Rev Bras Ginecol Obstet
· 2025 · PMID 41341946
·
Full text
OBJECTIVE: This study sought to analyze the profile of fetuses, newborns and pregnant women with alloimmunization (anti-RhD) referred to and treated over the twenty years since the launch of the Rio de Janeiro State. MET...OBJECTIVE: This study sought to analyze the profile of fetuses, newborns and pregnant women with alloimmunization (anti-RhD) referred to and treated over the twenty years since the launch of the Rio de Janeiro State. METHODS: An observational, retrospective, descriptive study was conducted, with data obtained by analyzing the medical records of 481 mothers and their newborns. The study cohort consisted of pregnancies affected by RhD alloimmunization who delivered between March 2004 and March 2024 in Rio de Janeiro. RESULTS: The absolute number of cases declined over the study period. Only 5.2% of the cohort began prenatal care in the first trimester of pregnancy and more than half (51.6%) of women arrived at the referral center in the third trimester. 40% of the women had prior severe HDFN. During this period, 422 intrauterine transfusions were performed on 71 fetuses, an average of 5.9 transfusions per patient. Infant mortality; was low, with 4% stillborn or evolving to neonatal mortality. CONCLUSION: The trend observed over the last 20 years is a reduction in the absolute number of HDFN cases which is perhaps more related to reproductive issues, particularly the sharp reduction in parity in our state, rather than to the implementation of alloimmunization prophylaxis.
Rev Bras Ginecol Obstet
· 2025 · PMID 41341945
·
Full text
OBJECTIVE: To compare the efficacy of a traditional open ASC technique (ASC-T) to an open modified technique (ASC-M). METHODS: Retrospective cohort study with stage 3 or 4 apical prolapse women, who operated on using one...OBJECTIVE: To compare the efficacy of a traditional open ASC technique (ASC-T) to an open modified technique (ASC-M). METHODS: Retrospective cohort study with stage 3 or 4 apical prolapse women, who operated on using one of the two techniques were included in the study: ASC-T (vaginal mesh is secured with eight sutures) and ASC-M (four sutures). The POP-Q was used to objectively assess anatomical improvement. Women with less than one year of follow-up, without POP-Q classification, or with incomplete data were excluded. RESULTS: A total of 223 women underwent ASC: 120 in ASC-T and 103 in ASC-M. The average age was 65.3 (±6.5) years in the ASC-T group and 65 (±8.5) years in the ASC-M group, with no difference between them (p=0.706). There was no difference in intraoperative increased bleeding (p=1.000) and bladder injury (p=0.706) in both groups. Comparing the POP-Q points pre- and postoperatively, we observed improvement in all points in both groups (p<0.001) without difference between them. The analysis of variance for repeated measures was used to compare the outcomes between the two groups. The postoperative prolapse stage was similar between the two groups in the apical (p=0.251) and anterior (p=0.052) vaginal compartments. In the subjective evaluation, we observed a high rate of cure and improvement in both groups, respectively 81.7% and 16.7% in the ASC-T group, and 91.3% and 8.7% in the ASC-M group (p=0.100). CONCLUSION: Both sacrocolpopexy techniques were effective in treating apical prolapse, as evidenced by both objective and subjective cure rates, with a low complication rate.
Çınar R, Günday ÖK, Kahraman A
… +1 more, Yılmazer M
Rev Bras Ginecol Obstet
· 2025 · PMID 41341944
·
Full text
OBJECTIVE: This study aims to explore the combined role of ANGPTL3, 4, 8, omentin-1, leptin, TNF-α, and IL-6 molecules known for their roles in fat metabolism, obesity, and inflammation, yet whose connection to PCOS is s...OBJECTIVE: This study aims to explore the combined role of ANGPTL3, 4, 8, omentin-1, leptin, TNF-α, and IL-6 molecules known for their roles in fat metabolism, obesity, and inflammation, yet whose connection to PCOS is still debated in the development of PCOS. METHODS: A prospective cross-sectional study involving PCOS patients (n=30) and BMI-matched controls (n=30) was conducted. Levels of ANGPTL3, 4, 8, omentin-1, leptin, TNF-α, and IL-6 were measured in peripheral venous blood samples. RESULTS: When dividing both the PCOS and control groups into six BMI-based subgroups normal weight (20-24.9 kg/m), slightly overweight (25-29.9 kg/m), and obese (30-39.9 kg/m) there were significant differences in levels of ANGPTL3 and 8, omentin-1, leptin, IL-6, and TNF-α (p<0.05). Comparison between the entire PCOS and control groups showed that CRP levels were significantly higher in the PCOS group (p<0.0001), while omentin-1 levels were significantly lower (p=0.022). Regression analysis, including ANGPTL3, 4, 8, IL-6, and TNF-α alongside CRP and omentin-1, indicated a significant model for PCOS (Nagelkerke R=0.698, p<0.0001, PPV=80%, NPV=90%). In ROC analysis, the AUC for CRP and omentin-1 were significant (p<0.05; AUC=0.800-0.328). CONCLUSION: This study suggests a continuous interaction among ANGPTL, omentin-1, leptin, and cytokines in the etiopathogenesis of PCOS.
Provinciatto H, Barbalho ME, da Câmara PM
… +6 more, Bertani MS, Marinho AD, Philip CE, Balieiro CCA, Pontes KFM, Araujo Júnior E
Rev Bras Ginecol Obstet
· 2025 · PMID 41341943
·
Full text
OBJECTIVE: Thyroid peroxidase antibody (TPOAb) is a prevalent condition amongst women of reproductive age and has been associated with adverse pregnancy outcomes. However, there is currently no proven treatment for euthy...OBJECTIVE: Thyroid peroxidase antibody (TPOAb) is a prevalent condition amongst women of reproductive age and has been associated with adverse pregnancy outcomes. However, there is currently no proven treatment for euthyroid pregnant women with TPOAb. Therefore, we aimed to investigate the efficacy of levothyroxine treatment in this population. METHODS: We searched PubMed, Embase and Cochrane Central from inception to or randomized controlled trials (RCTs) comparing levothyroxine with placebo or no treatment in euthyroid pregnant women who were positive for TPOAb. Our main outcomes were miscarriage, preterm birth, and live birth. We performed subgroup analysis based on recurrent pregnancy loss (RPL). RESULTS: We included 8 RCTs comprising 1,645 pregnant women, of whom 814 (49.5%) were randomized to receive levothyroxine. Pregnant women treated with levothyroxine had significantly lower miscarriages (RR 0.78; 95% CI 0.63-0.98; p=0.035). No significant difference was found regarding pre-term birth (RR 0.78; 95% CI 0.55-1.13; p=0.189) and live birth (RR 1.05; 95% CI 0.99-1.12; p=0.097). Our subgroup analysis demonstrated a significant interaction (p=0.048) between patients with RPL (RR 1.21; 95% CI 1.03-1.42; p=0.023) and no RPL (RR 1.00; 95% CI 0.92-1.09; p=0.922). CONCLUSION: Levothyroxine reduced miscarriage in pregnant women with TPOAb and improved live birth rate when associated with RPL. Our subgroup analysis also provides evidence that levothyroxine may have a higher benefit for patients with a history of RPL. PROSPERO REGISTRY: CRD42023410433.
Rev Bras Ginecol Obstet
· 2025 · PMID 41341942
·
Full text
OBJECTIVE: To identify factors that predict the likelihood of a successful vaginal birth after cesarean section (VBAC). METHODS: An observational, case-control study was conducted at Hospital das Clínicas, Botucatu Medic...OBJECTIVE: To identify factors that predict the likelihood of a successful vaginal birth after cesarean section (VBAC). METHODS: An observational, case-control study was conducted at Hospital das Clínicas, Botucatu Medical School, a tertiary referral center in Brazil. Medical records of women with singleton term pregnancies, one previous cesarean section, and a live fetus in cephalic presentation who delivered between January 2013 and December 2015 were reviewed. Participants were classified according to delivery mode: vaginal birth after cesarean section or repeat cesarean section. Maternal demographics, clinical and obstetric characteristics, and neonatal outcomes were analyzed. Associations were assessed using chi-square, and significant variables were entered into a multivariate logistic regression model. RESULTS: A total of 653 women met the inclusion criteria. Of these, 324(49.6%) achieved a vaginal birth, and 329(50.4%) underwent a repeat cesarean section. Factors associated with a higher likelihood of vaginal birth included a history of prior vaginal delivery, cervical dilation of at least 4 cm at admission, a Bishop score of 6 or higher, spontaneous onset of labor, absence of chronic hypertension, and neonates classified as appropriate or small for gestational age. In contrast, advanced maternal age, unemployment, diabetes, and hypertensive disorders were associated with an increased likelihood of cesarean delivery. CONCLUSION: VBAC was more likely in women with cervical dilation of 4 cm or more at admission, a Bishop score of 6 or higher, a history of vaginal birth, spontaneous labor onset, absence of chronic hypertension, and lower neonatal birth weight.
de Oliveira AM, Dos Santos PA, Souza PES
… +4 more, do Sacramento MS, Souza CF, Ladeia AMT, Petto J
Rev Bras Ginecol Obstet
· 2025 · PMID 41341940
·
Full text
OBJECTIVE: To test the hypothesis that the quarterly injectable contraceptive increases the activity of the renin-angiotensin-aldosterone system. METHODS: This was a cross-sectional observational study that included eutr...OBJECTIVE: To test the hypothesis that the quarterly injectable contraceptive increases the activity of the renin-angiotensin-aldosterone system. METHODS: This was a cross-sectional observational study that included eutrophic, irregularly active women, aged between 18 and 30 years, who had been taking quarterly injectable contraceptive (150mg of medroxyprogesterone acetate) for at least 6 months or who had not used any type of hormonal contraceptive for at least 6 months. At first the volunteers underwent a physical examination and answered a standard questionnaire. They were then sent for blood collection of laboratory variables: plasma renin activity and concentration, angiotensin-converting enzyme 1 (ACE 1), and aldosterone. The data was analyzed using the two-tailed Student's t-test, with significance <0.05. RESULTS: Sixty-two women were included in this study, divided into the Injectable Contraceptive Group (ICG) with n=23 and the No Contraceptive Group (NCG) with n=39. ICG had lower mean plasma renin activity values than NCG, respectively 0.4 ± 0.17 vs 1 ± 0.6 (p <0.01). The mean values for plasma renin concentration, ACE 1, and aldosterone did not differ between the groups (respectively, p= 0.21; 0.66; 0.09). CONCLUSION: Women using quarterly injectable contraceptives do not show greater activity of the renin-angiotensin-aldosterone system than their counterparts who do not use this drug.
Siqueira-Souza M, Vivas CC, Dos Anjos JC
… +5 more, Morau GBA, Troncon JK, Barreto LF, Verruma CG, Dos Reis RM
Rev Bras Ginecol Obstet
· 2025 · PMID 41341939
·
Full text
An 8-year-old girl presented with vaginal bleeding without puberty signs. During investigation at 10 years old, the patient presented with advanced bone age, prepubertal hormone levels and internal genitalia. Hysteroscop...An 8-year-old girl presented with vaginal bleeding without puberty signs. During investigation at 10 years old, the patient presented with advanced bone age, prepubertal hormone levels and internal genitalia. Hysteroscopy and vaginoscopy at 10 years and 10 months of age revealed endometrial proliferation despite infantile genitalia. Histopathology showed positive receptors for estrogen and progesterone. This is the first report of endometrial estrogen and progesterone receptor activity in this context. Despite normal serum estradiol, the findings suggest a local action of estrogen. Follow-up until 11 years of age showed progressive development of secondary sexual characteristics. This case report emphasizes the need to consider isolated vaginal bleeding, without the development of secondary sexual characteristics, as a result of endometrial hypersensitivity to low estrogen levels during pubertal development, which may alter the chronology of pubertal development in girls.
Cunha ACR, Garcês CP, Sisconeto TM
… +5 more, Costa JG, Rodrigues ML, Mariano IM, Amaral AL, Puga GM
Rev Bras Ginecol Obstet
· 2025 · PMID 41341938
·
Full text
OBJECTIVE: This study aimed to investigate the relationship between blood pressure (BP) responses during a mental stress test with 24-hour ambulatory BP (ABPM) and its variability (BPV) in postmenopausal hypertensive wom...OBJECTIVE: This study aimed to investigate the relationship between blood pressure (BP) responses during a mental stress test with 24-hour ambulatory BP (ABPM) and its variability (BPV) in postmenopausal hypertensive women. METHODS: BP reactivity under mental stress and ABPM were evaluated in 75 postmenopausal hypertensive women between 50 and 70 years, on non-consecutive days. We used the values of the variation (∆) of systolic BP (SBP) and diastolic BP from the reactivity test as independent variables, and the BPV indexes Average Real Variability (ARV), 24-hour SD, and SDdn (standard deviation weighted by daytime and nighttime duration) as dependent variables. In the multiple linear regression analysis, three models were tested: 1) without adjustment; 2) adjusted for time since menopause; and 3) adjusted for both nocturnal BP dipping classification and time since menopause. RESULTS: The ARV index showed a significant association with ∆SBP variation in all models (model 1,2 and 3: β coefficient: 0.04, CI 95%: [0.00;0.08]). CONCLUSION: In conclusion, blood pressure variation during the mental stress test is related to ambulatory blood pressure variation, specifically to ARV in postmenopausal hypertensive women. These findings suggest that systolic blood pressure responses to mental stress may be a relevant predictor of daily blood pressure variability.
Gaur R, Thakur K, Kaur N
… +3 more, Kumar R, Patidar V, Rai P
Rev Bras Ginecol Obstet
· 2025 · PMID 41341937
·
Full text
OBJECTIVE: When spontaneous vaginal delivery is not feasible, Instrument-assisted vaginal delivery (IVD) is utilized, which often involves the use of vacuum extractors (VE) and obstetric forceps. This study intent to eva...OBJECTIVE: When spontaneous vaginal delivery is not feasible, Instrument-assisted vaginal delivery (IVD) is utilized, which often involves the use of vacuum extractors (VE) and obstetric forceps. This study intent to evaluate the risks and benefits associated with utilizing obstetric forceps vs vacuum extractors for IVD, focusing on maternal and neonatal outcomes. METHODS: Following PRISMA guidelines, a full literature search was done in PubMed, Embase, and Google Scholar until April 2024. The review examined randomized controlled trials (RCTs) that compared forceps and vacuum extractors. Two writers extracted the data and assessed its quality separately, with a third resolving any inconsistencies. The statistical study was conducted using R software, with a random-effects model used to quantify risk differences and evaluate heterogeneity. RESULTS: Seven RCTs, totalling 2,299 individuals, were included. A meta-analysis revealed that forceps significantly increased the incidence of perineal tears (Risk difference = 0.08, 95% CI 0.02-0.13) and vaginal injuries (Risk Difference = 0.12, 95% CI 0.05-0.19). Vacuum extractors were associated with an increased risk of infant cephalohematoma (Risk Difference = -0.06, 95% CI -0.08, -0.04). There was no significant difference in maternal anaesthesia required or failure to accomplish vaginal delivery with the intended instrument. CONCLUSION: Obstetric forceps are more likely to cause maternal perineal tears and vaginal injuries, whereas vacuum extractors increase the likelihood of neonatal cephalohematoma. Both methods have comparable anaesthetic needs and success rates for vaginal birth. The clinical scenario ought to guide the choice of instruments, with an emphasis on risk minimization through proper training.PROSPERO: CRD42024577839.
de Almeida AC, de Almeida RRG, Castelo BB
… +1 more, Baccaro LFC
Rev Bras Ginecol Obstet
· 2025 · PMID 41341936
·
Full text
OBJECTIVE: To evaluate the types of treatments used for non-tubal ectopic pregnancy (NTEP), the success rates of medical treatment, and the incidence of severe complications. METHODS: Retrospective study of all NTEP admi...OBJECTIVE: To evaluate the types of treatments used for non-tubal ectopic pregnancy (NTEP), the success rates of medical treatment, and the incidence of severe complications. METHODS: Retrospective study of all NTEP admitted in the University of Campinas (UNICAMP) Women's hospital, Brazil, from 01/01/2000 to 01/31/2023. Outcome variables were medical treatment success and the presence of severe complications. Independent variables were clinical and sociodemographic data. Statistical analysis was carried out by the Cochran-Armitage and chi-square test. RESULTS: In total 60 cases of NTEP were included (3 abdominal, 15 cervical, 12 cesarean scar, 24 interstitial fallopian tube, 3 heterotopic e 3 ovarian). In cases of abdominal, cesarean scar, heterotopic and ovarian NTEP, the main type of treatment was surgery. Medical treatment was used mainly in cervical and interstitial NTEP (p<0.01). Medical treatment (included methotrexate single dose, multiple doses or direct injection) success rate was 73.7%, with no correlation with NTEP location (p=1.000). No change in trend was identified in the success rate of medical treatment for NTEP in the period evaluated (Cochran-Armitage test: z=0.46; p= 0.644). Severe complications occurred in 12(20) of NTEP, with no association with NTEP location (p=0.27), but with hemodynamic instability (p=0.01). CONCLUSION: The medical treatment success rate found in our study for NTEP was similar to that reported in the medical literature for tubal EP. Two out of ten women with NTEP had severe complications. The occurrence of severe complications was not associated to the site of NTEP but to the presence of hemodynamic instability at admission.
Rev Bras Ginecol Obstet
· 2025 · PMID 41341935
·
Full text
OBJECTIVE: To synthesize current scientific evidence on the benefits and potential contributions of integrating AI-based technologies with traditional diagnostic methods used for the detection and early diagnosis of cerv...OBJECTIVE: To synthesize current scientific evidence on the benefits and potential contributions of integrating AI-based technologies with traditional diagnostic methods used for the detection and early diagnosis of cervical cancer in adult women. METHODS: An exhaustive search was conducted in academic databases (PubMed, Scopus and BIREME) using specific search terms and Boolean operators in December 2024. Independently conducted by three researchers across all databases, the selection process included articles involving adult women with either suspected or confirmed cervical cancer, in which the application of artificial intelligence (AI) technologies was examined across various techniques used for early diagnosis of the disease, such as cytology, colposcopy, and radiological imaging, among others. Only articles published between 1999 and 2022 were included. The included articles were reviewed in full text by all authors, and relevant data were extracted and organized into a chart comprising the following items: author and year of publication, title, study design, type of AI technology used, and a summary of the content. RESULTS: AI, particularly through Machine Learning (ML) algorithms, demonstrated significant improvements in the accuracy, sensitivity, and efficiency of cervical lesion classification when combined with conventional diagnostic techniques like cervical cytology, colposcopy, and biopsy. This combined approach outperformed traditional methods used in isolation. CONCLUSION: The integration of AI with standard cervical cancer screening and diagnostic methods offers substantial benefits, including faster detection times, reduced workload for pathologists, and improved patient outcomes by facilitating earlier treatment initiation and reducing diagnostic variability. Considering the available literature, the use of AI may offer potential benefits; however, further studies are required.
Negrao EMS, Almeida MA, Cardoso EF
… +5 more, Almeida AS, Sousa SS, Cardoso-Filho C, Jales RM, Vale DB
Rev Bras Ginecol Obstet
· 2025 · PMID 41341934
·
Full text
OBJECTIVE: To analyze recall rates in a public breast cancer screening facility in Campinas, Brazil. METHODS: A prospective assessment of outcomes on screening mammographies (MMG) between July 2023 and August 2024. BI-RA...OBJECTIVE: To analyze recall rates in a public breast cancer screening facility in Campinas, Brazil. METHODS: A prospective assessment of outcomes on screening mammographies (MMG) between July 2023 and August 2024. BI-RADS® 0,4/5 indicated positive results, and women recalled. The variables were age, whether first or subsequent MMG, and biopsy (cancer positive or negative). The outcomes were recall rate and cancer detection rate on the recall (CDR). Prevalence ratio with 95% confidence interval (PR) estimated the risk. RESULTS: There were included 19,377 MMG on women over 40: 15,983 subsequent MMG (82.5%), and 1,646 women recalled (BR 0,4/5). Adherence to recall was over 99%. The recall rates were 12.4% at first and 7.7% at subsequent MMG. Recall rate was 1.6 times higher at first than at subsequent MMG (PR 1.61;1.45-1.79). CDR was higher at subsequent MMG. A first MMG reduced the risk of cancer detection by 71% (PR 0.29-0.15;0.58). Compared to women 50-69, there were no differences in the risks of recall and cancer detection at first MMG. At subsequent MMG the recall risk was higher in women 40-49 (PR 1.16;1.03-1.30), and over 69 (PR 1.47;1.03-2.12). The risk of cancer detection was 60% lower in women 40-49 (PR 0.60;0.36-0.99), and 2.7 times higher in women over 69 (PR 2.78;1.32-5.84). CONCLUSION: The recall rates were 12.4% at first and 7.7% at subsequent MMG. Adherence was high. Screening efficiency was higher in women 50-69. At subsequent screenings women 40-49 showed a higher recall rate and a lower CDR when compared to women 50-69.
Rev Bras Ginecol Obstet
· 2025 · PMID 41341933
·
Full text
OBJECTIVE: Advanced maternal age has become more common due to factors such as increased academic preparation for women, labor market participation, delayed family planning, and advances in reproductive medicine. This ph...OBJECTIVE: Advanced maternal age has become more common due to factors such as increased academic preparation for women, labor market participation, delayed family planning, and advances in reproductive medicine. This phenomenon raises questions about the risks and gestational outcomes associated with advanced maternal age (AMA). This study aims to explore the gestational and perinatal outcomes in pregnant women with AMA (> 35 years), comparing them with those of women aged 20 to 34 years. METHODS: The research was conducted as an observational and retrospective analysis, examining data from 2012 to 2022 from the Hospital Production System (SIH/SUS) available on the DATAsus platform, covering all regions of Brazil. Variables analyzed included gestational duration, type of pregnancy (single or multiple), mode of delivery, Robson group, APGAR score at five minutes, birth weight, and occurrence of congenital anomalies. RESULTS: Pregnant women with AMA showed statistically significant differences in the higher percentage of cesarean sections (63.3% AMA vs 58% non-AMA, p<0.05), higher percentage of low birth weight newborns (12.5% AMA vs 6.7% non-AMA, p<0.05), lower APGAR scores at the fifth minute (OR = 1.08, p<0.001) and a higher prevalence of any congenital anomalies (1.23% AMA vs 0.77% non-AMA, OR =OR = 1.34, p < 0.001). In addition, this group had a higher incidence of premature births (12.99% AMA vs 8.78% non-AMA) and multiple pregnancies (1.39% AMA vs 0.83% non-AMA). Furthermore, in the Robson classification, there was a predominance of older mothers in Group 5 (previous cesarean section) and in the groups with nulliparity. CONCLUSION: Pregnant women with AMA face higher gestational and perinatal risks, such as preterm births and an increased need for cesarean sections. These findings underscore the importance of public policies and personalized management strategies to improve maternal and neonatal outcomes for older pregnant women.
Arlindo EM, Souza RT, Costa ML
… +3 more, Cecatti JG, da Cunha EV, Vettorazzi J
Rev Bras Ginecol Obstet
· 2025 · PMID 41341932
·
Full text
OBJECTIVE: To compare maternal and perinatal outcomes in pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection among admissions in public and private maternity hospita...OBJECTIVE: To compare maternal and perinatal outcomes in pregnant and postpartum women with severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) infection among admissions in public and private maternity hospitals before COVID-19 vaccination. METHODS: We performed a secondary analysis of the REBRACO (in Portuguese, the Brazilian Network of COVID-19 During Pregnancy) initiative, a national multicenter cohort study in Brazil, considering pregnant and postpartum women with suspected or confirmed SARS-CoV-2 infections (from February 2020 to February 2021) in 15 maternity centers (2 private and 13 public facilities). Sociodemographic and obstetric characteristics were compared according to the type of hospital care. The clinical and laboratory findings and maternal and perinatal outcomes were compared between the two groups. The prevalence ratio and its 95% confidence interval for each predictor and outcome were calculated. RESULTS: Of the 559 symptomatic cases tested, 289 confirmed COVID-19 cases were included, with 213 (72.7%) and 76 (27.3%) women in public and private hospitals, respectively. The frequency of SARS-CoV-2 infection did not differ significantly between the groups. Women treated at public hospitals had lower education levels (p<0.001), and 50% declared that their pregnancy was unplanned. We recorded 13 maternal deaths among women treated at public hospitals and no maternal deaths among pregnant women treated at private hospitals (p=0.024). Pregnant women in public hospitals had higher rates of fever (p=0.041), tachypnea (p=0.003), abnormal laboratory findings of liver enzymes (p=0.005), and severe acute respiratory syndrome (SARS) (p=0.014), and their neonates presented with more neonatal respiratory distress (p=0.020). CONCLUSION: Adverse maternal and perinatal outcomes were worse in the public hospital group, with increased rates of SARS and neonatal respiratory distress. The alarming difference in the number of deaths between patients treated in the public and private sectors highlights the urgency of better understanding the social determinants of health and calls the attention of leaders and policymakers to take action in mitigating their impact.
Ponce-Najera E, Ojeda-López DM, González-Holveman R
… +5 more, Rodríguez-Calderon R, Bedia-Mejía KP, Salazar-Trujillo JC, Lezama-Ruvalcaba JL, López-Ortiz CGS
Rev Bras Ginecol Obstet
· 2025 · PMID 41341931
·
Full text
OBJECTIVE: This study aimed to analyze the relationship between aneuploidy and maternal age based on preimplantation genetic testing for aneuploidies (PGT-A) and the distribution of aneuploidy across individual chromosom...OBJECTIVE: This study aimed to analyze the relationship between aneuploidy and maternal age based on preimplantation genetic testing for aneuploidies (PGT-A) and the distribution of aneuploidy across individual chromosomes. METHODS: This is a single-center retrospective cohort study. The study included patients who underwent PGT-A during their in vitro fertilization (IVF) cycle between 2016 and 2024. PGT-A was performed on 1,341 embryos from 481 patients using next-generation sequencing (NGS)-based techniques. We conducted a Logistic regression analysis to determine the relationship between maternal age and the rate of aneuploidy; additionally, the most commonly affected chromosome and the characteristics of the detected alterations were evaluated. Statistical analysis was performed using STATA v17. RESULTS: Among all patients, the observed aneuploidy rate was 55.85%. In patients younger than 30 years, the aneuploidy rate was 26.92%, with a progressive increase to 62% in women older than 40 years. Chromosomes 22, 21, 16, and 15 were the most frequently affected. Logistic regression indicated that age is a significant predictive factor for aneuploidy (coefficient = 0.0956; p < 0.001), with an odds ratio of 1.10 (95% CI: 1.07-1.13), meaning that the probability of aneuploidy increases by approximately 10% for each additional year of age. CONCLUSION: Our results indicate that an increase in maternal age is significantly associated with a higher incidence of aneuploidy in embryos that underwent PGT-A. These findings are significant for patient counseling and optimizing embryo selection in assisted reproduction treatments.
Poli OB, Silva JCRE, Petta CA
… +14 more, Lino CAPC, Schor E, Ribeiro HSAA, Nogueira J, da Cunha JSL, França MC, Carneiro MM, de Oliveira MAP, Tcherniakovsky M, Abrão MS, Dib RP, Quintairos RA, Podgaec S, Pearce S
Rev Bras Ginecol Obstet
· 2025 · PMID 41341930
·
Full text
•Chronic pelvic pain is a common and complex condition that significantly affects women's quality of life. •Neuropathic pain and nociplastic pain are important components in the pain picture of these patients and should...•Chronic pelvic pain is a common and complex condition that significantly affects women's quality of life. •Neuropathic pain and nociplastic pain are important components in the pain picture of these patients and should be considered in clinical treatment. •Oral neuromodulators, antidepressants and anticonvulsants for the control of neuropathic and nociplastic pain should be present in the therapeutic arsenal of the gynecologist who treats patients with chronic pelvic pain. •Pregabalin is the medication with the best pharmacokinetic profile; nortriptyline has the best adverse effects profile; duloxetine is the most widely used and has the lowest risks; and venlafaxine should be used as a second-line inhibitor. •Although the drug classes can be combined to reduce the total doses and minimize side effects, maximizing the analgesic effect, monotherapies are recommended as the first line to avoid polypharmacy.
Almeida MO, Delgado A, da Silva RCB
… +6 more, Alves FC, Cabral NO, da Paz MMS, Vieira MA, de Assis TJCF, Lemos A
Rev Bras Ginecol Obstet
· 2025 · PMID 41341928
·
Full text
OBJECTIVE: To analyse the effectiveness of kinesiotherapy in the labour of pregnant women induced by misoprostol. METHODS: This is a clinical trial carried out with pregnant women pharmacologically induced by misoprostol...OBJECTIVE: To analyse the effectiveness of kinesiotherapy in the labour of pregnant women induced by misoprostol. METHODS: This is a clinical trial carried out with pregnant women pharmacologically induced by misoprostol (25mcg, vaginally). They were randomised into two groups: Intervention Group (IG) of induced pregnant women who underwent kinesiotherapy during the active phase of labour; and Control Group (CG), of induced pregnant women who did not do physical therapy during the active phase of labour. Among the variables studied were vaginal delivery, induction time, duration of the labour, and the number of misoprostol doses. Data were analysed by the Statistical Package for the Social Sciences (SPSS). The IG had more vaginal deliveries (p=0.016). The other variables analysed showed no difference between groups. RESULTS: Kinesiotherapy during the active phase of labour in women induced by misoprostol was effective for performing more vaginal deliveries despite not showing any difference in the other outcomes studied. CONCLUSION: The findings of this study indicate that after the application of kinesiotherapy, during the active phase of labour in pregnant women induced by misoprostol, the number of vaginal deliveries increases. BRAZILIAN REGISTRY OF CLINICAL TRIALS REBEC: RBR-3mvj4m7.