Você pesquisou por y?yr=2022 - Revista Brasileira de Ginecologia e Obstetrícia
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):449-451
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Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):449-451
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):548-556
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):548-556
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):540-547
, , , , The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):540-547
, , , , The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.
, , , , , Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
, , , , , , , Placenta accreta spectrum (PAS) is a serious diseases, and the recommendation is that the treatment is conducted in centers of excellence. Such hospitals are not easy to find in low- and middle-income countries. We seek to describe the process of prenatal diagnosis, surgical management, and postnatal histological analysis in a low-income country referral hospital with limited resources.
A descriptive, retrospective study was carried out including patients with a pre- or intraoperative diagnosis of PAS. The clinical results of the patients were studied as well as the results of the prenatal ultrasound and the correlation with the postnatal pathological diagnosis.
In total, 129 patients were included. Forty-eight of them had a prenatal PAS ultrasound diagnosis (37.2%). In the remaining 81 (62.8%), the diagnosis was intraoperative. Although hysterectomy was performed in all cases, one-third of the patients (31%) did not have a histological study of the uterus. In 40% of the patients who had a histological study, PAS was not reported by the pathologist.
The frequency of prenatal diagnosis and the availability of postnatal histological studies were very low in the studied population. Surgical skill, favored by a high flow of patients, is an important factor to avoid complications in settings with limited resources.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):467-474
, , , , , , , Placenta accreta spectrum (PAS) is a serious diseases, and the recommendation is that the treatment is conducted in centers of excellence. Such hospitals are not easy to find in low- and middle-income countries. We seek to describe the process of prenatal diagnosis, surgical management, and postnatal histological analysis in a low-income country referral hospital with limited resources.
A descriptive, retrospective study was carried out including patients with a pre- or intraoperative diagnosis of PAS. The clinical results of the patients were studied as well as the results of the prenatal ultrasound and the correlation with the postnatal pathological diagnosis.
In total, 129 patients were included. Forty-eight of them had a prenatal PAS ultrasound diagnosis (37.2%). In the remaining 81 (62.8%), the diagnosis was intraoperative. Although hysterectomy was performed in all cases, one-third of the patients (31%) did not have a histological study of the uterus. In 40% of the patients who had a histological study, PAS was not reported by the pathologist.
The frequency of prenatal diagnosis and the availability of postnatal histological studies were very low in the studied population. Surgical skill, favored by a high flow of patients, is an important factor to avoid complications in settings with limited resources.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):497-502
Construction and validation of the WhatsApp Stress Scale (WASS), a questionnaire designed for physicians that measures how the use of smartphones and related software communication applications affects the quality of life of gynecologists who use this tool to communicate with patients.
The present cross-sectional observational study analyzed 60 gynecologists according to weekly WhatsApp usage time for communication with patients and compared the data with the perception of the doctor on the use of this virtual interaction as a stressor. Physicians were equally divided into three groups:<2hours, 2 to 5 hours, and>5 hours. The authors created a questionnaire in Likert scale format. The study proceeded in three phases: development of the questionnaire items, pretesting, constructing, and validity and reliability testing using factor analysis, Cronbach α coefficient, and paired t-test.
A 9-item instrument using a 5-point Likert scale was created and administered to the participants in 3 different times: T0, T1 (15minutes after the end of T0), and T2 (15 days later). All questionnaire items possessed adequate content validity indices and the internal consistency of the instrument was satisfactory (Cronbach α 0.935; 95% confidence interval [CI]: 0.744-0.989; p=0.0001). No statistically significant differences were observed in the responses between the rounds of testing, indicating good test-retest reliability. A positive association between the high frequency of WhatsApp usage for communication with patients and the stress perceived by the doctor was shown.
The WASS is a valid and reliable instrument for assessing the use of messaging applications to communicate with patients as a stressor perceived by gynecologists.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):497-502
Construction and validation of the WhatsApp Stress Scale (WASS), a questionnaire designed for physicians that measures how the use of smartphones and related software communication applications affects the quality of life of gynecologists who use this tool to communicate with patients.
The present cross-sectional observational study analyzed 60 gynecologists according to weekly WhatsApp usage time for communication with patients and compared the data with the perception of the doctor on the use of this virtual interaction as a stressor. Physicians were equally divided into three groups:<2hours, 2 to 5 hours, and>5 hours. The authors created a questionnaire in Likert scale format. The study proceeded in three phases: development of the questionnaire items, pretesting, constructing, and validity and reliability testing using factor analysis, Cronbach α coefficient, and paired t-test.
A 9-item instrument using a 5-point Likert scale was created and administered to the participants in 3 different times: T0, T1 (15minutes after the end of T0), and T2 (15 days later). All questionnaire items possessed adequate content validity indices and the internal consistency of the instrument was satisfactory (Cronbach α 0.935; 95% confidence interval [CI]: 0.744-0.989; p=0.0001). No statistically significant differences were observed in the responses between the rounds of testing, indicating good test-retest reliability. A positive association between the high frequency of WhatsApp usage for communication with patients and the stress perceived by the doctor was shown.
The WASS is a valid and reliable instrument for assessing the use of messaging applications to communicate with patients as a stressor perceived by gynecologists.
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Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):458-466
, , , , , Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG.
A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared.
Themean age of the HG group (n=532) was 26.3 ± 4.1 years, and that of the control group (n=534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n=249) had ketone(+), 33% (n=174), ketone(++), and 21% (n=109), ketone(+++). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p<0.001; and 135.2 ± 30.4/108.9 ± 62.2; p<0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone(+++) than in the groups with ketone(+) or ketone(++): 7.6 ± 1.9/5.5 ± 2.4; p<0.001; 3.8(2.8-4.6)/2.9(2.3- 3.6); p<0.001; and 149.9 ± 48.0/135.9 ± 65.7; p<0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients.
The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):458-466
, , , , , Hyperemesis gravidarum (HG) is a pregnancy complication that can progress with persistent nausea and vomiting. The aim of the present study is to evaluate the relationship between hematological parameters and HG.
A total of 532 pregnant women with HG who were admitted to the Department of Obstetrics and Gynecology between March 2019 and February 2021, and 534 healthy pregnant women with characteristics similar to those of the case group were included in the study. The hematological parameters of both groups were compared. In addition, the hematological parametersof patients with HG according to the severity of ketonuria were compared.
Themean age of the HG group (n=532) was 26.3 ± 4.1 years, and that of the control group (n=534) was 25.9 ± 4.8 years. Among patients with HG, 46% (n=249) had ketone(+), 33% (n=174), ketone(++), and 21% (n=109), ketone(+++). The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were higher in the HG group than in the control group: 3.8 (2.8-5.8)/3.2 (2.6-4.0); p<0.001; and 135.2 ± 30.4/108.9 ± 62.2; p<0.001 respectively. The neutrophil count, NLR, and PLR were higher in the group with ketone(+++) than in the groups with ketone(+) or ketone(++): 7.6 ± 1.9/5.5 ± 2.4; p<0.001; 3.8(2.8-4.6)/2.9(2.3- 3.6); p<0.001; and 149.9 ± 48.0/135.9 ± 65.7; p<0.001 respectively. The mean corpuscular hemoglobin (MCH) level, the NLR, and the PLR were identified as independent predictors of the presence of HG and the level of ketone positivity in HG patients.
The NLR and PLR were high in patients with HG, suggesting the its inflammatory activity. They may be important markers associated with the presence and severity of HG.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):519-531
To provide a survey of relevant literature on umbilical artery Doppler ultrasound use in clinical practice, technical considerations and limitations, and future perspectives.
Literature searches were conducted in PubMed and Medline, restricted to articles written in English. Additionally, the references of all analyzed studies were searched to obtain necessary information.
The use of this technique as a routine surveillance method is only recommended for high-risk pregnancies with impaired placentation. Meta-analyses of randomized trials have established that obstetric management guided by umbilical artery Doppler findings can improve perinatal mortality and morbidity. The values of the indices of Umbilical artery Doppler decrease with advancing gestational age; however, a lack of consensus on reference ranges prevails.
Important clinical decisions are based on the information obtained with umbilical artery Doppler ultrasound. Future efforts in research are imperative to overcome the current limitations of the technique.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):519-531
To provide a survey of relevant literature on umbilical artery Doppler ultrasound use in clinical practice, technical considerations and limitations, and future perspectives.
Literature searches were conducted in PubMed and Medline, restricted to articles written in English. Additionally, the references of all analyzed studies were searched to obtain necessary information.
The use of this technique as a routine surveillance method is only recommended for high-risk pregnancies with impaired placentation. Meta-analyses of randomized trials have established that obstetric management guided by umbilical artery Doppler findings can improve perinatal mortality and morbidity. The values of the indices of Umbilical artery Doppler decrease with advancing gestational age; however, a lack of consensus on reference ranges prevails.
Important clinical decisions are based on the information obtained with umbilical artery Doppler ultrasound. Future efforts in research are imperative to overcome the current limitations of the technique.
, , , Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):452-457
, , , To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).
Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12.
The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis.
There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(5):452-457
, , , To detect depression during pregnancy and in the immediate postpartum period using the Edinburgh postpartum depression scale (EPDS).
Cross sectional study of 315 women, aged between 14 and 44 years, who received perinatal care at the Leonor Mendes de Barros Hospital, in São Paulo, between July 1st, 2019 and October 30th, 2020. The cutoff point suggesting depression was ≥ 12.
The screening indicated 62 (19.7%) patients experiencing depression. Low family income, multiparity, fewer prenatal appointments, antecedents of emotional disorders, dissatisfaction with the pregnancy, poor relationship with the partner, and psychological aggression were all risk factors associated with depression in pregnancy or in the immediate postpartum period. Antecedents of depression and psychology aggression during pregnancy were significant variables for predicting perinatal depression in the multivariate analysis.
There is a significant association between the occurrence of perinatal depression and the aforementioned psychosocial factors. Screening patients with the EPDS during perinatal and postpartum care could facilitate establishing a line of care to improve the wellbeing of mother and infant.