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Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):27-32
DOI 10.1590/S0100-72032013000100006
PURPOSE: To compare and analyze socioeconomic aspects and the emotional experience of women with spontaneous or induced abortion and in women living in the outskirts of São Paulo. METHODS: A prospective case-control study carried out from July 2008 to March 2010, involving semi-structured interviews with women who presented a previous diagnosis of abortion and who had been admitted to two public hospitals in the outskirts of São Paulo. The study included 100 women with diagnosis of abortion and were hospitalized for curettage. Eleven women who reported induced abortion (11%) represented the case group. The control group (n=22) was selected at a 2:1 ratio according to the following procedure: for every case of induced abortion, the next two cases of spontaneous abortion at the same hospital. A semistructured interview was conducted with questions regarding emotional aspects and family, social and economic context. RESULTS: The women with induced abortion compared to the group with spontaneous abortion had lower educational level, with more frequent elementary level (82 versus 36%, p=0.04), lower income (median, R$ 1,000.00 versus R$ 1,400.00, p=0.04), lower personal income (median, R$ 200.00 versus R$ 333.00, p=0.04), higher frequency of negative feelings upon suspicion (82 versus 22%, p=0.004) and confirmation (72 versus 22%, p=0.03) of pregnancy. CONCLUSION: Among women looking for health care in hospitals in the outskirts of São Paulo, induced abortion is related to unfavorable socioeconomic conditions, which affects the emotional experiences of suspicion and confirmation of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(1):27-32
DOI 10.1590/S0100-72032013000100006
PURPOSE: To compare and analyze socioeconomic aspects and the emotional experience of women with spontaneous or induced abortion and in women living in the outskirts of São Paulo. METHODS: A prospective case-control study carried out from July 2008 to March 2010, involving semi-structured interviews with women who presented a previous diagnosis of abortion and who had been admitted to two public hospitals in the outskirts of São Paulo. The study included 100 women with diagnosis of abortion and were hospitalized for curettage. Eleven women who reported induced abortion (11%) represented the case group. The control group (n=22) was selected at a 2:1 ratio according to the following procedure: for every case of induced abortion, the next two cases of spontaneous abortion at the same hospital. A semistructured interview was conducted with questions regarding emotional aspects and family, social and economic context. RESULTS: The women with induced abortion compared to the group with spontaneous abortion had lower educational level, with more frequent elementary level (82 versus 36%, p=0.04), lower income (median, R$ 1,000.00 versus R$ 1,400.00, p=0.04), lower personal income (median, R$ 200.00 versus R$ 333.00, p=0.04), higher frequency of negative feelings upon suspicion (82 versus 22%, p=0.004) and confirmation (72 versus 22%, p=0.03) of pregnancy. CONCLUSION: Among women looking for health care in hospitals in the outskirts of São Paulo, induced abortion is related to unfavorable socioeconomic conditions, which affects the emotional experiences of suspicion and confirmation of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):281-285
DOI 10.1590/S0100-72032013000600008
PURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(6):281-285
DOI 10.1590/S0100-72032013000600008
PURPOSE: It was to describe and compare the preference of nulliparous and primiparous women for a particular mode of delivery and to determine whether the previous experience of childbirth influences the delivery process. METHODS: We conducted a prospective cross-sectional study. One-hundred interviews were held with 56 nulliparous and 44 primiparous women using previously prepared questionnaires. The quantitative and categorical data were evaluated by the chi-square or Fisher's Exact Test. RESULTS: 60.7% of nulliparous women and 70.5% of primiparous women reported to prefer vaginal delivery. When analyzing the answers about receiving sufficient information about the type of delivery, the presence or absence of influence on the choice of route of delivery and the preferred route of delivery by the partner, there were no statistically significant differences between the two groups. The level of significance used for the tests was 0.05. CONCLUSIONS: This study permitted us to conclude that the previous experience of delivery does not influence the expectation of the delivery process or the choice for a specific mode of delivery. When choosing the route of delivery, women seek to ensure the health of mother and neonate, as well as to avoid the process of pain and suffering.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):29-36
DOI 10.1590/S0100-72032002000100005
Purpose: to study computerized cardiotocography performed in high-risk pregnancies, analyze the results, and correlate the criteria to perinatal results. Patients and Methods: two hundred and thirty-three high-risk pregnancies were studied prospectively, performing a total of 485 computerized cardiotocographies. The exclusion criteria included fetal anomalies and signal loss over 20% (proportion of 3.75-millisecond periods in which there were no valid pulse intervals). The perinatal results of 71 pregnancies were correlated to the last cardiotocography, performed at least seven days before birth, excluding patients with absent or reversed end diastolic velocities in the umbilical arteries. Results: thirty-three examinations with signal loss over 20% were excluded. The normal criteria were met in 404 (83.3%), and 62.1% examinations met the criteria within 20 minutes and 79% within 30 minutes. The abnormal computerized cardiotocography was related significantly (p<0.05) to adverse perinatal results, such as: preterm delivery, first minute Apgar score less than 7 (33%), neonatal intensive care admission (55.5%) and intubation of newborn at delivery (44.4%). Conclusions: computerized cardiotocography in high-risk pregnancies met the normal criteria in most of the cases, with the examination performed for 30 minutes. The cases that did not meet the criteria correlated significantly to adverse perinatal results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(1):29-36
DOI 10.1590/S0100-72032002000100005
Purpose: to study computerized cardiotocography performed in high-risk pregnancies, analyze the results, and correlate the criteria to perinatal results. Patients and Methods: two hundred and thirty-three high-risk pregnancies were studied prospectively, performing a total of 485 computerized cardiotocographies. The exclusion criteria included fetal anomalies and signal loss over 20% (proportion of 3.75-millisecond periods in which there were no valid pulse intervals). The perinatal results of 71 pregnancies were correlated to the last cardiotocography, performed at least seven days before birth, excluding patients with absent or reversed end diastolic velocities in the umbilical arteries. Results: thirty-three examinations with signal loss over 20% were excluded. The normal criteria were met in 404 (83.3%), and 62.1% examinations met the criteria within 20 minutes and 79% within 30 minutes. The abnormal computerized cardiotocography was related significantly (p<0.05) to adverse perinatal results, such as: preterm delivery, first minute Apgar score less than 7 (33%), neonatal intensive care admission (55.5%) and intubation of newborn at delivery (44.4%). Conclusions: computerized cardiotocography in high-risk pregnancies met the normal criteria in most of the cases, with the examination performed for 30 minutes. The cases that did not meet the criteria correlated significantly to adverse perinatal results.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
To present the cross-cultural adaptation to Brazilian Portuguese language of the Pregnancy and Weight Gain Attitude Scale.
This scale was developed in order to verify whether attitude toward thinness affects weight gain during pregnancy and contains statements that express different attitudes of pregnant women regarding their own weight gain. The procedures were: translation, back translation, comprehension evaluation, preparation of a final version, application of the scale to 180 pregnant women (mean age=29.6, gestational age=25.7 weeks) and psychometric analysis.
Satisfactory equivalence between the versions and satisfactory internal consistency (Cronbach's alpha 0.7) were detected. The exploratory factor analysis suggested four subscales with 51.4% total variance explained.
The scale proved to be valid and can be used in studies with pregnant women in Brazil to assess attitudes toward weight gain and to detect and prevent dysfunctional behaviors during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
To present the cross-cultural adaptation to Brazilian Portuguese language of the Pregnancy and Weight Gain Attitude Scale.
This scale was developed in order to verify whether attitude toward thinness affects weight gain during pregnancy and contains statements that express different attitudes of pregnant women regarding their own weight gain. The procedures were: translation, back translation, comprehension evaluation, preparation of a final version, application of the scale to 180 pregnant women (mean age=29.6, gestational age=25.7 weeks) and psychometric analysis.
Satisfactory equivalence between the versions and satisfactory internal consistency (Cronbach's alpha 0.7) were detected. The exploratory factor analysis suggested four subscales with 51.4% total variance explained.
The scale proved to be valid and can be used in studies with pregnant women in Brazil to assess attitudes toward weight gain and to detect and prevent dysfunctional behaviors during pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
Apresentar a adaptação transcultural para o português da Escala de Atitudes em Relação ao Ganho de Peso na Gestação.
Essa escala, que contém afirmações que expressavam diferentes atitudes de gestantes em relação ao seu próprio ganho de peso, foi desenvolvida para determinar se as atitudes em relação ao corpo afetariam o ganho de peso durante a gestação. Os procedimentos foram: tradução, retrotradução, avaliação da compreensão, elaboração de versão final, aplicação da escala em 180 gestantes (média 29,6 anos e idade gestacional 25,7 semanas) e análise psicométrica.
Constatou-se equivalência satisfatória entre as versões inglês-português e boa consistência interna (Alpha de Cronbach 0,7). A análise fatorial exploratória sugeriu quatro subescalas com variância total explicada de 51,4%.
A escala se demonstrou válida e pode ser utilizada em estudos com gestantes no Brasil para avaliação de atitudes em relação ao ganho de peso e detecção e prevenção de comportamentos disfuncionais durante a gestação.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(7):320-327
DOI 10.1590/SO100-720320140004998
Apresentar a adaptação transcultural para o português da Escala de Atitudes em Relação ao Ganho de Peso na Gestação.
Essa escala, que contém afirmações que expressavam diferentes atitudes de gestantes em relação ao seu próprio ganho de peso, foi desenvolvida para determinar se as atitudes em relação ao corpo afetariam o ganho de peso durante a gestação. Os procedimentos foram: tradução, retrotradução, avaliação da compreensão, elaboração de versão final, aplicação da escala em 180 gestantes (média 29,6 anos e idade gestacional 25,7 semanas) e análise psicométrica.
Constatou-se equivalência satisfatória entre as versões inglês-português e boa consistência interna (Alpha de Cronbach 0,7). A análise fatorial exploratória sugeriu quatro subescalas com variância total explicada de 51,4%.
A escala se demonstrou válida e pode ser utilizada em estudos com gestantes no Brasil para avaliação de atitudes em relação ao ganho de peso e detecção e prevenção de comportamentos disfuncionais durante a gestação.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(6):353-363
DOI 10.1590/S0100-72032000000600006
Purpose: to study the prognostic parameters for perinatal death in pregnancies with absent or reversed end-diastolic flow velocity on umbilical artery dopplervelocimetry. Methods: two hundred and four pregnancies were retrospectively reviewed. The methods used were cardiotocography, fetal biophysical profile, amniotic fluid index and dopplervelocimetry of ductus venosus, fetal aorta, middle cerebral artery, umbilical arteries and uterine artery. The logistic regression model was applied to one hundred and seventy cases in order to determine the most accurate variable for predicting perinatal death. Results: the mortality rates were: 28 cases of intrauterine fetal death (13.7%) and 45 neonatal deaths (22.1%). A statistically significant correlation was found between death and the studied variables. The perinatal death rate in the group with birth weight below 1,000 g was 74.7%, and in the group with gestational age at delivery below 31 weeks it was 66.3%. By logistic regression, birth weight was the most accurate variable for predicting perinatal death, and a probability curve for death according to this variable was obtained. Conclusions: absent or reversed end-diastolic flow velocity in the umbilical arteries is a severe fetal condition, where the risk of perinatal death is mainly related to birth weight and a gestational age at delivery below 31 weeks.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2000;22(6):353-363
DOI 10.1590/S0100-72032000000600006
Purpose: to study the prognostic parameters for perinatal death in pregnancies with absent or reversed end-diastolic flow velocity on umbilical artery dopplervelocimetry. Methods: two hundred and four pregnancies were retrospectively reviewed. The methods used were cardiotocography, fetal biophysical profile, amniotic fluid index and dopplervelocimetry of ductus venosus, fetal aorta, middle cerebral artery, umbilical arteries and uterine artery. The logistic regression model was applied to one hundred and seventy cases in order to determine the most accurate variable for predicting perinatal death. Results: the mortality rates were: 28 cases of intrauterine fetal death (13.7%) and 45 neonatal deaths (22.1%). A statistically significant correlation was found between death and the studied variables. The perinatal death rate in the group with birth weight below 1,000 g was 74.7%, and in the group with gestational age at delivery below 31 weeks it was 66.3%. By logistic regression, birth weight was the most accurate variable for predicting perinatal death, and a probability curve for death according to this variable was obtained. Conclusions: absent or reversed end-diastolic flow velocity in the umbilical arteries is a severe fetal condition, where the risk of perinatal death is mainly related to birth weight and a gestational age at delivery below 31 weeks.
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Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(7):377-383
, , , , , , , , , To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo.
Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period.
A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency.
The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2023;45(7):377-383
, , , , , , , , , To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo.
Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period.
A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency.
The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):394-400
DOI 10.1590/S0100-72032013000900003
PURPOSE: To investigate the usefulness of the measurement of cervical length and of the test for phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) performed sequentially in the prediction of preterm birth and the correlation between tests. METHODS: We analyzed data from 101 asymptomatic pregnant women with a history of premature delivery. The ultrasound measurement of cervical length and phIGFBP-1 test were performed in parallel every three weeks, between 24 and 34 week. The best cutoff value for each cervical evaluation was established by the ROC curve, and the two tests were compared using nonparametric tests. We determined the sensitivity, specificity and predictive values of each test and of the association of the exams for the occurrence of delivery before the 37th weeks. RESULTS: There were 25 preterm births (24.8%). The cervix length showed the highest sensitivity and was able to predict preterm birth in all evaluations, with similar accuracy at different gestational ages. The test for phIGFBP-1 was not helpful at 24 weeks, but was able to predict prematurity when performed at 27, 30 and 33 weeks. The combination of tests increased the sensitivity (81.8%) and negative predictive value (93.7%) when compared to the separate use of each test. The mean cervical length was lower in women with a positive test. CONCLUSIONS: Both cervical length and the test for phIGFBP-1 were able to predict premature delivery, and sequential combination of both tests showed a high sensitivity and high negative predictive value.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2013;35(9):394-400
DOI 10.1590/S0100-72032013000900003
PURPOSE: To investigate the usefulness of the measurement of cervical length and of the test for phosphorylated insulin-like growth factor binding protein-1 (phIGFBP-1) performed sequentially in the prediction of preterm birth and the correlation between tests. METHODS: We analyzed data from 101 asymptomatic pregnant women with a history of premature delivery. The ultrasound measurement of cervical length and phIGFBP-1 test were performed in parallel every three weeks, between 24 and 34 week. The best cutoff value for each cervical evaluation was established by the ROC curve, and the two tests were compared using nonparametric tests. We determined the sensitivity, specificity and predictive values of each test and of the association of the exams for the occurrence of delivery before the 37th weeks. RESULTS: There were 25 preterm births (24.8%). The cervix length showed the highest sensitivity and was able to predict preterm birth in all evaluations, with similar accuracy at different gestational ages. The test for phIGFBP-1 was not helpful at 24 weeks, but was able to predict prematurity when performed at 27, 30 and 33 weeks. The combination of tests increased the sensitivity (81.8%) and negative predictive value (93.7%) when compared to the separate use of each test. The mean cervical length was lower in women with a positive test. CONCLUSIONS: Both cervical length and the test for phIGFBP-1 were able to predict premature delivery, and sequential combination of both tests showed a high sensitivity and high negative predictive value.
