About
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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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 ArticleAssociation of placental histopathological findings with COVID-19 and its predictive factors
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3
Views219See moreAbstract
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.
Views219
Summary
Original ArticleAssociation of placental histopathological findings with COVID-19 and its predictive factors
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo3
Views219See moreAbstract
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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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
- Renata Stefânia Olah de Souza
, - Adriana Gomes Luz ,
- Ruth Zielinski ,
- Luis Otavio Zanatta Sarian ,
- Cassia Raquel Teatin Juliato , [ … ],
- Luiz Gustavo Oliveira Brito
Summary
Original ArticleAssessment 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
- Renata Stefânia Olah de Souza ,
- Adriana Gomes Luz ,
- Ruth Zielinski ,
- Luis Otavio Zanatta Sarian ,
- Cassia Raquel Teatin Juliato ,
- Lucia Alves da Silva Lara ,
- Luiz Gustavo Oliveira Brito
Views242See moreObjective:
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.
Views242Summary
Original ArticleAssessment 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
- Renata Stefânia Olah de Souza ,
- Adriana Gomes Luz ,
- Ruth Zielinski ,
- Luis Otavio Zanatta Sarian ,
- Cassia Raquel Teatin Juliato ,
- Lucia Alves da Silva Lara ,
- Luiz Gustavo Oliveira Brito
Views242See moreObjective:
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.
- Renata Stefânia Olah de Souza
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Original Article
Bacteriological characteristics of primary breast abscesses in patients from the community in the era of microbial resistance
- Vicente Sperb Antonello ,
- Jessica Dallé ,
- Mirela Foresti Jimenez ,
- Patrícia Tramontini ,
- Andrei Gustavo Reginatto
Summary
Original ArticleBacteriological 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
- Vicente Sperb Antonello ,
- Jessica Dallé ,
- Mirela Foresti Jimenez ,
- Patrícia Tramontini ,
- Andrei Gustavo Reginatto
Views155See moreAbstract
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.
Views155Summary
Original ArticleBacteriological 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
- Vicente Sperb Antonello ,
- Jessica Dallé ,
- Mirela Foresti Jimenez ,
- Patrícia Tramontini ,
- Andrei Gustavo Reginatto
Views155See moreAbstract
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.
- Vicente Sperb Antonello
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Original Article
Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
- Lina Rigodanzo Marins ,
- Tiago Elias Rosito ,
- Lucia Maria Kliemann ,
- Edson Capp ,
- Helena von Eye Corleta
Summary
Original ArticleGender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo33
- Lina Rigodanzo Marins ,
- Tiago Elias Rosito ,
- Lucia Maria Kliemann ,
- Edson Capp ,
- Helena von Eye Corleta
Views198Abstract
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.
Key-words FertilityFertility preservationGonadal steroid hormonesHormone treatmentSpermatogenesisTransgender personsTransgender womenSee moreViews198Summary
Original ArticleGender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo33
- Lina Rigodanzo Marins ,
- Tiago Elias Rosito ,
- Lucia Maria Kliemann ,
- Edson Capp ,
- Helena von Eye Corleta
Views198Abstract
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.
Key-words FertilityFertility preservationGonadal steroid hormonesHormone treatmentSpermatogenesisTransgender personsTransgender womenSee more
- Lina Rigodanzo Marins
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Original Article
Screening and prevention of preterm birth: how is it done in clinical practice?
- Roberta Bulsing dos Santos ,
- Janete Vettorazzi ,
- Marcos Wengrover Rosa ,
- Ellen Machado Arlindo ,
- Edimárlei Gonsales Valério
Summary
Original ArticleScreening and prevention of preterm birth: how is it done in clinical practice?
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
- Roberta Bulsing dos Santos ,
- Janete Vettorazzi ,
- Marcos Wengrover Rosa ,
- Ellen Machado Arlindo ,
- Edimárlei Gonsales Valério
Views228Abstract
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.
Key-words attitudes, practiceCervical length measurementgynecologistshealth knowledgeInfant, prematureobstetriciansPreterm birthPreventionScreeningsurveys and questionnairesSee moreViews228Summary
Original ArticleScreening and prevention of preterm birth: how is it done in clinical practice?
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
- Roberta Bulsing dos Santos ,
- Janete Vettorazzi ,
- Marcos Wengrover Rosa ,
- Ellen Machado Arlindo ,
- Edimárlei Gonsales Valério
Views228Abstract
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.
Key-words attitudes, practiceCervical length measurementgynecologistshealth knowledgeInfant, prematureobstetriciansPreterm birthPreventionScreeningsurveys and questionnairesSee more - Roberta Bulsing dos Santos
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Original Article
Transforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis
- Andreia Jacobo ,
- Renata Fogaça Borges ,
- Carlos Augusto Bastos de Souza ,
- Vanessa Krebs Genro ,
- João Sabino Cunha-Filho
Summary
Original ArticleTransforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo31
- Andreia Jacobo ,
- Renata Fogaça Borges ,
- Carlos Augusto Bastos de Souza ,
- Vanessa Krebs Genro ,
- João Sabino Cunha-Filho
Views225See moreAbstract
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.
Views225Summary
Original ArticleTransforming growth factor beta-1 (TGF-β1) expression in patients with adenomyosis
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo31
- Andreia Jacobo ,
- Renata Fogaça Borges ,
- Carlos Augusto Bastos de Souza ,
- Vanessa Krebs Genro ,
- João Sabino Cunha-Filho
Views225See moreAbstract
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.
- Andreia Jacobo
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Original Article
Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses
- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal , [ … ],
- Luciano Marcondes Machado Nardozza
Summary
Original ArticleMode 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
- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views5Abstract
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.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson classificationSee moreViews5Summary
Original ArticleMode 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
- Jaqueline Brandão Mazzola ,
- Ana Cristina Perez Zamarian ,
- Ana Carolina Rabachini Caetano ,
- Luiza Grosso Silva Drumond ,
- Vivian Macedo Gomes Marçal ,
- Amanda Botelho ,
- Edward Araujo Júnior ,
- Sue Yasaki Sun ,
- Luciano Marcondes Machado Nardozza
Views5Abstract
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.
Key-words Cesarean sectionFetal growth retardationFetusGestational ageInfant, newbornInfant, small for gestational agePregnancy outcomerobson classificationSee more - Jaqueline Brandão Mazzola
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Original Article
Fertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists
- Renata Lack Ranniger ,
- Rívia Mara Lamaita ,
- Bárbara Flecha D’Abreu ,
- Mariana Rodrigues Tolentino ,
- Eduardo Batista Cândido , [ … ],
- Agnaldo Lopes Silva-Filho
Summary
Original ArticleFertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25
- Renata Lack Ranniger ,
- Rívia Mara Lamaita ,
- Bárbara Flecha D’Abreu ,
- Mariana Rodrigues Tolentino ,
- Eduardo Batista Cândido ,
- Warne Pedro Andrade ,
- Angélica Nogueira-Rodrigues ,
- Agnaldo Lopes Silva-Filho
Views203Objective:
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.
Key-words attitudesFertilityFertility preservationgynecologistshealth knowledgeNeoplasmsOncologistsOocyte retrievalpracticeReproductionsurveys and questionnairesSee moreViews203Summary
Original ArticleFertility preservation in female cancer patients in Brazil: perceptions and attitudes of infertility specialists
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25
- Renata Lack Ranniger ,
- Rívia Mara Lamaita ,
- Bárbara Flecha D’Abreu ,
- Mariana Rodrigues Tolentino ,
- Eduardo Batista Cândido ,
- Warne Pedro Andrade ,
- Angélica Nogueira-Rodrigues ,
- Agnaldo Lopes Silva-Filho
Views203Objective:
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.
Key-words attitudesFertilityFertility preservationgynecologistshealth knowledgeNeoplasmsOncologistsOocyte retrievalpracticeReproductionsurveys and questionnairesSee more
- Renata Lack Ranniger
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FEBRASGO POSITION STATEMENT
Hyperprolactinemia in women: diagnostic approach
- Andrea Glezer ,
- Heraldo Mendes Garmes ,
- Leandro Kasuki ,
- Manoel Martins ,
- Paula Condé Lamparelli Elias , [ … ],
- Andrea Prestes Nácul
Summary
FEBRASGO POSITION STATEMENTHyperprolactinemia in women: diagnostic approach
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS04
Views782Summary
FEBRASGO POSITION STATEMENTHyperprolactinemia in women: diagnostic approach
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS04
- Andrea Glezer
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FEBRASGO POSITION STATEMENT
Hyperprolactinemia in women: treatment
- Cristina Laguna Benetti-Pinto ,
- Andrea Prestes Nácul ,
- Ana Carolina Japur Rosa e Silva ,
- Gustavo Arantes Rosa Maciel ,
- Vania dos Santos Nunes Nogueira , [ … ],
- Andrea Glezer
Summary
FEBRASGO POSITION STATEMENTHyperprolactinemia in women: treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS05
Views758Summary
FEBRASGO POSITION STATEMENTHyperprolactinemia in women: treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS05
- Cristina Laguna Benetti-Pinto
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FEBRASGO POSITION STATEMENT
Breech birth care: Number 1 – 2024
- Álvaro Luiz Lage Alves ,
- Alexandre Massao Nozaki ,
- Carla Betina Andreucci Polido ,
- Lucas Barbosa da Silva ,
- Roxana Knobel
Summary
FEBRASGO POSITION STATEMENTBreech birth care: Number 1 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgofps1
Views591Summary
FEBRASGO POSITION STATEMENTBreech birth care: Number 1 – 2024
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgofps1
- Álvaro Luiz Lage Alves
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Trabalhos Originais
Search for human papillomavirus in samples of normal endometrial tissue and tissue with carcinoma by the PCR technique
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):277-287
Summary
Trabalhos OriginaisSearch for human papillomavirus in samples of normal endometrial tissue and tissue with carcinoma by the PCR technique
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):277-287
DOI 10.1590/S0100-72032004000400003
Views734See moreOBJECTIVE: to compare the prevalence of DNA of human papillomavirus (HPV), in samples of normal endometrial tissue, and tissue with endometrial carcinoma of women submitted to surgical treatment (hysterectomy), or between endometrial carcinoma and benign disease, through the PCR technique. METHODS: this is an observational control-case study where 100 women (50 with endometrial carcinoma and 50 with normal endometrial tissue) were analyzed for the detection of HPV DNA in samples of endometrial tissue kept in paraffin blocks by the PCR technique. The cases of endometrial carcinoma with uncertain primary site of the lesion as well as the cases with previous or current history of pre-neoplasic lesions or carcinoma of the lower genital tract were excluded. Variables as age, smoking habit, endometrial trophism, squamous differentiation and degree of tumor differentiation were also evaluated. RESULTS: the estimated relative risk of the presence of HPV in the endometrial carcinoma and in the normal endometrial tissue was the same. HPV was detected in 8% of the cases of carcinoma and 10% in the normal endometrial tissue. In spite of HPV having been 3.5 times more detected in women with smoking habit in the group without carcinoma, there was no statistical difference. The presence of HPV was also not correlated with the women’s age, endometrial trophism, squamous differentiation and degree of tumor differentiation. The HPV types 16 (5 cases) and 18 (4 cases) were the viruses most frequently found both in the normal endometrial tissue or in the tissue with carcinoma. No oncogenic low risk virus was detected in the samples. CONCLUSION: The same proportion of HPV is present in the endometrial tissue of women with endometrial cancer and with normal endometrium. It could not be demonstrated a possible correlation of DNA of HPV with the development of endometrial carcinoma.
Views734Summary
Trabalhos OriginaisSearch for human papillomavirus in samples of normal endometrial tissue and tissue with carcinoma by the PCR technique
Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(4):277-287
DOI 10.1590/S0100-72032004000400003
Views734See moreOBJECTIVE: to compare the prevalence of DNA of human papillomavirus (HPV), in samples of normal endometrial tissue, and tissue with endometrial carcinoma of women submitted to surgical treatment (hysterectomy), or between endometrial carcinoma and benign disease, through the PCR technique. METHODS: this is an observational control-case study where 100 women (50 with endometrial carcinoma and 50 with normal endometrial tissue) were analyzed for the detection of HPV DNA in samples of endometrial tissue kept in paraffin blocks by the PCR technique. The cases of endometrial carcinoma with uncertain primary site of the lesion as well as the cases with previous or current history of pre-neoplasic lesions or carcinoma of the lower genital tract were excluded. Variables as age, smoking habit, endometrial trophism, squamous differentiation and degree of tumor differentiation were also evaluated. RESULTS: the estimated relative risk of the presence of HPV in the endometrial carcinoma and in the normal endometrial tissue was the same. HPV was detected in 8% of the cases of carcinoma and 10% in the normal endometrial tissue. In spite of HPV having been 3.5 times more detected in women with smoking habit in the group without carcinoma, there was no statistical difference. The presence of HPV was also not correlated with the women’s age, endometrial trophism, squamous differentiation and degree of tumor differentiation. The HPV types 16 (5 cases) and 18 (4 cases) were the viruses most frequently found both in the normal endometrial tissue or in the tissue with carcinoma. No oncogenic low risk virus was detected in the samples. CONCLUSION: The same proportion of HPV is present in the endometrial tissue of women with endometrial cancer and with normal endometrium. It could not be demonstrated a possible correlation of DNA of HPV with the development of endometrial carcinoma.
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Letter to the Editor
Letter to Editor: In response to existence of SARS-CoV-2 in the peritoneal fluid
- Gustavo Romero-Velez ,
- Guillermo Ponce de Leon-Ballesteros ,
- Juan Barajas-Gamboa ,
- Jerry Dang ,
- Andrew Strong , [ … ],
- Mathew Kroh
Summary
Letter to the EditorLetter to Editor: In response to existence of SARS-CoV-2 in the peritoneal fluid
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo24
Views562Summary
Letter to the EditorLetter to Editor: In response to existence of SARS-CoV-2 in the peritoneal fluid
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo24
- Gustavo Romero-Velez
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Editorial
The path to elimination: FEBRASGO 2023’s targeted strategies against cervical cancer in Brazil
- Agnaldo Lopes da Silva Filho ,
- Cecilia Maria Roteli-Martins ,
- Neila Maria de Góis Speck ,
- Newton Sérgio de Carvalho ,
- Eduardo Batista Cândido , [ … ],
- Júlio César Teixeira
Summary
EditorialThe path to elimination: FEBRASGO 2023’s targeted strategies against cervical cancer in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgoedt2
Views436Summary
EditorialThe path to elimination: FEBRASGO 2023’s targeted strategies against cervical cancer in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgoedt2
- Agnaldo Lopes da Silva Filho
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FEBRASGO POSITION STATEMENT
Use of hormones and risk of venous thromboembolism
- Venina Isabel Poço Viana Leme de Barros ,
- André Luiz Malavasi Longo de Oliveira ,
- Denis Jose do Nascimento ,
- Eduardo Zlotnik ,
- Marcelo Melzer Teruchkin , [ … ],
- Paulo Francisco Ramos Margarido
Summary
FEBRASGO POSITION STATEMENTUse of hormones and risk of venous thromboembolism
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS02
- Venina Isabel Poço Viana Leme de Barros ,
- André Luiz Malavasi Longo de Oliveira ,
- Denis Jose do Nascimento ,
- Eduardo Zlotnik ,
- Marcelo Melzer Teruchkin ,
- Marcos Arêas Marques ,
- Paulo Francisco Ramos Margarido
Views301See moreKey points
•The risk of venous thromboembolism (VTE) is not increased in women using long-acting reversible contraceptive methods (LARCs) with progestogens.
•Oral contraceptives with levonorgestrel or norgestimate confer half the risk of VTE compared to oral contraceptives containing desogestrel, gestodene or drospirenone.
•Progestogen-only pills do not confer an increased risk of VTE.
•Women using transdermal contraceptive patches and combined oral contraceptives (COCs) are at an approximately eight times greater risk of VTE than non-users of hormonal contraceptives (HCs), corresponding to 9.7 events per 10,000 women/years.
•Vaginal rings increase the risk of VTE by 6.5 times compared to not using HC, corresponding to 7.8 events per 10,000 women/years.
•Several studies have demonstrated an increased risk of VTE in transgender individuals receiving hormone therapy (HT).
•Hormone therapy during menopause increases the risk of VTE by approximately two times, and this risk is increased by obesity, thrombophilia, age over 60 years, surgery and immobilization.
•The route of estrogen administration, the dosage and type of progestogen associated with estrogen may affect the risk of VTE in the climacteric.
•Combined estrogen-progesterone therapy increases the risk of VTE compared to estrogen monotherapy.
•Postmenopausal HT increases the risk of thrombosis at atypical sites.
Views301Summary
FEBRASGO POSITION STATEMENTUse of hormones and risk of venous thromboembolism
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS02
- Venina Isabel Poço Viana Leme de Barros ,
- André Luiz Malavasi Longo de Oliveira ,
- Denis Jose do Nascimento ,
- Eduardo Zlotnik ,
- Marcelo Melzer Teruchkin ,
- Marcos Arêas Marques ,
- Paulo Francisco Ramos Margarido
Views301See moreKey points
•The risk of venous thromboembolism (VTE) is not increased in women using long-acting reversible contraceptive methods (LARCs) with progestogens.
•Oral contraceptives with levonorgestrel or norgestimate confer half the risk of VTE compared to oral contraceptives containing desogestrel, gestodene or drospirenone.
•Progestogen-only pills do not confer an increased risk of VTE.
•Women using transdermal contraceptive patches and combined oral contraceptives (COCs) are at an approximately eight times greater risk of VTE than non-users of hormonal contraceptives (HCs), corresponding to 9.7 events per 10,000 women/years.
•Vaginal rings increase the risk of VTE by 6.5 times compared to not using HC, corresponding to 7.8 events per 10,000 women/years.
•Several studies have demonstrated an increased risk of VTE in transgender individuals receiving hormone therapy (HT).
•Hormone therapy during menopause increases the risk of VTE by approximately two times, and this risk is increased by obesity, thrombophilia, age over 60 years, surgery and immobilization.
•The route of estrogen administration, the dosage and type of progestogen associated with estrogen may affect the risk of VTE in the climacteric.
•Combined estrogen-progesterone therapy increases the risk of VTE compared to estrogen monotherapy.
•Postmenopausal HT increases the risk of thrombosis at atypical sites.
- Venina Isabel Poço Viana Leme de Barros
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FEBRASGO POSITION STATEMENT
Vulvovaginitis in pregnant women
- Geraldo Duarte ,
- Iara Moreno Linhares ,
- Regis Kreitchmann ,
- Andréa da Rocha Tristão ,
- Evelyn Traina , [ … ],
- Joelma Queiroz Andrade
Summary
FEBRASGO POSITION STATEMENTVulvovaginitis in pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS03
- Geraldo Duarte ,
- Iara Moreno Linhares ,
- Regis Kreitchmann ,
- Andréa da Rocha Tristão ,
- Evelyn Traina ,
- Ivete Canti ,
- Marcos Takimura ,
- Joelma Queiroz Andrade
Views296See moreKey points
• The balanced vaginal microbiome is the main factor defending the vaginal environment against infections. Lactobacilli play a key role in this regard, maintaining the vaginal pH within the normal range (3.8 to 4.5).
•Hormonal and immune adaptations resulting from pregnancy influence changes in the vaginal microbiome during pregnancy.
•An altered vaginal microbiome predisposes to human immunodeficiency virus (HIV) infection.
•Bacterial vaginosis is the main clinical expression of an imbalanced vaginal microbiome.
•Vulvovaginal candidiasis depends more on the host’s conditions than on the etiological agent.
•Trichomonas vaginalis is a protozoan transmitted during sexual intercourse.
•The use of probiotics is not approved for use in pregnant women.
Views296Summary
FEBRASGO POSITION STATEMENTVulvovaginitis in pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-FPS03
- Geraldo Duarte ,
- Iara Moreno Linhares ,
- Regis Kreitchmann ,
- Andréa da Rocha Tristão ,
- Evelyn Traina ,
- Ivete Canti ,
- Marcos Takimura ,
- Joelma Queiroz Andrade
Views296See moreKey points
• The balanced vaginal microbiome is the main factor defending the vaginal environment against infections. Lactobacilli play a key role in this regard, maintaining the vaginal pH within the normal range (3.8 to 4.5).
•Hormonal and immune adaptations resulting from pregnancy influence changes in the vaginal microbiome during pregnancy.
•An altered vaginal microbiome predisposes to human immunodeficiency virus (HIV) infection.
•Bacterial vaginosis is the main clinical expression of an imbalanced vaginal microbiome.
•Vulvovaginal candidiasis depends more on the host’s conditions than on the etiological agent.
•Trichomonas vaginalis is a protozoan transmitted during sexual intercourse.
•The use of probiotics is not approved for use in pregnant women.
- Geraldo Duarte
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Review Article
Breastfeeding and the Benefits of Lactation for Women’s Health
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):354-359
Summary
Review ArticleBreastfeeding and the Benefits of Lactation for Women’s Health
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):354-359
Views4See moreAbstract
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.
Views4Summary
Review ArticleBreastfeeding and the Benefits of Lactation for Women’s Health
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(6):354-359
Views4See moreAbstract
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.
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Review Article
Preeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512
Summary
Review ArticlePreeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512
Views5Abstract
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 complicationsSee moreViews5Summary
Review ArticlePreeclampsia
Revista Brasileira de Ginecologia e Obstetrícia. 2017;39(9):496-512
Views5Abstract
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 complicationsSee more
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Artigos Originais
Translation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):504-510
Summary
Artigos OriginaisTranslation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):504-510
DOI 10.1590/S0100-72032008001000005
Views2PURPOSE: to translate from English into Portuguese, adapt culturally and validate the Female Sexual Function Index (FSFI). METHODS: knowing the objectives of this research, two Brazilian translators have prepared a version each from the FSFI into Portuguese. Both versions have then been retro-translated into English by two English translators. After harmonizing the differences, they have been pre-tested in a pilot study. The final versions from the FSFI and from another questionnaire, the Short-Form Health Survey, which had already been translated and published in Portuguese, have then been simultaneously administered to one hundred patients, to test the FSFI psychometric proprieties concerning reliability (internal consistency and testing-retesting) and construct validity. Retesting was done after four weeks from the first interview. RESULTS: the process of cultural adaptation has not altered the Portuguese version of the FSFI, as compared to the original. The FSFI standardized Cronbach alpha was 0.96, and the evaluation by domains has varied from 0.31 to 0.97. As a measure of test-retest confidentiality, it was applied the intra-class coefficient, which has been considered strong and identical (1.0). Pearson’s correlation coefficient between the FSFI and the Short-Form Health Survey was positive, but weak in most of the interrelated domains, varying from 0.017 to 0.036. CONCLUSIONS: the FSFI English version has been translated into Portuguese and culturally adapted, being reliable to evaluate the sexual response of Brazilian women.
Key-words QuestionnairesReproducibility of resultsSexual dysfunctions, psychologicalTranslationsValidation studiesWomen's healthSee moreViews2Summary
Artigos OriginaisTranslation into Portuguese, cross-national adaptation and validation of the Female Sexual Function Index
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(10):504-510
DOI 10.1590/S0100-72032008001000005
Views2PURPOSE: to translate from English into Portuguese, adapt culturally and validate the Female Sexual Function Index (FSFI). METHODS: knowing the objectives of this research, two Brazilian translators have prepared a version each from the FSFI into Portuguese. Both versions have then been retro-translated into English by two English translators. After harmonizing the differences, they have been pre-tested in a pilot study. The final versions from the FSFI and from another questionnaire, the Short-Form Health Survey, which had already been translated and published in Portuguese, have then been simultaneously administered to one hundred patients, to test the FSFI psychometric proprieties concerning reliability (internal consistency and testing-retesting) and construct validity. Retesting was done after four weeks from the first interview. RESULTS: the process of cultural adaptation has not altered the Portuguese version of the FSFI, as compared to the original. The FSFI standardized Cronbach alpha was 0.96, and the evaluation by domains has varied from 0.31 to 0.97. As a measure of test-retest confidentiality, it was applied the intra-class coefficient, which has been considered strong and identical (1.0). Pearson’s correlation coefficient between the FSFI and the Short-Form Health Survey was positive, but weak in most of the interrelated domains, varying from 0.017 to 0.036. CONCLUSIONS: the FSFI English version has been translated into Portuguese and culturally adapted, being reliable to evaluate the sexual response of Brazilian women.
Key-words QuestionnairesReproducibility of resultsSexual dysfunctions, psychologicalTranslationsValidation studiesWomen's healthSee more -
Review Article
Primary Dysmenorrhea: Assessment and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):501-507
Summary
Review ArticlePrimary Dysmenorrhea: Assessment and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):501-507
Views6See moreAbstract
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.
Views6Summary
Review ArticlePrimary Dysmenorrhea: Assessment and Treatment
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):501-507
Views6See moreAbstract
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.
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Review Article
Multiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):554-562
Summary
Review ArticleMultiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):554-562
Views3See moreAbstract
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.
Views3Summary
Review ArticleMultiple Pregnancy: Epidemiology and Association with Maternal and Perinatal Morbidity
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):554-562
Views3See moreAbstract
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.
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Artigos Originais
Coverage of the Pap smear in Brazil and its determining factors: a systematic literature review
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):485-492
Summary
Artigos OriginaisCoverage of the Pap smear in Brazil and its determining factors: a systematic literature review
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):485-492
DOI 10.1590/S0100-72032005000800009
Views2See morePURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE – 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women’s failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women’s failure to submit to the Pap smear.
Views2Summary
Artigos OriginaisCoverage of the Pap smear in Brazil and its determining factors: a systematic literature review
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(8):485-492
DOI 10.1590/S0100-72032005000800009
Views2See morePURPOSE: to present an overview of the coverage of the Pap smear in Brazil, emphasizing the determinant factors associated with failure of women to submit to the test. METHODS: the literature was reviewed using the LILACS (Latin-American and Caribbean Literature in Sciences of the Health), MEDLINE – 1966 to 2004 (International Literature in Sciences of the Health), PAHO (Collection of the Library of the Pan-American Organization of Health), and WHOLIS (System of Information of the Library of OMS) databases. The review was enlarged through the search of bibliographical references of relevant studies, request for published and unpublished studies by specialists, and other sources. Articles that fulfilled the following criteria were selected: to be a cross-sectional study, carried out in Brazil, including information about periodicity of the Pap test (some time in life or in the last three years) and/or containing information about factors associated with failure of women to submit to the test. Duplicates and articles without summary were excluded. A total of 13 articles fulfilling these criteria were selected. RESULTS: there are few studies on the coverage of Pap smear in Brazil. Most of them are concentrated in the big cities of the South and Southeast regions of the country. Besides the shortage, little methodological standardization exists in relation to the sampling and profile of the investigated women, which turns difficult the comparison among them. These methodological differences must have contributed to the great variability found in the coverage. However, in spite of all of the problems, a trend of time series increase is observed in the percentage of women who had at least one Pap smear in life. The two studies accomplished in the eighties showed coverage of 55.0 and 68.9% some time in life, while a household survey carried out in 2002 and 2003 presented values that varied from 73.4 to 92.9%; however, two studies of national inclusion presented estimates below 70.0% in the last three years. On the other hand, some variables were associated with the women’s failure to submit to the Pap smear: low socioeconomic level, low education, low family income, and to belong to the younger age groups. CONCLUSION: the data here presented point to regional inequalities in the coverage of the Pap smear in the Brazilian female population and to the need of intervention targeted to those factors associated with women’s failure to submit to the Pap smear.
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Trabalhos Originais
Pré-natal Care Profile among Public Health Service (“Sistema Único de Saúde”) Users from Caxias do Sul
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(5):293-299
Summary
Trabalhos OriginaisPré-natal Care Profile among Public Health Service (“Sistema Único de Saúde”) Users from Caxias do Sul
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(5):293-299
DOI 10.1590/S0100-72032002000500002
Views3See morePurpose: to study the prenatal care among Public Health Service (“Sistema Único de Saúde”) users from Caxias do Sul – RS. Methods: a transversal study of 702 pregnancies attended at the Hospital Geral -Universidade de Caxias do Sul from March 2000 to March 2001 based on the criteria set by the “Programa Nacional de Humanização do Pré-natal e Nascimento (PNHPN)” of the Brazilian Ministry of Health. Results: the observed prenatal coverage was 95.4%, whereas the average of visits was 6.2. The main reported reason for not following prenatal care was the lack of information about its importance (65.6%). In 51.5% of the cases, prenatal care started in the third month of pregnancy, whereas 44.3% of the pregnant women carried out all the proposed complementary tests. Prenatal care was considered inappropriate in 64.8% and appropriate in 35.2% of the cases. The quality of prenatal attention was significantly associated with the mother’s education, as well as with the number of previous deliveries. The higher the educational level, the better the quality of observed prenatal care (p=0.0148). In addition, the higher number of previous deliveries showed to be associated with a later beginning of prenatal care and a lower number of visits (p=0.0008). Conclusions: the prenatal care available at Caxias do Sul in spite of its good coverage, should be reviewed in terms of quality. Special attention should be given to education in health along the prenatal assistance.
Views3Summary
Trabalhos OriginaisPré-natal Care Profile among Public Health Service (“Sistema Único de Saúde”) Users from Caxias do Sul
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(5):293-299
DOI 10.1590/S0100-72032002000500002
Views3See morePurpose: to study the prenatal care among Public Health Service (“Sistema Único de Saúde”) users from Caxias do Sul – RS. Methods: a transversal study of 702 pregnancies attended at the Hospital Geral -Universidade de Caxias do Sul from March 2000 to March 2001 based on the criteria set by the “Programa Nacional de Humanização do Pré-natal e Nascimento (PNHPN)” of the Brazilian Ministry of Health. Results: the observed prenatal coverage was 95.4%, whereas the average of visits was 6.2. The main reported reason for not following prenatal care was the lack of information about its importance (65.6%). In 51.5% of the cases, prenatal care started in the third month of pregnancy, whereas 44.3% of the pregnant women carried out all the proposed complementary tests. Prenatal care was considered inappropriate in 64.8% and appropriate in 35.2% of the cases. The quality of prenatal attention was significantly associated with the mother’s education, as well as with the number of previous deliveries. The higher the educational level, the better the quality of observed prenatal care (p=0.0148). In addition, the higher number of previous deliveries showed to be associated with a later beginning of prenatal care and a lower number of visits (p=0.0008). Conclusions: the prenatal care available at Caxias do Sul in spite of its good coverage, should be reviewed in terms of quality. Special attention should be given to education in health along the prenatal assistance.
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Artigos Originais
Validation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(5):235-242
Summary
Artigos OriginaisValidation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(5):235-242
DOI 10.1590/S0100-72032005000500002
Views1See morePURPOSE: the proposal of the present study was to translate and to validate King’s Health Questionnaire (KHQ) for Brazilian women with urinary incontinence. METHODS: a hundred and thirty-four patients with urinary incontinence, confirmed by urodynamic study, were enrolled from the outpatient clinic of Uroginecology. Initially, we translated the KHQ into the Brazilian Portuguese language in agreement with international criteria. Due to language and cultural differences we performed a cultural, structural, conceptual, and semantic adaptation of the KHQ, in order to make sure that patients were able to fully understand the questions. All patients answered the KHQ twice on the same day, within an interval of 30 min, applied by two different interviewers. After 7 to 14 days, on a second visit, the questionnaire was applied again. Reliability (intra- and interobserver internal consistency), construct and discriminative validity were tested. RESULTS: several cultural adaptations were necessary until we reached the final version. The intra-observer internal consistency (alpha of Cronbach) of the several dimensions varied from moderate to high (0.77-0.90), and the interobserver internal consistency varied from 0.66 to 0.94. Moderate to strong correlation was detected among the specific KHQ urinary incontinence dominions and clinical urinary incontinence manifestations known to affect the quality of life of these patients. CONCLUSION: KHQ was adapted to the Portuguese language and to the Brazilian culture, showing great reliability and validity. It should be included and used in any Brazilian urinary incontinence clinical trial.
Views1Summary
Artigos OriginaisValidation of a quality of life questionnaire (King’s Health Questionnaire) in Brazilian women with urinary incontinence
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(5):235-242
DOI 10.1590/S0100-72032005000500002
Views1See morePURPOSE: the proposal of the present study was to translate and to validate King’s Health Questionnaire (KHQ) for Brazilian women with urinary incontinence. METHODS: a hundred and thirty-four patients with urinary incontinence, confirmed by urodynamic study, were enrolled from the outpatient clinic of Uroginecology. Initially, we translated the KHQ into the Brazilian Portuguese language in agreement with international criteria. Due to language and cultural differences we performed a cultural, structural, conceptual, and semantic adaptation of the KHQ, in order to make sure that patients were able to fully understand the questions. All patients answered the KHQ twice on the same day, within an interval of 30 min, applied by two different interviewers. After 7 to 14 days, on a second visit, the questionnaire was applied again. Reliability (intra- and interobserver internal consistency), construct and discriminative validity were tested. RESULTS: several cultural adaptations were necessary until we reached the final version. The intra-observer internal consistency (alpha of Cronbach) of the several dimensions varied from moderate to high (0.77-0.90), and the interobserver internal consistency varied from 0.66 to 0.94. Moderate to strong correlation was detected among the specific KHQ urinary incontinence dominions and clinical urinary incontinence manifestations known to affect the quality of life of these patients. CONCLUSION: KHQ was adapted to the Portuguese language and to the Brazilian culture, showing great reliability and validity. It should be included and used in any Brazilian urinary incontinence clinical trial.
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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.
