Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia最新文献

{"title":"Surgical management of endometriosis: indications, patient preparation, and perioperative planning: Number 6 - 2026.","authors":"Agnaldo Lopes da Silva, Sérgio Podgaec, Ricardo de Almeida Quintarios, Júlio César Rosa E Silva","doi":"10.61622/rbgo/2026FPS6","DOIUrl":"10.61622/rbgo/2026FPS6","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586137","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}

{"title":"When technology advances faster than competence: the risk of deskilling in obstetrics and gynecology.","authors":"Agnaldo Lopes da Silva, Eduardo Cordioli, Sérgio Podgaec, Marcos Felipe Silva de Sá, Maria Celeste Osorio Wender","doi":"10.61622/rbgo/2026rbgo37","DOIUrl":"10.61622/rbgo/2026rbgo37","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586146","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}

{"title":"Prenatal exposure to paracetamol and risk of autism spectrum disorder: systematic review and meta-analysis of observational studies.","authors":"Juliana Almeida Oliveira, Maria Julia Lemos, Laura Fonseca Queiroz, João Vitor Sciorilli, Tam Tran, Isabella de Oliveira Ortiz, Bruna Benigna Sales Armstrong, Flávia Ribeiro de Oliveira","doi":"10.61622/rbgo/2026rbgo108","DOIUrl":"10.61622/rbgo/2026rbgo108","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aimed to assess the ASD risk in offspring exposed to prenatal acetaminophen compared to non-exposed offspring.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed, Embase, and Cochrane Central Register of Controlled Trials databases up to October 2025. Studies were included if they involved pregnant women, compared exposed versus non-exposed groups, were RCTs or cohort studies, and reported ASD outcomes. Data was extracted independently by two authors, with discrepancies resolved by consensus. Statistical analyses used odds ratios (ORs) with 95% confidence intervals, Cochran Q, and I² statistics with a random-effects model. Study quality was appraised using the ROBINS-E tool.</p><p><strong>Results: </strong>Eight studies, involving 2,560,208 patients, were included. Pooled results showed an 18% increased risk of ASD diagnosis (p <0.0001) and a non-significant 16% increase for ASD symptoms (p=0.1719). Dose-response relationships and gender-specific effects were reported by studies, while familial confounding and \"some concerns\" to \"high\" risk of bias were identified.</p><p><strong>Conclusion: </strong>A consistent, albeit modest, association was found. These findings emphasize the necessity for careful benefit-risk assessments and informed dialogue with expectant mothers regarding pain and fever management during pregnancy.<b>PROSPERO</b>: CRD420251160888.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586084","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}

{"title":"Association between sperm parameters and recurrent pregnancy loss in infertile couples: a cross-sectional study.","authors":"Farzaneh Rashidi, Fatemeh Tanhaye Kalate Sabz, Nazanin Hesari, Sahar Shariatnia, Elahe Yekta, Tooba Farazmand","doi":"10.61622/rbgo/2026rbgo23","DOIUrl":"10.61622/rbgo/2026rbgo23","url":null,"abstract":"<p><strong>Objective: </strong>Recurrent pregnancy loss (RPL) is known as a significant reproductive issue globally, which affects almost 5% of couples. Various factors contribute to the incidence of RPL. Considering the crucial role of male factors in the incidence of RPL, this study investigates the relationship between sperm parameters and RPL.</p><p><strong>Methods: </strong>This cross-sectional study was performed on 253 infertile couples who were eligible to participate and referred to the infertility center of BentolHoda Hospital from February 2022 to March 2023. The information was collected through demographic, medical, and infertility assessments, as well as laboratory examinations. Participants were categorized into two groups: couples experiencing RPL and couples facing primary or secondary infertility, which served as controls. Data were analyzed using descriptive statistical tests, the chi-square test, and logistic regression. Variations in different sperm parameters, as well as other demographic factors, were investigated between the two groups.</p><p><strong>Results: </strong>According to the findings, 32.4% of infertile couples had a history of RPL. The Chi-Square test results demonstrated a statistically significant association between motility and viscosity in couples with a history of recurrent pregnancy loss (p < 0.05). The results of the logistic regression analysis showed that the variables age (B = 0.103), drug therapy for infertility (B = -2.826), sperm viscosity (B = -1.440), and sperm motility (B = 1.113) could significantly relate to the PRL.</p><p><strong>Conclusion: </strong>The findings of this study suggest that low sperm motility, female age, and high sperm viscosity are factors that influence the occurrence of RPL.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586199","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}

{"title":"Validation of the VALue of UteruS (VALUS) instrument in brazilian portuguese language for women with uterine fibroids and endometrial polyps: a cross-sectional study.","authors":"Fernanda Rios Valvano, Carolina Neves Buhl, Glaucia Miranda Varella Pereira, Olivia Hui-Chiu Chang, Joao Paulo Leonardo-Pinto, Luiz Gustavo Oliveira Brito","doi":"10.61622/rbgo/2026rbgo20","DOIUrl":"10.61622/rbgo/2026rbgo20","url":null,"abstract":"<p><strong>Objective: </strong>To translate and culturally validate the VALue of the UteruS (VALUS) instrument in Brazilian Portuguese language and to identify predictors for VALUS score.</p><p><strong>Methods: </strong>A cross-sectional study (February to November 2024) at a tertiary, academic hospital was performed with 164 women presenting symptomatic uterine fibroids (UF) (n=139) or endometrial polyps (n=25) that underwent hysterectomy or myomectomy/polypectomy. The VALUS instrument was translated and culturally validated first. Psychometric variables (internal consistency, test-retest, discriminant validity) were calculated. Women completed the VALUS instrument prior to the decision-making process to undergo surgery. The Uterine Fibroid Symptoms-Quality of Life (UFS-QOL) was also completed for women with UF. Uni- and multivariate linear regression was calculated to seek for associated factors with the VALUS total score.</p><p><strong>Results: </strong>Women that underwent hysterectomy were older, with higher education, higher parity and frequency of abdominal/pelvic surgeries than the non-hysterectomy group. VALUS scores were statistically higher in the non-hysterectomy for some questions and total score. Internal consistency of the VALUS instrument was excellent (alpha=0.890) and test-retest analysis did not differ between the groups (p=0.891). The UFS-QoL quality of life score presented a negative correlation with VALUS instrument. Multivariate linear regression demonstrated that the presence of abdominal/pelvic surgeries was associated with a lower VALUS score.</p><p><strong>Conclusion: </strong>VALUS demonstrated adequate internal consistency and reliability, but with low discriminant validity for the prediction of hysterectomy versus uterine-preservation in women with UF or endometrial polyps. Presence of abdominal/pelvic surgery is associated with a lower VALUS score.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586241","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}

{"title":"Association between High AMH Levels in PCOS Patients and IVF/ICSI Outcomes: a systematic review and meta-analysis.","authors":"Angélica Martins, Renato Ferreira-da-Silva, Ana Margarida Póvoa","doi":"10.61622/rbgo/2026rbgo25","DOIUrl":"10.61622/rbgo/2026rbgo25","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between high Anti-Müllerian Hormone (AMH) levels and key outcomes of In Vitro Fertilization (IVF)/Intracytoplasmic Sperm Injection (ICSI) in women with Polycystic Ovary Syndrome (PCOS).</p><p><strong>Data sources: </strong>A systematic search was performed in MEDLINE (via PubMed), Web of Science, and Scopus, on September 17, 2024.</p><p><strong>Selection of studies: </strong>We included observational studies in PCOS patients stratified by AMH levels that reported any of the IVF/ICSI outcomes of interest, namely: live birth rate, clinical pregnancy rate, miscarriage rate, oocytes retrieved, MII oocytes and fertilization rate.</p><p><strong>Data collection: </strong>Two reviewers independently extracted data and assessed risk of bias using the National Heart, Lung, and Blood Institute Study Quality Assessment Tool. Discrepancies were resolved by consensus. Data were pooled using meta-analysis when appropriate. Sensitivity analyses were conducted using a leave-one-out approach.</p><p><strong>Data synthesis: </strong>Thirteen studies met the inclusion criteria. Ten were rated as low risk of bias, two as unclear, and one as high risk, indicating overall fair to strong methodological quality. Women with high AMH levels had a lower live birth rate (odds ratio [OR]: 0.85; 95%CI: 0.71-1.02), which became significant after leave-one-out analysis (OR: 0.80; 95%CI: 0.64-0.99). Clinical pregnancy rates were 2% lower in women with elevated AMH levels (OR: 0.98; 95%CI: 0.82-1.17). Miscarriage rates showed a non-significant 25% increase in women with high AMH levels (OR: 1.25; 95%CI: 0.88-1.76). High AMH levels were associated with more retrieved oocytes in the overall meta-analysis (mean difference: 3.52; 95%CI: 1.70-5.33), with consistent findings in sensitivity analyses. There was no significant difference in fertilization rate between the two groups.</p><p><strong>Conclusion: </strong>While high AMH levels indicate greater ovarian reserve, they negatively influence reproductive outcomes in PCOS patients. These findings highlight the need for individualized ART strategies and further research to clarify underlying mechanisms.<b>PROSPERO</b>: CRD42024596056.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586169","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}

{"title":"Neutrophil-lymphocyte ratio as prognostic factor in metastatic breast cancer.","authors":"Gustavo Motta Cabello Dos Santos, Nereida Kilza Costa-Lima, Isabela da Mata Tiezzi, Giovana Kobayashi Pavão, Israel Geraldo Silva, Priscila Malara Maia, Hélio Humberto Angotti Carrara, Daniel Guimarães Tiezzi","doi":"10.61622/rbgo/2026rbgo10","DOIUrl":"https://doi.org/10.61622/rbgo/2026rbgo10","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to analyze the role of the neutrophil to lymphocyte ratio (NLR) as a prognostic factor in metastatic breast cancer (MBC).</p><p><strong>Methods: </strong>A retrospective cohort study including 359 recurrent MBC patients was performed. Clinical and pathological attributes were retrieved from patients' medical files and their importance in the overall survival were evaluated using the Cox univariate and multivariate proportional hazard models. A confidence interval of 95% was used to select significant variables and the Wald test was used to infer the best NLR cutoff value to discriminate into low and high categories.</p><p><strong>Results: </strong>In univariate analyses, the variables estrogen receptor (ER) and progesterone receptor (PR) expressions, previous treatment with adjuvant chemo, NLR, PLR (platelet-lymphocyte ratio), age at diagnosis and the main metastatic site (bone/lymph node, visceral or central nervous system) variables were significant to determine the hazards. After filtering the collinear variables, the final model was tested with 6 variables based on 339 patients and the NLR at the time of the recurrence diagnosis (NLR_rec), the hormone receptor (ER or PR) status and the age at diagnosis were considered significant. The best NLR_rec value to discriminate against patients was 4.43 (Wald test= 51.7) and there were 239 patients categorized as low and 111 as high NLR category. The median overall survival time was 18 and 4 months in NLR-low and NLR-high groups, respectively (p< 0.001).</p><p><strong>Conclusion: </strong>NLR is an independent prognostic factor in recurrent MBC patients.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13472547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762996","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}

{"title":"Severe menstrual pain is not normal: adolescent dysmenorrhoea as a marker of future chronic pain.","authors":"Omero Benedicto Poli-Neto, Rachel Reid-McCann, Katy Vincent","doi":"10.61622/rbgo/2026rbgoedt2","DOIUrl":"10.61622/rbgo/2026rbgoedt2","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586110","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}

{"title":"Metformin + Insulin vs. Insulin for GDM and T2DM during pregnancy: systematic review and meta-analysis.","authors":"Christiano Hallack, Bernardo Vieira Nogueira, Maressa Bomfim, Nathália Meireles, Wellington Martins","doi":"10.61622/rbgo/2026rbgo18","DOIUrl":"10.61622/rbgo/2026rbgo18","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the effectiveness and safety of adding metformin to insulin (M+I) versus insulin alone for pregnant women with type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM), focusing on stillbirth as the primary outcome.</p><p><strong>Sources of data: </strong>PubMed, Embase, and Cochrane Central were searched. No date limits. Last search: January 2025.</p><p><strong>Eligibility criteria: </strong>Randomized clinical trials including women with T2DM or GDM were eligible. Trials restricted to type 1 diabetes were excluded.</p><p><strong>Data collection and synthesis: </strong>Two reviewers extracted maternal and neonatal outcomes and assessed risk of bias with the Cochrane RoB 2 tool. Evidence certainty was graded using GRADE. Data were pooled with random-effects models and reported as risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals.</p><p><strong>Results: </strong>Nine RCTs (2,420 women) were included, most with GDM and some with T2DM. Moderate-quality evidence indicated reduced stillbirth risk with M+I (6 RCTs, 2,196 participants; RR 0.36, 95% CI 0.14-0.90; NNT 111). Low-quality evidence suggested lower risks of gestational hypertension (4 RCTs; RR 0.68, 95% CI 0.48-0.97) and neonatal hypoglycemia (7 RCTs; RR 0.49, 95% CI 0.30-0.80). No significant differences were found for cesarean section, preterm delivery, or other neonatal outcomes. Heterogeneity, baseline imbalances, and small samples limited certainty.</p><p><strong>Conclusions: </strong>M+I may reduce stillbirth and some adverse outcomes compared with insulin alone, but most evidence remains low certainty. Further high-quality RCTs are needed.<b>Registered in PROSPERO</b>: CRD42024617330.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586314","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}

{"title":"Diagnosis and management of endometriosis-associated infertility Number 4 - 2026.","authors":"Agnaldo Lopes da Silva, Rívia Mara Lamaita, Sérgio Podgaec, Ricardo de Almeida Quintarios, Paula Andrea Navarro, Rui Ferriani","doi":"10.61622/rbgo/2026FPS4","DOIUrl":"10.61622/rbgo/2026FPS4","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"48 ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870831","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}