Gestational Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87

    Summary

    Original Article

    Access and adequacy of antenatal care in a city in Brazil during two phases of the COVID-19 pandemic

    Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87

    DOI 10.61622/rbgo/2024rbgo87

    Views15

    Abstract

    Objective:

    To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.

    Methods:

    Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.

    Results:

    395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.

    Conclusion:

    The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.

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  • Review Article

    Assessment of Pelvic Floor Disorders due to the Gestational Diabetes Mellitus Using Three-Dimensional Ultrasonography: A Narrative Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1134-1140

    Summary

    Review Article

    Assessment of Pelvic Floor Disorders due to the Gestational Diabetes Mellitus Using Three-Dimensional Ultrasonography: A Narrative Review

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(12):1134-1140

    DOI 10.1055/s-0042-1759742

    Views6

    Abstract

    Gestational diabetes mellitus (GDM)is an entity with evolving conceptual nuances that deserve full consideration. Gestational diabetes leads to complications and adverse effects on the mother's and infants' health during and after pregnancy. Women also have a higher prevalence of urinary incontinence (UI) related to the hyperglycemic status during pregnancy. However, the exact pathophysiological mechanism is still uncertain. We conducted a narrative review discussing the impact of GDM on the women's pelvic floor and performed image assessment using three-dimensional ultrasonography to evaluate and predict future UI.

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    Assessment of Pelvic Floor Disorders due to the Gestational Diabetes Mellitus Using Three-Dimensional Ultrasonography: A Narrative Review
  • Artigos Originais

    Study of ophthalmic artery hemodynamic pattern in pregnant women with gestational diabetes mellitus

    Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):473-477

    Summary

    Artigos Originais

    Study of ophthalmic artery hemodynamic pattern in pregnant women with gestational diabetes mellitus

    Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):473-477

    DOI 10.1590/S0100-72032012001000007

    Views6

    PURPOSES: To evaluate the hemodynamic patterns of the ophthalmic artery by Doppler analysis in women with gestational diabetes mellitus (GDM), comparing them to normal pregnant women. METHODS: A prospective case-control study that analyzed the ophthalmic artery Doppler indices in two groups: one consisting of 40 women diagnosed with GDM and the other of 40 normal pregnant women. Included were pregnant women with GDM criteria of the American Diabetes Association - 2012, with 27 weeks of pregnancy to term, and excluded were women with hypertension, use of vasoactive drugs on or previous diagnosis of diabetes. Doppler analysis was performed in one eye with a 10 MHz linear transducer and the Sonoace 8000 Live Medison® equipment . The following variables were analyzed: pulsatility index (PI), resistance index (RI), peak velocity ratio (PVR), peak systolic velocity (PSV) and end diastolic velocity (EDV). To analyze the normality of the samples we used the Lillefors test, and to compare means and medians we used the Student's t-test and Mann-Whitney test according to data normality, with the level of significance set at 95%. RESULTS: The median and mean values with standard deviation of the variables of the ophthalmic artery Dopplervelocimetry group GDM and normal pregnant women were: IP=1.7±0.6 and 1.6±0.4 (p=0.7); IR=0.7 and 0.7 (p=0.9); RPV=0.5±0.1 and 0.5±0.1 (p=0.1), PSV=33.6 and 31.9 cm/sec (p=0.7); VDF=6.3 and 7.9 cm/sec (p=0.4). There was no significant difference in the means and medians of these variables between the two groups of pregnant women. CONCLUSIONS: The ophthalmic artery hemodynamic patterns, analyzed by means of a Doppler technique remained unchanged in the group of pregnant women with GDM compared to the group of normal pregnant women, suggesting that the time of exposure to the disease during pregnancy was too short to cause significant vascular disorders in the central territory.

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  • Artigos Originais

    Pregnancy and Gestational Diabetes: a prejudicial combination to female sexual function?

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(5):219-224

    Summary

    Artigos Originais

    Pregnancy and Gestational Diabetes: a prejudicial combination to female sexual function?

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(5):219-224

    DOI 10.1590/S0100-72032011000500003

    Views9

    To compare the sexual function of healthy adult pregnant women with that of gestational diabetes patients (GDM) in the third trimester. METHODS: This cross-sectional study enrolled two groups of women managed antenatal care clinics. Inclusion criteria were: maternal age .20 years, gestational age at least 28 weeks, being in a heterosexual relationship with the same partner for at least 6 months, and being able to read. We excluded women with a medical recommendation for sexual abstinence due to clinical or obstetric disorders; hypertension controlled through medications; pregnancy resulting from rape; absent or sexually unavailable partner in the last month; hospital admission in the last month; use of vaginal creams in the last 30 days; multiple pregnancy, regular use of alcohol or illicit drugs or use of medications that can interfere with sexual function. Eighty-seven patients fulfilled the selection criteria and were included in the study. The Sexual Quotient . Feminine Version (QS-F) questionnaire was used to assess sexual function. Student's t and X² tests were used to compare differences between groups and p<0.05 was considered significant. RESULTS: The mean gestational age of the participants was 34 weeks. There were no significant differences in the mean QS-F scores between groups (62.5 healthy vs 62.8 GDM women, p=0.9). Approximately half the participants (47 and 47.5% of the healthy and GDM women, respectively, p=0.9) had total scores up to 60, indicative of dysfunction in one of the assessed domains (desire, sexual satisfaction, arousal, orgasm, dyspareunia and vaginismus). CONCLUSIONS: The prevalence of sexual dysfunction was high among women in the third trimester of pregnancy and did not differ significantly between healthy women and women with GDM.

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