Assuntos
Carcinoma Endometrioide/cirurgia , Carcinoma de Células de Transição/patologia , Neoplasias Primárias Múltiplas/cirurgia , Neoplasias Ovarianas/patologia , Neoplasias Uterinas/cirurgia , Carcinoma Endometrioide/patologia , Carcinoma de Células de Transição/cirurgia , Feminino , Humanos , Histerectomia , Achados Incidentais , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/patologia , Neoplasias Ovarianas/cirurgia , Ovariectomia , SalpingectomiaRESUMO
The aim of this study was to analyse low molecular weight heparin (LMWH) use during pregnancy in terms of patient evaluation, treatment indication and social and financial costs. This was a retrospective analysis of patients using LMWH in their pregnancies. A total of 147 women were included in the study. The most common indications were thrombophilia (55/147, 37.4%); recurrent pregnancy loss (RPL); (47/147, 32.0%) and previous single pregnancy loss (18/147, 12.2%). In the RPL group, 53.1% of patients were not evaluated with standard tests; 31.9% of women were incompletely evaluated and 15% were properly evaluated. Out of 104 women screened for thrombophilia, 32 (32/104, 30.8%) were tested during pregnancy. Despite published guidelines and increasing scientific evidence against their use in some indications, LMWHs are prescribed widely during pregnancy for a variety of indications. Public and healthcare providers' education to change this attitude should be implemented.
Assuntos
Aborto Espontâneo/prevenção & controle , Mau Uso de Serviços de Saúde , Heparina de Baixo Peso Molecular/uso terapêutico , Complicações Hematológicas na Gravidez/tratamento farmacológico , Trombofilia/tratamento farmacológico , Adulto , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto JovemRESUMO
The objective of the study was to compare intracytoplasmic sperm injection (ICSI) outcome and gonadotropin doses between obese women with PCOS and non-obese patients with PCOS. This follow-up study represents ICSI outcomes in obese women with PCOS (BMIâ≥â30 kg/m(2)) compared with non-obese women with PCOS (BMIâ<â30 kg/m(2)). Obese (nâ=â18) and non-obese (nâ=â26) women with PCOS underwent long protocol pituitary suppression, ovarian stimulation and ICSI with fresh embryo transfer. Obese patients with PCOS required higher doses of gonadotropin (2994 IU vs 1719 IU; pâ<â0.001). Miscarriage rate was significantly higher in obese women compared with the non-obese women with PCOS (60% vs 6.7%, pâ=â0.002). Our results are valuable for counselling couples before initiation of assisted reproduction techniques (ART).
