Relação entre o uso de contraceptivos e a citologia oncótica cérvico-vaginal
Data
2022-01-27
Autores
Lima, Grasiele de Cássia Baião [UNIFESP]
Orientadores
Di Bella, Zsuzsanna IIona Katalin de Jármy [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: O estudo tem como objetivo analisar o uso de contraceptivos e os
resultados de citologia cérvico-vaginal em mulheres atendidas em Ambulatórios
de Planejamento Familiar (PF) e Patologia do Trato Genital Inferior (PTGI) do
Departamento de Ginecologia da Escola Paulista de Medicina -UNIFESP, em
2020. Método: Trata-se de um estudo observacional, comparativo e
transversal. A amostra foi formada por 177 mulheres no menacme dos 25 aos
50 anos. Para a coleta levantou-se dados demográficos, antecedentes
ginecológicos, sexuais e antecedentes obstétricos. As análises foram
realizadas no Excel e no software estatístico com os testes de Mann Whitney, T
de Student, análise da regressão logística, teste Qui-Quadrado, exato de Fisher
e teste da razão de verossimilhança. Resultados: 95 (53,7%) das pacientes
foram atendidas no PF e 82 (46,3%) na PTGI. Os métodos contraceptivos
hormonais mais utilizados na PTGI foram os combinados (28,1%) e os
progestagênios isolados (14,7%) não incluindo o DIU hormonal e no PF, 16,9%
utilizavam métodos combinados e 10,5% progestagênios isolados sem incluir o
DIU hormonal. Nas citologias oncóticas, ficou evidente que o grupo do PF
apresentou percentual menor de alterações do que as pacientes da PTGI,
sendo 92,7% do PTGI e 3,2% do PF. O uso de nenhum método contraceptivo,
seguido pelo uso de métodos combinados e de progestagênio isolado e do uso
de métodos não hormonais foram associados a maior chance de alterações na
CO comparado a usuária de DIU de cobre. Conclusão: Assim, o uso de DIU
de cobre, a ocorrência de parto cesárea e de abortamentos mostraram serem
fatores protetores para citologia cérvico-vaginal alterada, enquanto ser solteira
ou divorciada, ter escolaridade baixa e fazer uso irregular de método
contraceptivo são considerados fatores de risco.
Objective: The study aims to analyze the use of contraceptives and the results of cervical-vaginal cytology in women attending the Family Planning (PF) and Lower Genital Tract Pathology (PTGI) Clinics of the Gynecology Department of Escola Paulista de Medicina -UNIFESP, in 2020. Methods: This is an observational, comparative and cross-sectional study. The sample consisted of 177 women aged 25 to 50 years. For the collection, demographic data, gynecological, sexual and obstetric history were collected. Analyzes were performed using Excel and statistical software using Mann Whitney, Student's t, logistic regression analysis, chi-square test, Fisher's exact test, and likelihood ratio test. Results: 95 (53.7%) of the patients were seen at the PF and 82 (46.3%) at the PTGI. The hormonal contraceptive methods most used in PTGI were combined (28.1%) and isolated progestagens (14.7%) not including the hormonal IUD, and in FP, 16.9% used combined methods and 10.5% isolated progestagens without including the hormonal IUD. In oncotic cytology, it was evident that the PF group had a lower percentage of alterations than the PTGI patients, 92.7% of the PTGI and 3.2% of the PF. The use of no contraceptive method, followed by the use of combined methods and isolated progestagen, and the use of non-hormonal methods were associated with a greater chance of changes in OC compared to a copper IUD user. Conclusion: Thus, the use of copper IUDs, the occurrence of cesarean delivery and abortions proved to be protective factors for altered cervical-vaginal cytology, while being single or divorced, having low education and irregular use of contraceptive methods are considered risk factors.
Objective: The study aims to analyze the use of contraceptives and the results of cervical-vaginal cytology in women attending the Family Planning (PF) and Lower Genital Tract Pathology (PTGI) Clinics of the Gynecology Department of Escola Paulista de Medicina -UNIFESP, in 2020. Methods: This is an observational, comparative and cross-sectional study. The sample consisted of 177 women aged 25 to 50 years. For the collection, demographic data, gynecological, sexual and obstetric history were collected. Analyzes were performed using Excel and statistical software using Mann Whitney, Student's t, logistic regression analysis, chi-square test, Fisher's exact test, and likelihood ratio test. Results: 95 (53.7%) of the patients were seen at the PF and 82 (46.3%) at the PTGI. The hormonal contraceptive methods most used in PTGI were combined (28.1%) and isolated progestagens (14.7%) not including the hormonal IUD, and in FP, 16.9% used combined methods and 10.5% isolated progestagens without including the hormonal IUD. In oncotic cytology, it was evident that the PF group had a lower percentage of alterations than the PTGI patients, 92.7% of the PTGI and 3.2% of the PF. The use of no contraceptive method, followed by the use of combined methods and isolated progestagen, and the use of non-hormonal methods were associated with a greater chance of changes in OC compared to a copper IUD user. Conclusion: Thus, the use of copper IUDs, the occurrence of cesarean delivery and abortions proved to be protective factors for altered cervical-vaginal cytology, while being single or divorced, having low education and irregular use of contraceptive methods are considered risk factors.
Descrição
Citação
LIMA, G C B. Relação entre o uso de contraceptivos e a citologia oncótica cérvico-vaginal. São Paulo, 2022, 58 f. Dissertação (Mestrado em Ginecologia) - Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). São Paulo, 2022.