Camila Maria Sampaio Ferreira Avelino, Rosângela Ferreira Frade de Araújo
{"title":"Effects of vitamin D supplementation on oxidative stress biomarkers of Iranian women with polycystic ovary syndrome: a meta-analysis study.","authors":"Camila Maria Sampaio Ferreira Avelino, Rosângela Ferreira Frade de Araújo","doi":"10.61622/rbgo/2024rbgo37","DOIUrl":"10.61622/rbgo/2024rbgo37","url":null,"abstract":"<p><strong>Objective: </strong>To identify the impact of redox imbalance on the clinical evolution of patients with polycystic ovary syndrome and carry out a qualitative and quantitative projection of the benefits of vitamin D supplementation.</p><p><strong>Data sources: </strong>Combinations of the keywords <i>polycystic ovary syndrome, vitamin D, oxidative stress, reactive oxygen species, antioxidant</i>, and <i>free radicals</i> were used in PubMed, Cochrane Library, LILACS, EMBASE, and Web of Science databases. The last search was conducted on August 22, 2023.Selection of studies: Based on the inclusion and exclusion criteria, studies were selected considering a low risk of bias, published in the last 5 years in English, which investigated the effects of vitamin D supplementation in women with PCOS, focusing on oxidative stress markers. Of the 136 articles retrieved, 6 intervention studies (445 women) were included.</p><p><strong>Data collection: </strong>The risk of bias in included studies was assessed using the Jadad scale, and analysis and visualization of continuous data were performed using Review Manager 5.4.1, summarized as standardized mean differences (SMD) with confidence intervals (CI) of 95%.</p><p><strong>Data synthesis: </strong>Vitamin D effectively reduced malondialdehyde (<i>P</i>=0.002) and total testosterone (<i>P</i>=0.0004) levels and increased total antioxidant capacity levels (<i>P</i>=0.01). Although possible improvements in the modified Ferriman-Gallwey hirsutism score, levels of sex hormone-binding globulin, and free androgen index were identified and the results were not statistically significant.</p><p><strong>Conclusion: </strong>Vitamin D is a promising alternative for the treatment of PCOS with a positive influence on the oxidative, metabolic, and endocrine disorders of this syndrome.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592309","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}
Amanda Botelho, Adriana Luckow Invitti, Rosiane Mattar, David Baptista da Silva Pares, Camilla Parente Salmeron, João Victor Jacomele Caldas, Nathalia Mello, Alberto Borges Peixoto, Edward Araujo Júnior, Sue Yazaki Sun
{"title":"Risk factors for postpartum hemorrhage according to the Robson classification in a low-risk maternity hospital.","authors":"Amanda Botelho, Adriana Luckow Invitti, Rosiane Mattar, David Baptista da Silva Pares, Camilla Parente Salmeron, João Victor Jacomele Caldas, Nathalia Mello, Alberto Borges Peixoto, Edward Araujo Júnior, Sue Yazaki Sun","doi":"10.61622/rbgo/2024rbgo53","DOIUrl":"10.61622/rbgo/2024rbgo53","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital.</p><p><strong>Methods: </strong>We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression.</p><p><strong>Results: </strong>There were 11,935 deliveries during the study period. According to Robson's Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x<sup>2</sup>(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R<sup>2</sup> Nagelkerke: 0.011, p<0.001] and birth weight [x<sup>2</sup>(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R<sup>2</sup> Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653).</p><p><strong>Conclusion: </strong>Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592314","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}
Mayara Dos Santos Farias Ferreira Silva, Melania Maria Ramos de Amorim, Brena Melo, André Vieira Lanza, Maria Eduarda Trigueiro Ramos, Bruna Antunes Durães de Carvalho, Natalia Nunes Tenório, Leila Katz
{"title":"The profile of patients with postpartum hemorrhage admitted to the obstetric intensive care: a cross-sectional study.","authors":"Mayara Dos Santos Farias Ferreira Silva, Melania Maria Ramos de Amorim, Brena Melo, André Vieira Lanza, Maria Eduarda Trigueiro Ramos, Bruna Antunes Durães de Carvalho, Natalia Nunes Tenório, Leila Katz","doi":"10.61622/rbgo/2024rbgo47","DOIUrl":"10.61622/rbgo/2024rbgo47","url":null,"abstract":"<p><strong>Objective: </strong>In Brazil, postpartum hemorrhage (PPH) is a major cause of maternal morbidity and mortality. Data on the profile of women and risk factors associated with PPH are sparse. This study aimed to describe the profile and management of patients with PPH, and the association of risk factors for PPH with severe maternal outcomes (SMO).</p><p><strong>Methods: </strong>A cross-sectional study was conducted in Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) obstetric intensive care unit (ICU) between January 2012 and March 2020, including patients who gave birth at the hospital and that were admitted with PPH to the ICU.</p><p><strong>Results: </strong>The study included 358 patients, of whom 245 (68.4%) delivered in the IMIP maternity, and 113 (31.6%) in other maternity. The mean age of the patients was 26.7 years, with up to eight years of education (46.1%) and a mean of six prenatal care. Uterine atony (72.9%) was the most common cause, 1.6% estimated blood loss, 2% calculated shock index (SI), 63.9% of patients received hemotransfusion, and 27% underwent hysterectomy. 136 cases of SMO were identified, 35.5% were classified as maternal near miss and 3.0% maternal deaths. Multiparity was associated with SMO as an antepartum risk factor (RR=1.83, 95% CI1.42-2.36). Regarding intrapartum risk factors, abruptio placentae abruption was associated with SMO (RR=2.2 95% CI1.75-2.81). Among those who had hypertension (49.6%) there was a lower risk of developing SMO.</p><p><strong>Conclusion: </strong>The principal factors associated with poor maternal outcome were being multiparous and placental abruption.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592283","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}
Kellen Silva Sousa, Henrique Vitor Leite, Mário Dias Corrêa, Matheus Silva Sousa, Anna Luíza Rocha Queiroz
{"title":"Prevalence of macrosomic newborn and maternal and neonatal complications in a high-risk maternity.","authors":"Kellen Silva Sousa, Henrique Vitor Leite, Mário Dias Corrêa, Matheus Silva Sousa, Anna Luíza Rocha Queiroz","doi":"10.61622/rbgo/2024rbgo48","DOIUrl":"10.61622/rbgo/2024rbgo48","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the prevalence of macrosomic newborns (birth weight above 4000 grams) in a high-risk maternity from 2014 to 2019, as well as the maternal characteristics involved, risk factors, mode of delivery and associated outcomes, comparing newborns weighing 4000-4500 grams and those weighing above 4500 grams.</p><p><strong>Methods: </strong>This is an observational study, case-control type, carried out by searching for data in hospital's own system and clinical records. The criteria for inclusion in the study were all patients monitored at the service who had newborns with birth weight equal than or greater than 4000 grams in the period from January 2014 to December 2019, being subsequently divided into two subgroups (newborns with 4000 to 4500 grams and newborns above 4500 grams). After being collected, the variables were transcribed into a database, arranged in frequency tables. For treatment and statistical analysis of the data, <i>Excel</i> and <i>R</i> software were used. This tool was used to create graphs and tables that helped in the interpretation of the results. The statistical analysis of the variables collected included both simple descriptive analyzes as well as inferential statistics, with univariate, bivariate and multivariate analysis.</p><p><strong>Results: </strong>From 2014 to 2019, 3.3% of deliveries were macrosomic newborns. The average gestational age in the birth was 39.4 weeks. The most common mode of delivery (65%) was cesarean section. Diabetes mellitus was present in 30% of the deliveries studied and glycemic control was absent in most patients. Among the vaginal deliveries, only 6% were instrumented and there was shoulder dystocia in 21% of the cases. The majority (62%) of newborns had some complication, with jaundice (35%) being the most common.</p><p><strong>Conclusion: </strong>Birth weight above 4000 grams had a statistically significant impact on the occurrence of neonatal complications, such as hypoglycemia, respiratory distress and 5th minute APGAR less than 7, especially if birth weight was above 4500 grams. Gestational age was also shown to be statistically significant associated with neonatal complications, the lower, the greater the risk. Thus, macrosomia is strongly linked to complications, especially neonatal complications.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592312","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}
Gustavo Werutsky, Mahira Lopes, Rafaela Gomes de Jesus, Antonia Angeli Gazola, Rodrigo Azevedo Pellegrini, Taiane Francieli Rebelatto, Laura von Wallwitz Freitas, Ana Paula Heck, Arthur Ferreira da Silva, Matheus Füehr Rodrigues, Gustavo Gössling, Juliana Giacomazzi, Matheus Soares Rocha, Daniela Dornelles Rosa, Carlos Henrique Barrios, Eduardo Henrique Cronemberger, Geraldo Silva Queiroz, José Bines, Sérgio Daniel Simon, Andre Poisl Fay
{"title":"The impact of a breast cancer diagnosis on marital outcomes and factors associated with divorce and separation.","authors":"Gustavo Werutsky, Mahira Lopes, Rafaela Gomes de Jesus, Antonia Angeli Gazola, Rodrigo Azevedo Pellegrini, Taiane Francieli Rebelatto, Laura von Wallwitz Freitas, Ana Paula Heck, Arthur Ferreira da Silva, Matheus Füehr Rodrigues, Gustavo Gössling, Juliana Giacomazzi, Matheus Soares Rocha, Daniela Dornelles Rosa, Carlos Henrique Barrios, Eduardo Henrique Cronemberger, Geraldo Silva Queiroz, José Bines, Sérgio Daniel Simon, Andre Poisl Fay","doi":"10.61622/rbgo/2024rbgo60","DOIUrl":"10.61622/rbgo/2024rbgo60","url":null,"abstract":"<p><strong>Objective: </strong>To analyze marital outcomes, divorce or separation, and its association with demographic, socioeconomic, and clinicopathological factors among breast cancer (BC) survivors after 2-years of diagnosis.</p><p><strong>Methods: </strong>We performed a retrospective analysis of marital status at baseline and at years 1 and 2 of follow-up of women aged ≥ 18 years diagnosed with invasive BC participating in the AMAZONA III (GBECAM0115) study. The BC diagnosis occurred between January 2016 and March 2018 at 23 institutions in Brazil.</p><p><strong>Results: </strong>Of the 2974 women enrolled in AMAZONA III, 599 were married or living under common law at baseline. Divorce or separation occurred in 35 (5.8%) patients at 2 years of follow-up. In the multivariate analysis, public health insurance coverage was associated with a higher risk of marital status change (8.25% vs. 2.79%, RR 3.09, 95% CI 1.39 - 7.03, p = 0.007). Women who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation (8.1% vs. 4.49%, RR 1.97, 95 CI 1.04 - 3.72, p = 0.0366) than those who underwent breast-conserving surgery.</p><p><strong>Conclusion: </strong>Women covered by the public health system and those who underwent mastectomy, adenomastectomy or skin-sparing mastectomy were associated with a higher risk of divorce or separation. This evidence further supports the idea that long-term marital stability is associated with a complex interplay between socioeconomic conditions and stressors, such as BC diagnosis and treatment. <b>ClinicalTrials Registration:</b> NCT02663973.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592281","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}
Geraldo Duarte, Antonio Rodrigues Braga, Regis Kreitchmann, Maria Luiza Bezerra Menezes, Angélica Espinosa Barbosa Miranda, Ana Gabriela Alvares Travassos, Patrícia Pereira Dos Santos Melli, Roseli Mieko Yamamoto Nomura, Agnaldo Lopes da Silva, Maria Celeste Osório Wender
{"title":"Prevention, diagnosis, and treatment protocol of dengue during pregnancy and the postpartum period.","authors":"Geraldo Duarte, Antonio Rodrigues Braga, Regis Kreitchmann, Maria Luiza Bezerra Menezes, Angélica Espinosa Barbosa Miranda, Ana Gabriela Alvares Travassos, Patrícia Pereira Dos Santos Melli, Roseli Mieko Yamamoto Nomura, Agnaldo Lopes da Silva, Maria Celeste Osório Wender","doi":"10.61622/rbgo/2024rbgo73","DOIUrl":"10.61622/rbgo/2024rbgo73","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11239217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592313","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}
Rayanne Moreira da Cunha, Mariana Oliveira Veloso, Samuel Soares Coutinho, Luana Darc de Menezes Braga, Adriana Silva de Barros, Germana Mesquita Magalhães, Pedro Olavo de Paula Lima, Simony Lira do Nascimento, Leonardo Robson Pinheiro Sobreira Bezerra
{"title":"Sexual function in women with endometriosis and pelvic floor myofascial pain syndrome.","authors":"Rayanne Moreira da Cunha, Mariana Oliveira Veloso, Samuel Soares Coutinho, Luana Darc de Menezes Braga, Adriana Silva de Barros, Germana Mesquita Magalhães, Pedro Olavo de Paula Lima, Simony Lira do Nascimento, Leonardo Robson Pinheiro Sobreira Bezerra","doi":"10.61622/rbgo/2024rbgo40","DOIUrl":"https://doi.org/10.61622/rbgo/2024rbgo40","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the sexual function and pelvic floor muscles (PFM) function of women with endometriosis and chronic pelvic pain (CPP) with and without Myofascial Pelvic Pain Syndrome (MPPS).</p><p><strong>Methods: </strong>Cross-sectional study conducted between January 2018 and December 2020. Women with deep endometriosis underwent assessments for trigger points (TP) and PFM function using the PERFECT scale. Electromyographic activity (EMG) and sexual function through Female Sexual Function Index (FSFI) were assessed. Statistical analyses included chi-square and Mann-Whitney tests.</p><p><strong>Results: </strong>There were 46 women. 47% had increased muscle tone and 67% related TP in levator ani muscle (LAM). Weakness in PFM, with P≤2 was noted in 82% and P≥3 in only 17%. Incomplete relaxation of PFM presented in 30%. EMG results were resting 6.0, maximal voluntary isometric contraction (MVIC) 61.9 and Endurance 14.2; FSFI mean total score 24.7. We observed an association between increased muscle tone (<i>P</i><.001), difficulty in relaxation (<i>P</i>=.019), and lower Endurance on EMG (<i>P</i>=.04) in women with TP in LAM. Participants with TP presented lower total FSFI score (<i>P</i>=.02). TP in the right OIM presented increased muscle tone (<i>P</i>=.01). TP in the left OIM presented lower values to function of PFM by PERFECT (P=.005), and in MVIC (P=.03) on EMG.</p><p><strong>Conclusion: </strong>Trigger points (TP) in pelvic floor muscles (PFM) and obturator internus muscle (OIM) correlates with poorer PFM and sexual function, particularly in left OIM TP cases. Endometriosis and chronic pelvic pain raise muscle tone, weaken muscles, hinder relaxation, elevate resting electrical activity, lower maximum voluntary isometric contraction, and reduce PFM endurance.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395830","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}
Lisieux de Lourdes Martins Nóbrega Pessoa, Amaxsell Thiago Barros de Souza, Ayane Cristine Alves Sarmento, Ana Paula Ferreira Costa, Isis Kelly Dos Santos, Eduardo Pereira de Azevedo, Kleyton Santos de Medeiros, Ana Katherine Gonçalves, Ricardo Ney Cobucci
{"title":"Laser therapy for genitourinary syndrome of menopause: systematic review and meta-analysis of randomized controlled trial.","authors":"Lisieux de Lourdes Martins Nóbrega Pessoa, Amaxsell Thiago Barros de Souza, Ayane Cristine Alves Sarmento, Ana Paula Ferreira Costa, Isis Kelly Dos Santos, Eduardo Pereira de Azevedo, Kleyton Santos de Medeiros, Ana Katherine Gonçalves, Ricardo Ney Cobucci","doi":"10.61622/rbgo/2024rbgo38","DOIUrl":"10.61622/rbgo/2024rbgo38","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM).</p><p><strong>Data sources: </strong>Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction.</p><p><strong>Studies selection: </strong>RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy.</p><p><strong>Data collection: </strong>Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author.</p><p><strong>Data synthesis: </strong>Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=-0.85; 95% CI=-1.59 to -0.10), dryness (MD=-0.62; 95% CI=-1.12 to -0.12) and burning (MD= -0.64; 95% CI=-1.28 to -0.01) decreased. No serious adverse effects were reported.</p><p><strong>Conclusion: </strong>CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395823","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}
Agnaldo Lopes da Silva, Matheus Eduardo Soares Pinhati, Gabriel Lage Neves, Eduarda Naves Gonçalves de Almeida, Teresa Lamaita Lopes, Rívia Mara Lamaita, Eduardo Batista Cândido
{"title":"Patient positioning in minimally invasive gynecologic surgery: strategies to prevent injuries and improve outcomes.","authors":"Agnaldo Lopes da Silva, Matheus Eduardo Soares Pinhati, Gabriel Lage Neves, Eduarda Naves Gonçalves de Almeida, Teresa Lamaita Lopes, Rívia Mara Lamaita, Eduardo Batista Cândido","doi":"10.61622/rbgo/2024rbgo46","DOIUrl":"https://doi.org/10.61622/rbgo/2024rbgo46","url":null,"abstract":"<p><p>Effective patient positioning is a critical factor influencing surgical outcomes, mainly in minimally invasive gynecologic surgery (MIGS) where precise positioning facilitates optimal access to the surgical field. This paper provides a comprehensive exploration of the significance of strategic patient placement in MIGS, emphasizing its role in preventing intraoperative injuries and enhancing overall surgical success. The manuscript addresses potential complications arising from suboptimal positioning and highlights the essential key points for appropriate patient positioning during MIGS, encompassing what the surgical team should or shouldn't do. In this perspective, the risk factors associated with nerve injuries, sliding, compartment syndrome, and pressure ulcers are outlined to guide clinical practice. Overall, this paper underscores the critical role of precise patient positioning in achieving successful MIGS procedures and highlights key principles for the gynecological team to ensure optimal patient outcomes.</p>","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395827","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}
Antonio Braga, Penélope Saldanha Marinho, Marcos Nakamura-Pereira, José Carlos Peraçoli, Cláudia Mello
{"title":"Prediction and secondary prevention of preeclampsia from the perspective of public health management - the initiative of the State of Rio de Janeiro.","authors":"Antonio Braga, Penélope Saldanha Marinho, Marcos Nakamura-Pereira, José Carlos Peraçoli, Cláudia Mello","doi":"10.61622/rbgo/2024EDT03","DOIUrl":"https://doi.org/10.61622/rbgo/2024EDT03","url":null,"abstract":"","PeriodicalId":74699,"journal":{"name":"Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia","volume":"46 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11460422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395828","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}