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  • Original Article

    Results of the Insertion of Hysteroscopic Sterilization Devices in a Brazilian Public Hospital

    Rev Bras Ginecol Obstet. 2020;42(6):325-332

    Summary

    Original Article

    Results of the Insertion of Hysteroscopic Sterilization Devices in a Brazilian Public Hospital

    Rev Bras Ginecol Obstet. 2020;42(6):325-332

    DOI 10.1055/s-0040-1712129

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    Abstract

    Objective

    To evaluate the insertion of the hysteroscopic intratubal sterilization device for female sterilization concerning the technique and the feasibility.

    Methods

    Retrospective study with data collection of medical records of 904 patients who underwent device insertion between January and September 2016 in a public hospital in Rio de Janeiro (Brazil) with data analysis and descriptive statistics.

    Results

    In 85.8% of the cases, the uterine cavity was normal, and themost commonlydescribed findings upon hysteroscopy were synechiae (9.5%). The procedure lasted an average of 3.56minutes (range: 1 to 10minutes), and the pain was considered inexistent or mild in 58,6% of the cases, mild or moderate in 32,8%, and severe or agonizing in less than 1% (0.8%) of the cases, based on a verbal scale ranging from 0 to 10. The rate of successful insertions was of 85.0%, and successful tubal placement was achieved in 99.5% of the cases. There were no severe complications related to the procedure, but transient vasovagal reactions occurred in 5 women (0.6%).

    Conclusion

    Female sterilization performed by hysteroscopy is a safe, feasible, fast, and well-tolerated procedure. The rates of successful insertions and tubal placements were high. There were few and mild adverse effects during the procedure, and there were no severe complications on the short term.

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    Results of the Insertion of Hysteroscopic Sterilization Devices in a Brazilian Public Hospital
  • Original Article

    Vulval intraepithelial lesions in HIV-infected patients

    Rev Bras Ginecol Obstet. 2005;27(7):407-414

    Summary

    Original Article

    Vulval intraepithelial lesions in HIV-infected patients

    Rev Bras Ginecol Obstet. 2005;27(7):407-414

    DOI 10.1590/S0100-72032005000700007

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    PURPOSE: to evaluate the prevalence of vulval squamous intraepithelial lesions and associated factors in HIV-infected patients attended at the public health services of Rio de Janeiro city. METHOD: a total of 374 HIV-infected patients were attended at public services in Rio de Janeiro city and submitted to gynecological examination, Pap smear and colposcopic examination of the cervix and vulva. The association of vulval intraepithelial lesion was analyzed according to the results of clinical (age and cervical lesions), laboratorial (CD4 count) and behavioral (number of partners and smoking habit) variables. The study (independent) variables were the epidemiological data, the immunologic status and the results of gynecological propaedeutic. Thus, age, the smoking habit, number of sexual partners, count of T CD4 lymphocites, and cervical intraepithelial lesion were selected. In the beginning, a bivariate analysis was performed, aiming at assessing the association between the presence of vulval intraepithelial lesion (ultimate variable) and the independent variables (age, smoking habits, number of sexual partners, cytology, colposcopy and CD4 count). Thereafter, the results with statistical significance (p<0.05) were submitted to a multiple logistic regression, and the probability ratio with the respective 95% confidence interval was established. RESULTS: the prevalence of vulval intraepithelial lesions was 40%. In the multivariate analysis CD4 count below 500 cells/mm³ OR=2.69 [IC 95%: 1.61-4.52], abnormal colposcopy OR=1.64 [IC 95%: 1.01-2.67] and age under 26 OR=1.98 [IC 95%: 1.18-3.30] were significant. In the vulval and cervical simultaneous lesion subgroup, age under 26 OR=3.30 [IC 95%: 1.65-6.59] and CD4 count below 500 cells/mm³ OR=4.15 [IC 95%: 1.92-8.96], were significant on analysis. CONCLUSIONS: the prevalence of vulval squamous intraepithelial lesions in HIV-infected patients is high. Immunodeficiency, presence of cervical intraepithelial lesions and age under 26 were associated with the presence of vulval intraepithelial lesions.

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  • Original Article

    Preterm premature rupture of the fetal membranes: factors associated with bronchopulmonary dysplasia

    Rev Bras Ginecol Obstet. 2010;32(10):497-503

    Summary

    Original Article

    Preterm premature rupture of the fetal membranes: factors associated with bronchopulmonary dysplasia

    Rev Bras Ginecol Obstet. 2010;32(10):497-503

    DOI 10.1590/S0100-72032010001000005

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    PURPOSE: to analyze obstetric and neonatal factors associated with bronchopulmonary dysplasia outcome in patients with preterm premature amniorrhexis. METHODS: we analyzed 213 medical records of patients of Fernandes Figueira Institute who suffered premature amniorrhexis (<34 weeks of gestation) in the period from 1998 to 2002. Multiple gestations were excluded. Clinical-obstetric and neonatal variables were considered in relation to the bronchopulmonary dysplasia outcome. Data were subjected to bivariate analysis, and the values showing statistical significance (p<0.05) were subjected to logistic regression analysis. RESULTS: the prevalence of bronchopulmonary dysplasia was 6.10%. Univariate analysis of the factors associated with the pulmonary dysplasia outcome were: neonatal mechanical ventilation for more than ten days(OR: 54.00 [11.55-278.25] p=0.000); birth gestational age of less than 30 weeks (OR: 6.33 [1.26- 43.06] p=0.017); birth weight <1,000 g (OR: 4.82 [1.34-17.53] p=0.010); birth weight <1.500 g (OR: 14.09 [1.82-300.50] p=0.003; patent ductus arteriosus (OR: 12.33 [3.07-50.10], p=0.000); hyaline membrane disease (OR: 8.46 [2.21-35.00] p=0.000); congenital pneumonia (OR: 7.48 [2.03-27.93] p=0.000); use of neonatal surfactant (OR: 19.66 [4.54-97.76] p=0.000), and neonatal infection (OR: 7.67 [0.99-163.79] p=0.049). In the final multivariate model, only the variables "neonatal mechanical ventilation">10 days (p=0.001) and "use of a surfactant" (p=0.040) remained independently associated with bronchopulmonary dysplasia. CONCLUSIONS: the factors associated with bronchopulmonary dysplasia are related to neonatal features, asprolonged mechanical ventilation and the use of a surfactant influencethe development of thedisease.

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