Germ Cell Tumors in Dysgenetic Gonads.

This review describes the germ cell neoplasms that are malignant and most commonly associated with several types of gonadal dysgenesis. The most common neoplasm is gonadoblastoma, while others including dysgerminomas, yolk-sac tumors and teratomas are rare but can occur. The purpose of this review is to evaluate the incidences of these abnormalities and the circumstances surrounding these specific tumors.According to well-established methods, a PubMed systematic review was performed, to obtain relevant studies published in English and select those with the highest-quality data.Initially, the first search was performed using gonadal dysgenesis as the search term, resulting in 12,887 PubMed papers, published, from 1945 to 2017. A second search using ovarian germ cell tumors as the search term resulted in 10,473 papers, published from 1960 to 2017. Another search was performed in Medline, using germ cell neoplasia as the search term, and this search resulted in 7,560 papers that were published between 2003 to 2016, with 245 new papers assessing gonadoblastomas.The higher incidence of germ cell tumors in gonadal dysgenesis is associated with a chromosomal anomaly that leads to the absence of germ cells in these gonads and, consequently, a higher incidence of neoplasms when these tumors are located inside the abdomen. Several hypotheses suggest that increased incidence of germ cell tumors involves all or part of the Y chromosome or different genes.

Pregnancy After Bariatric Surgery: a Comparative Study of Post-Bariatric Pregnant Women Versus Non-Bariatric Obese Pregnant Women.

PURPOSE: To evaluate the impact of bariatric surgery on the gestational outcomes. MATERIALS AND METHODS: Retrospective study of pregnant women hospitalized for delivery in the maternity in Curitiba, Brazil, who had a body mass index (BMI) greater than or equal to 30 kg/m2 and/or who had undergone bariatric surgery. Interviews were performed, and the patients' medical records and antenatal information cards were evaluated. RESULTS: Ninety-three pregnant women who had bariatric surgery and 205 obese pregnant women were selected. A lower occurrence of hypertensive diseases was observed in pregnant women who had undergone bariatric surgery (14%) compared with obese pregnant women (56.6%). Moreover, a reduced occurrence of diabetes was found in post-bariatric pregnant women (16.1%) compared with obese pregnant women (30.2%). There were no differences in the frequency of prematurity, in delivery methods, or in postpartum complications. There was a higher number of cases of babies who were small for gestational age and a lower number of babies who were large for gestational age in the post-bariatric group. When comparing obese pregnant women to post-bariatric pregnant women who had remained obese, a reduced frequency of hypertensive diseases and diabetes was found in the latter group, but the weight difference between their newborns was not statistically significant. CONCLUSION: There was a lower occurrence of health-related issues complicating pregnancy among women who had undergone bariatric surgery, but these women's newborns were more likely to be small for gestational age, a finding which was less significant the less weight the mother had lost.

Environmental toxins and the impact of other endocrine disrupting chemicals in women's reproductive health.

This review aimed to look into agents and mechanisms characterized as endocrine disrupting chemicals (EDCs). These agents are known to cause several harmful effects to the reproductive system of women and wildlife. There is a wide range of chemicals, developed for commercial use mainly in agriculture, which may cause endocrine disruption. Numerous studies show evidence of environmental contamination. However, no one is being held liable for the damages. The most important potentially harmful agents are identified and described, along with the different effects they have on the female genital area. Brazil is a large consumer of pesticides and others chemicals that may interfere with a normal women's life. We analyzed and described the mode of action and the impacts of different EDCs (bisphenols, phthalates, atrazine, polychlorinated and polybrominated biphenyls, DDT-dichlorodiphenyltrichloroethane; DDE-dichlorodiphenyldichloroethylene; DDD-dichlorodiphenyldichloroethane; and DES-diethylstilbestrol) on the genital area, ovarian steroidogenesis, polycystic ovary syndrome, endometriosis, the structure of the uterus and the vagina, and on the formation of leiomyomas.

Germ cell tumors in dysgenetic gonads

This review describes the germ cell neoplasms that are malignant and most commonly associated with several types of gonadal dysgenesis. The most common neoplasm is gonadoblastoma, while others including dysgerminomas, yolk-sac tumors and teratomas are rare but can occur. The purpose of this review is to evaluate the incidences of these abnormalities and the circumstances surrounding these specific tumors. According to well-established methods, a PubMed systematic review was performed, to obtain relevant studies published in English and select those with the highest-quality data. Initially, the first search was performed using gonadal dysgenesis as the search term, resulting in 12,887 PubMed papers, published, from 1945 to 2017. A second search using ovarian germ cell tumors as the search term resulted in 10,473 papers, published from 1960 to 2017. Another search was performed in Medline, using germ cell neoplasia as the search term, and this search resulted in 7,560 papers that were published between 2003 to 2016, with 245 new papers assessing gonadoblastomas. The higher incidence of germ cell tumors in gonadal dysgenesis is associated with a chromosomal anomaly that leads to the absence of germ cells in these gonads and, consequently, a higher incidence of neoplasms when these tumors are located inside the abdomen. Several hypotheses suggest that increased incidence of germ cell tumors involves all or part of the Y chromosome or different genes.

Endocrine disruptors and their influence in the origin of breast neoplasm and other breast pathologies / Disruptores endócrinos e o seu papel na gênese das neoplasias e de outras patologias das mamas

A higher occurrence of early breast cancer in women has created the need to identify possible etiologic agents characterized as direct co-responsible. The motivation for this review is the relevance of detecting potential endocrine disruptors responsible for harmful effects on breast tissue and, consequently, its damage

Uma maior ocorrência no surgimento precoce das neoplasias das mamas em mulheres tem gerado a necessidade da descoberta dos possíveis agentes etiológicos caracterizados como corresponsáveis diretos. A relevância da detecção dos possíveis disruptores endócrinos responsáveis por exercer efeitos danosos nos tecidos mamários e, consequentemente, o seu comprometimento é a motivação da presente revisão

Fatigue and quality of life in breast cancer survivors: a comparative study.

PURPOSE: To assess fatigue and quality of life in disease-free breast cancer survivors in relation to a sample of age-matched women with no cancer history and to explore the relationship between fatigue and quality of life. METHODS: A cross-sectional study was conducted in a sample of 202 consecutive disease-free Brazilian breast cancer survivors, all of whom had completed treatment, treated at 2 large hospitals. The patients were compared to age-matched women with no cancer history attending a primary health care center. The Piper Fatigue Scale-Revised and the World Health Organization Quality of Life Instrument (WHOQOL-BREF) were used to measure the fatigue and quality of life, respectively. Socio-demographic and clinical variables were also obtained. The χ2 test, generalized linear model, and Spearman correlation coefficient were used for statistical purposes. The adopted level of significance was 5%. RESULTS: Breast cancer survivors experienced significantly greater total and subscale fatigue scores than comparison group (all p-values<0.05). In addition, survivors reported a poorer quality of life in physical (p=0.002), psychological (p=0.03), and social relationships (p=0.03) domains than comparison group. No difference was found for the environmental domain (p=0.08) for both groups. For survivors of breast cancer and for comparison group, the total and subscale fatigue scores were related to lower quality of life (all p-values<0.01). CONCLUSION: The findings of this study highlight the importance of assessing fatigue and quality of life in breast cancer survivors.

Fatigue and quality of life in breast cancer survivors: a comparative study / Fadiga e qualidade de vida em pacientes sobreviventes de câncer de mama: um estudo comparativo

PURPOSE: To assess fatigue and quality of life in disease-free breast cancer survivors in relation to a sample of age-matched women with no cancer history and to explore the relationship between fatigue and quality of life. METHODS: A cross-sectional study was conducted in a sample of 202 consecutive disease-free Brazilian breast cancer survivors, all of whom had completed treatment, treated at 2 large hospitals. The patients were compared to age-matched women with no cancer history attending a primary health care center. The Piper Fatigue Scale-Revised and the World Health Organization Quality of Life Instrument (WHOQOL-BREF) were used to measure the fatigue and quality of life, respectively. Socio-demographic and clinical variables were also obtained. The χ2 test, generalized linear model, and Spearman correlation coefficient were used for statistical purposes. The adopted level of significance was 5%. RESULTS: Breast cancer survivors experienced significantly greater total and subscale fatigue scores than comparison group (all p-values<0.05). In addition, survivors reported a poorer quality of life in physical (p=0.002), psychological (p=0.03), and social relationships (p=0.03) domains than comparison group. No difference was found for the environmental domain (p=0.08) for both groups. For survivors of breast cancer and for comparison group, the total and subscale fatigue scores were related to lower quality of life (all p-values<0.01). CONCLUSION: The findings of this study highlight the importance of assessing fatigue and quality of life in breast cancer survivors. .

OBJETIVO: Avaliar a fadiga e a qualidade de vida de sobreviventes de câncer de mama, livres da doença, em relação a uma amostra de mulheres da mesma idade, sem histórico de câncer, e explorar a relação entre fadiga e qualidade de vida. MÉTODOS: Estudo transversal realizado com uma amostra consecutiva de 202 pacientes brasileiras, sobreviventes de câncer de mama e livres da doença, que haviam completado o tratamento em 2 grandes hospitais. As pacientes foram comparadas com mulheres da mesma idade, sem história de câncer, acompanhadas em uma Unidade Básica de Saúde. A Escala de Fadiga de Piper-Revisada e o World Health Organization Quality of Life Instrument (WHOQOL-BREF) foram usados para avaliar a fadiga e a qualidade de vida, respectivamente. Dados sociodemográficos e clínicos também foram obtidos. O teste do χ2, modelo linear generalizado e coeficiente de correlação de Spearman foram utilizados para fins estatísticos. Foi adotado o nível de significância de 5%. RESULTADOS: As sobreviventes de câncer de mama apresentaram significativamente maiores escores de fadiga total e das subescalas do que o grupo controle (todos os valores de p<0,05). Além disso, as sobreviventes relataram pior qualidade de vida nos domínios físico (p=0,002), psicológico (p=0,03) e relações sociais (p=0,03) do que o grupo controle. Nenhuma diferença foi encontrada para o domínio ambiental (p=0,08) entre os 2 grupos. Para as sobreviventes de câncer de mama e para o grupo controle, os escores de fadiga total e das subescalas estavam relacionados à baixa qualidade de vida (todos os valores de p<0,01). CONCLUSÃO: Os resultados deste estudo destacam a importância de avaliar a fadiga e a qualidade de vida em pacientes sobreviventes de câncer de mama. .

Uterus Didelphys with Obstructed Hemivagina and Ipsilateral Renal Agenesis (OHVIRA Syndrome).

This paper aimed to report a series of 19 cases of uterus didelphys associated with obstructed hemivagina and ipsilateral renal agenesis. This retrospective descriptive observational study included the medical records of 19 patients seen at the Endocrinology Gynecology Sector of the Obstetrics and Gynecology Department of the Federal University of Paraná, and focused on clinical data, complementary exams, patient management, and follow-up. From the 229 patients with genital anomalies seen between 1984 and 2009, 19 (8.3%) were diagnosed with uterus didelphys with vaginal septum and renal agenesis. The patients had a median age of ±16.3 years. Eight subjects (42.6 %) reported abdominal pain; two of them (0.1%) had pelvic masses and seven (36.8%) had dysmenorrhea. Blood retention was confirmed by ultrasound and/ or magnetic resonance imaging of the pelvis, which revealed the existence of a duplicated uterus of the didelphys type with a cystic mass containing old blood obliterating the hemivagina. Urinary tract examination revealed the existence of ipsilateral renal agenesis. Unusual manifestations such as associated infection and rupture of the vaginal septum during sexual intercourse were also reported. The prevalence of uterus didelphys associated with obstructed hemivagina and ipsilateral renal agenesis was 8.3% in a series of 229 genital anomalies. The observance of clinical features is essential for the early identification of the syndrome and the adequate management of the patients.

Qualidade de vida em pacientes sobreviventes de câncer de mama comparada à de mulheres saudáveis / Quality of file in breast cancer survivors compared to healthy women

OBJETIVOS: Avaliar a qualidade de vida em mulheres sobreviventes de câncer de mama e comparar com mulheres saudáveis pareadas por idade. MÉTODOS: Estudo transversal com uma amostra de 199 pacientes sobreviventes de câncer de mama, incluídas consecutivamente um ano ou mais após o diagnóstico. As pacientes haviam sido tratadas em dois grandes hospitais. Essas pacientes foram comparadas com um grupo de mulheres saudáveis, pareadas por idade com as pacientes, composto por funcionárias e voluntárias dos dois hospitais. A avaliação da qualidade de vida foi realizada através do World Health Organization Quality of Life Questionnaire, version bref (WHOQOL-bref), e foram obtidos dados socioeconômicos, clínicos e do tratamento. Os testes estatísticos utilizados foram do χ² e modelo linear generalizado. Foi adotado o nível de significância de 5%. RESULTADOS: As sobreviventes de câncer de mama tinham média de idade de 54,4 anos (DP=10,4) e tempo médio de diagnóstico de 5,0 anos (DP=4,6). As pacientes sobreviventes relataram piores avaliações de qualidade de vida geral (p<0,001) e para os domínios físico (p<0,05), psicológico (p=0,002) e meio ambiente (p=0,02) em relação às mulheres saudáveis, após controle para potenciais variáveis de confusão. Não houve diferença significativa para o domínio relações sociais (p=0,9). CONCLUSÕES: Muitas pacientes sobreviventes de câncer de mama experimentaram piores avaliações na qualidade de vida quando comparadas às mulheres saudáveis. Esses resultados podem ser úteis para estabelecer estratégias para melhorar a qualidade de vida de mulheres com câncer de mama.

PURPOSES: To assess the quality of life of breast cancer survivors compared to a sample of age-matched healthy women. METHODS: A cross-sectional design was conducted on 199 consecutive breast cancer survivors, one year or more after diagnosis, treated at two large hospitals. The patients were compared to age-matched healthy women consisting of employees and volunteers of the two hospitals. Quality of life was evaluated using the World Health Organization Quality of Life Questionnaire, version Bref (WHOQOL-bref) and socioeconomic, clinical, and treatment data were obtained. The χ² test and a generalized linear model were used for statistical analysis. The adopted level of significance was 5%. RESULTS: The mean age of breast cancer survivors was 54.4 years (SD=10.4) and the average length of time since diagnosis was 5.0 years (SD=4.6). The survivors reported a poorer overall quality of life (p=0.001), and for the physical (p<0.001), psychological (p=0.002) and environment (p=0.029) domains than the comparison group, after adjusting for potential confounders. There was no significant difference in the social relationships domain (p=0.929) between groups. CONCLUSION: The results suggest that many breast cancer survivors experienced worse quality of life assessment than healthy women. This information may be useful to establish strategies to improve the quality of life of women with breast cancer.

Fatigue after treatment in breast cancer survivors: prevalence, determinants and impact on health-related quality of life.

PURPOSE: Fatigue is a phenomenon that may persist for years after completion of adjuvant therapy, and is one of the most frequent symptoms associated with breast cancer survivors. The purposes of this study were to investigate the occurrence of fatigue in disease-free breast cancer survivors after treatment, to identify variables associated with fatigue, and to evaluate the impact of fatigue on health-related quality of life. METHODS: A cross-sectional study was conducted on 202 consecutive women diagnosed with in-situ to Stage III breast cancer attending in outpatient facilities of two large hospitals, one year or more after diagnosis. They completed the Piper Fatigue Scale-Revised and the European Organization for Research and Treatment of Cancer QLQ-C30. Multiple logistic regression models were used to identify predictive factors associated with fatigue. EORTC QLQC-30 scores for fatigued survivors were compared to non-fatigued survivors. RESULTS: The prevalence of fatigue reported by the breast cancer survivors was 37.6%. Multiple logistic regression analysis revealed that predictive factors for fatigue included younger age (odds ratio [OR]=2.23, 95% confidence interval [CI]=1.11-4.45, p = 0.024); presence of pain (OR = 3.87, 95% CI = 1.88-7.98, p = 0.000); dyspnea (OR = 3.72, 95% CI = 1.46-9.50, p = 0.006); insomnia (OR = 2.40, 95% CI = 1.19-4.86, p = 0.015); and nausea and vomiting (OR = 12.25, 95% CI = 1.18-126.75, p = 0.036). Fatigued women had poorer health-related quality of life than non-fatigued women in all domains. CONCLUSION: Our results suggest that many disease-free breast cancer survivors after treatment experienced fatigue that compromises their health-related quality of life.

[Quality of file in breast cancer survivors compared to healthy women]. / Qualidade de vida em pacientes sobreviventes de câncer de mama comparada à de mulheres saudáveis.

PURPOSES: To assess the quality of life of breast cancer survivors compared to a sample of age-matched healthy women. METHODS: A cross-sectional design was conducted on 199 consecutive breast cancer survivors, one year or more after diagnosis, treated at two large hospitals. The patients were compared to age-matched healthy women consisting of employees and volunteers of the two hospitals. Quality of life was evaluated using the World Health Organization Quality of Life Questionnaire, version Bref (WHOQOL-bref) and socioeconomic, clinical, and treatment data were obtained. The χ² test and a generalized linear model were used for statistical analysis. The adopted level of significance was 5%. RESULTS: The mean age of breast cancer survivors was 54.4 years (SD=10.4) and the average length of time since diagnosis was 5.0 years (SD=4.6). The survivors reported a poorer overall quality of life (p=0.001), and for the physical (p<0.001), psychological (p=0.002) and environment (p=0.029) domains than the comparison group, after adjusting for potential confounders. There was no significant difference in the social relationships domain (p=0.929) between groups. CONCLUSION: The results suggest that many breast cancer survivors experienced worse quality of life assessment than healthy women. This information may be useful to establish strategies to improve the quality of life of women with breast cancer.

Doença celíaca e infertilidade / Celiac disease and infertility

Doença celíaca ou enteropatia por sensibilidade ao glúten é uma doença crônica condicionada pelo desenvolvimento de uma hipersensibilidade ao glúten. É associada a uma ampla gama de manifestações clínicas existindo, simultaneamente, má digestão e um déficit na absorção de muitos nutrientes e vitaminas. Diversos estudos têm mostrado, também, uma maior prevalência desta com quadros de infertilidade, aparentemente sem uma causa definida. Este é o motivo da presente revisão.

Celiac disease or gluten-sensitive enteropathy is a chronic illness characterized by the development of hypersensitivity to gluten. It is associated with a vast array of clinical manifestations, such as the occurrence of digestive problems and poor absorption of nutrients and vitamins. Several studies have also linked it to cases of infertility, apparently, without a known cause. This link is the motivation of the following review.

Histerectomia total versushisterectomia supracervical / Total hysterectomy versus supracervical hysterectomy

A histerectomia é um dos procedimentos cirúrgicos mais frequentemente executados na atualidade. Ela é direcionada ao tratamento de diversas doenças. Além disso, é procedimento de baixa morbidade, com resultados confiáveis, sendo considerada segura. O diagnóstico responsável pela maioria das histerectomias, tanto no Brasil, quanto no resto do mundo, é o sangramento uterino secundário à leiomiomatose uterina. Todavia, mais de 95% das doenças que requerem histerectomia não necessitam, a priori, da remoção da cérvice, por serem condições benignas. Por outro lado, outras morbidades exigem sua remoção; todavia, essas condições respondem por menos de 2% das indicações de histerectomia. A presente revisão direciona-se a abordar os aspectos atinentes à manutenção ou remoção da cérvice uterina em uma histerectomia, reconhecendo as indicações absolutas e relativas que exigem a remoção da cérvice uterina, bem como discutir de forma clara e prática suas controvérsias. Desse modo, o médico assistente poderá orientar suas pacientes quanto à escolha do melhor procedimento cirúrgico, seja a histerectomia total ou a subtotal

Hysterectomy is one of the most frequent surgical procedures. It is employed in the treatment of several disorders. Furthermore, it is considered safe, having a low mortality rate, and reliable results. The main diagnosis for this procedure is secondary uterine bleeding by uterine leiomyomas. Over 95% of the diseases treatable by hysterectomy do not require cervix removal, as they are benign conditions. On the other hand, some diseases do need cervix removal, but these add up to only 2% or less of all clinical indications for hysterectomy. The aim of this review is to address important aspects of both maintenance and removal of the uterine cervix by hysterectomy, to acknowledge its relative and absolute indications and to discuss its controversies clearly and practically. Thus, the assistant physician will be able to counsel their patients on their choices of surgical procedure: either total or supracervical hysterectomy

Infecção por vírus herpes simples na gestação: aspectos epidemiológicos, diagnósticos e profiláticos / Herpes simplex virus infection in pregnancy: epidemiological, diagnostic, and prophylactic aspects

A infecção por vírus herpes simples (HSV) é uma das mais frequentes doenças sexualmente transmissíveis (DST) e, quando presente no período gestacional, pode determinar uma de suas complicações de maior morbidade, o herpes neonatal. Características epidemiológicas de tal doença foram estudadas pela literatura em diversas instâncias, mas não foram produzidos dados definitivos a respeito do real impacto que tal doença determina. Estratégias diagnósticas e profiláticas também foram sugeridas e testadas, porém diretrizes universalmente aceitas, capazes de reduzir a morbimortalidade de tal complicação, ainda não se encontram em uso. Há muitas controvérsias acerca da abordagem ideal de um caso de infecção herpética que se manifesta na gravidez, seja ela uma primoinfecção ou um caso de recorrência. Sabe-se que a entidade é potencialmente prevenível, porém ainda não existe evidência definitiva de que o custo de tal prevenção seja proporcional ao impacto da infecção

Herpes simplex virus infection is one of the most common sexually transmitted diseases (STD) and when it affects pregnancy, one of its most morbid complications, neonatal herpes, can ensue. Epidemiological information on this disease has already been studied by literature, but definitive data regarding the real burden of disease have not been produced. Diagnostic and prophylactic strategies have already been suggested and tested, but universally accepted guidelines, capable of diminishing the consequences of disease, are still not in use. There is much controversy on the optimal management of herpes in pregnancy, whether a primo-infection or a reactivation. It is known that the disease is potentially preventable, but there is still no absolute evidence that the cost of such prevention is proportional to the impact of such disease

Obstetricians' knowledge of periodontal disease as a potential risk factor for preterm delivery and low birth weight.

There is little information about the knowledge and attitudes of physicians regarding oral care. This study aimed to assess the knowledge and attitudes of obstetricians about the relationship between periodontal disease and preterm/low birth weight. A questionnaire was emailed to members of the Brazilian Federation of Gynecology and Obstetrics (FEBRASGO). The questionnaire elicited both personal information and knowledge and attitudes regarding the relationship between periodontal diseases and preterm labor. A total of 875 obstetricians responded to the questionnaire. The majority of respondents were female (54.1%), resided in the Southeast (45.6%), worked in both the public and private sectors (61.4%), and had over 15 years of experience in obstetrics (48.9%). A large proportion of obstetricians (93.4%) stated that bacteria were associated with periodontal disease, and 94% reported that periodontitis was a condition more severe than gingivitis. In total, over 80% of participating obstetricians reported smoking, preeclampsia, bacterial vaginosis and periodontal disease as risk factors or possible risk factors for preterm birth or low birth weight. A correlation between the experience of the obstetricians and referral of their patients for dental examinations (p < 0.001) was observed. Also, obstetricians who had had their own dental visits more recently were more likely to recommend the same for their patients (p < 0.001). It is concluded that, although obstetricians were aware of the association between gingival inflammation and adverse obstetric outcomes, the attitudes of these professionals were not in agreement with their apparent knowledge regarding periodontal diseases and their possible repercussions.

Neoplasias em gônadas disgenéticas / Neoplasms in dysgenetic gonadal

Conceitualmente, as gônadas disgenéticas são gônadas que não sofreram uma completa diferenciação. Em vista disso, constituem parte de uma ampla gama de entidades clínicas possuidoras de fenótipos e de genótipos diversos. Seus cariótipos contêm o cromossomo Y ou seus fragmentos, ou raramente não os contêm. Essas alterações geram maior risco para a ocorrência de neoplasias nessas gônadas. Na sequência deste estudo apresentamos as neoplasias mais comumente associadas aos diversos tipos de disgenesias gonadais. A neoplasia mais comum é o gonadoblastoma e outros como os disgerminomas e os tumores do seio endodérmico também podem estar associados. A detecção dessas anormalidades de modo precoce é o que nos motivou para a presente revisão

By definition, dysgenetic gonads are those that did not undergo a complete differentiation. They make up a vast array of clinical entities, having different phenotypes and genotypes. Their kariotypes contain the Y chromosome or fragments of it, and, in rare cases, do not contain it. Such alterations generate greater potential for the occurrence of neoplasms in such gonads. This study presents neoplasms which are most commonly associated with several types of gonadal dysgenesis. The most common neoplasia is gonadoblastoma and others like disgerminoma or yolk sac tumors may be associated. The early detection of such potential is the reason for this review

Obstetricians' knowledge of periodontal disease as a potential risk factor for preterm delivery and low birth weight

There is little information about the knowledge and attitudes of physicians regarding oral care. This study aimed to assess the knowledge and attitudes of obstetricians about the relationship between periodontal disease and preterm/low birth weight. A questionnaire was emailed to members of the Brazilian Federation of Gynecology and Obstetrics (FEBRASGO). The questionnaire elicited both personal information and knowledge and attitudes regarding the relationship between periodontal diseases and preterm labor. A total of 875 obstetricians responded to the questionnaire. The majority of respondents were female (54.1 percent), resided in the Southeast (45.6 percent), worked in both the public and private sectors (61.4 percent), and had over 15 years of experience in obstetrics (48.9 percent). A large proportion of obstetricians (93.4 percent) stated that bacteria were associated with periodontal disease, and 94 percent reported that periodontitis was a condition more severe than gingivitis. In total, over 80 percent of participating obstetricians reported smoking, preeclampsia, bacterial vaginosis and periodontal disease as risk factors or possible risk factors for preterm birth or low birth weight. A correlation between the experience of the obstetricians and referral of their patients for dental examinations (p < 0.001) was observed. Also, obstetricians who had had their own dental visits more recently were more likely to recommend the same for their patients (p < 0.001). It is concluded that, although obstetricians were aware of the association between gingival inflammation and adverse obstetric outcomes, the attitudes of these professionals were not in agreement with their apparent knowledge regarding periodontal diseases and their possible repercussions.