Você pesquisou por y - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):595-602
DOI 10.1590/S0100-72032004000800002
PURPOSE: to evaluate the effects of estradiol benzoate associated with dexamethasone on the squamocolumnar junction (SCJ) of rats in permanent estrus (PE) and then ovariectomized (Ovx). METHODS: thirty female rats were divided into six groups of five animals each: PhEG rats in physiological estrus (PhE) treated with propylene glycol (vehicle); OVXG rats in PhE, Ovx and treated with vehicle; PEG - rats in PE treated with vehicle; PEOVXG rats in PE, Ovx and treated with vehicle; ESTRG rats in PE, Ovx and treated with 10 mg per day benzoate of estradiol, and DEXAG in PE, Ovx and treated with 10 mg per day estradiol benzoate associated with 0.8 mg dexamethasone. PE induction was performed with 1.25 mg testosterone propionate per animal per day after birth. After 90 days, rats in the OVXG, EPOVXG, ESTRG, and DEXAG groups were ovariectomized. After 21 days of castration, all animals received the corresponding treatment for five days. At the end of the experiment, all animals were sacrificed and the uteri removed for histological routine. RESULTS: the borders of the SCJ in the PEG were irregular and not clearly delineated, with many buds towards the direction of the lamina propria as well as a reduction in the leukocyte number compared to the PhEG. The SCJ of the OVXG and PEOVXG was not very visible, with cubical epithelium on the endometrial side and with reduction in the layers of squamous epithelium due to stromal atrophy. The SCJ in the ESTRG was more developed than in the OVXG and PEOVXG, but it was similar to that of the PEG, having unclear borders. In contrast, the SCJ of the DEXAG was well-delineated and similar to the PhEG. CONCLUSION: our data suggest that estrogen associated with dexamethasone may be important for remodeling SCJ morphology in female rats with previously induced permanent estrus and subsequent ovariectomy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):595-602
DOI 10.1590/S0100-72032004000800002
PURPOSE: to evaluate the effects of estradiol benzoate associated with dexamethasone on the squamocolumnar junction (SCJ) of rats in permanent estrus (PE) and then ovariectomized (Ovx). METHODS: thirty female rats were divided into six groups of five animals each: PhEG rats in physiological estrus (PhE) treated with propylene glycol (vehicle); OVXG rats in PhE, Ovx and treated with vehicle; PEG - rats in PE treated with vehicle; PEOVXG rats in PE, Ovx and treated with vehicle; ESTRG rats in PE, Ovx and treated with 10 mg per day benzoate of estradiol, and DEXAG in PE, Ovx and treated with 10 mg per day estradiol benzoate associated with 0.8 mg dexamethasone. PE induction was performed with 1.25 mg testosterone propionate per animal per day after birth. After 90 days, rats in the OVXG, EPOVXG, ESTRG, and DEXAG groups were ovariectomized. After 21 days of castration, all animals received the corresponding treatment for five days. At the end of the experiment, all animals were sacrificed and the uteri removed for histological routine. RESULTS: the borders of the SCJ in the PEG were irregular and not clearly delineated, with many buds towards the direction of the lamina propria as well as a reduction in the leukocyte number compared to the PhEG. The SCJ of the OVXG and PEOVXG was not very visible, with cubical epithelium on the endometrial side and with reduction in the layers of squamous epithelium due to stromal atrophy. The SCJ in the ESTRG was more developed than in the OVXG and PEOVXG, but it was similar to that of the PEG, having unclear borders. In contrast, the SCJ of the DEXAG was well-delineated and similar to the PhEG. CONCLUSION: our data suggest that estrogen associated with dexamethasone may be important for remodeling SCJ morphology in female rats with previously induced permanent estrus and subsequent ovariectomy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):595-595
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):595-595
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):605-610
DOI 10.1590/S0100-72032004000800003
OBJECTIVE: to evaluate staging, surgical procedures and outcome of ovarian granulosa cell tumors (GCT), with emphasis in the possibility of conservative surgery (unilateral ooforectomy). METHODS: this is a retrospective cohort study in which 24 patients treated with GCT during the period of January 1994 to January 2004 were included. Variables of interest such as patient's age, symptoms, tumor size on physical examination, staging, treatment modalities (types of surgery and of adjuvant chemotherapy and/or radiotherapy) and prognosis have been analyzed. The chi-square test was used to check the association between variables, and the level of significance was set at p < 0.05, always describing the two-tailed Fisher exact test. RESULTS: the patients' age varied from 30 to 82 (mean 51.7) years old. The most frequently referred symptom was pelvic pain (n = 10; 41.7%). Fourteen patients (58.3%) presented clinical stage (CS) Ic, 5 (20.8%) CS IIIc and 5 (20.8%) CS Ia. More advanced clinical stages were significantly associated with palpable pelvic masses (p < 0.04). Endometrial hyperplasias were found in 3 (25%) of the 12 hysterectomy specimens. The follow-up period varied from 2 to 114 (mean 42.5) months. Among the 16 (66.7%) surviving and disease-free patients, 4 had CS Ia (25%), 11 CS Ib (68.8%) and 1 CS Ic (6.3%), whereas all patients who died had CS IIIc (p = 0.0008). All 6 patients (25%) that underwent conservative surgery were alive and without recurrence. CONCLUSION: although GCT usually present low aggressiveness, the clinical staging continues to be the main prognostic factor and hence it determines the option for conservative surgery and the use of adjuvant therapy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):605-610
DOI 10.1590/S0100-72032004000800003
OBJECTIVE: to evaluate staging, surgical procedures and outcome of ovarian granulosa cell tumors (GCT), with emphasis in the possibility of conservative surgery (unilateral ooforectomy). METHODS: this is a retrospective cohort study in which 24 patients treated with GCT during the period of January 1994 to January 2004 were included. Variables of interest such as patient's age, symptoms, tumor size on physical examination, staging, treatment modalities (types of surgery and of adjuvant chemotherapy and/or radiotherapy) and prognosis have been analyzed. The chi-square test was used to check the association between variables, and the level of significance was set at p < 0.05, always describing the two-tailed Fisher exact test. RESULTS: the patients' age varied from 30 to 82 (mean 51.7) years old. The most frequently referred symptom was pelvic pain (n = 10; 41.7%). Fourteen patients (58.3%) presented clinical stage (CS) Ic, 5 (20.8%) CS IIIc and 5 (20.8%) CS Ia. More advanced clinical stages were significantly associated with palpable pelvic masses (p < 0.04). Endometrial hyperplasias were found in 3 (25%) of the 12 hysterectomy specimens. The follow-up period varied from 2 to 114 (mean 42.5) months. Among the 16 (66.7%) surviving and disease-free patients, 4 had CS Ia (25%), 11 CS Ib (68.8%) and 1 CS Ic (6.3%), whereas all patients who died had CS IIIc (p = 0.0008). All 6 patients (25%) that underwent conservative surgery were alive and without recurrence. CONCLUSION: although GCT usually present low aggressiveness, the clinical staging continues to be the main prognostic factor and hence it determines the option for conservative surgery and the use of adjuvant therapy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):613-617
DOI 10.1590/S0100-72032004000800004
OBJECTIVE: the aim of the present study was to verify whether there is a correlation between the prevalence of the polymorphism in the progesterone receptor gene named PROGINS and pelvic endometriosis at different stages. METHODS: a case-control study carried out from November 2003 to May 2004. The genotypes of 104 women were analyzed 66 women had had surgically confirmed endometriosis (26 women at stages I-II and 40 at stages III-IV), and 38 were healthy women. The 306-base pair Alu insertion polymorphism in the intron G of the progesterone receptor gene was detected by polymerase chain reaction and analyzed on 2% agarose gel stained with ethidium bromide. ANOVA analysis was performed in order to make comparisons between among the studied groups. RESULTS: the groups of women with endometriosis stages I-II (EndoI group) and stages III-IV (EndoII group) showed statistically significant increased incidence of PROGINS polymorphic allele as compared with the control group: 27% in the EndoI group, 38% in EndoII and 18% in the control group (p < 0.001. In the analyses, a high frequency of the PROGINS insertion was observed in women with endometriosis as compared to healthy women, disregarding the clinical stage of the disease (p = 0.0385). CONCLUSION: there is a significant statistical association between the PROGINS polymorphism and pelvic endometriosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):613-617
DOI 10.1590/S0100-72032004000800004
OBJECTIVE: the aim of the present study was to verify whether there is a correlation between the prevalence of the polymorphism in the progesterone receptor gene named PROGINS and pelvic endometriosis at different stages. METHODS: a case-control study carried out from November 2003 to May 2004. The genotypes of 104 women were analyzed 66 women had had surgically confirmed endometriosis (26 women at stages I-II and 40 at stages III-IV), and 38 were healthy women. The 306-base pair Alu insertion polymorphism in the intron G of the progesterone receptor gene was detected by polymerase chain reaction and analyzed on 2% agarose gel stained with ethidium bromide. ANOVA analysis was performed in order to make comparisons between among the studied groups. RESULTS: the groups of women with endometriosis stages I-II (EndoI group) and stages III-IV (EndoII group) showed statistically significant increased incidence of PROGINS polymorphic allele as compared with the control group: 27% in the EndoI group, 38% in EndoII and 18% in the control group (p < 0.001. In the analyses, a high frequency of the PROGINS insertion was observed in women with endometriosis as compared to healthy women, disregarding the clinical stage of the disease (p = 0.0385). CONCLUSION: there is a significant statistical association between the PROGINS polymorphism and pelvic endometriosis.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):619-624
DOI 10.1590/S0100-72032004000800005
PURPOSE: to analyze the relationship of the imune system with preeclamptic pregnancies, comparing lymphocyte and lymphocyte subset analyses of normal pregnant women to pregnancy-induced hypertensive women. To evaluate this immunological function, 40 pregnant women were studied at the "Irmandade da Santa Casa Hospital" of São Paulo: 20 women with normal pregnancies and 20 women with pregnancy-induced hypertension. From all these pregnant women peripheral blood samples were obtained and submitted to the following tests: lymphocyte and lymphocyte subsets analyses (CD4+, CD8+, CD4+/CD8 +CD3+, CD19+). Statistical analysis was performed by the Mann-Whitney test. RESULTS: the serum lymphocyte counts were decreased in women with preeclampsia (preeclamptic group 2295.10±1328.16; control group 3892.80±1430.85, p<0,05); and so were CD4+ (preeclamptic group 1188.80±625.61, control group; 1742.25±628.40, p<0.05); CD8+ (preeclamptic group: 774.00±371.31, control group 1175.70±517.72, p<0,05) and CD3+ (preeclamptic group 1958.65±983.78, control group 2916.95±1117.88, p<0,05). The other tests showed no significant differences between groups. CONCLUSION: the findings indicated a decreased number of lymphocytes, CD4+, CD8+ and CD3+ in preeclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):619-624
DOI 10.1590/S0100-72032004000800005
PURPOSE: to analyze the relationship of the imune system with preeclamptic pregnancies, comparing lymphocyte and lymphocyte subset analyses of normal pregnant women to pregnancy-induced hypertensive women. To evaluate this immunological function, 40 pregnant women were studied at the "Irmandade da Santa Casa Hospital" of São Paulo: 20 women with normal pregnancies and 20 women with pregnancy-induced hypertension. From all these pregnant women peripheral blood samples were obtained and submitted to the following tests: lymphocyte and lymphocyte subsets analyses (CD4+, CD8+, CD4+/CD8 +CD3+, CD19+). Statistical analysis was performed by the Mann-Whitney test. RESULTS: the serum lymphocyte counts were decreased in women with preeclampsia (preeclamptic group 2295.10±1328.16; control group 3892.80±1430.85, p<0,05); and so were CD4+ (preeclamptic group 1188.80±625.61, control group; 1742.25±628.40, p<0.05); CD8+ (preeclamptic group: 774.00±371.31, control group 1175.70±517.72, p<0,05) and CD3+ (preeclamptic group 1958.65±983.78, control group 2916.95±1117.88, p<0,05). The other tests showed no significant differences between groups. CONCLUSION: the findings indicated a decreased number of lymphocytes, CD4+, CD8+ and CD3+ in preeclampsia.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):627-632
DOI 10.1590/S0100-72032004000800006
OBJECTIVE: to establish the rate of toxoplasmosis soroprevalence in postpartum women, attended in two hospitals of the Public Health System (SUS) in Cuiabá, and its correlation with age, previous abortion and women's knowledge of the disease. METHODS: a cross-sectional study including 205 women with ages from 14 to 43 (mean 22.4) years old, attended in these hospitals for two months, in the first or second days postpartum. Each woman answered a short questionnaire and had peripheral blood sample collected. Blood samples were stored at 20°C until assay. The seroprevalence was determined by quantitative detection of specific IgG antibody against Toxoplasma gondii, using a microparticle enzyme immunoassay. All samples were assayed at the same time. RESULTS: The average number of pregnancies in the women included in this study was 2.2, and the majority of them was pregnant for the first time. The seroprevalence found was 70.7% (165 of 205 women). No statistical correlation was found between seroprevalence and age (p = 0.967) or previous abortion (p = 0.82). Most of the women in this study (78%) did not know about toxoplasmosis and no statistical correlation was found between this condition and seroprevalence (p = 0.49). CONCLUSION: the high seroprevalence found in the present study is in accordance with surveys previously reported in our country and other developing countries. Among the women included in this study, an expressive number (29.3%) is still under risk of contamination. The lack of statistical correlation between seroprevalence and women's age, lack of knowledge about the disease and report of previous abortion is in accordance with some previous studies and in disagreement with others.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):627-632
DOI 10.1590/S0100-72032004000800006
OBJECTIVE: to establish the rate of toxoplasmosis soroprevalence in postpartum women, attended in two hospitals of the Public Health System (SUS) in Cuiabá, and its correlation with age, previous abortion and women's knowledge of the disease. METHODS: a cross-sectional study including 205 women with ages from 14 to 43 (mean 22.4) years old, attended in these hospitals for two months, in the first or second days postpartum. Each woman answered a short questionnaire and had peripheral blood sample collected. Blood samples were stored at 20°C until assay. The seroprevalence was determined by quantitative detection of specific IgG antibody against Toxoplasma gondii, using a microparticle enzyme immunoassay. All samples were assayed at the same time. RESULTS: The average number of pregnancies in the women included in this study was 2.2, and the majority of them was pregnant for the first time. The seroprevalence found was 70.7% (165 of 205 women). No statistical correlation was found between seroprevalence and age (p = 0.967) or previous abortion (p = 0.82). Most of the women in this study (78%) did not know about toxoplasmosis and no statistical correlation was found between this condition and seroprevalence (p = 0.49). CONCLUSION: the high seroprevalence found in the present study is in accordance with surveys previously reported in our country and other developing countries. Among the women included in this study, an expressive number (29.3%) is still under risk of contamination. The lack of statistical correlation between seroprevalence and women's age, lack of knowledge about the disease and report of previous abortion is in accordance with some previous studies and in disagreement with others.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):633-639
DOI 10.1590/S0100-72032004000800007
PURPOSE: to check whether there were differences in some social indicators between adolescent and adult pregnant women in the city of Ribeirão Preto, from January 1992 to December 1996. METHODS: the information was obtained from hospital discharge forms and was analyzed at the Hospital Data Processing Center of the FMRP-USP. The analyzed parameters were: number and types of deliveries, category of hospital admission, occupation, and obstetric diagnosis. The 6.04a text processor Epi-Info System, a data bank and statistics of epidemiology produced by the Centers of Disease Control and Prevention (Atlanta, GA, USA), and Dbase IV were used to process the information. The association between variables was tested by the chi² test, with level of significance set at 5%, using the GraphPad Prism version 2.0, 1995 software. RESULTS: a total of 43,253 deliveries occurred during this period, among which 7,134 (16.5%) corresponded to adolescent deliveries, while 36,119 (83.5%) to adult deliveries. The number of deliveries by adolescent girls increased 25.5% along this period. The proportion of adolescent deliveries in the unified health system category of admission increased, and it was higher than that of the adults'. Only 14.1% of the adolescents belonged to the economically active population, comparing with 34.8% of the adults. Only 6.8% of the adolescents were students, while 79.0% were house-workers or had a nonpaid occupation. In the analyzed period, the ratio of vaginal delivery increased among the adolescents, as compared to that of the adults. The ratio of cesarean delivery persisted stable and higher among the adults. Premature delivery and false labor were significantly more frequent among the adolescents. CONCLUSION: the number of deliveries increased among the adolescents, and most of them were normal. The ratio of admission by the unified health system category and that of vaginal delivery were higher among the adolescents. There were more adolescents without an economically active work. Thus, we recommend strategies to prevent adolescent pregnancy, mainly among the poor population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):633-639
DOI 10.1590/S0100-72032004000800007
PURPOSE: to check whether there were differences in some social indicators between adolescent and adult pregnant women in the city of Ribeirão Preto, from January 1992 to December 1996. METHODS: the information was obtained from hospital discharge forms and was analyzed at the Hospital Data Processing Center of the FMRP-USP. The analyzed parameters were: number and types of deliveries, category of hospital admission, occupation, and obstetric diagnosis. The 6.04a text processor Epi-Info System, a data bank and statistics of epidemiology produced by the Centers of Disease Control and Prevention (Atlanta, GA, USA), and Dbase IV were used to process the information. The association between variables was tested by the chi² test, with level of significance set at 5%, using the GraphPad Prism version 2.0, 1995 software. RESULTS: a total of 43,253 deliveries occurred during this period, among which 7,134 (16.5%) corresponded to adolescent deliveries, while 36,119 (83.5%) to adult deliveries. The number of deliveries by adolescent girls increased 25.5% along this period. The proportion of adolescent deliveries in the unified health system category of admission increased, and it was higher than that of the adults'. Only 14.1% of the adolescents belonged to the economically active population, comparing with 34.8% of the adults. Only 6.8% of the adolescents were students, while 79.0% were house-workers or had a nonpaid occupation. In the analyzed period, the ratio of vaginal delivery increased among the adolescents, as compared to that of the adults. The ratio of cesarean delivery persisted stable and higher among the adults. Premature delivery and false labor were significantly more frequent among the adolescents. CONCLUSION: the number of deliveries increased among the adolescents, and most of them were normal. The ratio of admission by the unified health system category and that of vaginal delivery were higher among the adolescents. There were more adolescents without an economically active work. Thus, we recommend strategies to prevent adolescent pregnancy, mainly among the poor population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):641-647
DOI 10.1590/S0100-72032004000800008
OBJECTIVE: to investigate whether it is possible to predict acidemia at birth in pregnancies with placental insufficiency using venous-arterial indices: pulsatility index for vein (PIV) of the ductus venosus (DV) over PI of the middle cerebral artery (MCA) and PIV of the DV over PI of the umbilical artery, and establish cut-off values for this prediction. PATIENTS AND METHODS: this was a prospective cross-sectional study involving forty-seven patients with placental insufficiency (umbilical artery resistance and pulsatility indices above the 95th percentile for gestational age) who were submitted to Dopplervelocimetry in the last 24 hours before delivery. All pregnancies were singleton, over 26 weeks of age and without structural or chromosome anomalies. Arterial cord blood was obtained for gasometry immediately after birth. Acidemia was defined as umbilical arterial pH < 7.20 in the absence of uterine contractions and pH < 7.15 in the presence of contractions. Metabolic or mixed acidemia at birth were considered pathological. A ROC curve was calculated for the venous-arterial indices: PIV DV/PI umbilical artery (UA) and PIV DV/PI MCA. A cut-off value was established and sensitivity, specificity, accuracy, positive and negative predictive values and positive and negative likelihood ratios were calculated. RESULTS: The DV/UA PI index was not a good predictor of acidemia at birth. The DV/MCA PI index was related to acidemia at birth (area under the curve 0,785, p = 0,004). The cut-off value was: 0,582, sensitivity 66,7%, specificity 77,1 and accuracy 74,5%. CONCLUSION: the PIV DV/PI MCA ratio is adequate for predicting acidemia at birth in pregnancies with placental insufficiency. The cut-off value was: 0,582.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(8):641-647
DOI 10.1590/S0100-72032004000800008
OBJECTIVE: to investigate whether it is possible to predict acidemia at birth in pregnancies with placental insufficiency using venous-arterial indices: pulsatility index for vein (PIV) of the ductus venosus (DV) over PI of the middle cerebral artery (MCA) and PIV of the DV over PI of the umbilical artery, and establish cut-off values for this prediction. PATIENTS AND METHODS: this was a prospective cross-sectional study involving forty-seven patients with placental insufficiency (umbilical artery resistance and pulsatility indices above the 95th percentile for gestational age) who were submitted to Dopplervelocimetry in the last 24 hours before delivery. All pregnancies were singleton, over 26 weeks of age and without structural or chromosome anomalies. Arterial cord blood was obtained for gasometry immediately after birth. Acidemia was defined as umbilical arterial pH < 7.20 in the absence of uterine contractions and pH < 7.15 in the presence of contractions. Metabolic or mixed acidemia at birth were considered pathological. A ROC curve was calculated for the venous-arterial indices: PIV DV/PI umbilical artery (UA) and PIV DV/PI MCA. A cut-off value was established and sensitivity, specificity, accuracy, positive and negative predictive values and positive and negative likelihood ratios were calculated. RESULTS: The DV/UA PI index was not a good predictor of acidemia at birth. The DV/MCA PI index was related to acidemia at birth (area under the curve 0,785, p = 0,004). The cut-off value was: 0,582, sensitivity 66,7%, specificity 77,1 and accuracy 74,5%. CONCLUSION: the PIV DV/PI MCA ratio is adequate for predicting acidemia at birth in pregnancies with placental insufficiency. The cut-off value was: 0,582.
