Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):179-179
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):181-185
DOI 10.1590/S0100-72031998000400002
With the purpose of identifying the social, demographic, pregnancy-related and medical care factors associated with maternal death, this study evaluated all deaths of women aged 10 to 49 years occurring in Recife, Pernambuco, Brazil, during 1992 and 1993. The data were obtained reviewing 1,013 death certificates, with 42 cases of identified maternal deaths. The data of these deaths were complemented with information from medical records, autopsies and also interviews with physicians from the hospitals where the death took place, and with the dead women's relatives. Almost two thirds (62%) of maternal deaths occurred among women aged 20 to 29 years and more than half of them were single. There was a higher number of deaths among caesarean deliveries than among vaginal ones. The majority of deaths occurred within the first three days of hospitalization and approximately 90% of hospital charges were sponsored by the National Health System (SUS).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):187-192
DOI 10.1590/S0100-72031998000400003
The present study describes 13 cases of appendicitis in the gravidic-puerperal cycle, at the Maternidade Escola Januário Cicco, from Jan/89 to Dec/96. The cases were assisted by a team of obstetricians and surgeons. Eleven patients were pregnant (4 in the 1st trimester, 6 in the 2nd and 1 in the 3rd) and 2 were in the puerperal period. The incidence was 1/3.422; the age ranged from 18 to 30 years and the majority was nulliparous. The most frequent symptom was abdominal pain (intense or moderate). The appendix was perforated in 6 cases, 2 of them with abdominal wall abscess and 1 patient had an abortion. Pregnancy presented no complications in 9 cases, and delivery occurred at term. The authors observed that appendix perforations occurred more frequently in cases whose symptoms had begun earlier. The authors found that the earlier the diagnosis, the better the prognosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):193-198
DOI 10.1590/S0100-72031998000400004
The patients who do not adjust to the metabolic changes of pregnancy and those with previous alterations in carbohydrate metabolism show a significant increase in perinatal morbidity and mortality. In order to contribute to a better prenatal management of diabetic patients, the authors reviewed 60 cases of diabetes during pregnancy, assisted at the Department of Obstetrics and Gynecology, Faculty of Medicine of Ribeirão Preto, University of São Paulo. The sample was divided into two groups: one with prenatal care according to the Department protocol, and referred to this center for pregnancy resolution, and the other without appropriate prenatal care. In the group with prenatal care according to the Department protocol the complications observed were related to prematurity. The group without appropriate care showed 3 cases of congenital malformations, 3 cases of prematurity, 1 case of severe neonatal hypoglycemia, 1 case of macrossomia, 1 case of intrauterine growth retardation and 1 neonatal death. Comparing the groups, it became clear that the appropriate prenatal care is essential for the diabetic pregnant patient, but also that a reference center, such as this Obstetrical and Gynecological Department, must be fully integrated with the regional health centers, in order to offer assistance before and during gestation to the diabetic patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):199-205
DOI 10.1590/S0100-72031998000400005
The purpose of the present study was to investigate the menstrual disturbances and the psychological effects of post-tubal sterilization - the so-called post-tubal sterilization syndrome. Does it exist? The authors followed-up prospectively 300 women from the Gynecological Endoscopy and Family Planning Section, Department of Obstetrics and Gynecology, Botucatu Medical School, Universidade Estadual Paulista (UNESP) during one, three and five years after tubal sterilization surgery. Different parameters such as menstrual cycle length, duration of menstrual flow, dysmenorrhea, pelvic pain, regret rates etc, after tubal ligation, were analyzed. Each woman served as her own control. In conclusion, our findings suggest that most women reported no menstrual changes subsequent to sterilization. These findings do not deny or diminish the importance or benefits of tubal sterilization, but serve as a focus for further investigation.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):209-213
DOI 10.1590/S0100-72031998000400006
Fine-needle aspiration cytology (FNAC) is a simple method and free from complications, among great value in mastology. Its accuracy can suffer the influence of several factors, among which we can highlight the experience of the physician who performs it. With the objective of verifying the effectiveness of FNAC performed by general gynecologists, 341 patients were studied concerning the relationship between the results of FNAC and the histology of the breast lesion. We obtained sensitivity of 70.87%, specificity of 70.58%, predictive positive value of 92.40%, predictive negative value of 89.36% and accuracy of 70.67%. We concluded that FNAC is of great value in handling breast lesions and can be appropriately performed by general gynecologists. The method, however, may lead to errors of diagnosis. We do not recommend, therefore, the use of the result of FNAC as a definitive diagnosis; instead this result must be interpreted in the context of the clinical diagnosis and mammography.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):217-219
DOI 10.1590/S0100-72031998000400007
A case of urethral leiomyoma - a mass of approximately 5 cm in diameter - located on the anterior wall of the vaginal lower third is reported. The patient was submitted to a surgical tumor excision. Histopathological and immunohistochemical studies indicated leiomyoma, which is always a benign, unusual neoplasm, rarely relapsing after excision. Its pathogenesis and clinical features are also focused on.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 1998;20(4):221-224
DOI 10.1590/S0100-72031998000400008
A case of postsurgical necrotizing fasciitis is presented. A 68-year-old female patient was submitted to a lumpectomy for a big breast lipoma. After surgen there was an aggressive local infection, with extensive necrosis of the breast tissue, including the superficial and deep fasciae and also the skin over the breast. The gravity of the disease and the difficulties in its diagnosis due to the late skin necrosis are emphasized. Under such circunstances an early and aggressive approach is necessary.