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

{"title":"Levothyroxine in euthyroid pregnant women with thyroid peroxidase antibody: a systematic review and meta-analysis of randomized controlled trials.","authors":"Henrique Provinciatto, Maria Esther Barbalho, Pedro Matos da Câmara, Marina Simão Bertani, Alice Deberaldini Marinho, Chris Elizabeth Philip, Caroline Cristine Almeida Balieiro, Karina Felippe Monezi Pontes, Edward Araujo Júnior","doi":"10.61622/rbgo/2025rbgo75","DOIUrl":"10.61622/rbgo/2025rbgo75","url":null,"abstract":"<p><strong>Objective: </strong>Thyroid peroxidase antibody (TPOAb) is a prevalent condition amongst women of reproductive age and has been associated with adverse pregnancy outcomes. However, there is currently no proven treatment for euthyroid pregnant women with TPOAb. Therefore, we aimed to investigate the efficacy of levothyroxine treatment in this population.</p><p><strong>Methods: </strong>We searched PubMed, Embase and Cochrane Central from inception to or randomized controlled trials (RCTs) comparing levothyroxine with placebo or no treatment in euthyroid pregnant women who were positive for TPOAb. Our main outcomes were miscarriage, preterm birth, and live birth. We performed subgroup analysis based on recurrent pregnancy loss (RPL).</p><p><strong>Results: </strong>We included 8 RCTs comprising 1,645 pregnant women, of whom 814 (49.5%) were randomized to receive levothyroxine. Pregnant women treated with levothyroxine had significantly lower miscarriages (RR 0.78; 95% CI 0.63-0.98; p=0.035). No significant difference was found regarding pre-term birth (RR 0.78; 95% CI 0.55-1.13; p=0.189) and live birth (RR 1.05; 95% CI 0.99-1.12; p=0.097). Our subgroup analysis demonstrated a significant interaction (p=0.048) between patients with RPL (RR 1.21; 95% CI 1.03-1.42; p=0.023) and no RPL (RR 1.00; 95% CI 0.92-1.09; p=0.922).</p><p><strong>Conclusion: </strong>Levothyroxine reduced miscarriage in pregnant women with TPOAb and improved live birth rate when associated with RPL. Our subgroup analysis also provides evidence that levothyroxine may have a higher benefit for patients with a history of RPL.</p><p><strong>Prospero registry: </strong>CRD42023410433.</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":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673053","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":"Predictive factors for vaginal delivery in pregnant women with previous cesarean section: a case-control study.","authors":"Gabriela Sabbatine Reis, Lucas Casagrande Passoni Lopes, Eleksandra Cibele Gusman Vendramini, Ênio Luis Damaso, Vera Therezinha Medeiros Borges","doi":"10.61622/rbgo/2025rbgo93","DOIUrl":"10.61622/rbgo/2025rbgo93","url":null,"abstract":"<p><strong>Objective: </strong>To identify factors that predict the likelihood of a successful vaginal birth after cesarean section (VBAC).</p><p><strong>Methods: </strong>An observational, case-control study was conducted at Hospital das Clínicas, Botucatu Medical School, a tertiary referral center in Brazil. Medical records of women with singleton term pregnancies, one previous cesarean section, and a live fetus in cephalic presentation who delivered between January 2013 and December 2015 were reviewed. Participants were classified according to delivery mode: vaginal birth after cesarean section or repeat cesarean section. Maternal demographics, clinical and obstetric characteristics, and neonatal outcomes were analyzed. Associations were assessed using chi-square, and significant variables were entered into a multivariate logistic regression model.</p><p><strong>Results: </strong>A total of 653 women met the inclusion criteria. Of these, 324(49.6%) achieved a vaginal birth, and 329(50.4%) underwent a repeat cesarean section. Factors associated with a higher likelihood of vaginal birth included a history of prior vaginal delivery, cervical dilation of at least 4 cm at admission, a Bishop score of 6 or higher, spontaneous onset of labor, absence of chronic hypertension, and neonates classified as appropriate or small for gestational age. In contrast, advanced maternal age, unemployment, diabetes, and hypertensive disorders were associated with an increased likelihood of cesarean delivery.</p><p><strong>Conclusion: </strong>VBAC was more likely in women with cervical dilation of 4 cm or more at admission, a Bishop score of 6 or higher, a history of vaginal birth, spontaneous labor onset, absence of chronic hypertension, and lower neonatal birth weight.</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":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673170","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":"Trends in breast cancer mortality in Mexican women.","authors":"Beatriz Villegas-Lara, Oswaldo Sinoe Medina-Gómez","doi":"10.61622/rbgo/2025rbgo90","DOIUrl":"10.61622/rbgo/2025rbgo90","url":null,"abstract":"<p><strong>Objective: </strong>To estimate age-adjusted mortality rates at the national and state levels, evaluates trends and their spatial distribution during the period 2000-2023 among Mexican women.</p><p><strong>Methods: </strong>Ecological study conducted from open access data, the age-standardized mortality rate of breast cancer during the period 2000-2023 was calculated. Joinpoint regression models were estimated for breast cancer mortality in Mexico and its states. Spatial analysis was performed using Moran's I statistic.</p><p><strong>Results: </strong>The age-adjusted mortality rate at the national level during 2000 was 18.99 per 100,000 women, the highest mortality rate occurred in the year 2020. Joinpoint analysis shows a decrease in mortality in the last five years, being greater in urban areas. For 2023, the highest mortality occurred in Sonora and Chihuahua, while Mexico City (-0.71; 95%CI -0.98 to -0.44) was the entity that showed a significant reduction in the mortality rate from breast cancer. The spatial analysis showed a local indicator of spatial association of 0.458 (p<0.05) for 2000 and 0.524 (p<0.05) for 2023 in the northern states of the country.</p><p><strong>Conclusion: </strong>Public health interventions must be implemented according to the social, economic, and cultural context to reduce mortality from breast cancer.</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":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673133","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 combination of circulating levels of ANGPTL, omentin-1, leptin and cytokines is associated with polycystic ovary syndrome in different BMI groups.","authors":"Rumeysa Çınar, Özlem Kayacık Günday, Ahmet Kahraman, Mehmet Yılmazer","doi":"10.61622/rbgo/2025rbgo86","DOIUrl":"10.61622/rbgo/2025rbgo86","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the combined role of ANGPTL3, 4, 8, omentin-1, leptin, TNF-α, and IL-6 molecules known for their roles in fat metabolism, obesity, and inflammation, yet whose connection to PCOS is still debated in the development of PCOS.</p><p><strong>Methods: </strong>A prospective cross-sectional study involving PCOS patients (n=30) and BMI-matched controls (n=30) was conducted. Levels of ANGPTL3, 4, 8, omentin-1, leptin, TNF-α, and IL-6 were measured in peripheral venous blood samples.</p><p><strong>Results: </strong>When dividing both the PCOS and control groups into six BMI-based subgroups normal weight (20-24.9 kg/m²), slightly overweight (25-29.9 kg/m²), and obese (30-39.9 kg/m²) there were significant differences in levels of ANGPTL3 and 8, omentin-1, leptin, IL-6, and TNF-α (p<0.05). Comparison between the entire PCOS and control groups showed that CRP levels were significantly higher in the PCOS group (p<0.0001), while omentin-1 levels were significantly lower (p=0.022). Regression analysis, including ANGPTL3, 4, 8, IL-6, and TNF-α alongside CRP and omentin-1, indicated a significant model for PCOS (Nagelkerke R²=0.698, p<0.0001, PPV=80%, NPV=90%). In ROC analysis, the AUC for CRP and omentin-1 were significant (p<0.05; AUC=0.800-0.328).</p><p><strong>Conclusion: </strong>This study suggests a continuous interaction among ANGPTL, omentin-1, leptin, and cytokines in the etiopathogenesis of PCOS.</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":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673144","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":"Analysis of the influence of advanced maternal age on gestational and fetal outcomes.","authors":"Rômulo Felipe Auler, Ramon Henrique Auler, Ana Clara Machado Teixeira, Giovanna Jost Tibolla, Vinícius Pessoa Nunes Vieira, Junior Bolsonelo, Edimárlei Gonsales Valério, Edison Capp","doi":"10.61622/rbgo/2025rbgo91","DOIUrl":"10.61622/rbgo/2025rbgo91","url":null,"abstract":"<p><strong>Objective: </strong>Advanced maternal age has become more common due to factors such as increased academic preparation for women, labor market participation, delayed family planning, and advances in reproductive medicine. This phenomenon raises questions about the risks and gestational outcomes associated with advanced maternal age (AMA). This study aims to explore the gestational and perinatal outcomes in pregnant women with AMA (> 35 years), comparing them with those of women aged 20 to 34 years.</p><p><strong>Methods: </strong>The research was conducted as an observational and retrospective analysis, examining data from 2012 to 2022 from the Hospital Production System (SIH/SUS) available on the DATAsus platform, covering all regions of Brazil. Variables analyzed included gestational duration, type of pregnancy (single or multiple), mode of delivery, Robson group, APGAR score at five minutes, birth weight, and occurrence of congenital anomalies.</p><p><strong>Results: </strong>Pregnant women with AMA showed statistically significant differences in the higher percentage of cesarean sections (63.3% AMA vs 58% non-AMA, p<0.05), higher percentage of low birth weight newborns (12.5% AMA vs 6.7% non-AMA, p<0.05), lower APGAR scores at the fifth minute (OR = 1.08, p<0.001) and a higher prevalence of any congenital anomalies (1.23% AMA vs 0.77% non-AMA, OR =OR = 1.34, p < 0.001). In addition, this group had a higher incidence of premature births (12.99% AMA vs 8.78% non-AMA) and multiple pregnancies (1.39% AMA vs 0.83% non-AMA). Furthermore, in the Robson classification, there was a predominance of older mothers in Group 5 (previous cesarean section) and in the groups with nulliparity.</p><p><strong>Conclusion: </strong>Pregnant women with AMA face higher gestational and perinatal risks, such as preterm births and an increased need for cesarean sections. These findings underscore the importance of public policies and personalized management strategies to improve maternal and neonatal outcomes for older pregnant women.</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":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673177","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":"Immediate care for victims of sexual violence: Number 9 - 2025.","authors":"Rosires Pereira de Andrade, Fernanda Garanhani de Castro Surita, Aline Veras Morais Brilhante, Robinson Dias de Medeiros, Cristião Fernando Rosas, Helena Borges Martins da Silva Paro, Marla Niag Dos Santos Rocha, Olimpio Barbosa de Moraes, Sara de Pinho Cunha Paiva, Stenia Dos Santos Lins, Marcia Sacramento Cunha Machado, Rivaldo Mendes de Albuquerque, Jose Paulo de Siqueira Guida, Zelia Maria Campos, Marli Camara Abelha","doi":"10.61622/rbgo/2025FPS9","DOIUrl":"10.61622/rbgo/2025FPS9","url":null,"abstract":"<p><p>Prompt care for victims of sexual violence is essential in the implementation of measures to prevent pregnancy resulting from violence and sexually transmitted infections, and to assess and monitor serological follow-up and gather evidence for possible criminal proceedings. In the absence of a referral service, any health service should take the appropriate initial measures and refer the victim to the referral service (if there is one) as quickly as possible. Referral services for immediate care for victims of sexual violence allow victims to be followed up for a longer period of time. However, acute care should be provided by any health unit to avoid care delays. There is no need for any legal complaint or registration of a police report for providing healthcare to victims of sexual violence. However, victims should be informed about their right to report the assault at any time, so an appropriate legal and police investigation can be carried out. It is important to address this topic during medical care. All services providing care to victims of sexual violence must be open and receiving victims continuously, without the need for other health units or a police authority. Obstetrician/gynecologists are often the professionals responsible for caring for victims of sexual violence and must be familiar with the initial care protocols for these 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":1.4,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672980","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":"Use of oral neuromodulators in chronic pelvic painNumber 8 - 2025.","authors":"Omero Benedicto Poli, Julio Cesar Rosa E Silva, Carlos Alberto Petta, Carlos Augusto Pires Costa Lino, Eduardo Schor, Helizabet Salomão Abdalla Ayroza Ribeiro, João Nogueira, João Sabino Lahorgue da Cunha, Marcia Cristina França, Márcia Mendonça Carneiro, Marco Aurélio Pinho de Oliveira, Marcos Tcherniakovsky, Maurício Simões Abrão, Raquel Papandreus Dib, Ricardo de Almeida Quintairos, Sergio Podgaec, Sidney Pearce","doi":"10.61622/rbgo/2025FPS8","DOIUrl":"10.61622/rbgo/2025FPS8","url":null,"abstract":"<p><p>•Chronic pelvic pain is a common and complex condition that significantly affects women's quality of life. •Neuropathic pain and nociplastic pain are important components in the pain picture of these patients and should be considered in clinical treatment. •Oral neuromodulators, antidepressants and anticonvulsants for the control of neuropathic and nociplastic pain should be present in the therapeutic arsenal of the gynecologist who treats patients with chronic pelvic pain. •Pregabalin is the medication with the best pharmacokinetic profile; nortriptyline has the best adverse effects profile; duloxetine is the most widely used and has the lowest risks; and venlafaxine should be used as a second-line inhibitor. •Although the drug classes can be combined to reduce the total doses and minimize side effects, maximizing the analgesic effect, monotherapies are recommended as the first line to avoid polypharmacy.</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":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673102","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 use of hormonal contraceptives in high performance Brazilian female swimmers: a cross-sectional study.","authors":"Ana Carla Carvalho, Natani Gaio, Patrícia Cristiane Müller, Simone Carla Benincá","doi":"10.61622/rbgo/2025rbgo82","DOIUrl":"10.61622/rbgo/2025rbgo82","url":null,"abstract":"<p><strong>Objective: </strong>Women may experience cognitive, emotional, and physical changes during the menstrual cycle, which can impact their physical and athletic performance. This study aimed to investigate whether Brazilian female swimmers in the senior category, i.e., over 18 years of age, federated with the Brazilian Confederation of Aquatic Sports (CBDA), use hormonal contraceptives (HCs) and assess the impacts on their health, athletic performance, and overall well-being.</p><p><strong>Methods: </strong>This is a cross-sectional descriptive observational study conducted via an online questionnaire based on the Google Forms® platform, sent via WhatsApp® and email to the participants. Questions were asked about age, use of contraceptive methods, observed changes in performance, among others. A total of 136 senior athletes participated in the study. Inclusion criteria were senior female athletes using hormonal contraceptive methods. Athletes who were not in the senior category and/or did not use hormonal contraceptive methods were excluded from the research.</p><p><strong>Results: </strong>A total of 136 senior athletes responded to the questionnaire. Of this total, 108 reported using hormonal contraceptive methods and were therefore included in the study. The results indicate that the majority of participants use oral contraceptives, with 61 (57%) using this method. Regarding the reason for using hormonal contraceptives, 88 (82.4%) use the method to control the menstrual cycle, in addition to alleviating menstrual symptoms, 63 (59.2%); 62 (57.9%) reported improvement in mood patterns, and 69 (64.55%) stated that they experience benefits from using the method.</p><p><strong>Conclusion: </strong>It is concluded that the use of hormonal contraceptives presents benefits related to the professional careers of athletes. Besides improving their training performance, HCs also help alleviate menstrual symptoms and control the menstrual cycle and flow.</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":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12711235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783921","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":"Endometrial estrogen and progesterone receptor activity in unusual chronology of pubertal development: a case report.","authors":"Michelly Siqueira-Souza, Carolina Chicharo Vivas, Jéssica Couto Dos Anjos, Gabrielle Barbosa Anelli Morau, Júlia Kefalás Troncon, Lucianna Fonseca Barreto, Carolina Gennari Verruma, Rosana Maria Dos Reis","doi":"10.61622/rbgo/2025rbgo63","DOIUrl":"10.61622/rbgo/2025rbgo63","url":null,"abstract":"<p><p>An 8-year-old girl presented with vaginal bleeding without puberty signs. During investigation at 10 years old, the patient presented with advanced bone age, prepubertal hormone levels and internal genitalia. Hysteroscopy and vaginoscopy at 10 years and 10 months of age revealed endometrial proliferation despite infantile genitalia. Histopathology showed positive receptors for estrogen and progesterone. This is the first report of endometrial estrogen and progesterone receptor activity in this context. Despite normal serum estradiol, the findings suggest a local action of estrogen. Follow-up until 11 years of age showed progressive development of secondary sexual characteristics. This case report emphasizes the need to consider isolated vaginal bleeding, without the development of secondary sexual characteristics, as a result of endometrial hypersensitivity to low estrogen levels during pubertal development, which may alter the chronology of pubertal development in girls.</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":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672913","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":"20 years experience of RhD alloimmunization at a state referral center in Rio de Janeiro: a study of 481 cases.","authors":"Fernando Maia Peixoto, Ana Heloisa Nascimento Beserra, Maria Cristina Pessoa Dos Santos","doi":"10.61622/rbgo/2025rbgo66","DOIUrl":"10.61622/rbgo/2025rbgo66","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to analyze the profile of fetuses, newborns and pregnant women with alloimmunization (anti-RhD) referred to and treated over the twenty years since the launch of the Rio de Janeiro State.</p><p><strong>Methods: </strong>An observational, retrospective, descriptive study was conducted, with data obtained by analyzing the medical records of 481 mothers and their newborns. The study cohort consisted of pregnancies affected by RhD alloimmunization who delivered between March 2004 and March 2024 in Rio de Janeiro.</p><p><strong>Results: </strong>The absolute number of cases declined over the study period. Only 5.2% of the cohort began prenatal care in the first trimester of pregnancy and more than half (51.6%) of women arrived at the referral center in the third trimester. 40% of the women had prior severe HDFN. During this period, 422 intrauterine transfusions were performed on 71 fetuses, an average of 5.9 transfusions per patient. Infant mortality; was low, with 4% stillborn or evolving to neonatal mortality.</p><p><strong>Conclusion: </strong>The trend observed over the last 20 years is a reduction in the absolute number of HDFN cases which is perhaps more related to reproductive issues, particularly the sharp reduction in parity in our state, rather than to the implementation of alloimmunization prophylaxis.</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":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145673168","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}