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  • Original Article

    Factors associated with the absence of postpartum consultations in a high-risk population

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo23

    Summary

    Original Article

    Factors associated with the absence of postpartum consultations in a high-risk population

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo23

    DOI 10.61622/rbgo/2024rbgo23

    Views181

    Abstract

    Objective:

    To assess the rate of missed postpartum appointments at a referral center for high-risk pregnancy and compare puerperal women who did and did not attend these appointments to identify related factors.

    Methods:

    This was a retrospective cross-sectional study with all women scheduled for postpartum consultations at a high-risk obstetrics service in 2018. The variables selected to compare women were personal, obstetric, and perinatal. The variables of interest were obtained from the hospital's electronic medical records. Statistical analyses were performed using the Chi-square, Fisher's exact, or Mann–Whitney tests. For the variable of the interbirth interval, a receiver operating characteristic curve (ROC) was used to best discriminate whether or not patients attended the postpartum consultation. The significance level for the statistical tests was 5%.

    Results:

    A total of 1,629 women scheduled for postpartum consultations in 2018 were included. The rate of missing the postpartum consultation was 34.8%. A shorter interbirth interval (p = 0.039), previous use of psychoactive substances (p = 0.027), current or former smoking (p = 0.003), and multiparity (p < 0.001) were associated with non-attendance.

    Conclusion:

    This study showed a high rate of postpartum appointment non-attendance. This is particularly relevant because it was demonstrated in a high-risk obstetric service linked to clinical severity or social vulnerability cases. This highlights the need for new approaches to puerperal women before hospital discharge and new tools to increase adherence to postpartum consultations, especially for multiparous women.

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  • Original Article

    Cervical Cancer Registered in Two Developed Regions from Brazil: Upper Limit of Reachable Results from Opportunistic Screening

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):347-353

    Summary

    Original Article

    Cervical Cancer Registered in Two Developed Regions from Brazil: Upper Limit of Reachable Results from Opportunistic Screening

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):347-353

    DOI 10.1055/s-0038-1660841

    Views13

    Abstract

    Objective

    The aim of this study was to assess the time trends and pattern of cervical cancer diagnosed in the period from 2001 to 2012 by means of an opportunistic screening program from two developed regions in Brazil.

    Methods

    An observational study analyzing 3,364 cancer records (n = 1,646 from Campinas and n = 1,718 from Curitiba region) available in hospital-based cancer registries was done. An additional 1,836 records of CIN3/AIS from the region of Campinas was analyzed. The statistical analysis assessed the pooled data and the data by region considering the year of diagnosis, age-group, cancer stage, and histologic type. The Cochran-Armitage trend test was applied and p-values < 0.05 were considered significant.

    Results

    The total annual cervical cancer registered from2001 to 2012 showed a slight drop (273-244), with an age average of 49.5 y, 13 years over the average for CIN3/AIS (36.8 y). A total of 20.6% of the diagnoses (1.6% under 25 y) were done out of the official screening age-range. The biennial rate of diagnoses by age group for the region of Campinas showed an increase trend for the age groups under 25 y (p = 0.007) and 25 to 44 y (p = 0.003). Stage III was the most recorded for both regions, with an annual average of 43%, without any trend modification. There was an increasing trend for stage I diagnoses in the region of Campinas (p = 0.033). The proportion of glandular histologic types registered had an increased trend over time (p = 0.002), higher for the region of Campinas (21.1% versus 12.5% for the region of Curitiba).

    Conclusion

    The number, pattern and trends of cervical cancer cases registered had mild and slow modifications and reflect the limited effectivity of the opportunistic screening program, even in developed places.

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    Cervical Cancer Registered in Two Developed Regions from Brazil: Upper Limit of Reachable Results from Opportunistic Screening

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