Home - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Association of placental histopathological findings with COVID-19 and its predictive factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3

    Summary

    Original Article

    Association of placental histopathological findings with COVID-19 and its predictive factors

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3

    DOI 10.61622/rbgo/2024AO03

    Views264

    Abstract

    Objective:

    The aims of the study are to describe the association of coronavirus disease (COVID-19) with the abnormal histopathological findings in human placenta and to highlight the potential predictors of these histopathological findings.

    Methods:

    A retrospective cohort study, held in two obstetric units from January 2021- 2022, 34 patients who were confirmed cases of COVID- 19 were followed up till the time of delivery as their placenta were sent for histopathology. Patients diagnosed with other viral infections, chorioamnionitis, or were known case of as pre-term or term pre labour rupture of membrans (PROM) were excluded as well as pre exisiting diabetes mellitus or pre-eclampsia. Data analysis were performed using STATA software version 16.

    Result:

    Specific histopatological findings (fetal vascular malperfusion, maternal vascular malperfusion, inflammatory pathology and thrombotic finding) were significantly high among 13 (38.2%) of the study group who got infected earlier in pregnancy (P<0.001). The period between the diagnosis of COVID-19 and the delivery significantly increases the odds of the presence of pathological findings by 2.75 times for each week the patients getting infected earlier.

    Conclusion:

    Association of abnormal placental histopathological findings with COVID-19 infection in pregnancy and the potential predictor for the occurrence of placental findings is the longer duration between the diagnosis of the infection and the delivery.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Association of placental histopathological findings with COVID-19 and its predictive factors
  • Original Article

    Assessment of sexual and body esteem in postpartum women with or without perineal laceration: a cross-sectional study with cultural translation and validation of the Vaginal Changes Sexual and Body Esteem Scale

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo35

    Summary

    Original Article

    Assessment of sexual and body esteem in postpartum women with or without perineal laceration: a cross-sectional study with cultural translation and validation of the Vaginal Changes Sexual and Body Esteem Scale

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo35

    DOI 10.61622/rbgo/2024rbgo35

    Views290

    Objective:

    We aimed to translate and determine cultural validity of the Vaginal Changes Sexual and Body Esteem Scale (VSBE) for Brazilian Portuguese language in postpartum women who underwent vaginal delivery with or without perineal laceration and cesarean section.

    Methods:

    A cross-sectional study conducted virtually, with online data collection through a survey with 234 postpartum women of 975 that were invited. Clinical, sociodemographic, and psychometric variables from the VSBE questionnaire were analyzed (content validity index, internal consistency, test-retest reliability, construct/structural and discriminant validity). Multivariate analysis was performed to explore associated factors with the presence of perineal laceration.

    Results:

    One-hundred fifty-eight women experienced vaginal delivery, of which 24.79% had an intact perineum, 33.33% had perineal laceration, and 9.4% underwent episiotomy; and 76 participants had cesarean sections. Women with perineal laceration were older, presented dyspareunia and previous surgeries than women without perineal laceration (p<0.05). For VSBE, a high internal consistency (Cronbach's α > 0.7) was observed, but it did not correlate with Body Attractiveness Questionnaire and Female Sexual Function Index; however, it correlated with the presence of women sutured for perineal laceration. Moreover, VSBE presented good structural validity with two loading factors after exploratory factor analysis. VSBE also demonstrated discriminant validity between the presence or absence of perineal laceration. The presence of urinary incontinence (UI) (OR=2.716[1.015-4.667];p=0.046) and a higher VSBE total score (OR=1.056[1.037-1.075];p<0.001) were the only factors associated with perineal laceration.

    Conclusion:

    Vaginal Changes Sexual and Body Esteem Scale demonstrated appropriate translation and good internal consistency, discriminant/construct validity and reliability. Vaginal Changes Sexual and Body Esteem Scale total score and presence of UI were associated with women that underwent perineal laceration.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Assessment of sexual and body esteem in postpartum women with or without perineal laceration: a cross-sectional study with cultural translation and validation of the Vaginal Changes Sexual and Body Esteem Scale
  • Original Article

    Bacteriological characteristics of primary breast abscesses in patients from the community in the era of microbial resistance

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo34

    Summary

    Original Article

    Bacteriological characteristics of primary breast abscesses in patients from the community in the era of microbial resistance

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo34

    DOI 10.61622/rbgo/2024rbgo34

    Views193

    Abstract

    Objective:

    The aim of this study is to evaluate the etiological profile and antimicrobial resistance in breast abscess cultures from patients from the community, treated at a public hospital located in Porto Alegre, Brazil.

    Methods:

    This is an retrospective cross-sectional study that evaluated the medical records of patients with bacterial isolates in breast abscess secretion cultures and their antibiograms, from January 2010 to August 2022.

    Results:

    Based on 129 positive cultures from women from the community diagnosed with breast abscesses and treated at Fêmina Hospital, 99 (76.7%) of the patients had positive cultures for Staphylococcus sp, 91 (92%) of which were cases of Staphylococcus aureus. Regarding the resistance profile of S. aureus, 32% of the strains were resistant to clindamycin, 26% to oxacillin and 5% to trimethoprim-sulfamethoxazole. The antimicrobials vancomycin, linezolid and tigecycline did not show resistance for S. aureus.

    Conclusion:

    Staphylococcus aureus was the most common pathogen found in the breast abscess isolates during the study period. Oxacillin remains a good option for hospitalized patients. The use of sulfamethoxazole plus trimethoprim should be considered as a good option for use at home, due to its low bacterial resistance, effectiveness and low cost.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Bacteriological characteristics of primary breast abscesses in patients from the community in the era of microbial resistance
  • Original Article

    Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo33

    Summary

    Original Article

    Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo33

    DOI 10.61622/rbgo/2024rbgo33

    Views238

    Abstract

    Objective:

    Evaluate histological changes in testicular parameters after hormone treatment in transgender women.

    Methods:

    Cross-section study with patients who underwent gonadectomy at Hospital de Clínicas de Porto Alegre from 2011 to 2019. Hormone treatment type, route of administration, age at initiation and duration were recorded. Atrophy parameters were observed: testicular volume, tubular diameter, basal membrane length, presence of spermatogonia and spermatids (diploid and haploid spermatozoid precursors).

    Results:

    Eighty-six patients were included. Duration of hormone treatment is associated with testicular atrophy and spermatogenesis arrest. Other characteristics of hormone treatment such as age of initiation, route of administration and type of treatment were not associated with testicular histological changes. Testicular volume may predict spermatogenesis arrest. Basal membrane length and tubular diameter ratio is an interesting predictor of germ cell presence.

    Conclusion:

    Cross-sex hormone treatment affects testicular germ cell presence. Basal membrane length and tubular diameter ratio reduces inter variability of measurements and better exemplify how atrophic seminiferous tubules are. Fertility preservation should be addressed by healthcare providers in order to recognize gender affirming treatment impact on transgender health.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
  • Original Article

    Screening and prevention of preterm birth: how is it done in clinical practice?

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32

    Summary

    Original Article

    Screening and prevention of preterm birth: how is it done in clinical practice?

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32

    DOI 10.61622/rbgo/2024rbgo32

    Views268

    Abstract

    Objective:

    To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country.

    Methods:

    Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices.

    Results:

    The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix.

    Conclusion:

    In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo31

    Summary

    Original Article

    Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo31

    DOI 10.61622/rbgo/2024rbgo31

    Views257

    Abstract

    Objective:

    To compare Transforming growth factor beta-1 (TGF-β1) expression in patients with and without adenomyosis.

    Methods:

    A prospective design was performed including 49 patients submitted to hysterectomy. Immunohistochemistry was performed on anatomopathological samples staged in paraffin blocks from patients with and without adenomyosis. The sample contained 28 adenomyosis cases and 21 controls. Student’s t-test and multivariate logistic regression tests were used for statistical analysis. Associations were considered significant at p < 0.05.

    Results:

    We found no significant association between adenomyosis and: smoking (p = 0.75), miscarriage (p = 0.29), number of previous pregnancies (p = 0.85), curettage (p = 0.81), pelvic pain (p = 0.72) and myoma (p = 0.15). However, we did find a relationship between adenomyosis and abnormal uterine bleeding (AUB) (p = 0.02) and previous cesarean section (p = 0.02). The mean TGF-β1 intensity (mean ± SD) in the ectopic endometrium of women with adenomyosis showed no significant association (184.17 ± 9.4 vs.184.66 ± 16.08, p = 0.86) from the topic endometrium of women without adenomyosis.

    Conclusion:

    TGF-β1 expression was not increased in the ectopic endometrium of women with adenomyosis.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis
  • Original Article

    Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30

    Summary

    Original Article

    Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo30

    DOI 10.61622/rbgo/2024rbgo30

    Views40

    Abstract

    Objective

    To evaluate the mode of delivery according to Robson classification (RC) and the perinatal outcomes in fetal growth restriction (FGR) and small for gestational age (SGA) fetuses.

    Methods

    Retrospective cohort study by analyzing medical records of singleton pregnancies from two consecutive years (2018 and 2019). FGR was defined according to Delphi Consensus. The Robson groups were divided into two intervals (1–5.1 and 5.2–10).

    Results

    Total of 852 cases were included: FGR (n = 85), SGA (n = 20) and control (n=747). FGR showed higher percentages of newborns < 1,500 grams (p<0.001) and higher overall cesarean section (CS) rates (p<0.001). FGR had the highest rates of neonatal resuscitation and neonatal intensive care unit admission (p<0.001). SGA and control presented higher percentage of patients classified in 1 - 5.1 RC groups, while FGR had higher percentage in 5.2 - 10 RC groups (p<0.001). FGR, SGA and control did not differ in the mode of delivery in the 1-5.1 RC groups as all groups showed a higher percentage of vaginal deliveries (p=0.476).

    Conclusion

    Fetuses with FGR had higher CS rates and worse perinatal outcomes than SGA and control fetuses. Most FGR fetuses were delivered by cesarean section and were allocated in 5.2 to 10 RC groups, while most SGA and control fetuses were allocated in 1 to 5.1 RC groups. Vaginal delivery occurred in nearly 60% of FGR allocated in 1-5.1 RC groups without a significant increase in perinatal morbidity. Therefore, the vaginal route should be considered in FGR fetuses.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Fertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25

    Summary

    Original Article

    Fertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25

    DOI 10.61622/rbgo/2024rbgo25

    Views241

    Objective:

    Fertility preservation is a priority in oncology for female cancer patients. However, there is a lack of communication between infertility specialists and oncologists. This study aimed to evaluate infertility specialists’ perceptions and experiences regarding fertility preservation.

    Methods:

    Conduct an online survey to profile infertility specialists. Participants were infertility affiliated with the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). The specialists received an online survey, which response rate were 30.9%, most of whom were in southern and southeastern. The survey consisted on 14 questions about the infertility specialists’ location, techniques in clinical practice, treatment successful rate, patients idea, etc.

    Results:

    The average experience in human reproduction were 15.5 ± 10.2 years (mean ± standard deviation, range 1-40). Among reproductive-aged female cancer patients recommended for fertility preservation, 60.3 ± 28.8% (range 10-100%) underwent preservation procedures. Main barriers were cost (41%), oncologists’ knowledge or acceptance (35%) and accessibility (9%). Most infertility specialists (58%) considered 40 years the limit for fertility preservation. Leukemia, lymphoma, breast and ovarian cancers were prioritized for fertility preservation, while lung, thyroid, gastric, and brain cancers were less relevant.

    Conclusion:

    This is the first Brazilian study about infertility specialists’ perceptions on oncology patients access to fertility preservation. These patients primarily receive treatment in the public health system, while infertility specialists mainly work in the private healthcare. This healthcare mode is currently fragmented, but integrating these experts is enhancing patient access to fertility preservation. Studies on this topic are still warranted.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Fertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists

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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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