Pub Date : 2024-07-26eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo65
Victor Hugo Palhares Flávio-Reis, Yago Marcos Pessoa-Gonçalves, Alan de Castro Barbosa, Chamberttan Souza Desidério, Wellington Francisco Rodrigues, Carlo José Freire Oliveira
Objective: Eclampsia is a hypertensive disorder that occurs during pregnancy and can lead to death. The literature has gaps by not providing comprehensive data on the epidemiology of the disease, restricting analysis to limited temporal intervals and geographical locations. This study aims to characterize the epidemiological profile of women who died from eclampsia in Brazil from 2000 to 2021.
Methods: The maternal mortality data were obtained from the Sistema de Informações sobre Mortalidade, with the following variables of interest selected: "Federative Unit," "Year," "Age Range," "Race/Color," and "Education Level." The collection of the number of live births for data normalization was conducted in the Sistema de Informações sobre Nascidos Vivos. Statistical analyses were performed using GraphPad Prism, calculating odds ratio for variables and fixing number of deaths per 100,000 live births for calculating maternal mortality ratio (MMR).
Results: There was a downward trend in maternal mortality rate during the study period. Maranhão stood out as the federative unit with the highest MMR (17 deaths per 100.000 live births). Mothers aged between 40 and 49 years (OR = 3.55, CI: 3.11-4.05) presents higher MMR. Additionally, black women showed the highest MMR (OR = 4.67, CI: 4.18-5.22), as well as mothers with no educational background (OR = 5.83, CI: 4.82-7.06).
Conclusion: The epidemiological profile studied is predominantly composed of mothers with little or no formal education, self-declared as Black, residing in needy states and with advanced aged. These data are useful for formulating public policies aimed at combating the issue.
目的:子痫是一种妊娠期高血压疾病,可导致死亡。由于没有提供有关该疾病流行病学的全面数据,文献分析仅限于有限的时间间隔和地理位置,因此存在空白。本研究旨在描述 2000 年至 2021 年巴西死于子痫的妇女的流行病学特征:孕产妇死亡数据来自 Sistema de Informações sobre Mortalidade,并选择了以下相关变量:"联邦单位"、"年份"、"年龄范围"、"种族/肤色 "和 "教育程度"。数据归一化所需的活产婴儿数由活产婴儿信息系统(Sistema de Informações sobre Nascidos Vivos)收集。使用 GraphPad Prism 进行统计分析,计算变量的几率比例,并确定每 10 万活产的死亡人数,以计算孕产妇死亡率(MMR):在研究期间,产妇死亡率呈下降趋势。马拉尼昂州是孕产妇死亡率最高的联邦单位(每 100 000 例活产中有 17 例死亡)。年龄在 40 至 49 岁之间的母亲(OR = 3.55,CI:3.11-4.05)的产妇死亡率较高。此外,黑人妇女的产妇死亡率最高(OR = 4.67,CI:4.18-5.22),没有教育背景的母亲的产妇死亡率也最高(OR = 5.83,CI:4.82-7.06):所研究的流行病学特征主要由受过很少或没有受过正规教育、自称为黑人、居住在贫困州和高龄产妇的母亲组成。这些数据有助于制定旨在解决这一问题的公共政策。
{"title":"Maternal deaths caused by eclampsia in Brazil: a descriptive study from 2000 to 2021.","authors":"Victor Hugo Palhares Flávio-Reis, Yago Marcos Pessoa-Gonçalves, Alan de Castro Barbosa, Chamberttan Souza Desidério, Wellington Francisco Rodrigues, Carlo José Freire Oliveira","doi":"10.61622/rbgo/2024rbgo65","DOIUrl":"10.61622/rbgo/2024rbgo65","url":null,"abstract":"<p><strong>Objective: </strong>Eclampsia is a hypertensive disorder that occurs during pregnancy and can lead to death. The literature has gaps by not providing comprehensive data on the epidemiology of the disease, restricting analysis to limited temporal intervals and geographical locations. This study aims to characterize the epidemiological profile of women who died from eclampsia in Brazil from 2000 to 2021.</p><p><strong>Methods: </strong>The maternal mortality data were obtained from the <i>Sistema de Informações sobre Mortalidade</i>, with the following variables of interest selected: \"Federative Unit,\" \"Year,\" \"Age Range,\" \"Race/Color,\" and \"Education Level.\" The collection of the number of live births for data normalization was conducted in the Sistema de Informações sobre Nascidos Vivos. Statistical analyses were performed using GraphPad Prism, calculating odds ratio for variables and fixing number of deaths per 100,000 live births for calculating maternal mortality ratio (MMR).</p><p><strong>Results: </strong>There was a downward trend in maternal mortality rate during the study period. Maranhão stood out as the federative unit with the highest MMR (17 deaths per 100.000 live births). Mothers aged between 40 and 49 years (OR = 3.55, CI: 3.11-4.05) presents higher MMR. Additionally, black women showed the highest MMR (OR = 4.67, CI: 4.18-5.22), as well as mothers with no educational background (OR = 5.83, CI: 4.82-7.06).</p><p><strong>Conclusion: </strong>The epidemiological profile studied is predominantly composed of mothers with little or no formal education, self-declared as Black, residing in needy states and with advanced aged. These data are useful for formulating public policies aimed at combating the issue.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo62
Bruna Obeica Vasconcellos, Susana Cristina Aidé Viviani Fialho, Isabel Cristina Chulvis do Val Guimarães, Caroline Alves de Oliveira Martins, José Rodrigo de Moraes, Rita Maira Zanine, Julia Correa Cardoso Guimarães, Faustino Pérez-López
Objective: To report the prevalence of malignant transformation of vulvar lichen sclerosus (VLS) and possible risk factors.
Methods: This is a cohort study with data analysis from medical records of 138 patients with histological diagnosis of VLS registered at the Vulvar Pathology Outpatient Clinic of the University Hospital, between 2007 and 2017. Predominance of risk factors was performed using logistic regression analysis. The variables studied were the length of follow-up, age, regular or irregular follow up; presence of symptoms (dyspareunia, pruritus and/or vulvar burning); histology characteristics, the presence of epithelial hyperplasia; and the presence of autoimmune diseases.
Results: There were 138 patients included in the study, and among them five progressed to malignant transformation. The patients had a median age of 59 years and 83% were symptomatic. The most frequent symptom was itching with 72%. Autoimmune diseases were present in 11.6%, the most prevalent being thyroid disease. All five case of malignant transformation (0.6%) had an irregular follow up. The logistic regression analysis was used among the studied variables, and no statistical significance was found among them (p ≥ 0.05). The relationship between hyperplasia and the clinical outcome of malignant transformation, in which non-significant but acceptable p value close to 0.05 was observed.
Conclusion: The prevalence of malignant transformation in patients with VLS was 0.6%, and common factors were the lack of adherence to medical treatments and the loss of follow-up.
{"title":"Study of 138 vulvar lichen sclerosus patients and the malignant risk transformation.","authors":"Bruna Obeica Vasconcellos, Susana Cristina Aidé Viviani Fialho, Isabel Cristina Chulvis do Val Guimarães, Caroline Alves de Oliveira Martins, José Rodrigo de Moraes, Rita Maira Zanine, Julia Correa Cardoso Guimarães, Faustino Pérez-López","doi":"10.61622/rbgo/2024rbgo62","DOIUrl":"10.61622/rbgo/2024rbgo62","url":null,"abstract":"<p><strong>Objective: </strong>To report the prevalence of malignant transformation of vulvar lichen sclerosus (VLS) and possible risk factors.</p><p><strong>Methods: </strong>This is a cohort study with data analysis from medical records of 138 patients with histological diagnosis of VLS registered at the Vulvar Pathology Outpatient Clinic of the University Hospital, between 2007 and 2017. Predominance of risk factors was performed using logistic regression analysis. The variables studied were the length of follow-up, age, regular or irregular follow up; presence of symptoms (dyspareunia, pruritus and/or vulvar burning); histology characteristics, the presence of epithelial hyperplasia; and the presence of autoimmune diseases.</p><p><strong>Results: </strong>There were 138 patients included in the study, and among them five progressed to malignant transformation. The patients had a median age of 59 years and 83% were symptomatic. The most frequent symptom was itching with 72%. Autoimmune diseases were present in 11.6%, the most prevalent being thyroid disease. All five case of malignant transformation (0.6%) had an irregular follow up. The logistic regression analysis was used among the studied variables, and no statistical significance was found among them (p ≥ 0.05). The relationship between hyperplasia and the clinical outcome of malignant transformation, in which non-significant but acceptable p value close to 0.05 was observed.</p><p><strong>Conclusion: </strong>The prevalence of malignant transformation in patients with VLS was 0.6%, and common factors were the lack of adherence to medical treatments and the loss of follow-up.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo30
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
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.
{"title":"Mode of delivery according to Robson classification and perinatal outcomes in restricted and small for gestational age fetuses.","authors":"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","doi":"10.61622/rbgo/2024rbgo30","DOIUrl":"10.61622/rbgo/2024rbgo30","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo61
Silas Otero Reis Salum, Eduardo Batista Candido, Maria Aparecida Custódio Domingues, Elida Paula Benquique Ojopi, Ângela Favorito Santarem Tonon, Agnaldo Lopes da Silva-Filho
Objective: Endometrial cancer (EC) is a heterogeneous disease with recurrence rates ranging from 15 to 20%. The discrimination of cases with a worse prognosis aims, in part, to reduce the length of surgical staging in cases with a better prognosis. This study aimed to evaluate the association between Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression and prognostic and morphological factors in EC.
Methods: This retrospective, cross-sectional, analytical study included 79 EC patients - 70 endometrioid carcinoma (EEC) and 9 serous carcinoma (SC) - and 74 benign endometrium controls. IMP3 expression was evaluated by immunohistochemistry-based TMA (Tissue Microarray), and the results were associated with morphological and prognostic factors, including claudins 3 and 4, estrogen and progesterone receptors, TP53, and KI67.
Results: IMP3 expression was significantly higher in SC compared to EEC in both extent (p<0.001) and intensity (p=0.044). It was also significantly associated with worse prognostic factors, including degree of differentiation (p=0.024, p<0.001), staging (p<0.001; p<0.001) and metastasis (p=0.002; p<0.001). IMP3 expression was also significant in extent (p=0.002) in endometrial tumors compared with controls. In addition, protein TP53 and KI67 showed significant associations in extent and intensity, respectively.
Conclusion: IMP3 expression was associated with worse prognostic factors studied. These findings suggest that IMP3 may be a potential biomarker for EC poorer prognosis.
{"title":"Association of insulin-like growth factor II mrna-binding protein 3 (IMP3) expression with prognostic and morphological factors in endometrial cancer.","authors":"Silas Otero Reis Salum, Eduardo Batista Candido, Maria Aparecida Custódio Domingues, Elida Paula Benquique Ojopi, Ângela Favorito Santarem Tonon, Agnaldo Lopes da Silva-Filho","doi":"10.61622/rbgo/2024rbgo61","DOIUrl":"10.61622/rbgo/2024rbgo61","url":null,"abstract":"<p><strong>Objective: </strong>Endometrial cancer (EC) is a heterogeneous disease with recurrence rates ranging from 15 to 20%. The discrimination of cases with a worse prognosis aims, in part, to reduce the length of surgical staging in cases with a better prognosis. This study aimed to evaluate the association between Insulin-like growth factor II mRNA-binding protein 3 (IMP3) expression and prognostic and morphological factors in EC.</p><p><strong>Methods: </strong>This retrospective, cross-sectional, analytical study included 79 EC patients - 70 endometrioid carcinoma (EEC) and 9 serous carcinoma (SC) - and 74 benign endometrium controls. IMP3 expression was evaluated by immunohistochemistry-based TMA (Tissue Microarray), and the results were associated with morphological and prognostic factors, including claudins 3 and 4, estrogen and progesterone receptors, TP53, and KI67.</p><p><strong>Results: </strong>IMP3 expression was significantly higher in SC compared to EEC in both extent (p<0.001) and intensity (p=0.044). It was also significantly associated with worse prognostic factors, including degree of differentiation (p=0.024, p<0.001), staging (p<0.001; p<0.001) and metastasis (p=0.002; p<0.001). IMP3 expression was also significant in extent (p=0.002) in endometrial tumors compared with controls. In addition, protein TP53 and KI67 showed significant associations in extent and intensity, respectively.</p><p><strong>Conclusion: </strong>IMP3 expression was associated with worse prognostic factors studied. These findings suggest that IMP3 may be a potential biomarker for EC poorer prognosis.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.
Methods: In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment.
Results: The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach's alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001).
Conclusion: This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.
{"title":"Validation and cultural translation for the Brazilian Portuguese version of the Estro-Androgenic- Symptom Questionnaire in Women.","authors":"Cássia Raquel Teatin Juliato, Ana Aline Coelho Oswaldo, Camila Carvalho de Araújo, Marina Rotoli, Lúcia Costa-Paiva, Rossella Nappi, Luiz Gustavo Oliveira Brito","doi":"10.61622/rbgo/2024rbgo56","DOIUrl":"10.61622/rbgo/2024rbgo56","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.</p><p><strong>Methods: </strong>In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment.</p><p><strong>Results: </strong>The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach's alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001).</p><p><strong>Conclusion: </strong>This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-26eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo58
Carlos Grandi, Karina Bezerra Salomão, Stella Felippe de Freitas, Paulo Ricardo Higassiaraguti Rocha, Ricardo de Carvalho Cavalli, Viviane Cunha Cardoso
Objective: To assess a panel of cytokines and placental insufficiency with the risk of preterm delivery (PTD).
Methods: Nested case-control study into the BRISA birth cohort. Eighty-two mother-infant-placenta pairs were selected at 20+0 to 25+6 weeks. Circulating biomarker levels were performed using Luminex flowmetric xMAP technology. Cytokines classified as Th1, Th2 or Th17 and other biomarkers were selected. The ratio between birth weight and placental weight (BW/PW) was used as a proxy for placental efficiency. Spearman correlation, univariate analyses and logistic regression models were calculated. Sensitivity, specificity, positive and negative likelihood ratios were calculated using the Receiver Operating Characteristic curve.
Results: Mean gestational age was 250 days, 14,6% were small for gestational age, 4,8% large for gestational age and 13,4% stunted. Placental efficiency was higher for term newborns (p<0,001), and 18/22 (81%) preterm biomarker values were higher than the control group. Th1 cytokines were highly correlated, while the weakest correlation was observed in other biomarkers. Less education was associated with a higher risk of PTD (p = 0.046), while there was no appreciable difference in the risk of PTD for placental insufficiency. Biomarkers showed negligible adjusted OR of PTD (0.90 to 1.02). IL-6, IL-8, IL-1β, TNFβ, IL-4, IL-13, GCSF, MIP1A, VEGF, EGF, and FGF2 presented a higher sensitivity ranging from 75.56% to 91.11%.
Conclusion: IL-8, IL-12p40, IL-4, IL-13, GCSF, MIP1B, and GMSF in asymptomatic pregnant women were associated with PTD. This finding suggests an activation of maternal inflammatory response.
{"title":"Mid-pregnancy circulating cytokine levels, placental efficiency and their relationship with preterm birth.","authors":"Carlos Grandi, Karina Bezerra Salomão, Stella Felippe de Freitas, Paulo Ricardo Higassiaraguti Rocha, Ricardo de Carvalho Cavalli, Viviane Cunha Cardoso","doi":"10.61622/rbgo/2024rbgo58","DOIUrl":"10.61622/rbgo/2024rbgo58","url":null,"abstract":"<p><strong>Objective: </strong>To assess a panel of cytokines and placental insufficiency with the risk of preterm delivery (PTD).</p><p><strong>Methods: </strong>Nested case-control study into the BRISA birth cohort. Eighty-two mother-infant-placenta pairs were selected at 20<sup>+0</sup> to 25<sup>+6</sup> weeks. Circulating biomarker levels were performed using Luminex flowmetric xMAP technology. Cytokines classified as Th1, Th2 or Th17 and other biomarkers were selected. The ratio between birth weight and placental weight (BW/PW) was used as a proxy for placental efficiency. Spearman correlation, univariate analyses and logistic regression models were calculated. Sensitivity, specificity, positive and negative likelihood ratios were calculated using the Receiver Operating Characteristic curve.</p><p><strong>Results: </strong>Mean gestational age was 250 days, 14,6% were small for gestational age, 4,8% large for gestational age and 13,4% stunted. Placental efficiency was higher for term newborns (p<0,001), and 18/22 (81%) preterm biomarker values were higher than the control group. Th1 cytokines were highly correlated, while the weakest correlation was observed in other biomarkers. Less education was associated with a higher risk of PTD (p = 0.046), while there was no appreciable difference in the risk of PTD for placental insufficiency. Biomarkers showed negligible adjusted OR of PTD (0.90 to 1.02). IL-6, IL-8, IL-1β, TNFβ, IL-4, IL-13, GCSF, MIP1A, VEGF, EGF, and FGF2 presented a higher sensitivity ranging from 75.56% to 91.11%.</p><p><strong>Conclusion: </strong>IL-8, IL-12p40, IL-4, IL-13, GCSF, MIP1B, and GMSF in asymptomatic pregnant women were associated with PTD. This finding suggests an activation of maternal inflammatory response.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11341184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo42
Claruza Braga Holanda Lavor, Francisca Adriele Vieira Neta, Antonio Brazil Viana, Francisco das Chagas Medeiros
Objective: To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Methods: Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Results: Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Conclusion: Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
{"title":"The impact of surgical treatment for deep endometriosis: metabolic profile, quality of life and psychological aspects.","authors":"Claruza Braga Holanda Lavor, Francisca Adriele Vieira Neta, Antonio Brazil Viana, Francisco das Chagas Medeiros","doi":"10.61622/rbgo/2024rbgo42","DOIUrl":"10.61622/rbgo/2024rbgo42","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.</p><p><strong>Methods: </strong>Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.</p><p><strong>Results: </strong>Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).</p><p><strong>Conclusion: </strong>Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo52
Gustavo Gonçalves Dos Santos, Anderson Lima Cordeiro da Silva, Edson Silva do Nascimento, Luis Henrique de Andrade
Objective: To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.
Methods: This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.
Results: A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).
Conclusion: The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.
目的:分析巴西孕妇和产后妇女因 COVID-19 或不明原因死亡的情况:分析巴西孕妇和产后妇女因 COVID-19 或不明原因死亡的情况:这是一项基于人口的回顾性、描述性-探索性研究,使用 Sistema de Informação de Vigilância Epidemiológica da Gripe(SIVEP-Gripe)数据库,研究 2020 年至 2021 年期间死于确诊 COVID-19 的育龄孕妇和产后妇女。所选变量包括:年龄、妊娠期、合并症类型和数量、肤色,使用统计计算平台 R 基金会 4.0.3 版和社会科学统计软件包 29.0 版进行分析:共有 19,333 名年龄在 10 至 55 岁之间的孕妇和产后妇女被确诊感染了 SARS,无论是确诊为 COVID-19 还是非特异性病因。根据死亡原因,这些病例被分为两组:死于 COVID-19 的病例(1 026 例)和死于非特异性原因的 SARS 的病例(253 例):结论:黑人和棕色人种妇女的死亡风险在产后和合并症(主要是糖尿病、心血管疾病和肥胖症)发生时有所增加。本文提供的数据引起了人们对非典型肺炎死亡人数的关注,尤其是在社会人口结构、医疗条件不稳定的人群中,如黑人。此外,在因不明原因死于非典型肺炎的妇女中,入住重症监护室的比例甚至更低,这也加剧了她们在充分获得医疗保健方面的局限性。
{"title":"Clinical, epidemiological characteristics and mortality of pregnant and postpartum women associated with COVID-19 in Brazil: cohort study.","authors":"Gustavo Gonçalves Dos Santos, Anderson Lima Cordeiro da Silva, Edson Silva do Nascimento, Luis Henrique de Andrade","doi":"10.61622/rbgo/2024rbgo52","DOIUrl":"10.61622/rbgo/2024rbgo52","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the death of Brazilian pregnant and postpartum women due to COVID-19 or unspecific cause.</p><p><strong>Methods: </strong>This is retrospective, descriptive-exploratory, population-based study carried out with the Sistema de Informação de Vigilância Epidemiológica da Gripe (SIVEP-Gripe) database, with pregnant and postpartum women of reproductive age who died from confirmed COVID-19 between 2020 and 2021. The chosen variables were: age, gestational period, type and number of comorbidities, skin color, using the statistical software R Foundation for Statistical Computing Platform, version 4.0.3 and Statistical Package for Social Science, version 29.0 for analysis.</p><p><strong>Results: </strong>A total of 19,333 cases of pregnant and postpartum women aged between 10 and 55 years diagnosed with SARS were identified, whether due to confirmed COVID-19 or unspecific causes. Of these, 1,279 died, these cases were classified into two groups according to the cause of death: deaths from COVID-19 (n= 1,026) and deaths from SARS of unspecific cause (n= 253).</p><p><strong>Conclusion: </strong>The risk of death increased among black and brown women, in the postpartum period and with the presence of comorbidities, mainly diabetes, cardiovascular diseases and obesity. The data presented here draw attention to the number of deaths from SARS, especially among sociodemographic profiles, precarious access to health, such as the black population. In addition, limitations in adequate access to health care are reinforced by even lower rates of ICU admissions among women who died from SARS of an unspecified cause.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo54
Omar Abu-Azzam, Mohammad Abu-Jeyyab, Mohammad Daradkeh, Sadeen Zein Eldeen, Saja Zuaiter, Mohammad Al-Mseadeen, Amer Sindiani, Eman Alshdaifat
Monkeypox (MPX), an orthopoxviral disease endemic in Africa, is now a public health emergency of international concern (PHEIC) as declared by the World Health Organization in July 2023. Although it is generally mild, the overall case fatality rate was reported to be 3%, and the basic reproduction number (R0) is > 1 in men who have sex with men (MSM, i.e., Portugal (1.4), the United Kingdom (1.6), and Spain (1.8)). However, R0 is < 1 in other settings. In concordance with the smallpox virus, it is also expected to increase the risk of adverse outcomes for both the mother and the fetus. The outcomes of the disease in an immunocompromised state of pregnancy are scary, showing high mortality and morbidity of both mother and fetus, with up to a 75% risk of fetal side effects and a 25% risk of severe maternal diseases. Therefore, it warrants timely diagnosis and intervention. The reverse transcription polymerase chain reaction (RT PCR) test is the standard approach to diagnosis. We summarized the recent findings of MPX on pregnancy, and the associated risk factors. We also give recommendations for active fetal surveillance, perinatal care, and good reporting to improve outcomes. The available vaccines have shown promise for primary disease prevention.
{"title":"Monkeypox infection and pregnancy in lower and middle-income countries: Precautions & recommendations.","authors":"Omar Abu-Azzam, Mohammad Abu-Jeyyab, Mohammad Daradkeh, Sadeen Zein Eldeen, Saja Zuaiter, Mohammad Al-Mseadeen, Amer Sindiani, Eman Alshdaifat","doi":"10.61622/rbgo/2024rbgo54","DOIUrl":"10.61622/rbgo/2024rbgo54","url":null,"abstract":"<p><p>Monkeypox (MPX), an orthopoxviral disease endemic in Africa, is now a public health emergency of international concern (PHEIC) as declared by the World Health Organization in July 2023. Although it is generally mild, the overall case fatality rate was reported to be 3%, and the basic reproduction number (R0) is > 1 in men who have sex with men (MSM, i.e., Portugal (1.4), the United Kingdom (1.6), and Spain (1.8)). However, R0 is < 1 in other settings. In concordance with the smallpox virus, it is also expected to increase the risk of adverse outcomes for both the mother and the fetus. The outcomes of the disease in an immunocompromised state of pregnancy are scary, showing high mortality and morbidity of both mother and fetus, with up to a 75% risk of fetal side effects and a 25% risk of severe maternal diseases. Therefore, it warrants timely diagnosis and intervention. The reverse transcription polymerase chain reaction (RT PCR) test is the standard approach to diagnosis. We summarized the recent findings of MPX on pregnancy, and the associated risk factors. We also give recommendations for active fetal surveillance, perinatal care, and good reporting to improve outcomes. The available vaccines have shown promise for primary disease prevention.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27eCollection Date: 2024-01-01DOI: 10.61622/rbgo/2024rbgo51
Elaine Cristina Fontes de Oliveira, Ines Katerina Damasceno Cavallo Cruzeiro, Cezar Antônio Abreu de Souza, Fernando Marcos Reis
Objective: To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.
Methods: We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.
Results: Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.
Conclusion: The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.
{"title":"Prevalence of karyotype alterations in couples with recurrent pregnancy loss in a tertiary center in Brazil.","authors":"Elaine Cristina Fontes de Oliveira, Ines Katerina Damasceno Cavallo Cruzeiro, Cezar Antônio Abreu de Souza, Fernando Marcos Reis","doi":"10.61622/rbgo/2024rbgo51","DOIUrl":"10.61622/rbgo/2024rbgo51","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities.</p><p><strong>Methods: </strong>We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding.</p><p><strong>Results: </strong>Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations.</p><p><strong>Conclusion: </strong>The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}