Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):470-477
DOI 10.1590/S0100-72032007000900006
PURPOSE: to assess the prevalence of the risk of post-partum depression in women in the post-natal ward of a hospital in São Paulo city, in the southeastern region of Brazil, and analyze the associated factors, including domestic violence (DV). METHODS: this was a descriptive, cross-sectional study. The participants were 133 women with at least 20 weeks of gestation age, who delivered their babies from August to September 2005 in a tertiary maternity in the city of São Paulo (Brazil). They were interviewed using the Portuguese version of the Abuse Assessment Screen for the diagnosis of violence and filled out a self-evaluation questionnaire for post-partum depression (Edinburgh Postnatal Depression Scale). Variables were presented as absolute and relative frequencies. The chi2 or Fisher exact tests were used to analyze possible associations between the variables of interest and post-partum depression. The value of 5% was considered significant. RESULTS: risk for post-partum depression was detected in 24 women (18%). A total of 38.3% of the participants interviewed had a history of abuse. There was an association between DV after they were 15 years old and risk of depression (p=0.036). The prevalence of abuse in the group of women at risk for post-partum depression was 58.3% and this was significantly higher than the 33.9% observed in the control group. CONCLUSIONS: the probability of presenting depression was high among the post-partum women attended at a tertiary maternity in the southeast of Brazil. The DV after they were 15 years old was significantly associated with risk of post-partum depression.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2006;28(11):671-679
DOI 10.1590/S0100-72032006001100007
PURPOSE: to investigate the influence of the maternal mobility during the active phase of labor. METHODS: a prospective clinical trial was conducted through comparative analysis among a treatment group (n=50) and a control group (n=50), in the Obstetric Center of the Hospital Universitário da Universidade de São Paulo (USP). The inclusion criteria were: primigravidae with a single fetus on cephalic presentation, with 37 to 42 weeks of pregnancy, with two uterine contractions every ten minutes and with cervical dilatation until 4 cm, besides the agreement to sign the free and informed consent term. The evolution of labor for cesarean section was the exclusion criteria. The patients were assisted during the active phase of labor by the physiotherapist and encouraged for staying in vertical position and movement, according to each dilatation stage and fetus head progression. The control group had obstetric support without the presence of the physiotherapist; it was selected retrospectively, according to the same inclusion and exclusion criteria. RESULTS: 58 primigravidae between 15 and 37 years old were accompanied; 50 of them (86.2%) evolved to vaginal birth and eight (13.7%) evolved to cesarean section and were excluded. Among the patients who were accompanied, the mean of active phase was five hours and 16 minutes, while in the control group it was eight hours and 28 minutes (p<0.001). This difference was maintained in relation to the amniotic sac either whole or ragged. As for the cervix uterine evanescence, the treatment group showed a smaller period of active phase in association to a thin uterine cervix (p<0.001). In the treatment group, none of the patients used analgesics during the active phase, against 62% of the control group (p<0.001). In this group, all the patients used some kind of anesthesia for delivery; in the treatment group, among those who used anesthesia, 76% did it while the dilatation was 9 or 10 cm and 12% did not use any kind of anesthesia (p<0.05). The average weight of the newborns and the apgar did not show significant difference rates between the two groups. CONCLUSIONS: the good performance of maternal mobility has positive influences on the labor process: it increases the tolerance to pain, avoids the use of drugs during labor, improves the evolution of dilatation and reduces the duration of the active phase.