Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):101-106
DOI 10.1590/S0100-72032006000200005
PURPOSE: to evaluate the effects of conjugated equine estrogens (CEE) and raloxifene (Ral), alone or combined, on the rat endometrium. METHODS: fifty-six adult rats were ovariectomized and randomly divided into seven groups: GCont (control); GCEE (CEE 50 µg/kg); GCEE/25 (CEE 25 µg/kg); GRal/0.75 (Ral 0.75 mg/kg); GRal/0.4 (Ral 0.4 mg/kg); GCEERal (50/0.75) - (CEE 50 µg/kg + Ral 0.75 mg/kg), and GCEE-Ral (25/0.4) - (CEE 25 µg/kg + Ral 0.4 mg/kg). The drugs were orally administered (gavage) for 21 consecutive days. At the end of the experiment, all animals were anesthetized and sacrificed. Fragments of uterus were removed, fixed in 10% formaldehyde and processed for paraffin inclusion. The histological sections were stained by HE and submitted to histomorphometric evaluation. The following parameters were analyzed: thickness of superficial epithelium and number of endometrial glands/mm² and of blood vessels/mm². The data were evaluated using ANOVA followed by the Turkey-Kramer test. RESULTS: in the GCont and only Ral treatment (GRal/0.75 and GRal/0.4) the endometrium showed signals of atrophy. In the groups treated with only CEE signs of endometrial proliferation were observed, mainly in group GCEE/50. Also, there was endometrial proliferation in the groups that received combined CEE and Ral (Ral GCEE (50/0.75) and GCEE-Ral (25/0.4)), but it was more intensive in the animals treated with isolated estrogen than in those that received combined estrogen and raloxifene. CONCLUSION: raloxifene may partially block the action of estrogen on the castrated adult rat endometrium.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):107-111
DOI 10.1590/S0100-72032006000200006
PURPOSE: we report a small series of pregnant women who underwent gastric bypass surgery for severe obesity, with a review of the literature on this topic. METHODS: five consecutive cases of pregnancy after gastroplasty between 2001 and 2004 were evaluated, and clinical, laboratory and therapeutic features were considered. Patients were 30 to 34 years old and all had been submitted to gastroplasty by the Capella technique. The outcomes for both the pregnant woman and the fetus were evaluated. A search of the English language literature was done through MEDLINE and Web of Science databases with the following terms: gastroplasty, gastric bypass surgery, bariatric surgery, and pregnancy. RESULTS: all 5 pregnancies were singleton. No major obstetric complications were observed and there were no premature or lowbirth weight infants. CONCLUSION: our data suggest that pregnancy following gastroplasty is safe for mother and fetus. However, since information about this topic is limited, further investigations are required to establish appropriate recommendations concerning the follow-up of these pregnancies.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):112-121
DOI 10.1590/S0100-72032006000200007
PURPOSE: to investigate the presence and outcome of uterinevascular malformations (UVAM) after gestational trophoblastic disease (GTD). METHODS: retrospective study of 2764 patients with GTD diagnosed from 1987 to 2004. All patients were followed up annually at the "Santa Casa da Misericórdia" Trophoblastic Disease Center (Rio de Janeiro, RJ, Brazil) with transvaginal ultrasonography (US) and color Doppler imaging. Seven patients had a final diagnosis of UVAM based on ultrasonographic analysis - pulsatility index (PI), resistance index (RI), peak systolic velocity (PSV) - and pelvic magnetic nuclear resonance (MNR) findings. Negative beta-hCG values were of utmost importance to establish differential diagnosis with persistent GTD. RESULTS: the incidence of UVAM after GTD was 0.2% (7/2764). US features of UVAM: PI mean 0.44±0,058 (extremes: 0.38-0.52); RI mean 0.36±0.072 (extremes: 0.29-0.50); PSV mean 64.6±23.99 cm/s (extremes: 37-96). MNR image showed a bulky uterus, myometrial inhomogeneity, serpiginous flow-related signal voids, and prominent parametrial vessels. The most common UVAM clinical presentation was vaginal hemorrhage, present in 52.7% (4/7). Pharmacological management with 150 mg medroxyprogesterone acetate was employed to control bleeding, after hemodynamic stabilization. These patients are still being followed and remain asymptomatic nowadays. Two patients with persistent UVAM became pregnant and had successful outcomes. CONCLUSION: patients with antecedent of GTD presenting transvaginal bleeding and negative beta-hCG may be considered to have UVAM and should be investigated through US with Doppler velocimetry. Conservative management is a valuable option in many of the acquired UVAM after GTD.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):122-125
DOI 10.1590/S0100-72032006000200008
PURPOSE: to evaluate the prevalence of hemoglobin S (HbS) in newborns, through clinical investigation and laboratory data. METHODS: a protocol established the drawing of 10 mL blood from the umbilical cord after its ligature and section, immediately after birth. The samples were kept in a tube with 5% EDTA and then submitted to high-performance liquid chromatography. The study included a clinical record taken from an interview with the mother, her physical and biochemical condition, as well as that of her newborn. Main criteria were newborn's weight, sex, first minute Apgar, and the mother's color. Statistical analysis was based on the Epi-Info 6.0 program and performed by Student's t test, with the level of significance set at p<0.05. RESULTS: from August 2001 to September 2002, 389 umbilical cord blood samples showed HbS in 16 newborn babies (4.1%). Fifteen of these presented sickle-cell traits (HbS) and the other had a diagnostic hypothesis of sickle-cell anemia (HbSS). Hemoglobinopathy prevailed among male babies. No significant difference was observed between newborns with or without HbS regarding averages of weight and Apgar scores; the same occurred regarding the mother's skin color (Caucasians, mulattos and blacks). CONCLUSION: searching for hemoglobin diseases in newborns should be considered because of the possibility of 25% sickle-cell anemia in the offspring of couples with sickle-cell traits. Screening for abnormal hemoglobin is important in the population at risk. Thus, the creation of programs with these aims is recommended to be included in hospital routines.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):126-135
DOI 10.1590/S0100-72032006000200009
Gender-based violence is related to the power imbalance between men and women that is present, to a greater or lesser degree, in all societies. It was recognized as a human rights problem by the UN relatively recently. It includes emotional, physical and sexual violence. Sexual violence is the extreme form of gender violence, usually accompanied by the other types of violence. Its prevalence is difficult to determine, but it most probably affects at least one third of women some time in their life. It has multiple consequences to women's physical and gynecological health, which depends in great part on the quality of the care the woman received immediately after the assault. Unfortunately, most emergency health services, including those in women's hospitals, are rarely prepared to provide the correct care for these women. Care should be multidisciplinary and involves crisis treatment, meticulous clinical examination with complementary auxiliary methods, treatment of physical lesions, prevention of pregnancy and of sexually transmitted infections and AIDS, and follow-up for at least six months after the aggression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):136-136
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):136-136
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(2):71-74