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  • Original Article

    The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo42

    Summary

    Original Article

    The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects

    Rev Bras Ginecol Obstet. 2024;46:e-rbgo42

    DOI 10.61622/rbgo/2024rbgo42

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    Abstract

    Objective

    To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.

    Methods

    Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.

    Results

    Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).

    Conclusion

    Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.

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  • Original Article

    Pubic Arch Angle Measurement by Transperineal Ultrasonography: A Prospective Cross-Sectional Study

    Rev Bras Ginecol Obstet. 2020;42(4):181-187

    Summary

    Original Article

    Pubic Arch Angle Measurement by Transperineal Ultrasonography: A Prospective Cross-Sectional Study

    Rev Bras Ginecol Obstet. 2020;42(4):181-187

    DOI 10.1055/s-0040-1709690

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    Abstract

    Objective

    To evaluate the ability of the pubic arch angle (PAA) as measured by transperineal ultrasonography during labor to predict the delivery type and cephalic pole disengagement mode.

    Methods

    The present prospective cross-sectional study included 221 women in singleton-gestational labor ≥ 37 weeks with cephalic fetuses who underwent PAA measurement using transperineal ultrasonography. These measurements were correlated with the delivery type, cephalic pole disengagement mode, and fetal and maternal characteristics.

    Results

    Out of the subjects, 153 (69.2%) had spontaneous vaginal delivery, 7 (3.2%) gave birth by forceps, and 61 (27.6%) delivered by cesarean section. For the analysis, deliveries were divided into two groups: vaginal and surgical (forceps and cesarean). The mean PAA was 102 ± 7.5º (range, 79.3-117.7º). No statistically significant difference was observed in delivery type (102.6 ± 7.2º versus 100.8 ± 7.9º, p = 0.105). The occipitoanterior position was seen in 94.1% of the fetuses and the occipitoposterior position in 5.8%. A narrower PAA was found in the group of surgical deliveries (97.9 ± 9.6º versus 102.6 ± 7.3º, p = 0.049). Multivariate regression analysis showed that PAA was a predictive variable for the occurrence of head disengagement in occipital varieties after birth (odds ratio, 0.9; 95% confidence interval, 0.82-0.99; p = 0.026).

    Conclusion

    Ultrasonographic measurement of the PAA was not a predictor of delivery type, but was associated with the persistence of occipital varieties after birth.

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    Pubic Arch Angle Measurement by Transperineal Ultrasonography: A Prospective Cross-Sectional Study
  • Original Article

    Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

    Rev Bras Ginecol Obstet. 2022;44(3):287-294

    Summary

    Original Article

    Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

    Rev Bras Ginecol Obstet. 2022;44(3):287-294

    DOI 10.1055/s-0041-1741032

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    Abstract

    Objective

    To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in~43% of women with PCOS, and NAFLD is the hepatic expression of MetS.

    Methods

    One hundred women, 50 with PCOS and 50 controls, matched by age (18- 35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively.

    Results

    The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval)=4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9±9.08 cm vs 94.96±6.99 cm) and triglycerides (162±54.63 mg/dL vs 137.54±36.91mg/dL) and lower average of HDL cholesterol (45.66±6.88 mg/dL vs 49.78±7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group.

    Conclusion

    Women with PCOS had 4-fold higher frequency of MetS andmore hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.

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