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13 articles
  • Editorial

    Impact of COVID-19 Pandemic on Gynecologic Oncology Surgery in Brasil

    Rev Bras Ginecol Obstet. 2021;43(11):803-804

    Summary

    Editorial

    Impact of COVID-19 Pandemic on Gynecologic Oncology Surgery in Brasil

    Rev Bras Ginecol Obstet. 2021;43(11):803-804

    DOI 10.1055/s-0041-1740274

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    The COVID-19 pandemic has influenced every aspect of human life for the past 20 months. To date, we have registered more than 21,500,000 cases of the disease and more than 610,000 deaths in Brazil. There were two waves of the disease, one peak in June 2020 and another in March 2021. The entire Brazilian health […]
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  • Original Article

    Association Between PON1 (L55M and Q192R) Genetic Polymorphism and Recurrent Pregnancy Loss in North Indian Women Exposed to Pesticides

    Rev Bras Ginecol Obstet. 2021;43(11):805-810

    Summary

    Original Article

    Association Between PON1 (L55M and Q192R) Genetic Polymorphism and Recurrent Pregnancy Loss in North Indian Women Exposed to Pesticides

    Rev Bras Ginecol Obstet. 2021;43(11):805-810

    DOI 10.1055/s-0041-1736342

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    Abstract

    Objective

    The aim of the present study was to examine the relation between the PON1 polymorphisms and recurrent pregnancy loss (RPL).

    Methods

    In a cross-sectional study, blood samples were collected from 100 females. DNA was extracted and PON1 genotypes were determined by polymerase chain reaction (PCR) amplification.

    Results

    Regarding PON1 L55M, the mutated allele (M) frequency was found in 70.5% in RPL and in 53.5% in controls; theMallele was significantly associated with an increased risk of RPL (adjusted odds ratio [ORadj]=2.07; 95% confidence interval [CI]; p<0.001). However, regarding PON1 Q192R, the R mutated allele frequency was found in 28.5% in RPL and in 33% in controls. The R allele did not show any risk for RPL (ORadj 0.81; 95%CI; p=0.329).

    Conclusion

    The present study suggests that there is an effect of genetic polymorphism on RPL and provides additional evidence that combines with the growing information about the ways in which certain PON1 genotypes can affect the development of the fetus in the uterus.

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  • Original Article

    Perinatal Outcomes and Factors Associated with Ethnic Group in cases of Preterm Birth: the Multicenter Study on Preterm Birth in Brazil

    Rev Bras Ginecol Obstet. 2021;43(11):811-819

    Summary

    Original Article

    Perinatal Outcomes and Factors Associated with Ethnic Group in cases of Preterm Birth: the Multicenter Study on Preterm Birth in Brazil

    Rev Bras Ginecol Obstet. 2021;43(11):811-819

    DOI 10.1055/s-0041-1739492

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    Abstract

    Objective

    To investigate the characteristics of women who had preterm birth (PTB) and related outcomes according to ethnicity.

    Methods

    A secondary analysis of a multicenter cross-sectional study conducted in Brazil. Women who had PTB were classified by self-report as white and non-white. Clinical, pregnancy, and maternal data were collected through postpartum interviews and reviews of medical charts. The sociodemographic, obstetric and clinical characteristics of the women, as well as the mode of delivery and the neonatal outcomes among different ethnic groups were compared through a bivariate analysis.

    Results

    Of the 4,150 women who had PTB, 2,317 (55.8%) were non-white, who were more likely: to be younger than 19 years of age (prevalence ratio [PR]: 1.05; 95% confidence interval [95%CI]: 1.01-1.09); to be without a partner; to live on low income; to have lower levels of schooling; to have ≥ 2 children; to perform strenuous work; to be fromthe Northeastern region of Brazil rather than the from Southern region; to have a history of ≥ 3 deliveries; to have an interpregnancy interval<12 months; to have pregnancy complications such as abortion, PTB, preterm premature rupture of membranes (pPROM), and low birth weight; to initiate antenatal care (ANC) visits in the second or third trimesters; to have have an inadequate number of ANC visits; to be under continuous overexertion; to smoke in the first and second or third trimesters; and to have anemia and gestational hypertension. The maternal and neonatal outcomes did not differ between the groups, except for the higher rate of low birth weight (73.7% versus 69.0%) in infants born to non-white women, and the higher rate of seizures (4.05% versus 6.29%) in infants born to white women.

    Conclusion

    Unfavorable conditions weremore common in non-whites than inwhites. Proper policies are required to decrease inequalities, especially in the context of prematurity, when women and their neonates have specific needs.

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  • Original Article

    Risk Factors Associated with Uterine Rupture and Dehiscence: A Cross-Sectional Canadian Study

    Rev Bras Ginecol Obstet. 2021;43(11):820-825

    Summary

    Original Article

    Risk Factors Associated with Uterine Rupture and Dehiscence: A Cross-Sectional Canadian Study

    Rev Bras Ginecol Obstet. 2021;43(11):820-825

    DOI 10.1055/s-0041-1739461

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    Abstract

    Objective

    To compare maternal and perinatal risk factors associated with complete uterine rupture and uterine dehiscence.

    Methods

    Cross-sectional study of patients with uterine rupture/dehiscence from January 1998 to December 2017 (30 years) admitted at the Labor and Delivery Unit of a tertiary teaching hospital in Canada.

    Results

    There were 174 (0.1%) cases of uterine disruption (29 ruptures and 145 cases of dehiscence) out of 169,356 deliveries. There were associations between dehiscence and multiparity (odds ratio [OR]: 3.2; p=0.02), elevated maternal body mass index (BMI; OR: 3.4; p=0.02), attempt of vaginal birth after a cesarian section (OR: 2.9; p=0.05) and 5-minute low Apgar score (OR: 5.9; p<0.001). Uterine rupture was associated with preterm deliveries (36.5 ± 4.9 versus 38.2 ± 2.9; p=0.006), postpartum hemorrhage (OR: 13.9; p<0.001), hysterectomy (OR: 23.0; p=0.002), and stillbirth (OR: 8.2; p<0.001). There were no associations between uterine rupture and maternal age, gestational age, onset of labor, spontaneous or artificial rupture of membranes, use of oxytocin, type of uterine incision, and birthweight.

    Conclusion

    This large cohort demonstrated that there are different risk factors associated with either uterine rupture or dehiscence. Uterine rupture still represents a great threat to fetal-maternal health and, differently from the common belief, uterine dehiscence can also compromise perinatal outcomes.

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  • Original Article

    Effectiveness of Counseling for Infertile Couples on Women’s Emotional Disturbance: A Randomized Clinical Trial

    Rev Bras Ginecol Obstet. 2021;43(11):826-833

    Summary

    Original Article

    Effectiveness of Counseling for Infertile Couples on Women’s Emotional Disturbance: A Randomized Clinical Trial

    Rev Bras Ginecol Obstet. 2021;43(11):826-833

    DOI 10.1055/s-0041-1736305

    Views1

    Abstract

    Objective

    The psychosocial burden of infertility among couples can be one of the most important reasons for women’s emotional disturbance. The goal of the present study was to investigate the effect of counseling on different emotional aspects of infertile women.

    Methods

    The present randomized clinical trial was performed on 60 couples with primary infertility who were referred for treatment for the first time and did not receive psychiatric or psychological treatment. Samples were allocated to an intervention group (30 couples) and a control group (30 couples) by simple randomization. The intervention group received infertility counseling for 6 45-minute sessions twice a week, and the control group received routine care. The Screening on Distress in Fertility Treatment (SCREENIVF) questionnaire was completed before and after the intervention. Samples were collected from November to December 2016 for 3 months. For the data analysis, we used the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Armonk, NY, United States) software, version 19.0, and the paired t-test, the independent t-test, the Mann-Whitney test, the Wilcoxon test, and the Chi-squared test.

    Results

    The mean age of the participants was 33.39±5.67 years. All studied couples had primary infertility and no children. The mean duration of the couples’ infertilitywas 3 years. There was a significant difference regarding depression (1.55±1.92; p<0.0001), social support (15.73±3.41; p<0.0001), and cognitions regarding domains of fertility problems (26.48±3.05; p=0.001) between the 2 groups after the intervention, but there was no significant difference regarding anxiety (25.03±3.09; p=0.35).

    Conclusion

    The findings showed that infertility counseling did not affect the total score of infertile women’ emotional status, but improved the domains of it except, anxiety.

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    Effectiveness of Counseling for Infertile Couples on Women’s Emotional Disturbance: A Randomized Clinical Trial
  • Original Article

    Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study

    Rev Bras Ginecol Obstet. 2021;43(11):834-839

    Summary

    Original Article

    Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study

    Rev Bras Ginecol Obstet. 2021;43(11):834-839

    DOI 10.1055/s-0041-1739464

    Views0

    Abstract

    Objective

    It has been suggested that excess body weight could represent a risk factor for infertility outcomes. The present study aimed to evaluate the association of overweight and anovulation among infertile women with regular menstrual cycles.

    Methods

    We conducted a retrospective case-control study with consistently anovulatory patients undergoing assisted reproduction treatment. The patients were stratified into normal weight (body mass index [BMI]: 18.5-24.9kg/m2) and overweight (BMI: 25.0- 29.9kg/m2).Those with polycystic ovary syndrome or obesity were excluded. The groups were matched for age, duration of infertility, prolactin, follicle stimulating hormone (FSH), thydroid stimulating hormone (TSH), luteinizing hormone (LH), and estradiol levels.

    Results

    Overweight was significantly associated with anovulation, when using the World Health Organization (WHO) criteria for anovulation: progesterone levels>5.65 ng/ml and ultrasonography evidence of follicle collapse (odds ratio [OR]: 2.69; 95% confidence interval [CI95%]: 1.04-6.98).

    Conclusion

    Body mass index above the normal range jeopardizes ovulation among non-obese infertile women with regular menstrual cycles.

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    Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study
  • Original Article

    Teleoncology Orientation of Low-Income Breast Cancer Patients during the COVID-19 Pandemic: Feasibility and Patient Satisfaction

    Rev Bras Ginecol Obstet. 2021;43(11):840-846

    Summary

    Original Article

    Teleoncology Orientation of Low-Income Breast Cancer Patients during the COVID-19 Pandemic: Feasibility and Patient Satisfaction

    Rev Bras Ginecol Obstet. 2021;43(11):840-846

    DOI 10.1055/s-0041-1739425

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    Abstract

    Objective

    The present study aims to assess the feasibility and patient satisfaction of teleoncology orientation in a vulnerable population of breast cancer patients assessed in a government health system during the coronavirus pandemic in 2020.

    Methods

    Eligible patients received an invitation to receive remote care to minimize exposure to an environment in which the risk of respiratory infection was present. The means of communication was telephone through an application that allows free conversation with no charge. An anonymous-response questionnaire based on a Likert-type scale was sent through a cell phone application or e-mail directly to each patient or close relative of the patient immediately after teleconsultation. Responses to the questions, which addressed utility, facility, interface quality, interaction quality, reliability, satisfaction, and interest in future evaluation, were compiled and analyzed.

    Results

    A total of 176 eligible patients scheduled for consultation were evaluated and 98 were included. Seventy (71.4%) successfully undertook the teleorientation. The questionnaire was submitted by 43 (61.4%) patients. The overall teleoncology orientation was classified as very positive by 41 (95.3%) patients. Specifically, regarding the questionnaire items, 43 (100%) patients scored 4 or 5 (agreed that the teleconsultation was beneficial) concerning the facility, followed by 42 (97.2%) for the interface quality, 41 (95.3%) for both utility and interaction quality, 40 (93%) for satisfaction and interest in future evaluation, and, finally, 39 (90.6%) for reliability.

    Conclusion

    Teleoncology orientation of low-income breast cancer patients is most feasible and leads to high patient satisfaction.

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    Teleoncology Orientation of Low-Income Breast Cancer Patients during the COVID-19 Pandemic: Feasibility and Patient Satisfaction
  • Original Article

    Prevalence of Urinary Incontinence in CrossFit Practitioners before and during the COVID-19 Quarantine and its Relationship with Training Level: An Observational Study

    Rev Bras Ginecol Obstet. 2021;43(11):847-852

    Summary

    Original Article

    Prevalence of Urinary Incontinence in CrossFit Practitioners before and during the COVID-19 Quarantine and its Relationship with Training Level: An Observational Study

    Rev Bras Ginecol Obstet. 2021;43(11):847-852

    DOI 10.1055/s-0041-1739463

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    Abstract

    Objective

    To compare the prevalence of urinary incontinence (UI) before and during the COVID-19 quarantine in CrossFit women and their relationship with training level.

    Methods

    A cross-sectional study was performed among 197 women practicing CrossFit. The inclusion criteria were nulliparous women, between 18 and 45 years old, who had trained, before quarantine, in accredited gyms. The exclusion criteria were not following the COVID-19 prevention protocols and having UI on other occasions than just sport. An online questionnaire was emailed containing questions about frequency, duration, and intensity of training and data related to the COVID-19 pandemic. The participants were invited to answer whether they were infected with COVID-19 and what treatment/recommendation they have followed. Whether UI stopped among participants, they were asked about the possible reasons why this happened. The training intensity was categorized as “the same,” “decreased” or “increased.”

    Results

    The mean age of the participants was 32 years old and most (98.5%) could practice CrossFit during the pandemic. There was a decrease in training intensity in 64% of the respondents. Exercises with their own body weight, such as air squat (98.2%), were the most performed. Urinary incontinence was reported by 32% of the participants before the COVID-19 pandemic, and by only 14% of them during the pandemic (odds ratio [OR]=0.32 [0.19-0.53]; p<0.01; univariate analysis). Practitioners reported that the reason possibly related to UI improvement was the reduction of training intensity and not performing doubleunder exercise.

    Conclusion

    The reduction in the intensity of CrossFit training during the COVID-19 quarantine decreased the prevalence of UI among female athletes.

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    Prevalence of Urinary Incontinence in CrossFit Practitioners before and during the COVID-19 Quarantine and its Relationship with Training Level: An Observational Study

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