Lucia Correia - Academia.edu (original) (raw)

Papers by Lucia Correia

Research paper thumbnail of Adolescent sexual and reproductive health - our reality Saúde sexual e reprodutiva das adolescentes - a nossa realidade

O s adolescentes são reconhecidos como um grupo vulnerável na área da saúde sexual e reprodutiva,... more O s adolescentes são reconhecidos como um grupo vulnerável na área da saúde sexual e reprodutiva, essencialmente pelos riscos de gravidez precoce e indesejada e das infeções de transmissão sexual. Esta vulnerabilidade está relacionada, entre outras causas, com a baixa perceção do risco e com os padrões de atividade sexualmonogamia seriada e multiplicidade de parceiros. Em Portugal a legislação contempla alguns aspetos fundamentais no que diz respeito à saúde sexual e re-produtiva do adolescente: garante o acesso a consultas de planeamento familiar a todos os que a procurem e a disponibilização de alguns métodos contracetivos gratuitos. Desde 1989 que a nossa instituição recebe e acompanha jovens com gravidez precoce. Ao sentir necessidade de alargar este atendimento, criou um projeto em parceria com a Fundação Calouste Gulbenkian: «Mais Vale Prevenir». O projeto, com a duração de três anos (2004-2007), que incluía diferentes profissionais de saúde-médicos, enfermeiros, nutricionistas, assistentes sociais e psicólogos-destinava-se à promoção de comportamentos saudáveis e prevenção da gravidez não desejada na adolescência e sua reincidência. Quando terminou, manteve-se a abordagem bio-psico-social e o mesmo modelo de intervenção na atual Consulta de Saúde Sexual e Reprodutiva integrada na Unidade de

Research paper thumbnail of Levonorgestrel intrauterine device effectiveness in heavy menstrual bleeding treatment in obese women Efetividade do dispositivo intra-uterino de levonorgestrel no tratamento de hemorragia uterina anómala em mulheres obesas

Objective: We aimed to identify if there was any difference in Levonorgestrel-releasing intrauter... more Objective: We aimed to identify if there was any difference in Levonorgestrel-releasing intrauterine system (LNG-IUS) efficacy or weight gain when used in heavy menstrual bleeding (HMB) treatment, between obese and non-obese women. Population and methods: This was a case-controlled retrospective study undertaken between 2002-2007. 194 women with HMB were treated with LNG-IUS and stratified into two groups accordingly with body mass index (BMI): Obese Group-BMI ≥ 30 (n=53) and Non-obese Group-BMI < 30 (n=141). Age, weight, days of spotting and days of menses were analyzed at 1, 3 and 6 months after insertion and then annually until 2 years. Analytic parameters of anemia (hemoglobin, serum ferritin, mean corpuscular volume) were reviewed at pre-insertion, at 6 months and then annually until 2 years. Results: During the 2-year follow-up there was a similar improvement in two groups regarding duration of menses, spotting and in analytic parameters of anemia. A statistically significant improvement was observed in obese group after 2 years of treatment regarding analytic parameters of anemia and menstrual characteristics, without weight gain. Conclusion: In obese women, the LNG-IUS is an effective treatment for heavy menstrual bleeding, without being associated to weight gain.

Research paper thumbnail of Gestational diabetes mellitus complicating twin pregnancies

Journal of Perinatal Medicine, 2011

Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus... more Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus (GDM). Study design: We compared 105 twin pregnancies with GDM (7.8% of all twin pregnancies) to 315 controls without GDM, matched for gestational age, chorionicity and year of birth. Results: Pre-gravid obesity appears to predispose women to GDM during twin pregnancy wodds ratio (OR) 3.5; 95% confidence interval (CI) 1.7, 7.0x. Overweight and obese women that subsequently developed GDM during their twin gestation were less likely to conceive spontaneously (OR 0.4; 95% CI 0.3, 0.7). Twins from the GDM group had more respiratory distress syndrome (RDS, OR 2.2; 95% CI 1.3, 3.7) and had a threefold , but not significantly increased perinatal mortality rate. Birth weight characteristics were similar in both groups. Conclusion: Twin pregnancies complicated by GDM might be associated with pre-pregnancy maternal obesity and are at increased risk of RDS and non-significant increased risk of perinatal death.

Research paper thumbnail of Primary vaginal cancer associated with HPV 68: A case report of an unusual presentation

International journal of gynaecology and obstetrics, Sep 14, 2020

Research paper thumbnail of M135 Effect of Antepartum Counseling on Postpartum Contraceptive Choices

International journal of gynaecology and obstetrics, Oct 1, 2012

Research paper thumbnail of ASC-H cytological result: clinical relevance and accuracy of colposcopy in predicting high-grade histological lesions—a 7-year experience of a single institution in Portugal

Journal of the American Society of Cytopathology, Nov 1, 2017

Introduction: ASC-H represents an interpretative challenge in clinical practice. We aimed to eval... more Introduction: ASC-H represents an interpretative challenge in clinical practice. We aimed to evaluate the histological outcome of ASC-H cytology and to evaluate the accuracy of colposcopy in predicting high-grade histological lesions. Material and Methods: Retrospective study of ASC-H cervical cytology result, from January 2010 to December 2016, at a tertiary hospital. Demographic characteristics, colposcopic findings, diagnostic procedures and histological outcomes were analysed using SPSS, version 22.0. Results: ASC-H prevalence was 0.25%. Patients mean age was 42.02 ± 12.8 years old. The overall incidence of cervical dysplasia of any grade was 83.6% (n=56) and the incidence of high-grade lesions was 50.8% (n=34) (including 1 case of in situ adenocarcinoma and 2 cases of squamous cell carcinoma). Among patients with type 1 or 2 transformation zone (TZ), 84.9% (n=45) had abnormal colposcopic findings, with 62.2% (n=28) corresponding to grade 2 and 37.8% (n=17) to grade 1. Colpo-histological concordance was of 85.4% (82.1% for grade 2 lesions and 100% for grade 1 lesions). The sensibility, specificity, positive predicted value (PPV) and negative predictive value (NPV) was 100%, 75%, 82.1% and 100%, respectively. The histological study of patients with type 3 TZ revealed 45.8% (n=11) of high-grade lesions. Conclusions: ASC-H is strongly associated with high-grade histological lesions. Therefore immediate evaluation of patients with this cytology abnormality is mandatory. Colposcopy, when performed by expertise clinicians, has great accuracy on detecting high-grade lesions. Histological evaluation of

Research paper thumbnail of Retroperitoneal recurrence of an ovarian juvenile granulosa cell tumor: A diagnostic challenge

International Journal of Gynecology & Obstetrics

SynopsisRetroperitoneal recurrence after excision of a juvenile granulosa cell tumor is rare and ... more SynopsisRetroperitoneal recurrence after excision of a juvenile granulosa cell tumor is rare and constitutes a diagnostic challenge, presenting with nonspecific symptoms and mimicking other conditions.

Research paper thumbnail of Non palpable Implanon rod - strategies for their localization and removal Implante contracetivo não palpável - estratégias para a sua localização e remoção

Overview and Aims: The contraceptive implant is frequently used to provide contraceptive protecti... more Overview and Aims: The contraceptive implant is frequently used to provide contraceptive protection over three years. The implant is inserted into the subcutaneous tissue of the upper arm, and should be palpable and easily removed. We evalua - ted the best imaging strategy for non-palpable implant (Implanon®) localization and removal. Study Design: Retrospective study. Population: A total of 11 women referred to a tertiary care hospital, between October 2009 and January 2012, for locali - zation and removal of their non-palpable implants. Methods: Different localization methods (ultrasound and magnetic resonance imaging) were evaluated for non-palpable rod. Results: Seven of the nonpalpable implants were inserted in a health care center, three in a district hospital and one in a private clinic. In three women, the reasons for requesting removal were the end of the implant validity, two wanted to be - come pregnant, two had weight gain, one had weight loss, one referred irregular ble...

Research paper thumbnail of Correia L, Simões T. A serious complication of uterine artery embolization. Acta Obstet Ginecol Port 2013; 7(2): 146-50

Research paper thumbnail of Saúde sexual e reprodutiva das adolescentes – a nossa realidade. Acta Obstet Ginecol Port 2013; 7(3):161-6

Research paper thumbnail of Resultado Obstétrico das gravidezes gemelares resultantes de Fecundação in Vitro (FIV), Microinjeção (ICSI) e Indução da Ovulação em comparação com as espontâneas. Acta Obstet Ginecol Port 2012; 6: 46-50

Research paper thumbnail of Adnexal Torsion. Acta Obstet Ginecol Port 2015; 9(1): 45-55

Research paper thumbnail of Endometriose com ascite hemorrágica: dois casos clínicos

Research paper thumbnail of Contraceptive choices pre and post pregnancy in adolescence

Journal of pediatric and adolescent gynecology, 2015

The main aim of this study is to evaluate the impact of adolescent pregnancy in the future contra... more The main aim of this study is to evaluate the impact of adolescent pregnancy in the future contraceptive choices. A secondary aim is to verify whether these choices differ from those made after an abortion. Retrospective study. Adolescent Unit of a tertiary care center. 212 pregnant teenagers. Medical records review. Intended pregnancy rate and contraceptive methods used before and after pregnancy. For contraceptive choices after pregnancy we considered: Group 1--teenagers who continued their pregnancy to delivery (n = 106) and Group 2--the same number of adolescents who chose to terminate their pregnancy. The intended pregnancy rate was 14.2%. Prior to a pregnancy continued to delivery, the most widely used contraceptive method was the male condom (50.9%), followed by oral combined contraceptives (28.3%); 18.9% of adolescents were not using any contraceptive method. After pregnancy, contraceptive implant was chosen by 70.8% of subjects (P < .001) and the oral combined contracept...

Research paper thumbnail of Gestational diabetes mellitus complicating twin pregnancies

Journal of Perinatal Medicine, 2011

Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus... more Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus (GDM). Study design: We compared 105 twin pregnancies with GDM (7.8% of all twin pregnancies) to 315 controls without GDM, matched for gestational age, chorionicity and year of birth. Results: Pre-gravid obesity appears to predispose women to GDM during twin pregnancy wodds ratio (OR) 3.5; 95% confidence interval (CI) 1.7, 7.0x. Overweight and obese women that subsequently developed GDM during their twin gestation were less likely to conceive spontaneously (OR 0.4; 95% CI 0.3, 0.7). Twins from the GDM group had more respiratory distress syndrome (RDS, OR 2.2; 95% CI 1.3, 3.7) and had a threefold , but not significantly increased perinatal mortality rate. Birth weight characteristics were similar in both groups. Conclusion: Twin pregnancies complicated by GDM might be associated with pre-pregnancy maternal obesity and are at increased risk of RDS and non-significant increased risk of perinatal death.

Research paper thumbnail of Lipschütz Genital Ulceration as Initial Manifestation of Primary Sjögren's Syndrome

Case reports in obstetrics and gynecology, 2018

Genital ulcers are challenging to any clinician and causes transcend many specialties. Skin ulcer... more Genital ulcers are challenging to any clinician and causes transcend many specialties. Skin ulceration in patients with primary Sjögren's syndrome is infrequent but an established feature of cutaneous involvement. Although gynecological symptoms, such as vulvovaginal dryness, dyspareunia, and pruritus, are common in women with primary Sjögren's syndrome, patients affected by vulvar ulcers are unknown. We describe an exceptional case of necrotic aphthous-type vulvar ulceration as initial presentation of primary Sjögren's syndrome that was possibly triggered by an infectious agent. Successful healing was achieved with oral corticosteroids, despite some loss of labia and labia as sequelae of the necrotizing process. Reactive acute genital ulcers (Lipschütz ulcers) should be considered as a possible manifestation of many autoimmune/inflammatory disorders, beyond the classic associations such as Behçet's syndrome or Crohn's disease.

Research paper thumbnail of Esterilização feminina: estudo comparativo entre esterilização histeroscópica e laparoscópica Female sterilization: comparative study of hysteroscopic versus laparoscopic sterilization

Overview and Aims: Female sterilization is increasingly requested as a contraceptive method. Hyst... more Overview and Aims: Female sterilization is increasingly requested as a contraceptive method. Hysteroscopic sterilization by transcervical placing of Essure® micro-inserts in the initial portion of the tubes is a recent alternative to laparoscopic sterilization. The objective of this study is to evaluate the safety and effectiveness of hysteroscopic versus laparoscopic sterilization. Study Design: Retrospective cohort study. Population: A total of 98 women undergoing sterilization in an outpatient clinic between July 2005 and July 2009. Methods: Patients’ age, associated diseases, anesthesic risk, procedure time, discomfort, adverse events and success rate were evaluated. Results: Mean age at surgery was 37.8 years (19-49), and there were no statistically significant differences between the groups regarding this parameter. Women in the hysteroscopic group had a significant number of associated diseases (98% versus 47%), obesity (31% versus 6%), and anes thesic risk (ASA III- 31% vers...

Research paper thumbnail of Gravidez ectópica intersticial - O estado da arte

Research paper thumbnail of Glassy Cell Carcinoma of the Cervix and Metastasis in Episiotomy Scar: A Case Report

Journal of lower genital tract disease, Jan 24, 2014

The authors describe the 20th known case of cervical cancer with metastasis in an episiotomy scar... more The authors describe the 20th known case of cervical cancer with metastasis in an episiotomy scar, being the first case describing an implant of malignant cells in the episiotomy scar associated with glassy cell carcinoma. One case report. We describe the case of a 34-year-old woman, with cervical cancer diagnosed 1 month after delivery. Four months later, a radical hysterectomy was performed. During surgery, a nodule at the site of the episiotomy scar was identified and removed. The histologic diagnosis revealed a glassy cell carcinoma of the cervix, with metastasis in the episiotomy scar. After surgery, chemotherapy and radiotherapy were performed. The disease progressed rapidly, and the patient died 9 months after surgery. The implantation of neoplastic cells in the perineum is a potential risk of vaginal delivery, with a 40% mortality rate. It thus seems advisable to avoid vaginal delivery as much as possible when cervical cancer is diagnosed during pregnancy. Given the rarity, ...

Research paper thumbnail of Cervical Cancer in Pregnancy

Journal of Lower Genital Tract Disease, 2013

ABSTRACT

Research paper thumbnail of Adolescent sexual and reproductive health - our reality Saúde sexual e reprodutiva das adolescentes - a nossa realidade

O s adolescentes são reconhecidos como um grupo vulnerável na área da saúde sexual e reprodutiva,... more O s adolescentes são reconhecidos como um grupo vulnerável na área da saúde sexual e reprodutiva, essencialmente pelos riscos de gravidez precoce e indesejada e das infeções de transmissão sexual. Esta vulnerabilidade está relacionada, entre outras causas, com a baixa perceção do risco e com os padrões de atividade sexualmonogamia seriada e multiplicidade de parceiros. Em Portugal a legislação contempla alguns aspetos fundamentais no que diz respeito à saúde sexual e re-produtiva do adolescente: garante o acesso a consultas de planeamento familiar a todos os que a procurem e a disponibilização de alguns métodos contracetivos gratuitos. Desde 1989 que a nossa instituição recebe e acompanha jovens com gravidez precoce. Ao sentir necessidade de alargar este atendimento, criou um projeto em parceria com a Fundação Calouste Gulbenkian: «Mais Vale Prevenir». O projeto, com a duração de três anos (2004-2007), que incluía diferentes profissionais de saúde-médicos, enfermeiros, nutricionistas, assistentes sociais e psicólogos-destinava-se à promoção de comportamentos saudáveis e prevenção da gravidez não desejada na adolescência e sua reincidência. Quando terminou, manteve-se a abordagem bio-psico-social e o mesmo modelo de intervenção na atual Consulta de Saúde Sexual e Reprodutiva integrada na Unidade de

Research paper thumbnail of Levonorgestrel intrauterine device effectiveness in heavy menstrual bleeding treatment in obese women Efetividade do dispositivo intra-uterino de levonorgestrel no tratamento de hemorragia uterina anómala em mulheres obesas

Objective: We aimed to identify if there was any difference in Levonorgestrel-releasing intrauter... more Objective: We aimed to identify if there was any difference in Levonorgestrel-releasing intrauterine system (LNG-IUS) efficacy or weight gain when used in heavy menstrual bleeding (HMB) treatment, between obese and non-obese women. Population and methods: This was a case-controlled retrospective study undertaken between 2002-2007. 194 women with HMB were treated with LNG-IUS and stratified into two groups accordingly with body mass index (BMI): Obese Group-BMI ≥ 30 (n=53) and Non-obese Group-BMI < 30 (n=141). Age, weight, days of spotting and days of menses were analyzed at 1, 3 and 6 months after insertion and then annually until 2 years. Analytic parameters of anemia (hemoglobin, serum ferritin, mean corpuscular volume) were reviewed at pre-insertion, at 6 months and then annually until 2 years. Results: During the 2-year follow-up there was a similar improvement in two groups regarding duration of menses, spotting and in analytic parameters of anemia. A statistically significant improvement was observed in obese group after 2 years of treatment regarding analytic parameters of anemia and menstrual characteristics, without weight gain. Conclusion: In obese women, the LNG-IUS is an effective treatment for heavy menstrual bleeding, without being associated to weight gain.

Research paper thumbnail of Gestational diabetes mellitus complicating twin pregnancies

Journal of Perinatal Medicine, 2011

Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus... more Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus (GDM). Study design: We compared 105 twin pregnancies with GDM (7.8% of all twin pregnancies) to 315 controls without GDM, matched for gestational age, chorionicity and year of birth. Results: Pre-gravid obesity appears to predispose women to GDM during twin pregnancy wodds ratio (OR) 3.5; 95% confidence interval (CI) 1.7, 7.0x. Overweight and obese women that subsequently developed GDM during their twin gestation were less likely to conceive spontaneously (OR 0.4; 95% CI 0.3, 0.7). Twins from the GDM group had more respiratory distress syndrome (RDS, OR 2.2; 95% CI 1.3, 3.7) and had a threefold , but not significantly increased perinatal mortality rate. Birth weight characteristics were similar in both groups. Conclusion: Twin pregnancies complicated by GDM might be associated with pre-pregnancy maternal obesity and are at increased risk of RDS and non-significant increased risk of perinatal death.

Research paper thumbnail of Primary vaginal cancer associated with HPV 68: A case report of an unusual presentation

International journal of gynaecology and obstetrics, Sep 14, 2020

Research paper thumbnail of M135 Effect of Antepartum Counseling on Postpartum Contraceptive Choices

International journal of gynaecology and obstetrics, Oct 1, 2012

Research paper thumbnail of ASC-H cytological result: clinical relevance and accuracy of colposcopy in predicting high-grade histological lesions—a 7-year experience of a single institution in Portugal

Journal of the American Society of Cytopathology, Nov 1, 2017

Introduction: ASC-H represents an interpretative challenge in clinical practice. We aimed to eval... more Introduction: ASC-H represents an interpretative challenge in clinical practice. We aimed to evaluate the histological outcome of ASC-H cytology and to evaluate the accuracy of colposcopy in predicting high-grade histological lesions. Material and Methods: Retrospective study of ASC-H cervical cytology result, from January 2010 to December 2016, at a tertiary hospital. Demographic characteristics, colposcopic findings, diagnostic procedures and histological outcomes were analysed using SPSS, version 22.0. Results: ASC-H prevalence was 0.25%. Patients mean age was 42.02 ± 12.8 years old. The overall incidence of cervical dysplasia of any grade was 83.6% (n=56) and the incidence of high-grade lesions was 50.8% (n=34) (including 1 case of in situ adenocarcinoma and 2 cases of squamous cell carcinoma). Among patients with type 1 or 2 transformation zone (TZ), 84.9% (n=45) had abnormal colposcopic findings, with 62.2% (n=28) corresponding to grade 2 and 37.8% (n=17) to grade 1. Colpo-histological concordance was of 85.4% (82.1% for grade 2 lesions and 100% for grade 1 lesions). The sensibility, specificity, positive predicted value (PPV) and negative predictive value (NPV) was 100%, 75%, 82.1% and 100%, respectively. The histological study of patients with type 3 TZ revealed 45.8% (n=11) of high-grade lesions. Conclusions: ASC-H is strongly associated with high-grade histological lesions. Therefore immediate evaluation of patients with this cytology abnormality is mandatory. Colposcopy, when performed by expertise clinicians, has great accuracy on detecting high-grade lesions. Histological evaluation of

Research paper thumbnail of Retroperitoneal recurrence of an ovarian juvenile granulosa cell tumor: A diagnostic challenge

International Journal of Gynecology & Obstetrics

SynopsisRetroperitoneal recurrence after excision of a juvenile granulosa cell tumor is rare and ... more SynopsisRetroperitoneal recurrence after excision of a juvenile granulosa cell tumor is rare and constitutes a diagnostic challenge, presenting with nonspecific symptoms and mimicking other conditions.

Research paper thumbnail of Non palpable Implanon rod - strategies for their localization and removal Implante contracetivo não palpável - estratégias para a sua localização e remoção

Overview and Aims: The contraceptive implant is frequently used to provide contraceptive protecti... more Overview and Aims: The contraceptive implant is frequently used to provide contraceptive protection over three years. The implant is inserted into the subcutaneous tissue of the upper arm, and should be palpable and easily removed. We evalua - ted the best imaging strategy for non-palpable implant (Implanon®) localization and removal. Study Design: Retrospective study. Population: A total of 11 women referred to a tertiary care hospital, between October 2009 and January 2012, for locali - zation and removal of their non-palpable implants. Methods: Different localization methods (ultrasound and magnetic resonance imaging) were evaluated for non-palpable rod. Results: Seven of the nonpalpable implants were inserted in a health care center, three in a district hospital and one in a private clinic. In three women, the reasons for requesting removal were the end of the implant validity, two wanted to be - come pregnant, two had weight gain, one had weight loss, one referred irregular ble...

Research paper thumbnail of Correia L, Simões T. A serious complication of uterine artery embolization. Acta Obstet Ginecol Port 2013; 7(2): 146-50

Research paper thumbnail of Saúde sexual e reprodutiva das adolescentes – a nossa realidade. Acta Obstet Ginecol Port 2013; 7(3):161-6

Research paper thumbnail of Resultado Obstétrico das gravidezes gemelares resultantes de Fecundação in Vitro (FIV), Microinjeção (ICSI) e Indução da Ovulação em comparação com as espontâneas. Acta Obstet Ginecol Port 2012; 6: 46-50

Research paper thumbnail of Adnexal Torsion. Acta Obstet Ginecol Port 2015; 9(1): 45-55

Research paper thumbnail of Endometriose com ascite hemorrágica: dois casos clínicos

Research paper thumbnail of Contraceptive choices pre and post pregnancy in adolescence

Journal of pediatric and adolescent gynecology, 2015

The main aim of this study is to evaluate the impact of adolescent pregnancy in the future contra... more The main aim of this study is to evaluate the impact of adolescent pregnancy in the future contraceptive choices. A secondary aim is to verify whether these choices differ from those made after an abortion. Retrospective study. Adolescent Unit of a tertiary care center. 212 pregnant teenagers. Medical records review. Intended pregnancy rate and contraceptive methods used before and after pregnancy. For contraceptive choices after pregnancy we considered: Group 1--teenagers who continued their pregnancy to delivery (n = 106) and Group 2--the same number of adolescents who chose to terminate their pregnancy. The intended pregnancy rate was 14.2%. Prior to a pregnancy continued to delivery, the most widely used contraceptive method was the male condom (50.9%), followed by oral combined contraceptives (28.3%); 18.9% of adolescents were not using any contraceptive method. After pregnancy, contraceptive implant was chosen by 70.8% of subjects (P < .001) and the oral combined contracept...

Research paper thumbnail of Gestational diabetes mellitus complicating twin pregnancies

Journal of Perinatal Medicine, 2011

Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus... more Objective: To compare outcomes of twin pregnancies with and without gestational diabetes mellitus (GDM). Study design: We compared 105 twin pregnancies with GDM (7.8% of all twin pregnancies) to 315 controls without GDM, matched for gestational age, chorionicity and year of birth. Results: Pre-gravid obesity appears to predispose women to GDM during twin pregnancy wodds ratio (OR) 3.5; 95% confidence interval (CI) 1.7, 7.0x. Overweight and obese women that subsequently developed GDM during their twin gestation were less likely to conceive spontaneously (OR 0.4; 95% CI 0.3, 0.7). Twins from the GDM group had more respiratory distress syndrome (RDS, OR 2.2; 95% CI 1.3, 3.7) and had a threefold , but not significantly increased perinatal mortality rate. Birth weight characteristics were similar in both groups. Conclusion: Twin pregnancies complicated by GDM might be associated with pre-pregnancy maternal obesity and are at increased risk of RDS and non-significant increased risk of perinatal death.

Research paper thumbnail of Lipschütz Genital Ulceration as Initial Manifestation of Primary Sjögren's Syndrome

Case reports in obstetrics and gynecology, 2018

Genital ulcers are challenging to any clinician and causes transcend many specialties. Skin ulcer... more Genital ulcers are challenging to any clinician and causes transcend many specialties. Skin ulceration in patients with primary Sjögren's syndrome is infrequent but an established feature of cutaneous involvement. Although gynecological symptoms, such as vulvovaginal dryness, dyspareunia, and pruritus, are common in women with primary Sjögren's syndrome, patients affected by vulvar ulcers are unknown. We describe an exceptional case of necrotic aphthous-type vulvar ulceration as initial presentation of primary Sjögren's syndrome that was possibly triggered by an infectious agent. Successful healing was achieved with oral corticosteroids, despite some loss of labia and labia as sequelae of the necrotizing process. Reactive acute genital ulcers (Lipschütz ulcers) should be considered as a possible manifestation of many autoimmune/inflammatory disorders, beyond the classic associations such as Behçet's syndrome or Crohn's disease.

Research paper thumbnail of Esterilização feminina: estudo comparativo entre esterilização histeroscópica e laparoscópica Female sterilization: comparative study of hysteroscopic versus laparoscopic sterilization

Overview and Aims: Female sterilization is increasingly requested as a contraceptive method. Hyst... more Overview and Aims: Female sterilization is increasingly requested as a contraceptive method. Hysteroscopic sterilization by transcervical placing of Essure® micro-inserts in the initial portion of the tubes is a recent alternative to laparoscopic sterilization. The objective of this study is to evaluate the safety and effectiveness of hysteroscopic versus laparoscopic sterilization. Study Design: Retrospective cohort study. Population: A total of 98 women undergoing sterilization in an outpatient clinic between July 2005 and July 2009. Methods: Patients’ age, associated diseases, anesthesic risk, procedure time, discomfort, adverse events and success rate were evaluated. Results: Mean age at surgery was 37.8 years (19-49), and there were no statistically significant differences between the groups regarding this parameter. Women in the hysteroscopic group had a significant number of associated diseases (98% versus 47%), obesity (31% versus 6%), and anes thesic risk (ASA III- 31% vers...

Research paper thumbnail of Gravidez ectópica intersticial - O estado da arte

Research paper thumbnail of Glassy Cell Carcinoma of the Cervix and Metastasis in Episiotomy Scar: A Case Report

Journal of lower genital tract disease, Jan 24, 2014

The authors describe the 20th known case of cervical cancer with metastasis in an episiotomy scar... more The authors describe the 20th known case of cervical cancer with metastasis in an episiotomy scar, being the first case describing an implant of malignant cells in the episiotomy scar associated with glassy cell carcinoma. One case report. We describe the case of a 34-year-old woman, with cervical cancer diagnosed 1 month after delivery. Four months later, a radical hysterectomy was performed. During surgery, a nodule at the site of the episiotomy scar was identified and removed. The histologic diagnosis revealed a glassy cell carcinoma of the cervix, with metastasis in the episiotomy scar. After surgery, chemotherapy and radiotherapy were performed. The disease progressed rapidly, and the patient died 9 months after surgery. The implantation of neoplastic cells in the perineum is a potential risk of vaginal delivery, with a 40% mortality rate. It thus seems advisable to avoid vaginal delivery as much as possible when cervical cancer is diagnosed during pregnancy. Given the rarity, ...

Research paper thumbnail of Cervical Cancer in Pregnancy

Journal of Lower Genital Tract Disease, 2013

ABSTRACT