Galvão JRP, Leal MDS, da Silva MNM
… +3 more, de Almeida NMS, Ferreira CIPF, Seco IMMGMNM
Rev Bras Ginecol Obstet
· 2025 · PMID 41341927
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OBJECTIVES: Clavicle fractures are the most common birth-related fractures. They may cause pain, arm mobility impairment, and brachial nerve injury (temporary or definitive). Therefore, we aimed to review the incidence,...OBJECTIVES: Clavicle fractures are the most common birth-related fractures. They may cause pain, arm mobility impairment, and brachial nerve injury (temporary or definitive). Therefore, we aimed to review the incidence, risk factors and prognosis of neonatal clavicle fractures in our hospital. METHODS: All cases of clavicle fractures diagnosed and registered during the neonatal period between 2018 and 2022, in a tertiary-care Portuguese hospital, were reviewed. Statistical descriptive analysis, odds ratios (ORs), and 95% confidence intervals(95%CI) were calculated. RESULTS: A total of 8132 births and 91 clavicle fractures were identified (1.1% incidence) - 0.04% (1/2512) in cesarean sections and 1.7% (90/5453) in vaginal births. An instrumental vaginal birth doubled the probability of clavicle fractures (OR 2.072, 95%CI 1.365-3.145 compared to spontaneous births). In 15.4% of clavicle fractures, births were complicated by shoulder dystocia. Shoulder dystocia significantly increased the risk of clavicle fracture (OR 35.71; 95% CI 17.86-71.43). Of the 91 cases, 22% resulted from pregnancies complicated by gestational diabetes; in these cases, the risk of clavicle fractures increased 76% (OR 1.761, 95%CI 1.068-2.904). Most of the cases were referred to a Neonatology follow-up appointment (92.3%). Fifteen neonates had a clinical suspicion of brachial plexus injury, but all of them regained normal arm mobility after physiotherapy. CONCLUSION: The incidence of clavicle fractures in our hospital is comparable to the literature (1.1%). To reduce the incidence of clavicle fractures not only its risk factors must be reduced, but a simulation-based labor ward team training program on shoulder dystocia should also be implemented.
Araújo LAC, Rebouças KCF, Duarte FB
… +2 more, José E, Peixoto RAC
Rev Bras Ginecol Obstet
· 2025 · PMID 41341925
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OBJECTIVE: Allogeneic bone marrow transplantation (BMT) carries the risk of the donor's cells recognizing the recipient as abnormal, triggering Graft Versus Host Disease (GVHD). This study aimed to understand the prevale...OBJECTIVE: Allogeneic bone marrow transplantation (BMT) carries the risk of the donor's cells recognizing the recipient as abnormal, triggering Graft Versus Host Disease (GVHD). This study aimed to understand the prevalence and gynecological complications, including vaginal microbiota evaluation. METHODS: A descriptive cross-sectional study was carried out from December 2022 to October 2023. Post-allogeneic BMT patients underwent gynecological evaluation at the Assis Chateaubriand Maternity School in Fortaleza-Ceará, Brazil, composed of structured interview and physical examination, which included collection of fresh examination of vaginal content, gram bacterioscopy and cervicovaginal cytology. RESULTS: A total of 22 patients between 21 and 61 years old (average: 38) were evaluated, with an average of 1028 (± 979) days post BMT. Of these patients, whether or not they had Vulvar and Vaginal Graft Versus Host Disease (VVGVHD), 15 reported various gynecological complaints (dryness being the most common). Of the total, twelve showed signs of genital atrophy on examination. A 45% prevalence of VVGVHD was found, with vulvar and vaginal involvement of 100% and 60%, respectively. Burning and dyspareunia symptoms were more prevalent in patients with VVGVHD than in those without it (p<0.05); there was no difference in Human Papillomavirus (HPV) induced lesions between the two groups. However, compared to the population not undergoing allogeneic BMT, these patients had a higher prevalence of induced HPV lesions and intermediate vaginal flora. CONCLUSION: The findings described in the present work are consistent with other studies available in recent literature. In conclusion, VVGVHD is a potentially mutilating condition, with a significant prevalence among post-BMT patients.
Begalli BM, Quintana SM, Marcolin AC
… +3 more, Coutinho CM, Duarte G, Okido MM
Rev Bras Ginecol Obstet
· 2025 · PMID 41341923
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OBJECTIVE: To analyze maternal request cesarean section (CDMR) through the perceptions of placenta accreta spectrum (PAS) survivors. METHODS: This retrospective observational study was conducted at a university hospital,...OBJECTIVE: To analyze maternal request cesarean section (CDMR) through the perceptions of placenta accreta spectrum (PAS) survivors. METHODS: This retrospective observational study was conducted at a university hospital, a reference center for the management of placenta accreta spectrum (PAS). Case identification was performed through a review of medical records, based on diagnoses related to placental disorders and postpartum hemorrhage. Only women who underwent puerperal hysterectomy between 2005 and 2023, with a PAS diagnosis confirmed by ultrasound conducted at the institution, were included. Eligible participants were contacted via instant messaging apps and invited to complete an online structured questionnaire, which included questions about their prior knowledge and post-event perceptions regarding cesarean delivery. Responses were compared between women in the cesarean delivery on maternal request (CDMR) group and those who underwent cesarean delivery for other indications. RESULTS: A total of 89 cases of hysterectomy for PAS were identified during the study period. Of the 60 eligible women contacted, 41 responded to the questionnaire. Among them, 11 (26.8%) reported having requested the cesarean delivery, while 30 (73.2%) underwent the procedure for other reasons. It was found that 81.8% of women in the CDMR group had private health insurance, compared to 46.6% in the "other indications" group. High parity (≥3 pregnancies) was more common in the "other indications" group (80.0%) than in the CDMR group (36.4%). Overall, 36.6% were unaware of the risks of cesarean delivery, 48.8% did not receive adequate counseling during prenatal care, and 85.4% of participants were unaware of PAS. In the CDMR group, these values were 36.4%, 45.5%, and 72.7%, respectively. After the adverse experience, 51.2% of participants reported a change in their perception of cesarean delivery, 53.7% stated that they would have made a different choice if they had more information at the time, and 78.0% believed that the general population was unaware of the risks associated with cesarean delivery. CONCLUSION: The perceptions of women who experienced a "near miss" contributed to a better understanding of the process behind Brazilian women's preference for cesarean section. Decisions influenced by a pro-cesarean cultural context and misinformation tend to be poorly founded and more prone to regret. In Brazil, while CDMR is framed as an expression of autonomy, inadequate information and limited freedom can exacerbate inequalities, disproportionately affecting women in vulnerable situations.
de Holanda TT, Vasconcelos JA, Oliveira NMV
… +4 more, Moreira JLC, Bruno SKB, de Sousa MDRP, Vasconcelos CTM
Rev Bras Ginecol Obstet
· 2025 · PMID 41098674
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OBJECTIVE: This review evaluated myo-inositol supplementation's effectiveness in pregnant women at high risk for Gestational Diabetes Mellitus (GDM). SOURCES: A systematic search in PubMed/MedLine, Cochrane, and VHL data...OBJECTIVE: This review evaluated myo-inositol supplementation's effectiveness in pregnant women at high risk for Gestational Diabetes Mellitus (GDM). SOURCES: A systematic search in PubMed/MedLine, Cochrane, and VHL databases was conducted using the following terms: "inositol," "diabetes," "gestational diabetes," and "prevention," with no limits on publication period or language. The reference lists were scanned for additional articles. SELECTION CRITERIA: Relevant studies were identified by screening titles, abstracts, and full texts, following inclusion and exclusion criteria and eliminating duplicates. One additional study was added after reviewing references. DATA COLLECTION: Guided by the PRISMA Statement, data were extracted using Microsoft Excel. The primary outcome was GDM incidence; secondary outcomes included maternal, birth, neonatal health, and adverse effects. DATA SYNTHESIS: Five studies were included. Myo-inositol supplementation significantly decreased the incidence of GDM in all studies. One study noted significant weight loss. Three studies found no reduction in insulin treatment needs with myo-inositol supplementation. One study showed a decrease in macrosomia incidence. No decrease in cesarean delivery rates was verified, though one study noted reduced hypertensive disorders' incidence with myo-inositol. Four studies evidenced no reduction in premature birth or shoulder dystocia. There was no significant difference in hypoglycemia incidence in three studies. One study showed a decrease in Neonatal Intensive Care Unit admissions with myo-inositol supplementation. One patient reported headaches. CONCLUSION: Due to study divergences, no clinical recommendations can be made. However, myo-inositol supplementation appears effective in reducing GDM incidence in at-risk pregnant women.
Iliman D, Kaya C, Kuras S
… +3 more, Kural A, Ekin M, Yasar L
Rev Bras Ginecol Obstet
· 2025 · PMID 41098673
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OBJECTIVE: Endometriosis, a gynecological condition characterized by the presence of endometrial tissue outside the uterus, affects millions of women worldwide. This study aimed to investigate neurotrimin (NTM)'s express...OBJECTIVE: Endometriosis, a gynecological condition characterized by the presence of endometrial tissue outside the uterus, affects millions of women worldwide. This study aimed to investigate neurotrimin (NTM)'s expression, a glycerophosphatidylinositol-anchored neural adhesion molecule, in endometriotic lesions and eutopic endometrial tissue. METHODS: In this laboratory based observational study NTM expression was measured in patients with early- and advanced-stage endometriosis and controls (patients without endometriosis who underwent gynecological surgery. Peritoneal endometriosis (peritoneum for controls) and eutopic endometrial tissue samples were collected from patients. Polymerase chain reaction and immunohistochemistry (IHC) were used to detect NTM in the tissue samples. Additionally, NTM levels in peripheral blood samples of all participants were measured using an enzyme-linked immunosorbent assay. RESULTS: NTM mRNA and protein levels were significantly higher in the endometriotic foci of the stage 3-4 endometriosis group than in the control group (p<0.01). Stage 1-2 endometriotic foci showed significantly higher NTM IHC staining than the control group; however, no significant difference was found between the mRNA levels. Eutopic endometrial tissue from the stage 3-4 group had significantly higher NTM mRNA levels than the other groups. No significant difference was found between the control and stage 1-2 groups for eutopic tissue. Eutopic endometrial NTM IHC staining did not differ between groups. No significant difference was observed in peripheral blood NTM levels. CONCLUSION: This study found increased NTM expression, a neural adhesion molecule, especially in advanced endometriosis. The endometrial tissue of patients with early-stage endometriosis also showed increased NTM expression in ectopic locations but not in eutopic tissue.
Chagas LAD, de Sousa RML, da Silva AVADC
… +5 more, Silva-Neto LGR, de Almeida-Pititto B, Teixeira LKA, Araujo Júnior E, Mattar R
Rev Bras Ginecol Obstet
· 2025 · PMID 41098672
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OBJECTIVE: To conduct a systematic review of the literature, compiling the available evidence from the last decade to better understand the relationship between the Dietary Inflammatory Index and the risk of Gestational...OBJECTIVE: To conduct a systematic review of the literature, compiling the available evidence from the last decade to better understand the relationship between the Dietary Inflammatory Index and the risk of Gestational Diabetes Mellitus. METHODS: A comprehensive search was systematically conducted including cohort and case-control studies, researched from the BVS, PubMed, Embase, and Google Scholar platforms with articles published between 2014 and 2024. The risk of bias was assessed using the Quality Assessment Tool. RESULTS: This review included 10 studies from five countries with participant numbers ranging from 164 to 90,740. In total, four case-control studies found higher DII values in the groups of pregnant women diagnosed with Gestational Diabetes Mellitus compared to those without the diagnosis. When analyzing the remaining cohort studies, one study showed a higher distribution of Gestational Diabetes Mellitus in the highest tertile of Dietary Inflammatory Index, and the other (five studies) showed an association between DII and Gestational Diabetes Mellitus risk when using models adjusted for anthropometry, gestational history, and dietary intake. CONCLUSION: Pregnant women diagnosed with Gestational Diabetes Mellitus have a diet with more pro-inflammatory characteristics, which increases the risk of adverse perinatal outcomes. REGISTRY OF SYSTEMATIC REVIEWS PROSPERO: CRD42024573560.
Cavalcante DCB, Scandolara TB, Kogure GS
… +6 more, Rodrigues C, Verruma CG, de Moraes MO, Dos Reis RM, Cavalcante MB, Furtado CLM
Rev Bras Ginecol Obstet
· 2025 · PMID 41098671
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OBJECTIVE: To evaluate the effects of aerobic and resistance exercise on body mass index (BMI), insulin levels, lipid profiles, and hormonal parameters in women with polycystic ovary syndrome (PCOS). DATA SOURCES: We sea...OBJECTIVE: To evaluate the effects of aerobic and resistance exercise on body mass index (BMI), insulin levels, lipid profiles, and hormonal parameters in women with polycystic ovary syndrome (PCOS). DATA SOURCES: We searched PubMed, Web of Science, and Embase databases for publications up to September 2024. Fully published articles involving reproductive-age women diagnosed with PCOS were included. STUDY SELECTION: Randomized controlled trials comparing supervised aerobic or resistance exercise to no intervention in women diagnosed with PCOS based on Rotterdam or NIH criteria were included. The Rayyan Systematic Review tool was used to organize study data. DATA COLLECTION: Data extraction was conducted independently by two reviewers. Meta-analysis employed random-effects modeling. DATA SYNTHESIS: Ten randomized controlled trials with 382 women were analyzed. Aerobic exercise interventions (12-24 weeks) reduced BMI, waist circumference, insulin levels, total cholesterol, and low-density lipoprotein. Effects on fasting glucose, high-density lipoprotein, and triglycerides varied. Hormonal assessments showed reduced testosterone and increased sex hormone-binding globulin in some studies. Resistance exercise improved lean body mass and reduced body fat percentage but showed minimal effects on hormonal parameters. Meta-analysis revealed aerobic exercise decreased insulin, cholesterol, and triglycerides compared to no intervention, while other metabolic and hormonal markers showed inconsistent changes. CONCLUSION: Aerobic and resistance exercise improve anthropometric measures, metabolic health, and hormonal balance in women with PCOS. These findings highlight exercise as a valuable therapeutic strategy for managing PCOS and enhancing overall health outcomes.
Eslami S, Heydari O, Mirzaee M
… +2 more, Shad Z, Mirzaee F
Rev Bras Ginecol Obstet
· 2025 · PMID 41098670
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OBJECTIVE: Pain is an unavoidable reality of labor and the most noticeable determinant of the labor experience. The present study was conducted to assess the effect of auriculotherapy on labor pain and labor duration. ME...OBJECTIVE: Pain is an unavoidable reality of labor and the most noticeable determinant of the labor experience. The present study was conducted to assess the effect of auriculotherapy on labor pain and labor duration. METHODS: This double blind, randomized, controlled clinical trial was conducted from 2021-2022 in Kerman, Iran. The sample consisted of 60 primiparous women assigned to an Intervention Group ( = 30) and a Control Group ( = 30). The study began after participants entered the active phase of labor at 37-40 weeks of pregnancy. In the Intervention Group, the researcher stimulated the desired points (uterus, pituitary gland, pelvis, cerebral, autonomous, sensory, endocrine gland, shen men, zero, external genitalia, and thalamus). Sham auriculotherapy (patches without seeds at the same acupoints) was done in the Control Group. Pain intensity in the two groups was recorded using the VAS before and after the intervention, when the cervix was dilated 4, 6, and 8 cm. Duration of labor was also recorded. Data were analyzed using SPSS 21 statistical software. RESULTS: Pain intensity was significantly lower in the Intervention Group than in the sham Control Group ( < 0.0001) in different cervical dilatations after intervention. Compared to the sham Control Group, the intervention group was significantly different in the average duration of labor ( < 0.0001). CONCLUSIONS: Auriculotherapy was demonstrated to attenuate the severity of labor pains and expedite the labor duration. Hence, policymakers in this field are recommended to pay greater attention to this non-invasive method.
Rev Bras Ginecol Obstet
· 2025 · PMID 41098669
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OBJECTIVE: In this systematic review, we aim to compare the GWG in pregnant women with diabetes treated with metformin and other interventions. METHODS: Data Sources: The searched baselines included PubMed, Scopus, Web o...OBJECTIVE: In this systematic review, we aim to compare the GWG in pregnant women with diabetes treated with metformin and other interventions. METHODS: Data Sources: The searched baselines included PubMed, Scopus, Web of Science, Embase, and Virtual Health Library (BVS). Study selection: We selected articles that compared the GWG in women with diabetes treated with metformin or insulin. We have included clinical trials (randomized or not), observational studies (cohort, case control, and cross-sectional). Reviews (systematic or not), posters, event abstracts, and letters were excluded. Data Collection: We pooled odds ratios (OR) and mean difference (MD) and used a random effect model using R Studio software to compare the weight gain, fetal birthweight and preeclampsia according to treatment. RESULTS: On research conducted in January 2024, with no data limit of the search, 433 trials were identified, of which 175 remained after duplicate removal. 50 studies were analyzed in the full text analyses and 9 were selected for the systematic review. 8 studies demonstrated that gestational weight gain during metformin treatment is lower when compared to other treatments, especially insulin, although it was not different from other outcomes. Meta-analyses demonstrated that oral medication GWG is lower than insulin with a standard mean difference (SMD) -1,05 [-1,87, - 0,23]. CONCLUSION: Oral medication has a lower gestational weight gain in patients with gestational diabetes when compared to insulin. INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS PROSPERO: CRD 42024492158.
Martins CAO, Ballalai I, Cunha J
… +1 more, Aidé S
Rev Bras Ginecol Obstet
· 2025 · PMID 41098668
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•Address the types of immunodeficiency and the greater susceptibility to severe infections compared to the general population, as well as a less efficient response to vaccine stimuli. •Provide information on the negative...•Address the types of immunodeficiency and the greater susceptibility to severe infections compared to the general population, as well as a less efficient response to vaccine stimuli. •Provide information on the negative impacts of infections on the health of immunodeficient individuals and their complications. •Provide knowledge of studies on the efficacy and safety of vaccines in the immunosuppressed population. •Clarify which vaccines should be indicated, the best time to administer them, and when to revaccinate. •Update gynecologists and obstetricians on the vaccination schedule for this population and on the position of the Brazilian Federation of Gynecology and Obstetrics Associations (Febrasgo) regarding the vaccines made available by the National Immunization Program, including by the Reference Centers for Special Immunobiologicals (Portuguese acronym: CRIEs) and private vaccination services.
Anelli GB, de Oliveira RZ, Meola J
… +9 more, Michelazzo D, Perussi-E-Silva R, Rosa-E-Silva JC, Becker C, Rahmioglu N, Hummelshoj L, Missmer S, Zondervan K, Poli-Neto OB
Rev Bras Ginecol Obstet
· 2025 · PMID 41098667
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OBJECTIVES: To translate and cross-culturally adapt the standard version of the WERF EPHect EPQ into Brazilian Portuguese and migrate it to an electronic version using REDCap. METHODS: The study included 120 women aged 1...OBJECTIVES: To translate and cross-culturally adapt the standard version of the WERF EPHect EPQ into Brazilian Portuguese and migrate it to an electronic version using REDCap. METHODS: The study included 120 women aged 18-50 years, with half completing the paper version and half the electronic version. The sample comprised 80 individuals with chronic pelvic pain (CPP), including 60 with endometriosis, recruited from a tertiary referral centre, and 40 women from a primary healthcare unit with no diagnosis of CPP or endometriosis. Illiterate or cognitively impaired individuals were excluded. The electronic migration was implemented in REDCap. RESULTS: The Brazilian Portuguese EPQ-S demonstrated linguistic accuracy and cultural equivalence to the original English version. The paper version consisted of 35 pages, and 86.7% of respondents commented on its length. Despite this, it was well-received, although minor difficulties were observed among participants with lower education levels. The electronic version provided a more accessible experience, with a significantly shorter completion time (52.1 ± 13.2 minutes) compared to the paper version (70.9 ± 21.4 minutes). Both formats exhibited similar rates of missing data for questions related to symptoms and contraceptive use. CONCLUSION: This study successfully translated, adapted, and migrated the WERF EPHect EPQ-S into Brazilian Portuguese using REDCap. The findings underscore the linguistic and cultural challenges of such adaptations and highlight the electronic version's advantages in accessibility, efficiency, and participant satisfaction. This research supports the development of cross-cultural assessment tools for endometriosis research and healthcare delivery.
Şahin B, Gürbüz TB, Çöteli ASD
… +4 more, Begen EE, Akay A, Boran N, Üstün Y
Rev Bras Ginecol Obstet
· 2025 · PMID 41098666
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OBJECTIVE: This study aims to to evaluate the frequency of ovarian involvement in endometrial cancer patients aged 50 years and younger, identify associated clinicopathological factors, and uniquely assess the role of th...OBJECTIVE: This study aims to to evaluate the frequency of ovarian involvement in endometrial cancer patients aged 50 years and younger, identify associated clinicopathological factors, and uniquely assess the role of the Systemic Immune-Inflammatory Index (SII) in predicting ovarian involvement. METHODS: Patients aged 50 years and younger diagnosed with endometrial cancer between 1992 and 2022 were retrospectively analyzed. Two groups were formed based on adnexal involvement: those with (ovarian metastasis or synchronous ovarian cancer) and without adnexal involvement. Clinicopathological predictors of adnexal involvement were evaluated. Preoperative complete blood count values (platelet, leukocyte, lymphocyte, and neutrophil counts) were used to calculate inflammatory indices: PLR (platelet-to-lymphocyte ratio), NLR (neutrophil-to-lymphocyte ratio), and SII (neutrophil × platelet / lymphocyte). A two-group analysis was performed based on the cut-off values of statistically significant parameters. Univariate and multivariate logistic regression analyses were conducted. RESULTS: Among 205 patients, histopathological ovarian metastasis was identified in 5.9% (n=12), and synchronous ovarian tumors in 2.4% (n=5). Significant differences were observed in neutrophil counts, NLR, and SII values between the groups (p<0.05). ROC analysis showed the optimal SII cut-off value as 992.58, with 70% sensitivity and 76% specificity (AUC=0.726). Ovarian involvement was significantly more frequent in patients with SII ≥ 992 (p<0.05). Univariate analysis revealed that myometrial invasion, LVSI, cervical stromal invasion, lymph node metastasis, omental involvement, grade of tumor, NLR and SII were significantly associated with ovarian involvement (p<0.05). Multivariate analysis identified histological grade, myometrial invasion, pelvic lymph node metastasis and SII as independent risk factors (p<0.05). CONCLUSION: Ovarian involvement is uncommon in patients under 50 years of age with low-grade tumors, absence of myometrial invasion, negative pelvic lymph nodes, and preoperative SII < 992.58. Ovarian-sparing surgery may be a safe option in selected cases, and SII could serve as a valuable index in guiding ovarian preservation decisions.
Rev Bras Ginecol Obstet
· 2025 · PMID 41098665
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OBJECTIVE: Endometriosis is known as a chronic inflammatory disease. This study investigates the differences in the inflammatory response between endometriomas and benign ovarian cysts during the preoperative and postope...OBJECTIVE: Endometriosis is known as a chronic inflammatory disease. This study investigates the differences in the inflammatory response between endometriomas and benign ovarian cysts during the preoperative and postoperative periods. METHODS: A retrospective analysis was conducted on patients who underwent laparoscopic cystectomy for endometriomas or non-endometriotic benign cysts between 2010 and 2021. The study compared demographic and gynecological characteristics, lesion size, serum follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH), and preoperative and postoperative values of erythrocyte distribution width (RDW), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and leukocytes between the two groups. RESULTS: The study included 116 patients (48.13%) in the Study Group and 125 (51.87%) in the Control Group. The mean age of the Study and Control Groups was 27.76 years and 24.54 years, respectively (p<0.001). A non-significant discrepancy in preoperative AMH and FSH values was observed between the two groups (p>0.05). Preoperative RDW (14.50±1.56 vs. 14.04±1.40), PLR (160.82±44.52 vs. 136.83±48.72), and NLR (2.60±1.10 vs. 2.17±1.13) were significantly higher in the Study Group (p<0.05). Nevertheless, only in the Study Group NLR exhibited a notable increase in the postoperative period (p<0.05). Preoperative NLR was positively correlated with cyst size in endometriomas but was not correlated with rASRM score, AMH, or FSH levels. CONCLUSION: The inflammatory markers RDW, PLR, and NLR were significantly elevated in endometriomas compared to other benign cysts during preoperative and postoperative periods. The inflammatory response increased with cyst size but was not related to ovarian reserve as measured by serum AMH or the stage of endometriosis.
Rev Bras Ginecol Obstet
· 2025 · PMID 41098664
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OBJECTIVE: This study aimed to assess the prevalence of cervical High-Grade Squamous Intraepithelial Lesions (HSIL) in women outside the screening age recommended by the Brazilian Guidelines for Cervical Cancer Screening...OBJECTIVE: This study aimed to assess the prevalence of cervical High-Grade Squamous Intraepithelial Lesions (HSIL) in women outside the screening age recommended by the Brazilian Guidelines for Cervical Cancer Screening (under 25 and over 64 years old). METHODS: The cross-sectional study was conducted at a reference hospital in Rio de Janeiro with a histopathological report of CIN 2 + from January 2010 to December 2020 through the analysis of medical records. RESULTS: Among 406 women diagnosed with Cervical Intraepithelial Neoplasia (CIN) 2+, 63 patients (15.5%) were outside the recommended screening age, 17(4.2%) of whom were under the age of 25, and 46 (11.3%) were older than 64 years. CIN 2 was most prevalent in women under 25 years old (29.4%); CIN 3 in those between 25 and 64 years old (55.1%); and invasive cancer predominated in women over 64 years old, with statistical significance (<0.001). CONCLUSION: The higher frequency of CIN 2 in young women under 25 years old supports the transient nature of these lesions, reinforcing that screening this age group may lead to unnecessary treatment. Conversely, the detection of high-grade lesions and cancer in older women is a consequence of inadequate screening earlier in life.
Almeida LLF, Neves GL, Pinhati MES
… +3 more, Lamaita RM, Cândido EB, da Silva AL
Rev Bras Ginecol Obstet
· 2025 · PMID 40673039
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OBJECTIVE: This study aims to evaluate the clinical and functional implications of cesarean section (CS) skin scars on women's lives, emphasizing the relationship between scar characteristics and quality of life. METHODS...OBJECTIVE: This study aims to evaluate the clinical and functional implications of cesarean section (CS) skin scars on women's lives, emphasizing the relationship between scar characteristics and quality of life. METHODS: In this cross-sectional study, women older than 18 years old who had undergone CS with a Pfannenstiel incision within the past 6-36 months were evaluated. The Patient Scar Assessment Questionnaire (PSAQ) and the Patient and Observer Scar Assessment Scale (POSAS) were used to assess clinical scar parameters. Functionality was appraised using eight questions derived from the International Classification of Functionality, Disability, and Health (ICF). The association between scar appearance scores and functionality questions was analyzed statistically. RESULTS: Ninety-six women were assessed, revealing that appearance and satisfaction with appearance had the worst scores on the PSAQ. Scar irregularity was the most frequently reported scar characteristic on the POSAS. On the ICF-derived questionnaire, the "self-care" domain was the most affected, with women reporting problems on activities such as choosing swimwear and lingeries. There was a significant correlation (p < 0,05) between the women dissatisfaction with the scar appearance and impairment in 'interpersonal interactions and relationships' and 'self-care', as the "domestic life" domain wasn't affected. CONCLUSIONS: Cesarean section skin scars can lead to dissatisfaction and functional impairments, affecting women's quality of life. These findings underscore the necessity for multidisciplinary care and thorough discussions about delivery methods to improve post-surgical outcomes.
Gomes I, Marçal F, Reis JVC
… +7 more, Silva APDS, Sampaio L, Moreira LA, Costa GL, Correa MD, Reis ZSN, Mayrink J
Rev Bras Ginecol Obstet
· 2025 · PMID 40673038
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OBJECTIVE: Low- and middle-income countries face significant challenges in managing women diagnosed with pre-eclampsia, from making the clinical decision about whether to deliver to transferring these women to healthy fa...OBJECTIVE: Low- and middle-income countries face significant challenges in managing women diagnosed with pre-eclampsia, from making the clinical decision about whether to deliver to transferring these women to healthy facilities where they can receive appropriate care. The aim of this study was to evaluate the performance and accuracy of the fullPIERS model in a referral Brazilian maternity hospital - to assess maternal and fetal morbidity and impatient mortality at birth admission. METHODS: A cross-sectional study analyzed pregnant women with preeclampsia diagnosis, between 2014 and 2023. The full PIERS model was applied to a database retrospectively collected and its accuracy to predict maternal and perinatal outcomes during the hospital stay was determined through a receiver operating curve. RESULTS: Analyzing 207 pregnant women with fullPIERS had an Area Under the Curve (AUC) for adverse maternal outcome discrimination of 0.672 (0.576-0.767 95% CI, p<0.001) and AUC 0.582, (0.504-0.6661 95% CI, p = 0.041) for maternal and perinatal outcomes. Nevertheless, the model had no discrimination utility to assess perinatal outcomes (AUC 0.561, 0.480-0.642 95% CI, p = 0.642). CONCLUSION: The fullPIERS model had limited performance in identifying women at increased risk of adverse outcomes birth admission and absent utility to assess perinatal outcomes. Future studies, combining different tools and validated in low- and middle-income countries should be carried out to improve maternal health.
Madruga CS, Barreto KIS, Seabra D
… +10 more, Miguel A, da Silva CJ, de Godoy GS, Rebouças LN, Ferreira NA, Bosso RA, Miziara CSMG, Canfield M, Cordeiro Q, Laranjeira RR
Rev Bras Ginecol Obstet
· 2025 · PMID 40673037
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