Você pesquisou por y?yr=2019 - Revista Brasileira de Ginecologia e Obstetrícia

8 articles
  • Editorial

    The Algorhytm: FRAX Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):467-468

    Summary

    Editorial

    The Algorhytm: FRAX Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):467-468

    DOI 10.1055/s-0039-1695027

    Views9
    The World Health Organization (WHO) defines osteoporosis as a skeletal disorder characterized by low bone mass combined with microarchitetural deterioration of the bone, leading to bone fragility and increased susceptibility to fracture. Its clinical relevance relies on the emerging fracture rate, as well as on the morbidity and mortality associated with hip fractures. Moreover, the […]
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  • Original Articles

    Putting Knowledge into Practice-The Challenge of Acquiring Healthy Habits during Pregnancy Colocando conhecimento em prática – O desafio de adquirir hábitos saudáveis durante a gravidez

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):469-475

    Summary

    Original Articles

    Putting Knowledge into Practice-The Challenge of Acquiring Healthy Habits during Pregnancy Colocando conhecimento em prática – O desafio de adquirir hábitos saudáveis durante a gravidez

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):469-475

    DOI 10.1055/s-0039-1692633

    Views18

    Abstract

    Objective

    The aim of this study was to investigate the knowledge concerning gestational weight gain (GWG), nutrition, and physical exercise (PE) in pregnant women, and how to put them into practice.

    Methods

    A cross-sectional study with 61 pregnant women above 26 weeks of gestation, at the Woman’s Hospital, CAISM, University of Campinas. Questionnaires regarding the knowledge of healthy habits (HH) during pregnancy, sociodemographic data, and previous obstetric outcomes were applied. An educational guide with advice on HH during pregnancy and in the postpartum period was offered.

    Results

    The average age of women was 28.7 ± 6.23 years, with 85% of them being married; 32% nulliparous; the average body mass index (BMI) before pregnancy was 25.4 ± 9.8 kg/m2, and themean number of years of schoolingwas 11.2 ± 3.8. Only 61%of the subjects had received any previous information about GWG during their antenatal care and were aware as to howmany pounds they should gain during pregnancy. Among the 61 women, 85% understood that they did not need to “eat for 2” and 99% knew that PE had benefits for their body and was safe for their baby. Half of the women practiced PE prior to pregnancy; however, only 31% continued the practice of PE during the pregnancy.

    Conclusion

    Despite understanding the need for HH during pregnancy, women still need encouragement to practice PE during pregnancy, as well as more information about GWG.

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  • Original Articles

    Ultrasound Evaluation of the Cervix to Predict Failed Labor Induction

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):476-484

    Summary

    Original Articles

    Ultrasound Evaluation of the Cervix to Predict Failed Labor Induction

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):476-484

    DOI 10.1055/s-0039-1693679

    Views19

    Abstract

    Objective

    Labor induction does not always result in vaginal delivery, and can expose both the mother and the fetus to the risks inherent to the induction procedure or a possible cesarean section. Transvaginal sonography (TVS) of the cervix is a useful tool to predict prematurity; in the present study, this tool was used to evaluate postterm induction.

    Methods

    We evaluated the ultrasound characteristics of the cervix (cervical length, cervical funneling, internal os dilation, the presence or absence of the cervical gland area [CGA], and the morphological changes of the cervix as a result of applying fundal pressure) before the onset of labor induction among women with postterm pregnancy to identify the possible predictors of failed labor induction. The Bishop score (BS) was used for comparison purposes. Three groups were evaluated: successful versus unsuccessful induction; vaginal delivery versus cesarean delivery (excluding cases of acute fetal distress [AFD]); and vaginal delivery versus cesarean delivery (including cases of AFD). A fourth group including only the primiparous women from the three previous groups was also evaluated.

    Results

    Based on the studied characteristics and combinations of variables, a cervical length ≥ 3.0 cm and a BS ≤ 2 were the best predictors of induction failure.

    Conclusion

    Although TVS is useful for screening for induction failure, this tool should not be used as an indication for cesarean section.

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  • Original Articles

    Intrauterine Device Insertion during Cesarean Section in Women without Prenatal Contraception Counseling: Lessons from a Country with High Cesarean Rates

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):485-492

    Summary

    Original Articles

    Intrauterine Device Insertion during Cesarean Section in Women without Prenatal Contraception Counseling: Lessons from a Country with High Cesarean Rates

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):485-492

    DOI 10.1055/s-0039-1693677

    Views7

    Abstract

    Objective

    Themoment of admission for deliverymay be inappropriate for offering an intrauterine device (IUD) to women without prenatal contraception counseling. However, in countries with high cesarean rates and deficient prenatal contraception counseling, this strategy may reduce unexpected pregnancies and repeated cesarean sections.

    Methods

    This was a prospective cohort study involving 100 women without prenatal contraception counseling. Postplacental IUD was offered after admission for delivery and placed during cesarean. The rates of IUD continuation, uterine perforation, and endometritis were assessed at 6 weeks and 6 months, and the proportion of women continuing with IUD at 6 months was assessed with respect to the number of previous cesareans.

    Results

    Ninety-seven women completed the follow-up. The rate of IUD continuation was 91% at 6 weeks and 83.5% at 6 months. The expulsion/removal rate in the first 6 weeks was not different from that between 6 weeks and 6 months (9 vs 9.1%, respectively). There were 2 cases of endometritis (2.1%), and no case of uterine perforation. Among 81 women continuing with intrauterine device after 6-months, 31% had undergone only the cesarean section in which the IUD was inserted, 44% had undergone 2 and 25% had undergone 3 or more cesarean sections.

    Conclusion

    Two thirds of the women who continued with IUD at 6 months had undergone 2 ormore cesarean sections. Since offering trial of labor is unusual after 2 or more previous cesareans, we believe that offering IUD after admission for delivery may reduce the risk of repeated cesarean sections and its inherent risks.

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    Intrauterine Device Insertion during Cesarean Section in Women without Prenatal Contraception Counseling: Lessons from a Country with High Cesarean Rates
  • Original Articles

    Assisted Reproductive Technologies in Latin America and Europe: a Comparative Analysis of Reported Databases for 2013

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):493-499

    Summary

    Original Articles

    Assisted Reproductive Technologies in Latin America and Europe: a Comparative Analysis of Reported Databases for 2013

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):493-499

    DOI 10.1055/s-0039-1693680

    Views4

    Abstract

    Objective

    To compare the Latin American and European assisted reproductive technology (ART) registries regarding data accessibility and quality, treatment utilization, effectiveness, safety, and quality of services.

    Methods

    We performed an ecological study using data from scientific publications of Latin American and European registries that report cycles initiated during 2013 (the most recent registries available until December of 2017). The summarized data are presented as frequencies, percentages, minimum-maximum values, and absolute numbers.

    Results

    Reporting clinics and cycle treatments were unevenly distributed between the participating countries for both registries, although access to ART is 15 times greater in Europe. In Latin America, individual services participate voluntarily reporting started cycles until cancellation, birth or miscarriage, while in Europe it varied among countries. It makes the data available from Latin America more uniform, although lesser representative when compared with European ones, given that reporting is compulsory formost countries. The cumulative live birth rate was better in Latin America. Female age, use of intracytoplasmic sperm injection (ICSI), cycles with transfer of ≥ 3 embryos, as well as multiple pregnancy rates were greater in the Latin American Register of Assisted Reproduction (RLA, in the Portuguese acronym). Assisted reproductive technology complications, such as ovarian hyperstimulation syndrome, hemorrhage, and infections were also higher in LatinAmerica, although they are extremely uncommon in both regions.

    Conclusion

    Both regions have points to improve in the quality of their reports. Latin America has produced a more uniform reporting, their clinical results are generally

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  • Original Articles

    Effectiveness of Solution-Focused Group Counseling on the Mental Health of Midwifery Students

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):500-507

    Summary

    Original Articles

    Effectiveness of Solution-Focused Group Counseling on the Mental Health of Midwifery Students

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):500-507

    DOI 10.1055/s-0039-1693741

    Views21

    Abstract

    Objective

    The present study was conducted with the objective of investigating the effectiveness of solution-focused group counseling (SFGC) on promoting the mental health of midwifery students.

    Methods

    The present study is an intervention-based study with a pretest, a post-test, and a control group. The statistical population included all of the midwifery students studying in the midwifery department of the Bam University of Medical Sciences, Kerman, Iran, who filled out the General Health Questionnaire (GHQ) in the screening phase. In the second phase, 40 individuals, having a low level of mental health based on the cutoff score of 23, were selected and randomly divided into 2 groups (intervention and control), each group with 20 participants. The intervention group participated in 5 sessions of 75 minutes for SFGC. Then, the post-test was held in both groups and the data analysis was conducted using the Mann-Whitney and the Kruskal-Wallis test with IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp, Armonk, NY, USA). The significance level was considered as p < 0.05.

    Results

    The findings showed that the mean of the post-test mental health scores of the intervention group (14.5 ± 50.35) and of the control group (23.6 ± 35.83) showed a statistically significant difference (p < 0.0001). Moreover, the comparison between the mean scores of the mental health subscales (physical symptoms, stress, social performance, and depression) showed a statistically significant difference in these groups, and SFGC improved physical symptoms, stress, social performance, and depression in the members of the intervention group.

    Conclusion

    Solution-focused group counseling may improve all levels of mental health. This type of counseling is recommended to be used to solve the psychological problemsand to improve the mental health of students, as well as of the staff of the health system.

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  • Review Article

    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519

    Summary

    Review Article

    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):508-519

    DOI 10.1055/s-0039-1695002

    Views56

    Abstract

    Objective

    We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence - UI, fecal incontinence - FI, and pelvic organ prolapse - POP).

    Data

    sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies.

    Data collection

    Two authors performed data extraction into a standardized spreadsheet.

    Data synthesis

    Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n= 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n= 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n= 3), low educational level (n= 4), low access to information (n= 5) and socioeconomic status (n= 3).

    Conclusion

    Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.

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    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review
  • Case Report

    Femoral Hernia Containing the Right Fallopian Tube: A Rare Finding

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):520-522

    Summary

    Case Report

    Femoral Hernia Containing the Right Fallopian Tube: A Rare Finding

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(8):520-522

    DOI 10.1055/s-0039-1693055

    Views3

    Abstract

    Femoral hernias comprise a small proportion of all groin hernias. They are more common in women and have a high rate of incarceration and strangulation, leading to emergency repair. A 61-year-old female patient was admitted to the emergency department complaining of a 2-day painful lump in the right groin, that had become more intense in the last 24 hours. Physical examination suggested the presence of a strangulated femoral hernia, and the patient underwent emergency surgical repair. Intraoperatively, the right fallopian tube was observed in the hernia sac. Since there were no signs of ischemia, the tube was reduced back into the pelvic cavity and the hernia was repaired. The postoperative period was uneventful, and the patient was discharged without complications, 3 days after surgery.

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    Femoral Hernia Containing the Right Fallopian Tube: A Rare Finding

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