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The Brazilian Journal of Gynecology and Obstetrics (RBGO), a scientific publication of the Federation of Gynecology and Obstetrics Societies (FEBRASGO), is aimed at gynecologists, obstetricians and professionals in related fields, with the aim of publishing research results on relevant topics in the field of Gynecology, Obstetrics and related areas.

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  • Review Article

    Breastfeeding and the Benefits of Lactation for Women’s Health

    Revista Brasileira de Ginecologia e Obstetrícia. 06-01-2018;40(6):354-359

    Summary

    Review Article

    Breastfeeding and the Benefits of Lactation for Women’s Health

    Revista Brasileira de Ginecologia e Obstetrícia. 06-01-2018;40(6):354-359

    DOI 10.1055/s-0038-1657766

    Views264

    Abstract

    The offer of the maternal breast to the baby is an unquestionable right of mothers and their children, and all efforts should bemade to promote, follow and maintain exclusive breastfeeding for up to 6months and supplement it until the child completes 2 years of age. Many publications are available in the literature about the qualities of breast milk, its benefits and health repercussions, stimulating the practice of breastfeeding and supporting campaigns for its implementation. However, although it is widely known that breastfeeding is an important step in the reproductive process of women and its practice offers benefits to both mother and child, most of the available information highlights the benefits of breast milk for children, while mention of the effects of breastfeeding on the health of the mother is usually neglected. Thus, the objective of the present study is to highlight the multiple benefits of breastfeeding for the physical and emotional health of the nursing mother. The authors consulted articles published in the databases PubMed, Virtual Health Library andWeb of Science using the keywords breastfeeding, breast milk, lactation and maternal health.

    Key-words breast milkBreastfeedingPostpartum period
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    Views264

    Summary

    Review Article

    Breastfeeding and the Benefits of Lactation for Women’s Health

    Revista Brasileira de Ginecologia e Obstetrícia. 06-01-2018;40(6):354-359

    DOI 10.1055/s-0038-1657766

    Views264

    Abstract

    The offer of the maternal breast to the baby is an unquestionable right of mothers and their children, and all efforts should bemade to promote, follow and maintain exclusive breastfeeding for up to 6months and supplement it until the child completes 2 years of age. Many publications are available in the literature about the qualities of breast milk, its benefits and health repercussions, stimulating the practice of breastfeeding and supporting campaigns for its implementation. However, although it is widely known that breastfeeding is an important step in the reproductive process of women and its practice offers benefits to both mother and child, most of the available information highlights the benefits of breast milk for children, while mention of the effects of breastfeeding on the health of the mother is usually neglected. Thus, the objective of the present study is to highlight the multiple benefits of breastfeeding for the physical and emotional health of the nursing mother. The authors consulted articles published in the databases PubMed, Virtual Health Library andWeb of Science using the keywords breastfeeding, breast milk, lactation and maternal health.

    Key-words breast milkBreastfeedingPostpartum period
    See more
  • Review Article

    Preeclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 09-01-2017;39(9):496-512

    Summary

    Review Article

    Preeclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 09-01-2017;39(9):496-512

    DOI 10.1055/s-0037-1604471

    Views275

    Abstract

    The authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia. The early treatment of acute hypertension, use of magnesium sulfate and early hospitalization in cases of preeclampsia are concepts to pursue the reduction of our pregnant women’s mortality.

    Key-words HELLP syndromeHigh risk pregnancyPreeclampsiapregnancy arterial hypertensionPregnancy complications
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    Views275

    Summary

    Review Article

    Preeclampsia

    Revista Brasileira de Ginecologia e Obstetrícia. 09-01-2017;39(9):496-512

    DOI 10.1055/s-0037-1604471

    Views275

    Abstract

    The authors review hypertensive disease during pregnancy with an academic and practical view, and using the best evidence available. This disease, which is the most important clinical disease in Brazilian pregnant women, may have its incidence reduced with prevention through the use of calcium and aspirin in pregnant women at risk. Previously, it was a disease that presented with hypertension with proteinuria, but it has now been classified with new clinical parameters besides proteinuria. Morbidity and mortality should be reduced in a continental country such as Brazil using protocols for the early treatment of complications by calculating severe outcomes in preeclampsia. The early treatment of acute hypertension, use of magnesium sulfate and early hospitalization in cases of preeclampsia are concepts to pursue the reduction of our pregnant women’s mortality.

    Key-words HELLP syndromeHigh risk pregnancyPreeclampsiapregnancy arterial hypertensionPregnancy complications
    See more
    Preeclampsia
  • Review Article

    Primary Dysmenorrhea: Assessment and Treatment

    Revista Brasileira de Ginecologia e Obstetrícia. 09-25-2020;42(8):501-507

    Summary

    Review Article

    Primary Dysmenorrhea: Assessment and Treatment

    Revista Brasileira de Ginecologia e Obstetrícia. 09-25-2020;42(8):501-507

    DOI 10.1055/s-0040-1712131

    Views275

    Abstract

    Primary dysmenorrhea is defined asmenstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of themenstrual cycle. It hasmajor implications for quality of life, such as limitation of daily activities and psychological stress, being one of themain causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, nonpharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments’ contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.

    Key-words Dysmenorrheahormonal contraceptionMenstrual cycleNSAIDsPain
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    Views275

    Summary

    Review Article

    Primary Dysmenorrhea: Assessment and Treatment

    Revista Brasileira de Ginecologia e Obstetrícia. 09-25-2020;42(8):501-507

    DOI 10.1055/s-0040-1712131

    Views275

    Abstract

    Primary dysmenorrhea is defined asmenstrual pain in the absence of pelvic disease. It is characterized by overproduction of prostaglandins by the endometrium, causing uterine hypercontractility that results in uterine muscle ischemia, hypoxia, and, subsequently, pain. It is the most common gynecological illness in women in their reproductive years and one of the most frequent causes of pelvic pain; however, it is underdiagnosed, undertreated, and even undervalued by women themselves, who accept it as part of themenstrual cycle. It hasmajor implications for quality of life, such as limitation of daily activities and psychological stress, being one of themain causes of school and work absenteeism. Its diagnosis is essentially clinical, based on the clinical history and normal physical examination. It is important to exclude secondary causes of dysmenorrhea. The treatment may have different approaches (pharmacological, nonpharmacological and surgical), but the first line of treatment is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and, in cases of women who want contraception, the use of hormonal contraceptives. Alternative treatments, such as topical heat, lifestyle modification, transcutaneous electrical nerve stimulation, dietary supplements, acupuncture, and acupressure, may be an option in cases of conventional treatments’ contraindication. Surgical treatment is only indicated in rare cases of women with severe dysmenorrhea refractory to treatment.

    Key-words Dysmenorrheahormonal contraceptionMenstrual cycleNSAIDsPain
    See more
  • Review Article

    Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity

    Revista Brasileira de Ginecologia e Obstetrícia. 09-01-2018;40(9):554-562

    Summary

    Review Article

    Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity

    Revista Brasileira de Ginecologia e Obstetrícia. 09-01-2018;40(9):554-562

    DOI 10.1055/s-0038-1668117

    Views222

    Abstract

    Twin pregnancy accounts for 2 to 4% of total births, with a prevalence ranging from 0.9 to 2.4% in Brazil. It is associated with worse maternal and perinatal outcomes. Many conditions, such as severe maternal morbidity (SMM) (potentially life-threatening conditions and maternal near-miss) and neonatal near-miss (NNM) still have not been properly investigated in the literature. The difficulty in determining the conditions associated with twin pregnancy probably lies in its relatively low occurrence and the need for larger population studies. The use of the whole population and of databases from large multicenter studies, therefore, may provide unprecedented results. Since it is a rare condition, it ismore easily evaluated using vital statistics from birth e-registries. Therefore, we have performed a literature review to identify the characteristics of twin pregnancy in Brazil and worldwide. Twin pregnancy has consistently been associated with SMM, maternal near-miss (MNM) and perinatal morbidity, with still worse results for the second twin, possibly due to some characteristics of the delivery, including safety and availability of appropriate obstetric care to women at a high risk of perinatal complications.

    Key-words High risk pregnancyMaternal morbidityMultiple pregnanciesPerinatal morbidity
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    Views222

    Summary

    Review Article

    Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity

    Revista Brasileira de Ginecologia e Obstetrícia. 09-01-2018;40(9):554-562

    DOI 10.1055/s-0038-1668117

    Views222

    Abstract

    Twin pregnancy accounts for 2 to 4% of total births, with a prevalence ranging from 0.9 to 2.4% in Brazil. It is associated with worse maternal and perinatal outcomes. Many conditions, such as severe maternal morbidity (SMM) (potentially life-threatening conditions and maternal near-miss) and neonatal near-miss (NNM) still have not been properly investigated in the literature. The difficulty in determining the conditions associated with twin pregnancy probably lies in its relatively low occurrence and the need for larger population studies. The use of the whole population and of databases from large multicenter studies, therefore, may provide unprecedented results. Since it is a rare condition, it ismore easily evaluated using vital statistics from birth e-registries. Therefore, we have performed a literature review to identify the characteristics of twin pregnancy in Brazil and worldwide. Twin pregnancy has consistently been associated with SMM, maternal near-miss (MNM) and perinatal morbidity, with still worse results for the second twin, possibly due to some characteristics of the delivery, including safety and availability of appropriate obstetric care to women at a high risk of perinatal complications.

    Key-words High risk pregnancyMaternal morbidityMultiple pregnanciesPerinatal morbidity
    See more
    Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
  • Review Article

    Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

    Revista Brasileira de Ginecologia e Obstetrícia. 05-01-2018;40(5):287-293

    Summary

    Review Article

    Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

    Revista Brasileira de Ginecologia e Obstetrícia. 05-01-2018;40(5):287-293

    DOI 10.1055/s-0038-1660777

    Views188

    Abstract

    Objective

    To perform a comprehensive review of the current evidence on the role of uterine artery Doppler, isolated or in combination with other markers, in screening for preeclampsia (PE) and fetal growth restriction (FGR) in the general population. The review included recently published large cohort studies and randomized trials.

    Methods

    A search of the literature was conducted usingMedline, PubMed, MeSH and ScienceDirect. Combinations of the search terms “preeclampsia,” “screening,” “prediction,” “Doppler,” “Doppler velocimetry,” “fetal growth restriction,” “small for gestational age” and “uterine artery” were used. Articles in English (excluding reviews) reporting the use of uterine artery Doppler in screening for PE and FGR were included.

    Results

    Thirty articles were included. As a single predictor, uterine artery Doppler detects less than 50% of the cases of PE and no more than 40% of the pregnancies affected by FGR. Logistic regression-based models that allow calculation of individual risk based on the combination of multiple markers, in turn, is able to detect ~ 75% of the cases of preterm PE and 55% of the pregnancies resulting in small for gestational age infants.

    Conclusion

    The use of uterine artery Doppler as a single predictive test for PE and FGR has poor accuracy. However, its combined use in predictive models is promising, being more accurate in detecting preterm PE than FGR.

    Key-words DopplerFetal growth restrictionPreeclampsiaScreeningUterine arteries
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    Views188

    Summary

    Review Article

    Uterine Artery Doppler in Screening for Preeclampsia and Fetal Growth Restriction

    Revista Brasileira de Ginecologia e Obstetrícia. 05-01-2018;40(5):287-293

    DOI 10.1055/s-0038-1660777

    Views188

    Abstract

    Objective

    To perform a comprehensive review of the current evidence on the role of uterine artery Doppler, isolated or in combination with other markers, in screening for preeclampsia (PE) and fetal growth restriction (FGR) in the general population. The review included recently published large cohort studies and randomized trials.

    Methods

    A search of the literature was conducted usingMedline, PubMed, MeSH and ScienceDirect. Combinations of the search terms “preeclampsia,” “screening,” “prediction,” “Doppler,” “Doppler velocimetry,” “fetal growth restriction,” “small for gestational age” and “uterine artery” were used. Articles in English (excluding reviews) reporting the use of uterine artery Doppler in screening for PE and FGR were included.

    Results

    Thirty articles were included. As a single predictor, uterine artery Doppler detects less than 50% of the cases of PE and no more than 40% of the pregnancies affected by FGR. Logistic regression-based models that allow calculation of individual risk based on the combination of multiple markers, in turn, is able to detect ~ 75% of the cases of preterm PE and 55% of the pregnancies resulting in small for gestational age infants.

    Conclusion

    The use of uterine artery Doppler as a single predictive test for PE and FGR has poor accuracy. However, its combined use in predictive models is promising, being more accurate in detecting preterm PE than FGR.

    Key-words DopplerFetal growth restrictionPreeclampsiaScreeningUterine arteries
    See more
  • Review Article

    Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

    Revista Brasileira de Ginecologia e Obstetrícia. 02-01-2016;38(2):97-111

    Summary

    Review Article

    Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

    Revista Brasileira de Ginecologia e Obstetrícia. 02-01-2016;38(2):97-111

    DOI 10.1055/s-0035-1571252

    Views155

    We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD = [1]1.24SDs; CI 95% = [1]1.77 to [1]0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD = [1]4.4 points; CI 95% = [1]16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD = 0.9g; 95%CI = 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.

    Key-words electrical stimulationMeta-analysisPhysiotherapysystematic reviewUrinary incontinence
    See more
    Views155

    Summary

    Review Article

    Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

    Revista Brasileira de Ginecologia e Obstetrícia. 02-01-2016;38(2):97-111

    DOI 10.1055/s-0035-1571252

    Views155

    We performed a systematic review and meta-analysis of randomized controlled trials that studied the conservative management of stress urinary incontinence (SUI). There were 1058 results after the initial searches, from which 37 studies were eligible according to previously determined inclusion criteria. For the primary outcomes, pelvic floor muscle training (PFMT) was more efficacious than no treatment in improving incontinence-specific quality of life (QoL) scales (SMD = [1]1.24SDs; CI 95% = [1]1.77 to [1]0.71SDs). However, its effect on pad tests was imprecise. Combining biofeedback with PFMT had an uncertain effect on QoL (MD = [1]4.4 points; CI 95% = [1]16.69 to 7.89 points), but better results on the pad test, although with elevated heterogeneity (MD = 0.9g; 95%CI = 0.71 to 1,10g); group PFMT was not less efficacious than individual treatment, and home PFMT was not consistently worse than supervised PFMT. Both intravaginal and superficial electrical stimulation (IES and SES) were better than no treatment for QoL and pad test. Vaginal cones had mixed results. The association of IES with PFMT may improve the efficacy of the latter for QoL and pad test, but the results of individual studies were not consistent. Thus, there is evidence of the use of PFMT on the treatment of SUI, with and without biofeedback.

    Key-words electrical stimulationMeta-analysisPhysiotherapysystematic reviewUrinary incontinence
    See more
    Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials
  • Review Article

    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 09-16-2019;41(8):508-519

    Summary

    Review Article

    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 09-16-2019;41(8):508-519

    DOI 10.1055/s-0039-1695002

    Views145

    Abstract

    Objective

    We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence – UI, fecal incontinence – FI, and pelvic organ prolapse – POP).

    Data

    sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies.

    Data collection

    Two authors performed data extraction into a standardized spreadsheet.

    Data synthesis

    Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n= 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n= 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n= 3), low educational level (n= 4), low access to information (n= 5) and socioeconomic status (n= 3).

    Conclusion

    Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.

    Key-words knowledgePelvic floorsystematic reviewUrinary incontinence
    See more
    Views145

    Summary

    Review Article

    Do Women have Adequate Knowledge about Pelvic Floor Dysfunctions? A Systematic Review

    Revista Brasileira de Ginecologia e Obstetrícia. 09-16-2019;41(8):508-519

    DOI 10.1055/s-0039-1695002

    Views145

    Abstract

    Objective

    We sought to investigate whether women present adequate knowledge of the main pelvic floor disorders (PFDs) (urinary incontinence – UI, fecal incontinence – FI, and pelvic organ prolapse – POP).

    Data

    sources A systematic review was performed in the MEDLINE, PEDro, CENTRAL, and Cochrane databases for publications from inception to April 2018. Selection of studies A total of 3,125 studies were reviewed. Meta-analysis was not possible due to the heterogeneity of primary outcomes and the diversity of instruments for measuring knowledge. The quality of the articles included in the analysis was evaluated with the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies.

    Data collection

    Two authors performed data extraction into a standardized spreadsheet.

    Data synthesis

    Nineteen studies were included, comprising 11,512 women. About the methodological quality (NOS), most of the studies (n= 11) presented a total score of 6 out of 10. Validated questionnaires and designed pilot-tested forms were the most frequently used ways of assessing knowledge. Some studies were stratified by race, age, or group minorities. The most used questionnaire was the prolapse and incontinence knowledge questionnaire (PIKQ) (n= 5). Knowledge and/or awareness regarding PFD was low to moderate among the studies. Urinary incontinence was the most prevalent PFD investigated, and the most important risk factors associated with the lack of knowledge of the pelvic floor were: African-American ethnicity (n= 3), low educational level (n= 4), low access to information (n= 5) and socioeconomic status (n= 3).

    Conclusion

    Most women have a gap in the knowledge of pelvic floor muscle dysfunctions, do not understand their treatment options, and are not able to identify risk factors for these disorders.

    Key-words knowledgePelvic floorsystematic reviewUrinary incontinence
    See more
  • Review Article

    Covid-19 and Pregnancy: An Overview

    Revista Brasileira de Ginecologia e Obstetrícia. 08-26-2020;42(7):420-426

    Summary

    Review Article

    Covid-19 and Pregnancy: An Overview

    Revista Brasileira de Ginecologia e Obstetrícia. 08-26-2020;42(7):420-426

    DOI 10.1055/s-0040-1713408

    Views113

    Abstract

    Since the World Health Organization (WHO) declared coronavirus infection (COVID-19) a Public Health Emergency of International Concern in January 2020, there have been many concerns about pregnant women and the possible effects of this emergency with catastrophic outcomes inmany countries. Information on COVID-19 and pregnancy are scarce and spread throughout a fewcase series, with no more than 50 cases in total. The present review provides a brief analysis of COVID-19, pregnancy in the COVID-19 era, and the effects of COVID-19 on pregnancy.

    Key-words COVID-19DeliveryPregnancyPrenatal care
    See more
    Views113

    Summary

    Review Article

    Covid-19 and Pregnancy: An Overview

    Revista Brasileira de Ginecologia e Obstetrícia. 08-26-2020;42(7):420-426

    DOI 10.1055/s-0040-1713408

    Views113

    Abstract

    Since the World Health Organization (WHO) declared coronavirus infection (COVID-19) a Public Health Emergency of International Concern in January 2020, there have been many concerns about pregnant women and the possible effects of this emergency with catastrophic outcomes inmany countries. Information on COVID-19 and pregnancy are scarce and spread throughout a fewcase series, with no more than 50 cases in total. The present review provides a brief analysis of COVID-19, pregnancy in the COVID-19 era, and the effects of COVID-19 on pregnancy.

    Key-words COVID-19DeliveryPregnancyPrenatal care
    See more
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Breast (44) Breast neoplasms (104) Cesarean section (76) Endometriosis (70) Infertility (56) Maternal mortality (44) Menopause (87) Obesity (60) Postpartum period (44) Pregnancy (246) Pregnancy complications (103) Pregnant women (44) Prenatal care (71) prenatal diagnosis (51) Prevalence (42) Quality of life (53) Risk factors (103) Ultrasonography (82) Uterine cervical neoplasms (42) Women's health (48)

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Objectives and Vision

The Brazilian Journal of Gynecology and Obstetrics (RBGO) aims to publish basic and clinical research in gynecology, obstetrics and other related specialties and to be a reference to support and promote the professional education of residents, researchers and university professors. As a VISION, RBGO aims to become an internationally recognized reference among the main global journals in Gynecology and Obstetrics.

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