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13 articles
  • FIGO Statement

    International Federation of Gynecology and Obstetrics Global Declaration on Cervical Cancer Elimination

    Rev Bras Ginecol Obstet. 2019;41(2):102-103

    Summary

    FIGO Statement

    International Federation of Gynecology and Obstetrics Global Declaration on Cervical Cancer Elimination

    Rev Bras Ginecol Obstet. 2019;41(2):102-103

    DOI 10.1055/s-0039-1679865

    Views2
    We Declare We, the participants of the XXII FIGO World Congress of Obstetrics and Gynecology, held in Rio de Janeiro between 14th and 19th October 2018, hereby declare that we will work collaboratively to scale up interventions with the aim of eliminating cervical cancer as a public health concern. In line with cervical cancer elimination […]
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  • Review Article

    Effectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis

    Rev Bras Ginecol Obstet. 2019;41(2):104-115

    Summary

    Review Article

    Effectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis

    Rev Bras Ginecol Obstet. 2019;41(2):104-115

    DOI 10.1055/s-0038-1676510

    Views2

    Abstract

    Diabetes during pregnancy has been linked to unfavorable maternal-fetal outcomes. Human insulins are the first drug of choice because of the proven safety in their use. However, there are still questions about the use of insulin analogs during pregnancy. The objective of the present study was to determine the effectiveness of insulin analogs compared withhuman insulin in the treatment of pregnant women with diabetes througha systematic review withmeta-analysis. The search comprised the period since the inception of each database until July 2017, and the following databases were used:MEDLINE, CINAHL, EMBASE, ISIWeb of Science, LILACS, Scopus, SIGLE andGoogle Scholar.We have selected 29 original articles: 11 were randomized clinical trials and 18 were observational studies.We have explored data from 6,382 participants. All of the articles were classified as having an intermediate to high risk of bias. The variable that showed favorable results for the use of insulin analogs was gestational age, with a mean difference of - 0.26 (95 % confidence interval [CI]: 0.03-0.49; p = 0.02), but with significant heterogeneity (Higgins test [I2] = 38%; chi-squared test [χ2] = 16.24; degree of freedom [DF] = 10; p = 0.09). This result, in the clinical practice, does not compromise the fetal well-being, since all babies were born at term. There was publication bias in the gestational age and neonatal weight variables. To date, the evidence analyzed has a moderate-to-high risk of bias and does not allow the conclusion that insulin analogs are more effective when compared with human insulin to treat diabetic pregnant women.

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    Effectiveness of Insulin Analogs Compared with Human Insulins in Pregnant Women with Diabetes Mellitus: Systematic Review and Meta-analysis
  • Review Article

    Occult Urinary Incontinence Treatment: Systematic Review and Meta-analysis-Brazilian Guidelines

    Rev Bras Ginecol Obstet. 2019;41(2):116-123

    Summary

    Review Article

    Occult Urinary Incontinence Treatment: Systematic Review and Meta-analysis-Brazilian Guidelines

    Rev Bras Ginecol Obstet. 2019;41(2):116-123

    DOI 10.1055/s-0038-1676842

    Views0

    Abstract

    Objective

    To evaluate if performing anti-incontinence procedures during surgical anterior and/or apical prolapse correction in women with asymptomatic urinary incontinence (UI) may prevent stress urinary incontinence (SUI) postoperatively.

    Methods

    We have performed a systematic review of articles published in the PubMed, Cochrane Library, and Lilacs databases until March 31, 2016. Two reviewers performed the data collection and analysis, independently. All of the selected studiesweremethodologically analyzed. The results are presented as relative risk (RR), with a 95% confidence interval (CI).

    Results

    After performing the selection of the studies, only nine trials fulfilled the necessary prerequisites. In the present review, 1,146 patients were included. Altogether, the review included trials of three different types of anti-incontinence procedures. We found that performing any anti-incontinence procedure at the same time of prolapse repair reduced the incidence of SUI postoperatively (RR = 0.50; 95% CI: 0.28-0.91). However, when we performed the analysis separately by the type of anti-incontinence procedure, we found different results. In the subgroup analysis with midurethral slings, it is beneficial to perform it to reduce the incidence of SUI (RR = 0.08; 95% CI: 0.02-0.28). On the other hand, in the subgroup analysis with Burch colposuspension, there was no significant difference with the control group (RR = 1.47; 95% CI: 0.28-7.79]).

    Conclusion

    Performing any prophylactic anti-incontinence procedure at the same time as prolapse repair reduced the incidence of SUI postoperatively. The Burch colposuspension did not show any decrease in the incidence of SUI postoperatively.

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    Occult Urinary Incontinence Treatment: Systematic Review and Meta-analysis-Brazilian Guidelines
  • Case Report

    Imaging Description of Extragenital Müllerian Adenosarcoma: A Case Report

    Rev Bras Ginecol Obstet. 2019;41(2):124-128

    Summary

    Case Report

    Imaging Description of Extragenital Müllerian Adenosarcoma: A Case Report

    Rev Bras Ginecol Obstet. 2019;41(2):124-128

    DOI 10.1055/s-0038-1676110

    Views5

    Abstract

    Müllerian adenosarcoma is a very rare gynecological disease, comprising 5% of uterine sarcomas. Extragenital localizations are even rarer.We report a very interesting case of a 27-year-old woman complaining of pelvic pain, with a subsequent diagnosis of extragenital Müllerian adenosarcoma. This is the first case reported in the literature with a complete and wide imaging description. Even if rare, Müllerian adenosarcoma should be hypothesized in case of young female patients presenting with suspicious pelvic mass.

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    Imaging Description of Extragenital Müllerian Adenosarcoma: A Case Report
  • Case Report

    Lithopedion Causing Intestinal Obstruction in a 71-Year-Old Woman: A Case Report

    Rev Bras Ginecol Obstet. 2019;41(2):129-132

    Summary

    Case Report

    Lithopedion Causing Intestinal Obstruction in a 71-Year-Old Woman: A Case Report

    Rev Bras Ginecol Obstet. 2019;41(2):129-132

    DOI 10.1055/s-0038-1676060

    Views1

    Abstract

    Ectopic pregnancy is the leading cause of pregnancy-related death during the first trimester, and it occurs in 1 to 2% of pregnancies. Over 90% of ectopic pregnancies are located in the fallopian tube. Abdominal pregnancy refers to an ectopic pregnancy that has implanted in the peritoneal cavity, external to the uterine cavity and fallopian tubes. The estimated incidence is 1 per 10,000 births and 1.4%of ectopic pregnancies. Lithopedion is a rare type of ectopic pregnancy, and it occurs when the fetus from an unrecognized abdominal pregnancymay die and calcify. The resulting “stone baby” may not be detected for decades andmay cause a variety of complications. Lithopedion is a very rare event that occurs in 0.0054% of all gestations. About 1.5 to 1.8% of the abdominal babies develop into lithopedion. There are only ~ 330 known cases of lithopedion in the world. We describe a lithopedion that complicated as intestinal obstruction in a 71-year-old woman.

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    Lithopedion Causing Intestinal Obstruction in a 71-Year-Old Woman: A Case Report
  • Letter to the Editor

    Comments on: Limitations of HPV DNA Testing in Screening of Cervical Adenocarcinomas

    Rev Bras Ginecol Obstet. 2019;41(2):133-134

    Summary

    Letter to the Editor

    Comments on: Limitations of HPV DNA Testing in Screening of Cervical Adenocarcinomas

    Rev Bras Ginecol Obstet. 2019;41(2):133-134

    DOI 10.1055/s-0039-1678591

    Views4
    Dear Editor, I read with great interest the article on HPV DNA testing for cervical cancer screening in Brazil, authored by the Brazilian Association for the Lower Genital Tract Pathology and Colposcopy (ABPTGIC, in the Portuguese acronym). In agreement with the authors, I have found irrefutable evidence sustaining the use of molecular detection of HPV […]
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  • Letter to the Editor

    Comments on: Isolated Nonocompaction Suggests Subclinical Myopathy

    Rev Bras Ginecol Obstet. 2019;41(2):135-136

    Summary

    Letter to the Editor

    Comments on: Isolated Nonocompaction Suggests Subclinical Myopathy

    Rev Bras Ginecol Obstet. 2019;41(2):135-136

    DOI 10.1055/s-0038-1676600

    Views3
    It is with interest that I read the article by Nappi et al about a fetus with left ventricular hypertrabeculation (LVHT), also known as left ventricular noncompaction (LVNC), at 26 weeks and 4 days of gestation. The fetus was delivered by cesarean section, preterm, at gestational week 31 and died 3 days after delivery for […]
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  • Editorial

    Answering the Call to Accelerate the Elimination of Cervical Cancer

    Rev Bras Ginecol Obstet. 2019;41(2):67-67

    Summary

    Editorial

    Answering the Call to Accelerate the Elimination of Cervical Cancer

    Rev Bras Ginecol Obstet. 2019;41(2):67-67

    DOI 10.1055/s-0039-1679864

    Views2
    The opportunity to improve the lives and survival rates of women through the elimination of cervical cancer is a dream that every obstetrician-gynecologist, every women’s health specialist, and our societies must embrace. I can never forget the anguished faces of the 4-year-old son and of the husband of one of my first young patients dying […]
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