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

{"title":"The accuracy of the fullPIERS model in predicting adverse maternal and perinatal outcomes: evidence from a tertiary care maternity unit.","authors":"Iury Gomes, Franz Marçal, João Victor de Carvalho Reis, Ana Paula Dos Santos Silva, Lucas Sampaio, Leonardo Alves Moreira, Guilherme Lelis Costa, Mário Dias Correa, Zilma Silveira Nogueira Reis, Jussara Mayrink","doi":"10.61622/rbgo/2025rbgo39","DOIUrl":"10.61622/rbgo/2025rbgo39","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651487","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":"Exploring awareness and attitudes toward oocyte cryopreservation among women of reproductive age.","authors":"Pedro Brandão, Rui Cândido, Fábio Carvalho, Liliane Nunes, Patrícia Matos, Pedro Frias, Marisa Coelho","doi":"10.61622/rbgo/2025rbgo53","DOIUrl":"10.61622/rbgo/2025rbgo53","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate awareness, perceptions, and attitudes toward oocyte cryopreservation among a diverse group of women.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in November 2023 using snowball sampling to distribute a structured questionnaire. The target population included women aged 18+ with childbearing potential, proficient in English. An anonymous online survey with 22 questions collected data on demographics, education, occupation, relationship status, reproductive intentions, and perceptions of oocyte cryopreservation.</p><p><strong>Results: </strong>A total of 502 responses were analyzed. Most participants were in their thirties, had higher education, and were in committed relationships. They represented 24 countries, mainly in Europe. Over 60% planned to have children, but 85% were unfamiliar with oocyte cryopreservation. Social media (56%) was the primary information source, followed by acquaintances (33%) and healthcare professionals (25%). Only 4.6% were actively considering the procedure, while 41.3% showed potential interest. Barriers included perceived lack of necessity, age concerns, and limited information. Women considering cryopreservation were typically younger and childless. Financial constraints and information gaps significantly influenced decision-making, with about one-third suggesting better information and cost reduction could increase willingness to pursue the procedure.</p><p><strong>Conclusion: </strong>Despite relatively high awareness of oocyte cryopreservation, actual consideration and uptake remain low. Addressing financial and informational barriers could improve acceptance, especially among younger women and those uncertain about their reproductive plans.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651476","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":"Beyond the cut: a cross-sectional analysis of the long-term clinical and functional impact of cesarean section scars.","authors":"Laila Lídia Faria Almeida, Gabriel Lage Neves, Matheus Eduardo Soares Pinhati, Rivia Mara Lamaita, Eduardo Batista Cândido, Agnaldo Lopes da Silva","doi":"10.61622/rbgo/2025rbgo55","DOIUrl":"10.61622/rbgo/2025rbgo55","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651469","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":"Prevalence and risk factors for placenta previa in a specialty hospital.","authors":"Mara Elisa Monterde-Fernández, Joel Jahaziel Díaz-Vallejo, Iliana Rodríguez-Parissi, Berenice Venegas-Espinoza, Ezri Cruz-Perez","doi":"10.61622/rbgo/2025rbgo30","DOIUrl":"10.61622/rbgo/2025rbgo30","url":null,"abstract":"<p><strong>Objective: </strong>Placenta previa is a risk factor for obstetric hemorrhage, which, if not managed, can lead to maternal and neonatal death. Most cases are diagnosed after 28 weeks of gestation; in many cases, prenatal diagnosis is not timely. The objective of this study was to estimate the prevalence of placenta previa and its risk factors.</p><p><strong>Methods: </strong>A retrospective case-control study was carried out with a total of 35 cases and 138 controls among pregnant women. The variables studied were previous cesarean section, BMI, abortions, uterine surgeries and maternal age, among others. The chi-square test was used to examine differences between groups; the OR was calculated for each factor via univariate and multivariate analyses.</p><p><strong>Results: </strong>The prevalence of placenta previa was 0.57%. The risk factors identified were advanced maternal age (OR 3.0; 95% CI 1.3-7.1) and previous cesarean section (OR 10.7; 95% CI 1.7-68.5).</p><p><strong>Conclusion: </strong>The prevalence of placenta previa was similar to that reported in the literature, and the most prevalent risk factors were advanced maternal age and previous cesarean section. The identification of risk factors in women with placenta previa makes it possible to establish action plans for personalized care during pregnancy and childbirth and to reduce complications.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651484","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":"Comments on: Follow-up of women after gynecological cancer treatment.","authors":"Celal Akdemir","doi":"10.61622/rbgo/2025rbgo62","DOIUrl":"10.61622/rbgo/2025rbgo62","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651471","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":"Comment on: The experience of pregnancy in the COVID-19 pandemic.","authors":"Bibek Roy","doi":"10.61622/rbgo/2025rbgo49","DOIUrl":"10.61622/rbgo/2025rbgo49","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651470","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":"Family counseling after prenatal diagnosis of congenital heart disease: the role of a multidisciplinary and humanized approach.","authors":"Luciane Alves da Rocha Amorim, Edward Araujo","doi":"10.61622/rbgo/2025EDT01","DOIUrl":"10.61622/rbgo/2025EDT01","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651478","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":"Impact of legal regulation on elective cesarean sections in a secondary complexity maternity hospital in São Paulo state.","authors":"Giulia Lopes Corte Mainardi, Vinicius Aniceto, João Vitor Zaniboni de Assumpção, Caio Antonio de Campos Prado, Ana Carolina Tagliatti Zani Mantovi, Elaine Christine Dantas Moisés","doi":"10.61622/rbgo/2025rbgo50","DOIUrl":"10.61622/rbgo/2025rbgo50","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of São Paulo State Law n° 17.137/2019 on the cesarean section rate at a public secondary-level maternity hospital and to analyze predictive factors and complications associated with cesarean under request. This law was enacted to allow pregnant women in São Paulo to request a cesarean section without medical indication.</p><p><strong>Methods: </strong>This retrospective study analyzed medical records of pregnant women ≥ 39 weeks gestation attended at the Ribeirão Preto Women's Health Reference Center (CRSMRP-Mater). Two groups were evaluated: 1,999 patients before the law (July 2018-July 2019) and 3,207 after its implementation (August 2019-July 2021, excluding the suspension period). Descriptive and analytical statistical methods were applied.</p><p><strong>Results: </strong>The overall cesarean rates increased significantly from 23.6% to 27.7% (p < 0.01), with 15,1% of cesareans during the law period being under maternal request (134 patients). A previous cesarean was the only factor significantly associated with electing a new cesarean. Hospital length of stay was significantly longer in the law period (p < 0.01), possibly reflecting the increased cesarean rate. No significant differences were observed in maternal or neonatal complications between cesareans under request and those conducted for medical reasons.</p><p><strong>Conclusion: </strong>São Paulo State Law n°. 17.137/2019 was associated with an increased cesarean rate in CRSMRP-Mater. The findings highlight the need for robust educational approaches and evidence-based obstetric practices to reduce unnecessary elective cesareans.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651480","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":"How maternal position affects umbilical and middle cerebral artery Doppler indices: insights from a scoping review.","authors":"Larissa Raso Hammes, Andre Hadyme Miyague, Renato Mitsunori Nisihara","doi":"10.61622/rbgo/2025rbgo45","DOIUrl":"10.61622/rbgo/2025rbgo45","url":null,"abstract":"<p><strong>Background: </strong>During pregnancy, the maternal supine position may reduce uterine and placental perfusion due to compression of the aorta and inferior vena cava by the gravid uterus, potentially impairing maternal and fetal oxygenation.</p><p><strong>Objective: </strong>This scoping review aimed to summarize the available evidence on the impact of maternal positioning during ultrasound examinations on fetal Doppler indices of the umbilical artery (UA) and middle cerebral artery (MCA).</p><p><strong>Methods: </strong>Studies were eligible if they included pregnant women undergoing fetal Doppler assessment in at least two different maternal positions and reported outcomes related to UA and/or MCA indices. Only studies published in English in the past 20 years were included.</p><p><strong>Sources of evidence: </strong>A comprehensive literature search was conducted in the PubMed/MEDLINE, Web of Science, and Scopus databases between September and October 2023.</p><p><strong>Charting methods: </strong>Two independent reviewers conducted the initial screening for relevance, with conflicts resolved by consensus or by a third reviewer.</p><p><strong>Results: </strong>Thirteen studies were initially identified. After applying the eligibility criteria, six observational prospective studies were included. These studies assessed changes in UA-PI, MCA-PI, and/or the cerebroplacental ratio (CPR) in response to different maternal positions during Doppler ultrasound.</p><p><strong>Conclusions: </strong>Evidence suggests that maternal positioning during fetal Doppler ultrasound can influence arterial indices, particularly when comparing supine and lateral decubitus positions. However, variability in methodology and small sample sizes limit the generalizability of findings. Further standardized studies are needed to guide clinical recommendations.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651479","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":"Emotional reactions and psychological responses expressed by adolescent and adult women survivors of sexual violence during outpatient follow-up.","authors":"Ana Luiza Teixeira, Stephanie Oliveira de Lima, Daniela de Oliveira Godoi, Alejandra Suyapa Becerra-Torres, José Paulo Guida, Renata Cruz Azevedo, Arlete Fernandes","doi":"10.61622/rbgo/2025rbgo37","DOIUrl":"10.61622/rbgo/2025rbgo37","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate psychological support data for survivors of sexual violence (SV) and compare the attitudes, responses, and feelings in adolescent and adult women.</p><p><strong>Methods: </strong>This was a retrospective study with two cohorts of female survivors of sexual violence, treated between 2011 and 2022. Women who had at least one psychological evaluation were included. The variables were sociodemographic; characteristics of violence; feelings; attitudes; symptoms observed/reported during support; time until emergency care; and indication of psychotropic medications. We calculated the mean and standard deviation (SD) and used the λ-Square or Fisher's Exact test and the Mann-Whitney test for comparative analysis. The significance level adopted was 5%.</p><p><strong>Results: </strong>Five hundred and twenty-one adolescents, mean age 14.8 (SD±2.0) and 312 adult women, mean age 31.7 years (SD±10.7), were compared. Two-thirds of all women reported themselves as white; adolescents took longer to seek care (p<0.001) more frequently than the adult group. Adult women had more histories of sexual abuse (p<0.001), penetration attacks (p<0.001), reported greater perception and disclosed violence more frequently (p<0.001) than the adolescent group. Adolescents reported more shame (p<0.001) while the group of adults more frequently expressed feelings of insecurity, anguish, expressions of crying, revolt, anger, humiliation and apathy. Anxious symptoms were expressed by 60% of adults and 44% of adolescents and the prescription of psychotropic medications was higher in the adult group compared to adolescents (p<0.001).</p><p><strong>Conclusion: </strong>Both groups of survivors suffered psychological impacts after SV, expressing/reporting different reactions to distress. These results highlight the importance of access to psychological support after SV.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"47 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651475","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}