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Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):185-192
DOI 10.1590/S0100-72032004000300003
PURPOSE: to investigate the glomerular alterations in patients with severe preeclampsia, as well as to evaluate the evolution of these lesions, relating them to the moment of the renal biopsy. METHODS: seventy-two pregnant women with hypertensive syndrome underwent renal biopsy in the puerperium. Appropriate samples for electron microscopic examination were obtained from 39 patients and grouped as follows: 25 with preeclampsia and 14 with superimposed preeclampsia. Biopsy findings were classified into: normal kidney, endothelial cell edema, mesangial expansion, mesangial interposition, subendothelial fibrinoid deposits, and podocyte fusion. RESULTS: the most frequent alterations found in both groups were subendothelial fibrinoid deposits and podocyte fusion. Endothelial edema was present in 84% of the preeclampsia patients and in 92.9% of the superimposed preeclampsia cases. There was no association between the degree of hypertension and the severity of endothelial edema. A tendency to mesangial interposition was observed in patients who had a biopsy after the seventh day after delivery. Podocyte fusion showed a significant association with 24-hour proteinuria. CONCLUSIONS: the above mentioned glomerular alterations represent a spectrum of complex and dynamic lesions that together represent the ultrastructural characteristics of preeclampsia which should no longer be diagnosed based only on the presence or absence of endothelial edema.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):185-192
DOI 10.1590/S0100-72032004000300003
PURPOSE: to investigate the glomerular alterations in patients with severe preeclampsia, as well as to evaluate the evolution of these lesions, relating them to the moment of the renal biopsy. METHODS: seventy-two pregnant women with hypertensive syndrome underwent renal biopsy in the puerperium. Appropriate samples for electron microscopic examination were obtained from 39 patients and grouped as follows: 25 with preeclampsia and 14 with superimposed preeclampsia. Biopsy findings were classified into: normal kidney, endothelial cell edema, mesangial expansion, mesangial interposition, subendothelial fibrinoid deposits, and podocyte fusion. RESULTS: the most frequent alterations found in both groups were subendothelial fibrinoid deposits and podocyte fusion. Endothelial edema was present in 84% of the preeclampsia patients and in 92.9% of the superimposed preeclampsia cases. There was no association between the degree of hypertension and the severity of endothelial edema. A tendency to mesangial interposition was observed in patients who had a biopsy after the seventh day after delivery. Podocyte fusion showed a significant association with 24-hour proteinuria. CONCLUSIONS: the above mentioned glomerular alterations represent a spectrum of complex and dynamic lesions that together represent the ultrastructural characteristics of preeclampsia which should no longer be diagnosed based only on the presence or absence of endothelial edema.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):247-247
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(3):247-247
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):661-666
DOI 10.1590/S0100-72032003000900007
PURPOSE: to present the most frequent gynecologic results in a cohort of 300 outpatient HIV-infected women. METHODS: this is a prospective and descriptive study of HIV-infected women that have been followed up at the gynecological clinic from November 1996 to December 2002. These patients were subjected to a specific protocol which included an interview, a gynecological evaluation and a collecting cervical sample for Pap smear, research of HPV (PCR) and colposcopy. Cervical biopsy was performed when necessary. Data were stored and analyzed by Epi-Info, version 6.0. RESULTS: the mean age was 34.5 years. The small number of sexual partners, average of three partners, and the predominance of heterosexual contagion should be mentioned: 271 (90.6%) patients were contaminated through sexual contact with their partners. There was a high prevalence of cervical intraepithelial neoplasia (CIN) representing 21.7% of the total group. Of 109 patients subjected to PCR, 89 (81.7%) were found to have some HPV genotype. An inflammatory smear was present in 69% of the patients. CONCLUSIONS: there is a high frequency of CIN and genital infectious diseases among HIV-infected women, mainly HPV.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(9):661-666
DOI 10.1590/S0100-72032003000900007
PURPOSE: to present the most frequent gynecologic results in a cohort of 300 outpatient HIV-infected women. METHODS: this is a prospective and descriptive study of HIV-infected women that have been followed up at the gynecological clinic from November 1996 to December 2002. These patients were subjected to a specific protocol which included an interview, a gynecological evaluation and a collecting cervical sample for Pap smear, research of HPV (PCR) and colposcopy. Cervical biopsy was performed when necessary. Data were stored and analyzed by Epi-Info, version 6.0. RESULTS: the mean age was 34.5 years. The small number of sexual partners, average of three partners, and the predominance of heterosexual contagion should be mentioned: 271 (90.6%) patients were contaminated through sexual contact with their partners. There was a high prevalence of cervical intraepithelial neoplasia (CIN) representing 21.7% of the total group. Of 109 patients subjected to PCR, 89 (81.7%) were found to have some HPV genotype. An inflammatory smear was present in 69% of the patients. CONCLUSIONS: there is a high frequency of CIN and genital infectious diseases among HIV-infected women, mainly HPV.