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  • Original Article

    Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

    Rev Bras Ginecol Obstet. 2022;44(12):1102-1109

    Summary

    Original Article

    Misoprostol Administration Before Hysteroscopy Procedures – A Retrospective Analysis

    Rev Bras Ginecol Obstet. 2022;44(12):1102-1109

    DOI 10.1055/s-0042-1755462

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    Abstract

    Objective

    To evaluate the use of misoprostol prior to hysteroscopy procedures regarding technical ease, the presence of side effects, and the occurrence of complications.

    Methods

    This is a retrospective, observational, analytical, case-control study, with the review of medical records of 266 patients followed-up at the Gynecological Videoendoscopy Sector of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the Universidade de São Paulo (HCFMRP – USP, in the Portuguese acronym) from 2014 to 2019, comparing 133 patients who used the drug before the procedure with 133 patients who did not.

    Results

    The occurrence of postmenopausal uterine bleeding was the main indication for hysteroscopy and revealed a statistical difference between groups (p < 0.001), being present in 93.23% of the patients in the study group and in 69.7% of the patients in the control group. Only 2 patients (1.5%) in the study group reported adverse effects. Although no statistical differences were observed regarding the occurrence of complications during the procedure (p = 0.0662), a higher total number of complications was noted in the group that used misoprostol (n = 7; 5.26%) compared with the group that did not use the drug (n = 1; 0.75%), a fact that is clinically relevant. When evaluating the ease of the technique (measured by the complete performance of all steps of the hysteroscopy procedure), it was verified that although there was no difference between groups (p = 0.0586), the control group had more than twice as many incompletely performed procedures (n = 17) when compared with the group that used misoprostol previously (n = 8), which is also clinically relevant.

    Conclusion

    The use of misoprostol prior to hysteroscopy in our service indicated that the drug can facilitate the performance of the procedure, but not without side effects and presenting higher complication rates.

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  • Original Article

    A Model for the Management of Female Sexual Dysfunctions

    Rev Bras Ginecol Obstet. 2017;39(4):184-194

    Summary

    Original Article

    A Model for the Management of Female Sexual Dysfunctions

    Rev Bras Ginecol Obstet. 2017;39(4):184-194

    DOI 10.1055/s-0037-1601435

    Views3

    Abstract

    Introduction

    Sexual pleasure is fundamental for the maintenance of health and well-being, but it may be adversely affected by medical and psychosocial conditions. Many patients only feel that their health is fully restored after they resume normal sexual activities. Any discussion of sexuality in a doctor's office is typically limited, mainly because of a lack of models or protocols available to guide the discussion of the topic.

    Objectives

    To present a model designed to guide gynecologists in the management of female sexual complaints.

    Methods

    This study presents a protocol used to assess women's sexual problems. A semi-structured interview is used to assess sexual function, and the teaching, orienting and permitting (TOP) intervention model that was designed to guide gynecologists in the management of sexual complaints.

    Results

    The use of protocols may facilitate the discussion of sexual issues in gynecological settings, and has the potential to provide an effective approach to the complex aspects of sexual dysfunction in women. The TOP model has three phases: teaching the sexual response, in which the gynecologist explains the physiology of the female sexual response, and focuses on the three main phases thereof (desire, excitement and orgasm); orienting a woman toward sexual health, in which sexual education is used to provide information on the concept and healthy experience of sexuality; and permitting and stimulating sexual pleasure, which is based on the assumption that sexual pleasure is an individual right and is important for the physical and emotional well-being.

    Conclusion

    The use of protocols may provide an effective approach to deal with female sexual dysfunction in gynecological offices.

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    A Model for the Management of Female Sexual Dysfunctions
  • Editorial

    Endometrial Polyps – When Should Hysteroscopic Resection Be Performed?

    Rev Bras Ginecol Obstet. 2016;38(7):315-316

    Summary

    Editorial

    Endometrial Polyps – When Should Hysteroscopic Resection Be Performed?

    Rev Bras Ginecol Obstet. 2016;38(7):315-316

    DOI 10.1055/s-0036-1586488

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    The prevalence of endometrial polyps in postmenopausal women can be as high as 35%, and it has been steadily increasing with the wide dissemination of ultrasound in the routine gynecological practice. Endometrial polyps are important because they can cause symptoms, and might be associated with endometrial cancer. The percentage of malignant lesions found in association […]
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  • Original Article

    Maternal mortality in a reference center in the Brazilian Southeast

    Rev Bras Ginecol Obstet. 2013;35(9):388-393

    Summary

    Original Article

    Maternal mortality in a reference center in the Brazilian Southeast

    Rev Bras Ginecol Obstet. 2013;35(9):388-393

    DOI 10.1590/S0100-72032013000900002

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    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.

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  • Editorial

    Importance of an Interdisciplinary Approach in the Treatment of Women with Endometriosis and Chronic Pelvic Pain

    Rev Bras Ginecol Obstet. 2023;45(11):635-637

    Summary

    Editorial

    Importance of an Interdisciplinary Approach in the Treatment of Women with Endometriosis and Chronic Pelvic Pain

    Rev Bras Ginecol Obstet. 2023;45(11):635-637

    DOI 10.1055/s-0043-1777001

    Views6
    Endometriosis, from a pathophysiological standpoint, can be defined as active endometrium-like tissue outside the uterus. However, to better understand and approach this complex disease, it should be addressed as a chronic inflammatory disease that can cause pelvic pain during a long period of a women’s reproductive lifetime. Due to nociplasty, women affected by endometriosis can […]
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