Você pesquisou por y?yr=2013 - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):385-387
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):385-387
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):388-393
DOI 10.1590/S0100-72032013000900002
PURPOSE: To describe the prevalence of maternal mortality at a tertiary care hospital and to assessits preventability. METHODS: This study, through the analysis of maternal deaths that occurred during the period from 1999 to 2010 at a reference in Campinas - Brazil, CAISM/ UNICAMP, discusses some of the factors associated with the main causes of death and some structural problems of structure of the health services. It is a retrospective descriptive study with evaluation of sociodemographic variables and the medical and obstetric history of women, and the causes of death. RESULTS: The majority of maternal deaths occurred due to direct obstetric (45%) and avoidable (36%) causes, in women with preterm gestation, who delivered by cesarean section (56%) and received various management procedures, including blood transfusion, ICU admission and need for laparotomy and/or hysterectomy. The hospital transfer was associated with the predominance of direct obstetric (19 versus 6, p=0.02) and avoidable causes (22 versus 9, p=0.01). CONCLUSIONS: We conclude that, despite current advances in Obstetrics, infections and hypertensive disorders are still the predominant causes of maternal mortality. We observed an increase of clinical-surgical conditions and neoplasms as causes of death among women during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):388-393
DOI 10.1590/S0100-72032013000900002
PURPOSE: To describe the prevalence of maternal mortality at a tertiary care hospital and to assessits preventability. METHODS: This study, through the analysis of maternal deaths that occurred during the period from 1999 to 2010 at a reference in Campinas - Brazil, CAISM/ UNICAMP, discusses some of the factors associated with the main causes of death and some structural problems of structure of the health services. It is a retrospective descriptive study with evaluation of sociodemographic variables and the medical and obstetric history of women, and the causes of death. RESULTS: The majority of maternal deaths occurred due to direct obstetric (45%) and avoidable (36%) causes, in women with preterm gestation, who delivered by cesarean section (56%) and received various management procedures, including blood transfusion, ICU admission and need for laparotomy and/or hysterectomy. The hospital transfer was associated with the predominance of direct obstetric (19 versus 6, p=0.02) and avoidable causes (22 versus 9, p=0.01). CONCLUSIONS: We conclude that, despite current advances in Obstetrics, infections and hypertensive disorders are still the predominant causes of maternal mortality. We observed an increase of clinical-surgical conditions and neoplasms as causes of death among women during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):394-400
DOI 10.1590/S0100-72032013000900003
PURPOSE: To investigate the usefulness of the measurement of cervical length and of the test for phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) performed sequentially in the prediction of preterm birth and the correlation between tests. METHODS: We analyzed data from 101 asymptomatic pregnant women with a history of premature delivery. The ultrasound measurement of cervical length and phIGFBP-1 test were performed in parallel every three weeks, between 24 and 34 week. The best cutoff value for each cervical evaluation was established by the ROC curve, and the two tests were compared using nonparametric tests. We determined the sensitivity, specificity and predictive values of each test and of the association of the exams for the occurrence of delivery before the 37th weeks. RESULTS: There were 25 preterm births (24.8%). The cervix length showed the highest sensitivity and was able to predict preterm birth in all evaluations, with similar accuracy at different gestational ages. The test for phIGFBP-1 was not helpful at 24 weeks, but was able to predict prematurity when performed at 27, 30 and 33 weeks. The combination of tests increased the sensitivity (81.8%) and negative predictive value (93.7%) when compared to the separate use of each test. The mean cervical length was lower in women with a positive test. CONCLUSIONS: Both cervical length and the test for phIGFBP-1 were able to predict premature delivery, and sequential combination of both tests showed a high sensitivity and high negative predictive value.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):394-400
DOI 10.1590/S0100-72032013000900003
PURPOSE: To investigate the usefulness of the measurement of cervical length and of the test for phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) performed sequentially in the prediction of preterm birth and the correlation between tests. METHODS: We analyzed data from 101 asymptomatic pregnant women with a history of premature delivery. The ultrasound measurement of cervical length and phIGFBP-1 test were performed in parallel every three weeks, between 24 and 34 week. The best cutoff value for each cervical evaluation was established by the ROC curve, and the two tests were compared using nonparametric tests. We determined the sensitivity, specificity and predictive values of each test and of the association of the exams for the occurrence of delivery before the 37th weeks. RESULTS: There were 25 preterm births (24.8%). The cervix length showed the highest sensitivity and was able to predict preterm birth in all evaluations, with similar accuracy at different gestational ages. The test for phIGFBP-1 was not helpful at 24 weeks, but was able to predict prematurity when performed at 27, 30 and 33 weeks. The combination of tests increased the sensitivity (81.8%) and negative predictive value (93.7%) when compared to the separate use of each test. The mean cervical length was lower in women with a positive test. CONCLUSIONS: Both cervical length and the test for phIGFBP-1 were able to predict premature delivery, and sequential combination of both tests showed a high sensitivity and high negative predictive value.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):407-412
DOI 10.1590/S0100-72032013000900005
PURPOSE: In placentas from uncomplicated pregnancies, Hofbauer cells either disappear or become scanty after the fourth to fifth month of gestation. Immunohistochemistry though, reveals that a high percentage of stromal cells belong to Hofbauer cells. The aim of this study was to investigate the changes in morphology and density of Hofbauer cells in placentas from normal and pathological pregnancies. METHODS: Seventy placentas were examined: 16 specimens from normal term pregnancies, 10 from first trimester's miscarriages, 26 from cases diagnosed with chromosomal abnormality of the fetus, and placental tissue specimens complicated with intrauterine growth restriction (eight) or gestational diabetes mellitus (10). A histological study of hematoxylin-eosin (HE) sections was performed and immunohistochemical study was performed using the markers: CD 68, Lysozyme, A1 Antichymotrypsine, CK-7, vimentin, and Ki-67. RESULTS: In normal term pregnancies, HE study revealed Hofbauer cells in 37.5% of cases while immunohistochemistry revealed in 87.5% of cases. In first trimester's miscarriages and in cases with prenatal diagnosis of fetal chromosomal abnormalities, both basic and immunohistochemical study were positive for Hofbauer cells. In pregnancies complicated with intrauterine growth restriction or gestational diabetes mellitus, a positive immunoreaction was observed in 100 and 70% of cases, respectively. CONCLUSIONS: Hofbauer cells are present in placental villi during pregnancy, but with progressively reducing density. The most specific marker for their detection seems to be A1 Antichymotrypsine. It is remarkable that no mitotic activity of Hofbauer cells was noticed in our study, as the marker of cellular multiplication Ki-67 was negative in all examined specimens.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):407-412
DOI 10.1590/S0100-72032013000900005
PURPOSE: In placentas from uncomplicated pregnancies, Hofbauer cells either disappear or become scanty after the fourth to fifth month of gestation. Immunohistochemistry though, reveals that a high percentage of stromal cells belong to Hofbauer cells. The aim of this study was to investigate the changes in morphology and density of Hofbauer cells in placentas from normal and pathological pregnancies. METHODS: Seventy placentas were examined: 16 specimens from normal term pregnancies, 10 from first trimester's miscarriages, 26 from cases diagnosed with chromosomal abnormality of the fetus, and placental tissue specimens complicated with intrauterine growth restriction (eight) or gestational diabetes mellitus (10). A histological study of hematoxylin-eosin (HE) sections was performed and immunohistochemical study was performed using the markers: CD 68, Lysozyme, A1 Antichymotrypsine, CK-7, vimentin, and Ki-67. RESULTS: In normal term pregnancies, HE study revealed Hofbauer cells in 37.5% of cases while immunohistochemistry revealed in 87.5% of cases. In first trimester's miscarriages and in cases with prenatal diagnosis of fetal chromosomal abnormalities, both basic and immunohistochemical study were positive for Hofbauer cells. In pregnancies complicated with intrauterine growth restriction or gestational diabetes mellitus, a positive immunoreaction was observed in 100 and 70% of cases, respectively. CONCLUSIONS: Hofbauer cells are present in placental villi during pregnancy, but with progressively reducing density. The most specific marker for their detection seems to be A1 Antichymotrypsine. It is remarkable that no mitotic activity of Hofbauer cells was noticed in our study, as the marker of cellular multiplication Ki-67 was negative in all examined specimens.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):413-420
DOI 10.1590/S0100-72032013000900006
PURPOSE: To characterize and compare clinical, anthropometric and biochemical-metabolic variables in patients with polycystic ovary syndrome (PCOS), stratified according to body mass index (BMI). METHODS: A cross-sectional study conducted on 78 women aged 18 to 45 years with a clinical diagnosis of PCOS by the Rotterdam criteria. Patients were stratified according to BMI. The variables analyzed were: age, marital status, physical inactivity, menstrual irregularity, blood pressure (BP), anthropometric measurements, lipid profile, fasting glucose, and hormone measurements. To compare the variables between the different BMI values we used analysis of variance and the Kruskal-Wallis test. The level of significance was set at 5% for all tests. RESULTS: The patients had a mean age of 26.3 years, 79.5% of them were sedentary and 68% had hyperandrogenism. Waist circumference, waist/hip ratio, waist/height ratio and percentage of body fat were higher in the obese group. The markers of cardiovascular risk (CVR - fasting glucose, systolic and diastolic BP and LDL-cholesterol) were directly proportional to BMI, whereas HDL-cholesterol and SHBG were inversely related to BMI. CONCLUSION: The presence of markers of CVR factors increased proportionally to BMI, indicating that the metabolic profile of obese women with PCOS is more unfavorable than that of non-obese patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):413-420
DOI 10.1590/S0100-72032013000900006
PURPOSE: To characterize and compare clinical, anthropometric and biochemical-metabolic variables in patients with polycystic ovary syndrome (PCOS), stratified according to body mass index (BMI). METHODS: A cross-sectional study conducted on 78 women aged 18 to 45 years with a clinical diagnosis of PCOS by the Rotterdam criteria. Patients were stratified according to BMI. The variables analyzed were: age, marital status, physical inactivity, menstrual irregularity, blood pressure (BP), anthropometric measurements, lipid profile, fasting glucose, and hormone measurements. To compare the variables between the different BMI values we used analysis of variance and the Kruskal-Wallis test. The level of significance was set at 5% for all tests. RESULTS: The patients had a mean age of 26.3 years, 79.5% of them were sedentary and 68% had hyperandrogenism. Waist circumference, waist/hip ratio, waist/height ratio and percentage of body fat were higher in the obese group. The markers of cardiovascular risk (CVR - fasting glucose, systolic and diastolic BP and LDL-cholesterol) were directly proportional to BMI, whereas HDL-cholesterol and SHBG were inversely related to BMI. CONCLUSION: The presence of markers of CVR factors increased proportionally to BMI, indicating that the metabolic profile of obese women with PCOS is more unfavorable than that of non-obese patients.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):421-426
DOI 10.1590/S0100-72032013000900007
Polycystic ovary syndrome (PCOS) is an endocrine disorder associated with several cardiometabolic risk factors, such as central obesity, insulin resistance, type 2 diabetes, metabolic syndrome, and hypertension. These factors are associated with adrenergic overactivity, which is an important prognostic factor for the development of cardiovascular disorders. Given the common cardiometabolic disturbances occurring in PCOS women, over the last years studies have investigated the cardiac autonomic control of these patients, mainly based on heart rate variability (HRV). Thus, in this review, we will discuss the recent findings of the studies that investigated the HRV of women with PCOS, as well as noninvasive methods of analysis of autonomic control starting from basic indexes related to this methodology.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):421-426
DOI 10.1590/S0100-72032013000900007
Polycystic ovary syndrome (PCOS) is an endocrine disorder associated with several cardiometabolic risk factors, such as central obesity, insulin resistance, type 2 diabetes, metabolic syndrome, and hypertension. These factors are associated with adrenergic overactivity, which is an important prognostic factor for the development of cardiovascular disorders. Given the common cardiometabolic disturbances occurring in PCOS women, over the last years studies have investigated the cardiac autonomic control of these patients, mainly based on heart rate variability (HRV). Thus, in this review, we will discuss the recent findings of the studies that investigated the HRV of women with PCOS, as well as noninvasive methods of analysis of autonomic control starting from basic indexes related to this methodology.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):427-431
DOI 10.1590/S0100-72032013000900008
Crime and violence have become a public health problem. Pregnant women have not been the exception and gunshot injuries occupy an important place as a cause of trauma. An important fact is that pregnant women, who suffer trauma, are special patients because pregnancy causes physiological and anatomical changes. Management of these patients should be multidisciplinary, by the general surgeon, the obstetrician and the neonatologist. However, even trauma referral centers could neither have the staff nor the ideal training for these specific cases. In this context we present the following case.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):427-431
DOI 10.1590/S0100-72032013000900008
Crime and violence have become a public health problem. Pregnant women have not been the exception and gunshot injuries occupy an important place as a cause of trauma. An important fact is that pregnant women, who suffer trauma, are special patients because pregnancy causes physiological and anatomical changes. Management of these patients should be multidisciplinary, by the general surgeon, the obstetrician and the neonatologist. However, even trauma referral centers could neither have the staff nor the ideal training for these specific cases. In this context we present the following case.
