Você pesquisou por y?yr=2022 - Revista Brasileira de Ginecologia e Obstetrícia

13 articles
  • Editorial

    The Use of Three-dimensional Printer Molds for Treatment of Vaginal Agenesis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1081-1082

    Summary

    Editorial

    The Use of Three-dimensional Printer Molds for Treatment of Vaginal Agenesis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1081-1082

    DOI 10.1055/s-0042-1760208

    Views5
    Although rare, vaginal agenesis is a relevant condition for gynecologists, who must be familiar with its current treatment. It results from agenesis of the Mullerian ducts, known as Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKHS), and the incidence is 1:5000 women. In this congenital malformation, genetic alterations affect the development of Mullerian ducts during the embryonic period and there […]
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  • Original Article

    Randomized Clinical Trial Comparing Quadratus Lumborum Block and Intrathecal Morphine for Postcesarean Analgesia

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1083-1089

    Summary

    Original Article

    Randomized Clinical Trial Comparing Quadratus Lumborum Block and Intrathecal Morphine for Postcesarean Analgesia

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1083-1089

    DOI 10.1055/s-0042-1759728

    Views6

    Abstract

    Objective

    To compare the efficacy of quadratus lumborum (QL) block and intrathecal morphine (M) for postcesarean delivery analgesia.

    Methods

    Thirty-one pregnant women with ≥ 37 weeks of gestation submitted to elective cesarean section were included in the study. They were randomly allocated to either the QL group (12.5 mg 0.5% bupivacaine for spinal anesthesia and 0.3 ml/kg 0.2% bupivacaine for QL block) or the M group (12.5 mg bupivacaine 0.5% and 100 mcg of morphine in spinal anesthesia). The visual analog scale of pain, consumption of morphine and tramadol for pain relief in 48 hours, and side effects were recorded.

    Results

    Median pain score and/or pain variation were higher in the morphine group than in the QL group (p = 0.02). There was no significant difference in the consumption of morphine or tramadol between groups over time. Side effects such as pruritus, nausea, and vomiting were observed only in the morphine group.

    Conclusion

    Quadratus lumborum block and intrathecal morphine are effective for analgesia after cesarean section. Patients undergoing QL block had lower postoperative pain scores without the undesirable side effects of opioids such as nausea, vomiting, and pruritus.

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    Randomized Clinical Trial Comparing Quadratus Lumborum Block and Intrathecal Morphine for Postcesarean Analgesia
  • Original Article

    Relationship between the Prenatal Diagnosis of Placenta Acreta Spectrum and Lower Use of Blood Components

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1090-1093

    Summary

    Original Article

    Relationship between the Prenatal Diagnosis of Placenta Acreta Spectrum and Lower Use of Blood Components

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1090-1093

    DOI 10.1055/s-0042-1758712

    Views15

    Abstract

    Objective

    To describe the clinical results of patients admitted and managed as cases of placenta accreta spectrum (PAS) at a Central American public hospital and the influence of the prenatal diagnosis on the condition.

    Materials and Methods

    A retrospective analysis of PAS patients treated at Hospital Bertha Calderón Roque, in Managua, Nicaragua, between June 2017 and September 2021. The diagnostic criteria used were those of the International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d'Obstétrique, FIGO, in French). The population was divided into patients with a prenatal ultrasonographic diagnosis of PAS (group 1) and those whose the diagnosis of PAS was established at the time of the caesarean section (group 2).

    Results

    During the search, we found 103 cases with a histological and/or clinical diagnosis of PAS; groups 1 and 2 were composed of 51 and 52 patients respectively. Regarding the clinical results of both groups, the patients in group 1 presented a lower frequency of transfusions (56.9% versus 96.1% in group 2), use of a lower number of red blood cell units (RBCUs) among those undergoing transfusions (median: 1; interquartile range: [IQR]: 0–4 versus median: 3; [IQR]: 2–4] in group 2), and lower frequency of 4 or more RBCU transfusions (29.4% versus 46.1% in group 2). Group 1 also exhibited a non-significant trend toward a lower volume of blood loss (1,000 mL [IQR]: 750–2,000 mL versus 1,500 mL [IQR]: 1,200–1,800 mL in group 2), and lower requirement of pelvic packing (1.9% versus 7.7% in group 2).

    Conclusion

    Establishing a prenatal diagnosis of PAS is related to a lower frequency of transfusions. We observed a high frequency of prenatal diagnostic failures of PAS. It is a priority to improve prenatal detection of this disease.

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  • Original Article

    Perinatal Outcomes in Women with Chronic Kidney Diseases

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1094-1101

    Summary

    Original Article

    Perinatal Outcomes in Women with Chronic Kidney Diseases

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1094-1101

    DOI 10.1055/s-0042-1753546

    Views10

    Abstract

    Objective

    To assess maternal and neonatal outcomes in women with chronic kidney disease (CKD) at a referral center for high-risk pregnancy.

    Methods

    A retrospective cohort of pregnant women with CKD was followed at the Women's Hospital of Universidade Estadual de Campinas, Brazil, between 2012 and 2020. Variables related to disease etiology, treatment duration, sociodemographic variables, lifestyle, other associated diseases, obstetric history, and perinatal outcomes were assessed. The causes of CKD were grouped into 10 subgroups. Subsequently, we divided the sample according to gestational age at childbirth, as preterm and term births, comparing maternal and neonatal outcomes, and baseline characteristics as well as outcomes among such groups.

    Results

    A total of 84 pregnancies were included, in 67 women with CKD. Among them, six pregnancies evolved to fetal death, five to miscarriage, and one was a twin pregnancy. We further analyzed 72 single pregnancies with live births; the mean gestational age at birth was 35 weeks and 3 days, with a mean birth weight of 2,444 g. Around half of the sample (51.39%) presented previous hypertension, and 27.7% developed preeclampsia. Among the preterm births, we observed a higher frequency of hypertensive syndromes, longer maternal intensive care unit (ICU) stay in the postpartum period, higher incidence of admission to the neonatal ICU, higher neonatal death, lower 5-minute Apgar score, and lower birth weight.

    Conclusion

    This study demonstrates increased adverse outcomes among pregnancies complicated by CKD and expands the knowledge on obstetric care among such women in an attempt to reduce maternal risks and identify factors related to prematurity in this population.

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    Perinatal Outcomes in Women with Chronic Kidney Diseases
  • Original Article

    Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1102-1109

    Summary

    Original Article

    Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1102-1109

    DOI 10.1055/s-0042-1755462

    Views12

    Abstract

    Objective

    To evaluate the use of misoprostol prior to hysteroscopy procedures regarding technical ease, the presence of side effects, and the occurrence of complications.

    Methods

    This is a retrospective, observational, analytical, case-control study, with the review of medical records of 266 patients followed-up at the Gynecological Videoendoscopy Sector of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the Universidade de São Paulo (HCFMRP – USP, in the Portuguese acronym) from 2014 to 2019, comparing 133 patients who used the drug before the procedure with 133 patients who did not.

    Results

    The occurrence of postmenopausal uterine bleeding was the main indication for hysteroscopy and revealed a statistical difference between groups (p < 0.001), being present in 93.23% of the patients in the study group and in 69.7% of the patients in the control group. Only 2 patients (1.5%) in the study group reported adverse effects. Although no statistical differences were observed regarding the occurrence of complications during the procedure (p = 0.0662), a higher total number of complications was noted in the group that used misoprostol (n = 7; 5.26%) compared with the group that did not use the drug (n = 1; 0.75%), a fact that is clinically relevant. When evaluating the ease of the technique (measured by the complete performance of all steps of the hysteroscopy procedure), it was verified that although there was no difference between groups (p = 0.0586), the control group had more than twice as many incompletely performed procedures (n = 17) when compared with the group that used misoprostol previously (n = 8), which is also clinically relevant.

    Conclusion

    The use of misoprostol prior to hysteroscopy in our service indicated that the drug can facilitate the performance of the procedure, but not without side effects and presenting higher complication rates.

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  • Original Article

    Three-dimensional Printer Molds for Vaginal Agenesis: An Individualized Approach as Conservative Treatment

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1110-1116

    Summary

    Original Article

    Three-dimensional Printer Molds for Vaginal Agenesis: An Individualized Approach as Conservative Treatment

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1110-1116

    DOI 10.1055/s-0042-1756214

    Views9

    Abstract

    Objective

    The aim of this study was to evaluate the use of vaginal molds, made with three-dimensional (3D) printing, for conservative treatment through vaginal dilation in patients with vaginal agenesis (VA).

    Methods

    A total of 16 patients with a diagnosis of VA (Mayer-Rokitansky-Küster-Hauser syndrome, total androgen insensitivity syndrome, and cervicovaginal agenesis) from the Federal University of São Paulo were selected. Device production was performed in a 3D printer, and the polymeric filament of the lactic polyacid (PLA) was used as raw material. A personalized treatment was proposed and developed for each patient.

    Results

    There were 14 patients who reached a final vaginal length of 6 cm or more. The initial total vaginal length (TVL) mean (SD) was 1.81(1.05) and the final TVL mean (SD) was 6.37 (0.94); the difference, analyzed as 95% confidence interval (95% CI) was 4.56 (5.27–3.84) and the effect size (95% CI) was 4.58 (2.88–6.28).

    Conclusion

    The 3D printing molds for vaginal dilation were successful in 87.5% of the patients. They did not present any major adverse effects and offered an economical, accessible, and reproducible strategy for the treatment of VA.

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    Three-dimensional Printer Molds for Vaginal Agenesis: An Individualized Approach as Conservative Treatment
  • Original Article

    Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1117-1121

    Summary

    Original Article

    Association of Obesity and Surgery Outcomes in Patients with Endometrial Cancer: A Single-Center Analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1117-1121

    DOI 10.1055/s-0042-1759632

    Views5

    Abstract

    Objective

    Although obesity can result in high morbidity and mortality in surgical outcomes because of multiple comorbidities, determinants of outcome in obese patients who underwent endometrial cancer surgery remain unclear. The aim of this study is to assess the relationship between body mass index (BMI) and surgical outcomes in obese patients with endometrial cancer.

    Methods

    An institutional retrospective review of the demographic details, clinical characteristics, and follow-up data of 142 patients with endometrial cancer who underwent surgery during a 72-month period was performed. The patients were divided into three groups based on their BMI; patients with BMI < 25 were identified as normal weight, patients with BMI between 25 and 30 were accepted as overweight, and those with BMI ≥ 30 kg/m2 were identified as obese. The groups' demographic and clinical variables were compared.

    Results

    Of the 142 patients, 42 were in the normal weight group, 55 in the overweight group, and 45 in the obese group. Age, surgical procedures, blood loss, preoperative health status, and metastatic lymph nodes did not show a significant difference between groups. However, surgery time and total lymph nodes were higher in the obese group. (p = 0.02, p = 0.00, and p = 0.00, respectively). Common complications were anemia, fever, intestinal injury, deep vein thrombosis, fascial dehiscence and urinary infection. There was no significant difference according to the complications.

    Conclusion

    Our results indicated that higher BMI was significantly associated with a longer duration of endometrial cancer surgery. Minimally invasive surgeries and conventional laparotomy could be performed safely in obese patients.

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  • Original Article

    Expert Recommendations on Monkeypox (MPX) in Pregnancy, Postpartum and Lactating Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1122-1125

    Summary

    Original Article

    Expert Recommendations on Monkeypox (MPX) in Pregnancy, Postpartum and Lactating Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1122-1125

    DOI 10.1055/s-0042-1759635

    Views11
    The Monkeypox Disease In 2020, Brazil and the whole world faced the COVID-19 pandemic, which caused a high number of deaths. This disease was particularly severe for pregnant and postpartum women and determined a significant increase in the Maternal Death Ratio (MMR). To face the disease and assist health professionals in the qualification of the […]
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