A prospective study with 225 expectant mothers seen in the prenatal clinic of a federal university. Sexual function was evaluated by means of the Female Sexual Function Index (FSFI), and all domains were analyzed (desire, arousal, lubrication, orgasm, satisfaction, and pain). Initially, a univariate analysis of the sample was done. The averages for each domain according to the risk of sexual dysfunction (FSFI ≤ 26.5) were compared using the Student’s t-test for independent samples. The strength of the correlation between sexual dysfunction and all sociodemographic, clinical and behavioral variables was measured by the Chi-Square (X2) test. Then, odds ratios (ORs) and their confidence intervals were assigned to perform a bivariate analysis. Any p values less than 0.05 were considered significant.

    Results

    Approximately two-thirds of the women (66.7%) showed signs of risk of sexual dysfunction (FSFI ≤ 26.5). Within these cases, all sexual dysfunction domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) were found to be statistically significant (p < 0.001). The domains most affected were desire (2.67), satisfaction (2.71) and arousal (2.78).

    Conclusions

    Pregnancy appears to be an important causative factor of sexual dysfunction among pregnant women.

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  • Review Article

    The Effectiveness of Anticholinergic Therapy for Overactive Bladders: Systematic Review and Meta-Analysis

    Rev Bras Ginecol Obstet. 2016;38(11):564-575

    Summary

    Review Article

    The Effectiveness of Anticholinergic Therapy for Overactive Bladders: Systematic Review and Meta-Analysis

    Rev Bras Ginecol Obstet. 2016;38(11):564-575

    DOI 10.1055/s-0036-1594289

    Views3

    Abstract

    The overactive bladder (OAB) has a significant negative impact on the quality of life of patients. Antimuscarinics have become the pharmacological treatment of choice for this condition. The objective of this systematic review and meta-analysis is to examine the evidence from randomized clinical trials about the outcomes of the antimuscarinic drugs available in Brazil on OABs. We searched MEDLINE and the Cochrane Central Register of Controlled Trials from the inception of these databases through to September 2015. The primary outcome measures were the mean decrease in urge urinary incontinence episodes and the mean decrease in the frequency of micturition. The results suggest that there is a moderate to high amount of evidence supporting the benefit of using anticholinergic drugs in alleviating OAB symptoms when compared with placebo. It is still not clear whether any of the specific drugs that are available in Brazil offer advantages over the others. These drugs are associated with adverse effects (dry mouth and constipation), although they are not related to an increase in the number of withdrawals.

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    The Effectiveness of Anticholinergic Therapy for Overactive Bladders: Systematic Review and Meta-Analysis
  • Case Report

    Mirror Syndrome after Fetoscopic Laser Treatment – A Case Report

    Rev Bras Ginecol Obstet. 2016;38(11):576-579

    Summary

    Case Report

    Mirror Syndrome after Fetoscopic Laser Treatment – A Case Report

    Rev Bras Ginecol Obstet. 2016;38(11):576-579

    DOI 10.1055/s-0036-1593895

    Views1

    Abstract

    Mirror syndrome is a rare disease with unknown pathophysiology that can be present in different diseases that can cause fetal hydrops. The prognosis is usually bad with a high perinatal mortality. We report an unusual form of mirror syndrome that manifested itself only after a successful treatment for fetal hydrops (caused by twin-twin transfusion syndrome, in Quinteros stage IV) was performed. This syndrome was controlled by medical treatment, and despite the usually bad prognosis seen in these cases, we could extend the pregnancy from the 23rd to the 34th week of gestation, resulting in the birth of 2 live infants.

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    Mirror Syndrome after Fetoscopic Laser Treatment – A Case Report

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