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  • Original Article

    Is there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):200-210

    Summary

    Original Article

    Is there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences

    Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(4):200-210

    DOI 10.1055/s-0040-1708885

    Views10

    Abstract

    Objective

    The present study is a systematic review of the literature to assess whether the presence of endometriosis determines or contributes to adverse obstetric outcomes.

    Data Sources

    The present work was carried out at the Hospital Israelita Albert Einstein, São Paulo, state of São Paulo, Brazil, in accordance to the PRISMA methodology for systematic reviews. A review of the literature was performed using PubMed, Web of Science and Scopus databases. The keywords used were: pregnancy outcome, pregnancy complications, obstetrical complications, obstetrics, obstetric outcomes and endometriosis. The survey was further completed by a manually executed review of cross-referenced articles, which was last performed on November 30, 2018.

    Selection of studies

    The survey disclosed a total of 2,468 articles, published from May 1946 to October 2017. A total of 18 studies were selected to be further classified according to their quality and relevance.

    Data Collection

    The Newcastle-Ottawa Quality Assessment Scale was used for classification. Five studies of greater impact and superior evidence quality and 13 studies of moderate evidence quality were selected. We analyzed the studies for the characteristics of their patients plus how endometriosis was diagnosed and their respective obstetric outcomes taking into account their statistical relevance.

    Data Synthesis

    Analyses of the higher impact and better quality studies have shown high incidence of preterm birth and placenta previa in patients with endometriosis.

    Conclusion

    Placenta previa and preterm birth are the most statistically significant outcomes related to endometriosis, as indicated by our systematic review. The present information is useful to alert obstetricians and patients about possible unfavorable obstetric outcomes.

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    Is there an Increased Risk for Unfavorable Obstetric Outcomes in Women with Endometriosis? An Evaluation of Evidences
  • 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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