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

{"title":"Impact of the Zero Maternal Death by Hemorrhage Strategy on health professionals' self-perceived knowledge in managing postpartum hemorrhage.","authors":"Gilson Geraldo de Oliveira, Mariana Larissa Oliveira Dos Santos, Gabriel Costa Osanan, George Dantas de Azevedo, Reginaldo Antônio de Oliveira Freitas","doi":"10.61622/rbgo/2025rbgo25","DOIUrl":"10.61622/rbgo/2025rbgo25","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the results of the Obstetric Hemorrhage Prevention and Management Course - Zero Maternal Death by Hemorrhage Strategy (0MMxH) among healthcare professionals before and after participation.</p><p><strong>Methods: </strong>A quasi-experimental design was employed, assessing the educational intervention in a convenience sample of healthcare professionals who had participated in the 0MMxH at least one year prior. Participants completed a retrospective pre-post questionnaire sent via email, focusing on self-perceived knowledge levels and the adoption of best practices in postpartum hemorrhage (PPH) management.</p><p><strong>Results: </strong>Out of 129 professionals who completed the 0MMxH training, 85 (65.9%) responded to the questionnaire. The percentages of respondents reporting no or low knowledge before and after the course were: shock index (52.8% to 0%, before and after, respectively), blood loss estimation (35.2% to 1.1%), care sequence for PPH (44.6% to 0%), rational use of crystalloids (37.5% to 1.1%), non-pneumatic anti-shock garment (83.5% to 3.4%), and damage control surgery (74.1% to 8.1%). These results indicate a significant improvement in self-perceived knowledge. After the course, the highest adoption rates of best practices were for shock index (83.5%), blood loss estimation (67.1%), and use of warm crystalloids (58.8%). However, gaps remained regarding non-pharmacological interventions for PPH management.</p><p><strong>Conclusion: </strong>Participants reported improved knowledge on most topics covered by the 0MMxH. The program was recognized as a crucial factor in adopting effective PPH management practices, underscoring the importance of training in enhancing obstetric care.</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":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328039","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":"Epidemiological profile of breast cancer in a reference center in the north region of Brazil.","authors":"Daniele Carvalhais França, Agnaldo Lopes da Silva, Anisse Marques Chami, Leticia da Conceição Braga","doi":"10.61622/rbgo/2025rbgo27","DOIUrl":"10.61622/rbgo/2025rbgo27","url":null,"abstract":"<p><strong>Objective: </strong>To describe the epidemiological data of women with breast cancer at a referral center in oncology in the northern region of Brazil.</p><p><strong>Methods: </strong>This is a retrospective cohort study. The study population consists of patients who were diagnosed with <i>in situ</i> or invasive BC (invasive carcinoma of no special type (ICNST) and invasive lobular carcinoma (ILC)) at the <i>Hospital de Amor da Amazônia</i>, in Porto Velho - Rondônia, between January 2012 and December 2021. The sampling plan adopted was of the convenience type. All patients who received the anatomopathological diagnosis of <i>in situ</i> or invasive BC at the <i>Hospital de Amor da Amazônia</i> from 2012 to 2021 and came from the North region were included. Exclusion criteria were non-origin from the North region and absence of diagnosis established by anatomopathological examination of breast cancer. Analysis of the database and medical records of the <i>Hospital de Amor da Amazônia</i> was carried out to collect information.</p><p><strong>Results: </strong>420 patients were included, 99.5% female, with complete elementary school (32,6%) and brown skin (68,1%). The mean age at diagnosis was 49 years. Forty-five percent were born in the northern region and 55% in other regions of Brazil. Eighty percent of tumors were invasive ductal carcinoma; 32.7% were luminal A-like, 25.1% luminal B-like, 19.4% HER2 enriched and 12.8% triple negative. When patients were subdivided by age ≤40 years and > 40 years, there was a statistically significant difference in the association with staging (p=0.000), histological type (p= 0.035), immunohistochemistry subtype (p=0.000), neoadjuvant chemotherapy (p=.000) and genetic counseling (p=0.001). The median survival was 7.99 years. The 5-year overall survival was 81%. The higher the stage, the lower the survival rate. Twenty-four distinct variants were described in patients undergoing genetic testing, 16 of uncertain significance and 8 pathogenic. Three new variants were described: <i>ATM</i> (c.8726G>C), <i>BRCA2</i> (c.2232A>C) and <i>ERCC5</i> (c.2164G>Ap).</p><p><strong>Conclusion: </strong>In this study, the age at diagnosis of breast cancer was lower, the tumor subtype was more aggressive, and patients were admitted in more advanced stages. Overall survival is lower compared to national and international data. Despite the small number of patients referred to genetic testing, it is important to search for germline mutations to improve patients' diagnosis and treatment.</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":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328037","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":"Evaluation of chronic radiation proctitis in patients with cervical cancer treated with pelvic radiotherapy: a cross-sectional study.","authors":"Renata Silva Aragão, Candice Lima Santos, Ariani Impieri Souza, Ana Luiza Fassizoli da Fonte, Beatriz Ximenes Bandeira de Moraes, Lucas Sandes de Lima, Luiza Dias Aguiar, Jurema Telles Oliveira Lima","doi":"10.61622/rbgo/2025rbgo26","DOIUrl":"10.61622/rbgo/2025rbgo26","url":null,"abstract":"<p><strong>Objective: </strong>A combination of chemotherapy and pelvic radiotherapy is recommended to treat locally advanced cervical cancer (CC), which has been associated with acute and chronic toxicities, especially radiation proctitis (RP). The objective of this study was to evaluate the frequency of RP and treatment management in females with CC who underwent pelvic radiotherapy at an oncology referral hospital.</p><p><strong>Methods: </strong>This cross-sectional study analyzed the medical records of patients treated with radiotherapy for CC between 2015-2017. We assessed sociodemographic, lifestyle, cancer, treatment, and clinical variables. We identified 298 records of females with CC who underwent pelvic radiotherapy during the defined period. Of these, 14 records were duplicates, 25 were excluded for lacking essential information, and 33 were missing in the archive. Accordingly, 226 relevant medical records were analyzed, with data regarding sociodemographic, clinical, cancer-related, treatment-related, and RP-related variables collected. Pearson's chi-square test was used to compare symptomatic and non-symptomatic patients. Fisher's exact test was used to compare chemotherapy doses. Statistical analysis was performed with Stata V12.1. A P-value less than 0.05 was considered significant.</p><p><strong>Results: </strong>The median patient age was 48 years (interquartile range 38-61). Patients predominantly had CC stages IIB and IIIB (>70%). Of the 226 females analyzed, 87(38.5%) experienced RP symptoms, represented by rectal bleeding; of these, 59 underwent colonoscopy, confirming RP in 58(98.3%). Accordingly, of the 226 females analyzed, 58(25.7%) had a confirmed diagnosis of RP. There was a statistically significant association between rectal bleeding and cumulative radiation dose (P < 0.001) and the presence of systemic arterial hypertension (P = 0.036). Regarding treatment, 38(65.5%) participants underwent argon plasma coagulation (APC), and of these, 22(57.9%) had no post-treatment macroscopic bleeding.</p><p><strong>Conclusion: </strong>Patients with CC who received radiotherapy at an oncology referral service had a high frequency of RP, and APC helped control bleeding in certain patients.</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":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328038","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":"Prophylactic internal iliac artery balloon occlusion in the management of placenta accreta spectrum disorders: a meta-analysis.","authors":"Nicole Dos Santos Pimenta, Ana Clara Felix de Farias Santos, Maírla Marina Ferreira Dias, Gabriela Oliveira Gonçalves Molino, Ana Gabriela Alves Pereira, Pedro Henrique Costa Matos da Silva","doi":"10.61622/rbgo/2025rbgo19","DOIUrl":"10.61622/rbgo/2025rbgo19","url":null,"abstract":"<p><strong>Objective: </strong>Placenta accreta spectrum (PAS) describes the failure of placental detachment. PAS is a pregnancy-associated life-threatening condition which increases hemorrhage risk. We evaluated safety and efficacy of internal iliac artery balloon occlusion (IIABOC) on bleeding volume among pregnant women with diagnosis or suspicion of PAS.</p><p><strong>Data source: </strong>We searched PubMed, Embase and Cochrane databases.</p><p><strong>Study selection: </strong>Randomized controlled trials (RCTs) and observational studies comparing the efficacy of preoperative prophylactic balloon catheters to a control group with standard care in patients with a prenatal screening of PAS.</p><p><strong>Data collect: </strong>We computed odds ratio (OR) for binary endpoints and mean difference (MD) for continuous endpoints, with 95% confidence intervals (CIs). We performed random effects models and assessed I² heterogeneity statistics.</p><p><strong>Data synthesis: </strong>Twenty-four studies were included, of whom 1,023 (51%) received balloons and 983 (49%) did not undergo balloon management. Patients receiving IIABOC had a greater decrease in estimated blood loss (MD -0.33; 95% CI -0.55, 0.11) and increase in operation time (MD 17.21; 95% CI 3.43, 30.99). Apgar score at fifth minute (MD -0.22; 95% CI -0.36,-0.07) significantly decreased. There were no significant differences between groups regarding hysterectomy rates (OR 1.35; 95% CI 0.88, 2.09) and maternal intensive care unit admission (OR 0.81; 95% CI 0.51,1.29).</p><p><strong>Conclusion: </strong>While IIABOC have demonstrated a significant reduction in estimated blood loss, these findings have not been consistently replicated in RCTs and the surgeon's level of experience must be taken into account since it biases the analysis.</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":1.4,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328040","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":"Efficacy of tranexamic acid application in gynecology and obstetrics procedures: a umbrella review of systematic reviews of randomized trials.","authors":"Nicole Cristina Lottermann, Nathalia Luiza Andreazza, Matheus de Araújo Moura Cavalcante, Laura Andrade Fernandez, Carla Vitola Gonçalvez, Linjie Zhang","doi":"10.61622/rbgo/2025rbgo18","DOIUrl":"10.61622/rbgo/2025rbgo18","url":null,"abstract":"<p><strong>Objective: </strong>This umbrella review aimed to synthesize evidence from systematic reviews of clinical trials on the efficacy of tranexamic acid in gynecology and obstetrics procedures.</p><p><strong>Methods: </strong>We searched Medline, Embase, SciELO and Cochrane Database of Systematic Reviews on March 11, 2024, using the term \"tranexamic acid\". Four reviewers independently select studies and extract data. We assessed the quality of systematic review and the quality of evidence, using AMSTAR 2 and GRADE tools, respectively.</p><p><strong>Results: </strong>Of 651 systematic reviews identified, 16 reviews with 96663 patients were included. The surgical procedures were cesarean section, myomectomy, hysterectomy, and cervical intraepithelial neoplasia surgery. All reviews showed a statistically significant and clinically relevant reduction in intraoperative and post-procedure blood loss, associated with intravenous or topical use of tranexamic acid. Tranexamic acid resulted in a significant reduction in the need for blood transfusions and a less pronounced drop in postoperative hematocrit and hemoglobin levels in cesarean section. Several reviews addressed the same question, but the number of included trials varied substantially, which might indicate flaws in search and selection of studies of these reviews. The quality of systematic reviews was low or critically low, and the quality of evidence was moderate.</p><p><strong>Conclusions: </strong>This umbrella review shows that tranexamic acid can reduce blood loss and hemorrhage in gynecology and obstetrics procedures. High quality systematic reviews are still needed.</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":1.4,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128438","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":"An assessment of total antioxidant and oxidant parameters and their correlation with embryo quality in in-vitro fertilization patients.","authors":"Utkucan Okuducu, Gökhan Bayhan, Dilek Ulusoy Karatopuk","doi":"10.61622/rbgo/2025rbgo22","DOIUrl":"10.61622/rbgo/2025rbgo22","url":null,"abstract":"<p><strong>Objective: </strong>In vitro, fertilization is the primary treatment method for infertility. Follicular fluid analysis is an approach used to optimize the results of assisted reproductive techniques. Oxidative stress represents the imbalance between the production of reactive oxygen species and their detoxification. Total Antioxidant and Oxidant Status, and Oxidative Stress Index levels are the main oxidative stress markers. This study investigated the effects of oxidative stress markers on infertility etiology, embryo quality, and success of In vitro fertilization.</p><p><strong>Methods: </strong>Before enrolling in the ICSI-ET cycle, participants had their FSH and LH levels assessed on the second day of the cycle. The ovarian degrees of the participants were evaluated by transvaginal ultrasonography. Participants underwent controlled ovarian stimulation using the GnRH antagonist protocol. TV-USG and serial E2 measurements were performed at appropriate intervals to follow follicular development. Follicle sizes, quantity, and endometrial thickness were recorded. Total Antioxidant and Oxidant Status, and Oxidative analyses were conducted using Rel Assay Diagnostics Assay Kits.</p><p><strong>Results: </strong>The average number of total oocytes in the participants was 10.25±6.66, and the average of mature M2 stage oocytes was 6.71±3.72. The average number of fertilized oocytes was 4.65±2.81. Fertilization rates were calculated as approximately 54.75±25.58%. A statistically significant positive correlation was found between embryo quality and serum Total Antioxidant Status levels (p=0.004). Similarly, a significant positive correlation was observed between embryo quality and follicular Total Antioxidant Status values (r = 0.42, p = 0.01).</p><p><strong>Conclusion: </strong>This study concluded that oxidative stress markers affect certain stages of the IVF treatment process.</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":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129842","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":"Clinical and epidemiological profile of pregnant and postpartum women affected by COVID-19 who required respiratory support.","authors":"Carolina Maria Pires Cunha, Melania Maria Ramos Amorim, Julianna de Azevedo Guendler, Alex Sandro Rolland Souza, Leila Katz","doi":"10.61622/rbgo/2025rbgo14","DOIUrl":"10.61622/rbgo/2025rbgo14","url":null,"abstract":"<p><strong>Objective: </strong>This study described the clinical and epidemiological profile and the management provided to pregnant and postpartum women with COVID-19 who required respiratory support.</p><p><strong>Methods: </strong>A descriptive study was conducted with pregnant and postpartum women with confirmed COVID-19 who received care between April 2020 and December 2021 in eight referral centers in northeastern Brazil. Statistical analysis was conducted using Epi-Info 7.2.5 and Medcalc, version 20.112.</p><p><strong>Results: </strong>Of the 720 patients admitted, 208 (32.7%) required respiratory support. Mean age of the participants was 28.9±7.1 years. Most (52.8%) were brown-skinned; 31.3% had little formal schooling; 41.1% had a personal income and 23.1% were married. Around half were referred from another hospital. Overall, 36.8% were obese and 36.9% were hypertensive. Criteria for severe acute respiratory syndrome (SARS) were present in 80.7% of cases. Overall, 151 patients (74.7%) required corticoids, and 150 (76.1%) were admitted to an intensive care unit. Non-invasive ventilation was needed in 89.4% of cases, with nasal catheters being the most common type (55.3% of cases). Invasive mechanical ventilation was necessary in 35.5% of cases and 91.6% had a cesarean section. Maternal near miss and death occurred in 24% and 12.9% of cases, respectively.</p><p><strong>Conclusion: </strong>Pregnant and postpartum women with COVID-19 who required respiratory support were predominantly brown-skinned, in the third trimester of pregnancy and had been referred from another hospital. The cesarean section rate was high; the presence of criteria for SARS was common and the rates of COVID-19-related maternal near miss and death were high.</p><p><strong>Clinical trials registry: </strong>NCT04462367.</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":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129844","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 of antiphospholipid syndrome among women with recurrent pregnancy loss: a cohort study.","authors":"Elaine Cristina Fontes de Oliveira, Daniel Dias Ribeiro, Janaína Campos Senra, Fernando Marcos Dos Reis","doi":"10.61622/rbgo/2025rbgo23","DOIUrl":"10.61622/rbgo/2025rbgo23","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the prevalence of antiphospholipid syndrome (APS) among women experiencing recurrent pregnancy loss (RPL).</p><p><strong>Methods: </strong>A cross-sectional was conducted, reviewing the medical records of 134 women with a history of two or more miscarriages, treated between January 2014 and May 2024 at a tertiary university center in Belo Horizonte, Brazil. APS screening was performed by assessing anticardiolipin (IgG and IgM), lupus anticoagulant, and anti-β2-glycoprotein-1 (IgG and IgM) antibodies, based on Sapporo criteria. All tests were performed during non-pregnant periods and at least 12 weeks after the last miscarriage.</p><p><strong>Results: </strong>The study included 134 women with a mean age of 33.8 ± 5.7 years. The number of prior miscarriages ranged from 2 to 11 per couple. Among the patients who presented the lupus anticoagulant, only two (1.49%) tested positive in two samples, as per revised Sapporo criteria. Considering IgG and IgM anticardiolipin antibodies, four patients (2.98%) tested positive in two samples according to old Sapporo criteria, with one patient having a positive IgG test in two samples, two having positive IgM in two samples and a single patient having both positive tests. None of the 56 patients tested positive for anti-β2-glycoprotein-1 antibodies in two samples.</p><p><strong>Conclusion: </strong>The prevalence of antiphospholipid antibodies, in line with revised Sapporo criteria, is low among Brazilian women with recurrent pregnancy loss, consistent with recent studies in literature. Ensuring the appropriateness of diagnostic criteria is crucial to avoid unnecessary treatment with platelet anticoagulants and heparin in this population.</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":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129685","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":"Hysterectomy rates per resident in final year of training in teaching hospitals: an ecologic study.","authors":"Luiza Nestori Chiozzotto, Nino José Wilson Moterani, Laura Bresciani Bento Gonçalves Moterani, Vinicius César Moterani, Francisco José Candido Dos Reis","doi":"10.61622/rbgo/2025rbgo24","DOIUrl":"10.61622/rbgo/2025rbgo24","url":null,"abstract":"<p><strong>Objective: </strong>Analyze the hysterectomy rates per resident in graduation year in teaching hospitals in the state of São Paulo (Brazil).</p><p><strong>Methods: </strong>We selected teaching hospitals in the state of São Paulo and gathered information from two public databases to estimate the hysterectomy rates per resident in their final year of training between 2009 and 2019.</p><p><strong>Results: </strong>Between 2009 and 2019, there was a 37.5% increase in the number of residents in their final year of training, a 4.31% increase in the number of hysterectomies, and a drop in the hysterectomy rates per resident of 24.1%. The reduction of the rate of hysterectomy per resident was more pronounced for vaginal route (46.4%) followed by abdominal route (23.3%). The ratio of laparoscopic hysterectomy per resident increased 264% during the period, however, this route was used in only 7% of the surgeries in 2019.</p><p><strong>Conclusions: </strong>The hysterectomy rates per resident in their final year of training showed a notable reduction. This trend, particularly pronounced in vaginal and abdominal routes, signals a shift towards minimally invasive techniques.</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":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129564","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":"The ımpact of demographic and obstetric factors on perception of traumatic birth and breastfeeding attitudes.","authors":"Ayşe Çuvadar, Elnaz Karamelikli, Yeter Çuvadar Baş","doi":"10.61622/rbgo/2025rbgo15","DOIUrl":"10.61622/rbgo/2025rbgo15","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to examine the effects of sociodemographic and obstetric factors on traumatic birth perception and breastfeeding attitudes in primiparous mothers who have had a vaginal birth in the early postpartum period.</p><p><strong>Methods: </strong>The sample of the research, developed with a cross-sectional and correlational design, consisted of 252 women residing in a province in the Western Black Sea region of Türkiye. The data were obtained by employing a Personal Information Form, Traumatic Childbirth Perception Scale, and Breastfeeding Attitudes of The Evaluation Scale. Data analysis was conducted using the statistical programming language R (R version 4.3.3).</p><p><strong>Results: </strong>Women who were not employed, had a planned pregnancy, and did not experience health problems during pregnancy had higher mean breastfeeding attitude scores, and this difference was statistically significant. It was determined that a one-unit increase in gestational week led to an average increase of 1.926 units in breastfeeding attitude score, and a one-unit increase in Traumatic Childbirth Perception Scale score led to an average decrease of 0.110 units in breastfeeding attitude score. The mean traumatic childbirth perception scores of women living in urban areas were found to be lower than those living in villages or towns, and the difference was statistically significant.</p><p><strong>Conclusion: </strong>The research findings indicate that gestational age, perception of traumatic childbirth, and certain sociodemographic factors significantly affect breastfeeding attitudes. Additionally, mothers living in urban areas have a lower perception of traumatic childbirth. Therefore, individualized approaches to childbirth and breastfeeding support are crucial.</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":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129688","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}