Rastreamento do câncer de colo do útero durante o acompanhamento pré-natal / Screening for cervical cancer during prenatal care

Objetivo: Avaliar o rastreamento do câncer do colo do útero em mulheres no período de acompanhamento pré-natal. Método: Revisão integrativa de literatura realizada em março de 2020, nas bases de dados LILACS, Web of Science, Scopus e MEDLINE. Para a seleção dos estudos foram utilizados os Descritores em Ciências da Saúde, seus respectivos sinônimos e os Medical Subject Headings correspondentes. Resultados: Os achados fortalecem as atuais recomendações sobre a realização do exame citopatológico (CP), inclusive durante o acompanhamento pré-natal, visto que a situação gravídica não impede a ocorrência e desenvolvimento de neoplasias cervicais. Conclusão: Existem lacunas no rastreio em gestantes. Os artigos incluídos neste estudo permitiram alavancar a importância do rastreio de câncer cervical em gestantes e subsidiar a atuação de profissionais à realização da prática nesse período.

Objective: To evaluate cervical cancer screening in women during prenatal care. Method: Integrative literature review carried out in March 2020, on the LILACS, Web of Science, Scopus and MEDLINE databases. Health Sciences Descriptors, their respective synonyms, and the corresponding Medical Subject Headings were used for study selection. Results: The findings strengthen the current recommendations regarding the convenience of carrying out cytopathological examination, even during prenatal care, since pregnancy does not prevent the occurrence and development of cervical neoplasia. Conclusion: There are gaps in the screening of pregnant women. The articles included in this study made it possible to emphasize the importance of screening for cervical cancer in pregnant women and provide practitioners with grounds for the performance of the practice during this period.

Indicaciones de estudio genético invasivo en una población seleccionada: Agosto de 2005 a diciembre de 2007 / Indications for invasive genetic studies in a population-based sample: August 2005 to december 2007

Antecedentes: la mayor utilización de ecografía prenatal y procedimientos diagnósticos invasivos ha permitido mejorar la identificación de malformaciones fetales al nacimiento. El dilema conlleva un riesgo relacionado con el procedimiento, por lo que los médicos siguen lidiando con la manera de identificar las pacientes con riesgo elevado para no someter a las de bajo riesgo a procedimientos diagnósticos innecesarios. En el presente estudio nos hemos planteado describir las diferentes indicaciones para el diagnóstico genético invasivo de alteraciones cromosómicas en una población seleccionada de Bogotá D.C. Pacientes y métodos: se realizó un estudio descriptivo de corte transversal entre el 1 de agosto de 2005 y el 31 de diciembre de 2007. Se revisaron las historias clínicas de embarazadas remitidas con indicación de estudio genético invasivo por anomalías cromosómicas. Resultados: se analizaron 374 embarazos, de los cuales el 98,9% (n=370) eran simples y el 1,1% (n=4) correspondían a gemelares, para un total de 378 análisis del cariotipo fetal. La edad materna promedio fue de 35 años y la gestacional promedio de 17,4 semanas. Se realizaron 366 amniocentesis (96,8%) y 12 biopsias de vellosidades coriónicas (3,2%). El estudio citogenético más solicitado fue el cariotipo 64,8% (n=245) y en 33,6% (n=127) de los casos se hizo análisis por FISH y cariotipo. Entre las indicaciones para solicitar estudio genético invasivo se destacan la edad materna con 35,7% (n=135), seguida de malformaciones menores ecográficas 14,8% (n=56), tamizaje segundo trimestre 9,3% (n=35), sonolucencia nucal aumentada 6,9% (n=26) y malformaciones mayores ecográficas 6,3% (n=24). Se reportaron 54 estudios citogenéticos alterados (14,3%); de ellos, 36 correspondieron a aneuploidías (66,67%) y dieciocho a variaciones estructurales (33,33%). Cuando la edad materna fue la única indicación de un procedimiento invasivo, sólo se detectó el 6,66% de cariotipos alterados, mientras que en el grupo...

Antecedents: increased use of prenatal ultrasound and invasive diagnostic procedures has improved the detection of congenital fetal defects. The dilemma entails a procedure-related risk for which physicians continue to put up with a way to identify highrisk patients to avoid unnecessary diagnostic procedures in low-risk patients. This population-based study, conducted in Bogotá D.C., describes the various indications for an invasive genetic study to identify chromosomal abnormalities. Patients and methods: this is a descriptive cross-sectional study performed between August 1st 2005 and December 31st 2007. The clinicalrecords of pregnant women referred with an indication for invasive prenatal testing due to chromosomal abnormalities were reviewed. Results: 374 pregnancies were assessed, where 98.9% (n=370) were single pregnancies and 1.1% (n=4) twin pregnancies, thus, 378 fetal karyotype analyses were conducted. The mean age was 35 years and the mean gestational age was 17.4 weeks. We performed 366 amniocentesis (96.8%) and 12 choryonic villus sampling (3.2%). Karyotype analysis was the most frequently requested cytogenetic study accounting for 64.8% (n=245) of cases and FISH and karyotype analyses wereperformed in 33.6% (n=127). Advanced maternal age in 35.7% (n=135) was the main indication for invasive genetic studies request, followed by minor malformations detected by ultrasound 14.8% (n=56), second-trimester screening 9.3% (n=35), enhanced nuchal translucency 6.9% (n=26) and major defects detected by ultrasound 6.3% (n=24). Fifty-four (54) cytogenetic studies were reported as abnormal (14.3%); 36 corresponding to aneuploidy (66.67%) and 18 to structural variations (33.33%). Only 6.66% abnormal karyotypes were determined when maternal age was the only indication for an invasive procedure, while aneuploidy was diagnosed in the minor or major defect or nuchal translucency groups in 25%, 29% and 26% respectively...