97 resultados para Obstetrics


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Objectives: To evaluate if the prevalence of cervical smear results varies between pregnant and nonpregnant women stratified by age group.Study design: Observational analytical study with a total sample of 1,336,180 pregnant and nonpregnant women, aged between 20 and 34 years, who underwent cervical cancer screening in the Primary Health Care of the national health system in the area of Campinas in Brazil during the period of 2005-2009. The source is the information system for cervical cancer screening. Data collected on abnormal cervical smears were analyzed using the Chi-square test and Fisher's exact test and the magnitude of the association between pregnancy and high-grade squamous epithelial lesions was analyzed by odds ratio (OR) and estimated values with confidence intervals (CI) of 95%.Results: 15,190 pregnant women and 395,961 non-pregnant women were analyzed and fulfilled the inclusion criteria. Regardless of age, no statistical differences were observed for high-grade squamous intraepithelial lesion prevalence (OR 0.90; CI 0.66-1.23). Taking into account the five-year age groups, however, low-grade squamous intraepithelial lesion was less prevalent in pregnant women aged 20-24 (OR 0.71; 0.54-0.95) and 25-29 years (OR 0.56; 0.35-0.89); also, atypical squamous cells of undetermined significance was more prevalent in non-pregnant women aged 25-29 years (OR 0.72; 0.54-0.97).Conclusion: The study showed that the cytological prevalence of high-grade squamous intraepithelial lesion was similar in pregnant and non-pregnant women, regardless of age. The results indicate that there are no reasons for specific approaches to cervical cancer screening for pregnant women. The examination should be carried out only on pregnant women who have not been tested according to current recommendations. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

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Conselho Nacional de Desenvolvimento Cientfico e Tecnolgico (CNPq)

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Fundao de Amparo Pesquisa do Estado de So Paulo (FAPESP)

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Concern about the identity of nursing professionals has existed since Florence Nightingale. The exercise of the nursing profession must be based on scientific principles so that the actual health problems of a given community can be assessed and actions targeted at improving the populations quality of life can be designed from such assessments. This problem assessment is referred to as Nursing Diagnosis. NANDA defines diagnosis as a clinical judgment about individual, family or community responses to actual or potential health problems/life processes. Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which nurses are accountable. The present study aimed at investigating the scientific production on Nursing Diagnosis (NANDA). This is an literature review. For data collection, an instrument that addressed the following items was used: identification of original articles and evaluation of their objectives, methodological characteristics, results and conclusion. In the present review, 15 articles that met the inclusion criteria were analyzed. They were all authored by nurses. Four articles addressed obstetrics, puerperium and neonatology, and the diagnosis of an unsatisfactory breastfeeding process was observed in 100% of cases. As regards chronic diseases, four articles were found, and two exclusively addressed diabetes, with a main diagnosis of an ineffective control of the therapeutic regimen. Three articles addressed the elderly, and the main diagnosis found was hindered mobility in more than 90% of cases. As regards, sexually transmitted diseases, one article was found with three diagnoses with 100% for disturbed sleep patterns, infection risk and ineffective protection. As to patients with sequelae, two articles were identified, and the diagnoses found were hindered physical mobility, with 100%; self-care deficit for... (Complete abstract click electronic access below)

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The Doppler ultrasound allows the assessment of blood flow and the differentiate vessels according to each spectral pattern, location and organ that irrigate, helping the examinations and disease diagnosis. The main methods used are Pulsed Doppler, Color Doppler and Power Doppler. In Brazil veterinary medicine, it shows progress since 1990, but its use is limited by the equipment high cost, the need for operator experience and patient cooperation. There are studies in obstetrics and reproduction of dogs and cats, such as evaluation of the testicular vasculature, including the use of contrast material, and attempts to evaluate prostate in healthy dogs or pathological conditions (cancer and testicular torsion , orchitis and benign prostatic hyperplasia; estrous cycle monitoring, evaluation of irrigation in follicles and corpus luteum, uterus and breasts (mammary tumors) in bitches; monitoring pregnancy from the assessment of maternal, fetal and placental hemodynamics, both in dogs as in cats, and aspirations for early detection of pregnancy in dogs. However, new studies are still required, given the lack of these species, especially cats

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Introduction: Preterm Labor (PTL) and Preterm Premature Rupture of Membranes (PPROM) cause severe complications for both mother and fetus. Among the risk factors associated with preterm labor and PPROM, genetic predisposition has been gaining importance. However, the association between polymorphic genes and the pathogenesis of PTL and PPROM remains elusive. A better understanding of the genetic mechanisms underlying these adverse pregnancy outcomes may enable the identification of high risk patients and allow new approaches to minimize the deleterious effects of prematurity. Aim: To determine the association between maternal IL-6 polymorphism gene and the occurrence of PTL and PPROM. Patients and Methods: The study included 109 patients with prior history of PL and/or PPROM that delivered prematurely at the Obstetrical Unit Care of Botucatu Medical School, UNESP between 2003 and 2012. The control group consisted of 68 patients that delivered at term, matched to the case group by age, ethnicity, and sex of the newborn. Oral swabs (Cath-AllTM Epicentre Biotechnologies) were collected for analysis of genetic polymorphisms by PCR. Statistical tests were performed to compare genotype, clinical and socio-demographic data from the groups. A p-value of <0.05 was considered significant. Results: The sociodemographic characteristics in both groups were homogeneously distributed. The frequency of the polymorphic allele C, associated with less production of IL-6, and therefore thought to be protective against PTL and PPROM, was 32,5% in the study group and 30,9% in the control group, without statistically significant differences. Conclusion: Considering the sample size included in this study, the frequency of the mutated allele is similar in pregnant women who delivered at term and gestational complications as PTL and PPROM

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Ps-graduao em Medicina Veterinria - FCAV

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Ps-graduao em Ginecologia, Obstetrcia e Mastologia - FMB

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Ps-graduao em Ginecologia, Obstetrcia e Mastologia - FMB

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Objective Despite rising global obesity rates, the impact of obesity on gestational trophoblastic neoplasia (GTN) remains uninvestigated. This study aimed at investigating whether overweight/obesity relates to response to chemotherapy in low-risk GTN patients.Methods This nonconcurrent cohort study included 300 patients with International Federation of Gynecology and Obstetrics-defined postmolar low-risk GTN treated with a single-agent chemotherapymethotrexate or actinomycin-D (actD)between 1973 and 2012 at the New England Trophoblastic Disease Center. Chemotherapy dosing was based on actual body weight regardless of obesity status, except for 5-day courses or pulse regimens of actD. Patients were classified as overweight/obese (body mass index [BMI] 25 kg/m(2)) or non-overweight/obese (BMI &lt;25 kg/m(2)). Information on patient characteristics and response to chemotherapy (need for second-line chemotherapy, reason for changing to an alternative chemotherapy, number of cycles, need for combination chemotherapy, and time to human chorionic gonadotropin remission) was obtained.Results Of 300 low-risk GTN patients, 81 (27%) were overweight/obese. Overweight/obese patients were older than the non-overweight/obese patients (median age: 30 vs 28 years, P = 0.004). First-line therapy using actD was more frequent in overweight/obese patients (6.2% vs 1.4%, P = 0.036). Resistance and toxicity were similar between groups. No significant difference in the number of chemotherapy cycles needed for remission or time required to achieve remission was found between groups.Conclusions No association between overweight/obesity and low-risk GTN outcomes was found. Current chemotherapy dosing using BMI seems to be appropriate for overweight/obese patients with low-risk GTN.

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Objective: To compare cervical cytology test results among pregnant and non-pregnant women, and to assess associations with age, screening history, and onset of sexual intercourse. Methods: A retrospective analysis was conducted of cervical smears obtained from women aged 18-34 years in the Campinas region of Brazil between January 2000 and December 2009. Eligible participants had not undergone cytological screening within the previous year and had no history of precursor lesions or cervical cancer. Multinomial logistic regression was performed for different age groups, with high-grade squamous intraepithelial lesions (HSILs) as the endpoint. Results: Overall, 3072 (0.4%) of 861 353 non-pregnant women and 135 (0.4%) of 37 568 pregnant women had HSILs. Odds of HSIL among pregnant and non-pregnant women did not differ in any age group. An increased age at first sexual intercourse among pregnant women reduced odds of HSILs in all age groups (odds ratio 0.9 [95% confidence interval 0.8-0.9] for all). Among women aged 21-24 years, 25-29 years, and 30-34 years, some associations were identified between an interval of less than 5 years since previous screening and reduced odds of HSILs. Conclusion: Mandatory cervical cytology screening does not seem to be necessary for pregnant women; protocols in place for non-pregnant women should be followed. (C) 2015 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.

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Fundao de Amparo Pesquisa do Estado de So Paulo (FAPESP)