Home - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article06-09-2025

    Epidemiological profile of breast cancer in a reference center in the north region of Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo27

    Abstract

    Original Article

    Epidemiological profile of breast cancer in a reference center in the north region of Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo27

    DOI 10.61622/rbgo/2025rbgo27

    Views16

    Abstract

    Objective:

    To describe the epidemiological data of women with breast cancer at a referral center in oncology in the northern region of Brazil.

    Methods:

    This is a retrospective cohort study. The study population consists of patients who were diagnosed with in situ or invasive BC (invasive carcinoma of no special type (ICNST) and invasive lobular carcinoma (ILC)) at the Hospital de Amor da Amazônia, in Porto Velho – Rondônia, between January 2012 and December 2021. The sampling plan adopted was of the convenience type. All patients who received the anatomopathological diagnosis of in situ or invasive BC at the Hospital de Amor da Amazônia from 2012 to 2021 and came from the North region were included. Exclusion criteria were non-origin from the North region and absence of diagnosis established by anatomopathological examination of breast cancer. Analysis of the database and medical records of the Hospital de Amor da Amazônia was carried out to collect information.

    Results:

    420 patients were included, 99.5% female, with complete elementary school (32,6%) and brown skin (68,1%). The mean age at diagnosis was 49 years. Forty-five percent were born in the northern region and 55% in other regions of Brazil. Eighty percent of tumors were invasive ductal carcinoma; 32.7% were luminal A-like, 25.1% luminal B-like, 19.4% HER2 enriched and 12.8% triple negative. When patients were subdivided by age ≤40 years and > 40 years, there was a statistically significant difference in the association with staging (p=0.000), histological type (p= 0.035), immunohistochemistry subtype (p=0.000), neoadjuvant chemotherapy (p=.000) and genetic counseling (p=0.001). The median survival was 7.99 years. The 5-year overall survival was 81%. The higher the stage, the lower the survival rate. Twenty-four distinct variants were described in patients undergoing genetic testing, 16 of uncertain significance and 8 pathogenic. Three new variants were described: ATM (c.8726G>C), BRCA2 (c.2232A>C) and ERCC5 (c.2164G>Ap).

    Conclusion:

    In this study, the age at diagnosis of breast cancer was lower, the tumor subtype was more aggressive, and patients were admitted in more advanced stages. Overall survival is lower compared to national and international data. Despite the small number of patients referred to genetic testing, it is important to search for germline mutations to improve patients’ diagnosis and treatment.

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    Epidemiological profile of breast cancer in a reference center in the north region of Brazil
  • Original Article06-09-2025

    Evaluation of chronic radiation proctitis in patients with cervical cancer treated with pelvic radiotherapy: a cross-sectional study

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo26

    Abstract

    Original Article

    Evaluation of chronic radiation proctitis in patients with cervical cancer treated with pelvic radiotherapy: a cross-sectional study

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo26

    DOI 10.61622/rbgo/2025rbgo26

    Views14

    Abstract

    Objective:

    A combination of chemotherapy and pelvic radiotherapy is recommended to treat locally advanced cervical cancer (CC), which has been associated with acute and chronic toxicities, especially radiation proctitis (RP). The objective of this study was to evaluate the frequency of RP and treatment management in females with CC who underwent pelvic radiotherapy at an oncology referral hospital.

    Methods:

    This cross-sectional study analyzed the medical records of patients treated with radiotherapy for CC between 2015–2017. We assessed sociodemographic, lifestyle, cancer, treatment, and clinical variables. We identified 298 records of females with CC who underwent pelvic radiotherapy during the defined period. Of these, 14 records were duplicates, 25 were excluded for lacking essential information, and 33 were missing in the archive. Accordingly, 226 relevant medical records were analyzed, with data regarding sociodemographic, clinical, cancer-related, treatment-related, and RP-related variables collected. Pearson’s chi-square test was used to compare symptomatic and non-symptomatic patients. Fisher’s exact test was used to compare chemotherapy doses. Statistical analysis was performed with Stata V12.1. A P-value less than 0.05 was considered significant.

    Results:

    The median patient age was 48 years (interquartile range 38–61). Patients predominantly had CC stages IIB and IIIB (>70%). Of the 226 females analyzed, 87(38.5%) experienced RP symptoms, represented by rectal bleeding; of these, 59 underwent colonoscopy, confirming RP in 58(98.3%). Accordingly, of the 226 females analyzed, 58(25.7%) had a confirmed diagnosis of RP. There was a statistically significant association between rectal bleeding and cumulative radiation dose (P < 0.001) and the presence of systemic arterial hypertension (P = 0.036). Regarding treatment, 38(65.5%) participants underwent argon plasma coagulation (APC), and of these, 22(57.9%) had no post-treatment macroscopic bleeding.

    Conclusion:

    Patients with CC who received radiotherapy at an oncology referral service had a high frequency of RP, and APC helped control bleeding in certain patients.

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    Evaluation of chronic radiation proctitis in patients with cervical cancer treated with pelvic radiotherapy: a cross-sectional study
  • Original Article06-09-2025

    Impact of the Zero Maternal Death by Hemorrhage Strategy on health professionals’ self-perceived knowledge in managing postpartum hemorrhage

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo25

    Abstract

    Original Article

    Impact of the Zero Maternal Death by Hemorrhage Strategy on health professionals’ self-perceived knowledge in managing postpartum hemorrhage

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo25

    DOI 10.61622/rbgo/2025rbgo25

    Views17

    Abstract

    Objective:

    This study aimed to evaluate the results of the Obstetric Hemorrhage Prevention and Management Course – Zero Maternal Death by Hemorrhage Strategy (0MMxH) among healthcare professionals before and after participation.

    Methods:

    A quasi-experimental design was employed, assessing the educational intervention in a convenience sample of healthcare professionals who had participated in the 0MMxH at least one year prior. Participants completed a retrospective pre-post questionnaire sent via email, focusing on self-perceived knowledge levels and the adoption of best practices in postpartum hemorrhage (PPH) management.

    Results:

    Out of 129 professionals who completed the 0MMxH training, 85 (65.9%) responded to the questionnaire. The percentages of respondents reporting no or low knowledge before and after the course were: shock index (52.8% to 0%, before and after, respectively), blood loss estimation (35.2% to 1.1%), care sequence for PPH (44.6% to 0%), rational use of crystalloids (37.5% to 1.1%), non-pneumatic anti-shock garment (83.5% to 3.4%), and damage control surgery (74.1% to 8.1%). These results indicate a significant improvement in self-perceived knowledge. After the course, the highest adoption rates of best practices were for shock index (83.5%), blood loss estimation (67.1%), and use of warm crystalloids (58.8%). However, gaps remained regarding non-pharmacological interventions for PPH management.

    Conclusion:

    Participants reported improved knowledge on most topics covered by the 0MMxH. The program was recognized as a crucial factor in adopting effective PPH management practices, underscoring the importance of training in enhancing obstetric care.

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  • Review Article06-09-2025

    Prophylactic internal iliac artery balloon occlusion in the management of placenta accreta spectrum disorders: a meta-analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo19

    Abstract

    Review Article

    Prophylactic internal iliac artery balloon occlusion in the management of placenta accreta spectrum disorders: a meta-analysis

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo19

    DOI 10.61622/rbgo/2025rbgo19

    Views22

    Abstract

    Objective:

    Placenta accreta spectrum (PAS) describes the failure of placental detachment. PAS is a pregnancy-associated life-threatening condition which increases hemorrhage risk. We evaluated safety and efficacy of internal iliac artery balloon occlusion (IIABOC) on bleeding volume among pregnant women with diagnosis or suspicion of PAS.

    Data source:

    We searched PubMed, Embase and Cochrane databases.

    Study selection:

    Randomized controlled trials (RCTs) and observational studies comparing the efficacy of preoperative prophylactic balloon catheters to a control group with standard care in patients with a prenatal screening of PAS.

    Data collect:

    We computed odds ratio (OR) for binary endpoints and mean difference (MD) for continuous endpoints, with 95% confidence intervals (CIs). We performed random effects models and assessed I2 heterogeneity statistics.

    Data synthesis:

    Twenty-four studies were included, of whom 1,023 (51%) received balloons and 983 (49%) did not undergo balloon management. Patients receiving IIABOC had a greater decrease in estimated blood loss (MD −0.33; 95% CI −0.55, 0.11) and increase in operation time (MD 17.21; 95% CI 3.43, 30.99). Apgar score at fifth minute (MD −0.22; 95% CI −0.36,−0.07) significantly decreased. There were no significant differences between groups regarding hysterectomy rates (OR 1.35; 95% CI 0.88, 2.09) and maternal intensive care unit admission (OR 0.81; 95% CI 0.51,1.29).

    Conclusion:

    While IIABOC have demonstrated a significant reduction in estimated blood loss, these findings have not been consistently replicated in RCTs and the surgeon’s level of experience must be taken into account since it biases the analysis.

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  • FEBRASGO POSITION STATEMENT05-16-2025

    Mayer-Rokitansky-Kuster-Hauser syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-FPS4

    Abstract

    FEBRASGO POSITION STATEMENT

    Mayer-Rokitansky-Kuster-Hauser syndrome

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-FPS4

    DOI 10.61622/rbgo/2025FPS4

    Views138

    Key points

    •Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH) is the leading cause of vaginal agenesis.

    •It is characterized by primary amenorrhea with typical adrenarche and telarche and may be associated with congenital urological and skeletal conditions that should be investigated.

    •Differential diagnoses include: vaginal obstructions (imperforate hymen, distal vaginal atresia, transverse vaginal septum), uterine obstructions (cervical atresia), and differences in sexual development (gonadal dysgenesis, complete androgen insensitivity and congenital adrenal hyperplasia due to CYP17 deficiency).

    •Laboratory tests (testosterone, follicle-stimulating hormone [FSH] and karyotype) and radiological tests (pelvic ultrasound and MRI) are necessary.

    •Vaginal dilation is the first line of treatment with high success rates.

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    Mayer-Rokitansky-Kuster-Hauser syndrome
  • Original Article04-30-2025

    Hysterectomy rates per resident in final year of training in teaching hospitals: an ecologic study

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo24

    Abstract

    Original Article

    Hysterectomy rates per resident in final year of training in teaching hospitals: an ecologic study

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo24

    DOI 10.61622/rbgo/2025rbgo24

    Views161

    Abstract

    Objective:

    Analyze the hysterectomy rates per resident in graduation year in teaching hospitals in the state of São Paulo (Brazil).

    Methods:

    We selected teaching hospitals in the state of São Paulo and gathered information from two public databases to estimate the hysterectomy rates per resident in their final year of training between 2009 and 2019.

    Results:

    Between 2009 and 2019, there was a 37.5% increase in the number of residents in their final year of training, a 4.31% increase in the number of hysterectomies, and a drop in the hysterectomy rates per resident of 24.1%. The reduction of the rate of hysterectomy per resident was more pronounced for vaginal route (46.4%) followed by abdominal route (23.3%). The ratio of laparoscopic hysterectomy per resident increased 264% during the period, however, this route was used in only 7% of the surgeries in 2019.

    Conclusions:

    The hysterectomy rates per resident in their final year of training showed a notable reduction. This trend, particularly pronounced in vaginal and abdominal routes, signals a shift towards minimally invasive techniques.

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    Hysterectomy rates per resident in final year of training in teaching hospitals: an ecologic study
  • Original Article04-30-2025

    Prevalence of antiphospholipid syndrome among women with recurrent pregnancy loss: a cohort study

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo23

    Abstract

    Original Article

    Prevalence of antiphospholipid syndrome among women with recurrent pregnancy loss: a cohort study

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo23

    DOI 10.61622/rbgo/2025rbgo23

    Views159

    Abstract

    Objective:

    This study aimed to evaluate the prevalence of antiphospholipid syndrome (APS) among women experiencing recurrent pregnancy loss (RPL).

    Methods:

    A cross-sectional was conducted, reviewing the medical records of 134 women with a history of two or more miscarriages, treated between January 2014 and May 2024 at a tertiary university center in Belo Horizonte, Brazil. APS screening was performed by assessing anticardiolipin (IgG and IgM), lupus anticoagulant, and anti-β2-glycoprotein-1 (IgG and IgM) antibodies, based on Sapporo criteria. All tests were performed during non-pregnant periods and at least 12 weeks after the last miscarriage.

    Results:

    The study included 134 women with a mean age of 33.8 ± 5.7 years. The number of prior miscarriages ranged from 2 to 11 per couple. Among the patients who presented the lupus anticoagulant, only two (1.49%) tested positive in two samples, as per revised Sapporo criteria. Considering IgG and IgM anticardiolipin antibodies, four patients (2.98%) tested positive in two samples according to old Sapporo criteria, with one patient having a positive IgG test in two samples, two having positive IgM in two samples and a single patient having both positive tests. None of the 56 patients tested positive for anti-β2-glycoprotein-1 antibodies in two samples.

    Conclusion:

    The prevalence of antiphospholipid antibodies, in line with revised Sapporo criteria, is low among Brazilian women with recurrent pregnancy loss, consistent with recent studies in literature. Ensuring the appropriateness of diagnostic criteria is crucial to avoid unnecessary treatment with platelet anticoagulants and heparin in this population.

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  • Original Article04-30-2025

    An assessment of total antioxidant and oxidant parameters and their correlation with embryo quality in in-vitro fertilization patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo22

    Abstract

    Original Article

    An assessment of total antioxidant and oxidant parameters and their correlation with embryo quality in in-vitro fertilization patients

    Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo22

    DOI 10.61622/rbgo/2025rbgo22

    Views153

    Abstract

    Objective:

    In vitro, fertilization is the primary treatment method for infertility. Follicular fluid analysis is an approach used to optimize the results of assisted reproductive techniques. Oxidative stress represents the imbalance between the production of reactive oxygen species and their detoxification. Total Antioxidant and Oxidant Status, and Oxidative Stress Index levels are the main oxidative stress markers. This study investigated the effects of oxidative stress markers on infertility etiology, embryo quality, and success of In vitro fertilization.

    Methods:

    Before enrolling in the ICSI-ET cycle, participants had their FSH and LH levels assessed on the second day of the cycle. The ovarian degrees of the participants were evaluated by transvaginal ultrasonography. Participants underwent controlled ovarian stimulation using the GnRH antagonist protocol. TV-USG and serial E2 measurements were performed at appropriate intervals to follow follicular development. Follicle sizes, quantity, and endometrial thickness were recorded. Total Antioxidant and Oxidant Status, and Oxidative analyses were conducted using Rel Assay Diagnostics Assay Kits.

    Results:

    The average number of total oocytes in the participants was 10.25±6.66, and the average of mature M2 stage oocytes was 6.71±3.72. The average number of fertilized oocytes was 4.65±2.81. Fertilization rates were calculated as approximately 54.75±25.58%. A statistically significant positive correlation was found between embryo quality and serum Total Antioxidant Status levels (p=0.004). Similarly, a significant positive correlation was observed between embryo quality and follicular Total Antioxidant Status values (r = 0.42, p = 0.01).

    Conclusion:

    This study concluded that oxidative stress markers affect certain stages of the IVF treatment process.

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    An assessment of total antioxidant and oxidant parameters and their correlation with embryo quality in in-vitro fertilization patients

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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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