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

15 articles
  • Editorial

    Contraception for Women with Polycystic Ovary Syndrome:Dealing with a Complex Condition

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):325-326

    Summary

    Editorial

    Contraception for Women with Polycystic Ovary Syndrome:Dealing with a Complex Condition

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):325-326

    DOI 10.1055/s-0042-1748036

    Views21
    Polycystic ovary syndrome (PCOS) is a complex condition, affecting around 9 to 13% of women at reproductive age and characterized by menstrual irregularity, ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. Women with PCOS also present higher prevalence of obesity, cardiometabolic disturbances, such as dyslipidemia and hypertension and greater risk of impaired glucose tolerance and diabetes. […]
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  • Original Article

    Analysis of Variables that Influence the Success Rates of Induction of Labor with Misoprostol: A Retrospective Observational Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):327-335

    Summary

    Original Article

    Analysis of Variables that Influence the Success Rates of Induction of Labor with Misoprostol: A Retrospective Observational Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):327-335

    DOI 10.1055/s-0042-1744287

    Views8

    Abstract

    Objective

    Determine the predictive criteria for success in inducing labor for live fetuses using misoprostol in pregnant women. Secondarily, the objective is to determine the rates of vaginal or cesarean delivery, duration of induction, interval of administration of misoprostol, the main causes of induction of labor and indication for operative delivery.

    Methods

    Medical records of 873 pregnant women admitted for cervical maturation from January 2017 to December 2018 were reviewed in a descriptive observational study of retrospective analysis, considering the following response variables: age, parity, Bishop Index, doses of misoprostol, labor induction time. Logistic regression models were used to predict success with misoprostol in non-operative deliveries.

    Results

    Of the 873 patients evaluated, 72% evolved with vaginal delivery, 23% of the cases were cesarean, 5% forceps or vacuum-extractor. For non-operative delivery the predictive variables at admission were age, parity, gestational age and dilation. During hospitalization, fewer vaginal touches,amniotomy or amniorrhexis with clear fluid lead to a shorter induction time and a greater chance of non-operative delivery. False positives and false negatives of the model were always below 50% and correct answers above 65%.

    Conclusion

    At admission, age less than 24 years, previous normal births, lower the gestational age and greater the dilation, were predictive of greater probability of nonoperative delivery. During hospitalization, the less vaginal touches and occurrence of amniotomy/amniorrhexis with clear liquid indicate shorter induction time. Future studies with a prospective design and analysis of other factors are necessary to assess the replicability, generalization of these findings.

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    Analysis of Variables that Influence the Success Rates of Induction of Labor with Misoprostol: A Retrospective Observational Study
  • Original Article

    Use of Triggers on in vitro Fertilization and Evaluation of Risk Factors for Sub-Optimal Maturation Rate

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):369-375

    Summary

    Original Article

    Use of Triggers on in vitro Fertilization and Evaluation of Risk Factors for Sub-Optimal Maturation Rate

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):369-375

    DOI 10.1055/s-0041-1741455

    Views9

    Abstract

    Objective

    To compare the oocyte maturation rate in the treatment of in vitro fertilization (IVF) in terms of the use of human chorionic gonadotropin (hCG), agonist gonadotropin-releasing hormone (GnRH) and dual trigger and to evaluate the associated risk factors for sub-optimal maturation rates.

    Methods

    A retrospective cohort study with 856 women who underwent IVF. They performed oocyte retrieval and were classified into 3 groups (1 - hCG, 2 - GnRHagonist, 3 - dual trigger). The primary outcome was maturation rate per trigger, and the secondary outcomes were the pregnancy rate per oocyte retrieval and the correlations between low maturation rate as well as the clinical and treatment characteristics of women.

    Results

    The maturation rate was 77% in group 1; 76% in group 2, and 83% in group 3 (p=0.003). Group 2 showed women with better ovarian reserve, greater number of oocytes collected, and more mature oocytes and embryos compared with the other groups (p<0.001). The cumulative clinical pregnancy rate was no different between the groups (p=0.755). Low ovarian reserve and low doses of follicle-stimulating hormone (FSH) administered during the stimulus were associated with a higher chance of null maturation rate.

    Conclusion

    The oocyte maturation rates and IVF results were similar in all groups. Low ovarian reserve is associated with the worst treatment results.

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  • Original Article

    Nipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):376-384

    Summary

    Original Article

    Nipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):376-384

    DOI 10.1055/s-0042-1742315

    Views8

    Abstract

    Objective

    The presence of an extensive intraductal component is associated to an increasing risk of relapse in the nipple-areola complex. The aim of the present study was to evaluate the outcomes of patients diagnosed with ductal carcinoma in situ (DCIS) who underwent nipple-sparing mastectomy (NSM) with immediate breast reconstruction using silicone implants.

    Methods

    We retrospectively analyzed the postoperative complications and oncological safety of 67 breast cancer patients diagnosed with pure DCIS who underwent NSM with immediate breast reconstruction using silicone implants between 2004 and 2018.

    Results

    Among the 127 NSM procedures performed, 2 hematomas (1.5%) and 1 partial nipple necrosis (0.7%) were observed. After a mean follow-up of 60months, the local recurrence rate was of 8.9%, the disease-free survival rate was of 90%, and 1 of the patients died.

    Conclusion

    Despite the local recurrence rate, we showed that NSM with immediate breast reconstruction using silicone implants is a feasible surgical approach, with a low rate of complications and high survival rates for patients with a diagnosis of pure DCIS when breast-conserving surgery is not an option.

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    Nipple-sparing Mastectomy with Immediate Implant-based Reconstruction for Patients with Pure Ductal Carcinoma in Situ
  • Original Article

    Knowledge, Attitude, and Practices Related to the SARS-CoV-2 Pandemic among Women Seeking Contraceptive Methods

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):391-397

    Summary

    Original Article

    Knowledge, Attitude, and Practices Related to the SARS-CoV-2 Pandemic among Women Seeking Contraceptive Methods

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):391-397

    DOI 10.1055/s-0041-1741448

    Views9

    Abstract

    Objective

    To determine knowledge, attitude, and preventive (KAP) practices towards the SARS-CoV-2 (COVID-19) pandemic among women in reproductive age seeking to use copper or hormonal intrauterine devices (IUD/LNG-IUS).

    Methods

    We conducted a cross-sectional study in which we applied a questionnaire on 400 women about KAP practices on COVID-19 at the University of Campinas, Campinas, SP, Brazil, from May to August 2020.

    Results

    The mean (±SD) age of the women was 30.8±7.9 years, and 72.8% of them reported being pregnant at least once. Most women (95%) had heard or read about COVID-19, and their main sources of information were television (91%) and government websites (53%). However, 53% of the women had doubts about the veracity of the information accessed.

    Conclusion

    Women without a partner and with>12 years of schooling had more information about COVID-19 and on its impact on new pregnancy, and those from high socioeconomic status had a higher chance of maintaining physical distance. Safety, effectiveness, comfort, and absence of hormone in the contraceptive method (in the case of TCu380A IUD) were the main reasons for the participants to seek the service during the pandemic, and the possibility to stop menstrual bleeding was the main reason to choose the LNG-IUS.

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  • Review Article

    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433

    Summary

    Review Article

    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):425-433

    DOI 10.1055/s-0042-1742292

    Views97

    Abstract

    Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarianmorphology ought not to be used as a diagnostic criterion. Treatment should targetmanifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes.

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    Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management
  • Review Article

    Imaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):435-441

    Summary

    Review Article

    Imaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):435-441

    DOI 10.1055/s-0041-1740296

    Views11

    Abstract

    Objective

    Antenatal recognition of severe cases of congenital diaphragmatic hernia (CDH) by ultrasound (US) and magnetic resonance imaging (MRI) may aid decisions regarding the indication of fetal endoscopic tracheal occlusion.

    Methods

    An integrative review was performed. Searches in MEDLINE and EMBASE used terms related to CDH, diagnosis, MRI, and US. The inclusion criteria were reviews and guidelines approaching US and MRI markers of severity of CDH published in English in the past 10 years.

    Results

    The search retrieved 712 studies, out of which 17 publications were included. The US parameters were stomach and liver positions, lung-to-head ratio (LHR), observed/expected LHR (o/e LHR), and quantitative lung index. The MRI parameters were total fetal lung volume (TFLV), observed/expected TFLV, relative fetal or percent predicted lung volumes, liver intrathoracic ratio, and modified McGoon index. None of the parameters was reported to be superior to the others.

    Conclusion

    The most mentioned parameters were o/e LHR, LHR, liver position, o/e TFLV, and TFLV.

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    Imaging Assessment of Prognostic Parameters in Cases of Isolated Congenital Diaphragmatic Hernia: Integrative Review
  • Febrasgo Position Statement

    Progestogen-only oral contraceptives

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):442-447

    Summary

    Febrasgo Position Statement

    Progestogen-only oral contraceptives

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):442-447

    DOI 10.1055/s-0042-1748754

    Views26
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