Pregnancy Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Prevalence of Sexual Dysfunctions and their Associated Factors in Pregnant Women in an Outpatient Prenatal Care Clinic

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):555-563
    09-30-2019

    Summary

    Original Article

    Prevalence of Sexual Dysfunctions and their Associated Factors in Pregnant Women in an Outpatient Prenatal Care Clinic

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(9):555-563
    09-30-2019

    DOI 10.1055/s-0039-1695021

    Views170

    Abstract

    Objective

    To determine the prevalence of sexual dysfunction and its associated factors in pregnant women.

    Methods

    A descriptive, cross-sectional study including 262 pregnant women aged 18 years or older with gestational age between 10 and 35 weeks. Women with urinary tract infections and conditions of gestational risk were excluded. The Pregnancy Sexual Response Inventory (PSRI) questionnaire was used. We performed a univariate descriptive analysis, and comparisons between the mean values of the sexual function domains were made using the Student t-test. The chi-squared test was used to determine the association between the independent and dependent variables. The prevalence ratios, with their respective 95% confidence intervals, were also estimated, and a multivariate analysis was performed.

    Results

    A total of 64.9% of women reported a decrease in the frequency of sexual activity during pregnancy. Slightly more than half of the women (50.8%) were satisfied, and arousal was reported as excellent/good by 30.5% of them. The frequency of sexual difficulties/dysfunctions increased with pregnancy, rising from 5.7% to 58.8%, and pain during sexual intercourse was reported by 45.8% of them. Having higher education degree decreased the chance of being sexually dissatisfied by 50%. The total PSRI score showed a significant decrease from the prepregnancy period (mean score = 89.8, “excellent”) to the pregnancy period (mean score = 59.2, “good”).

    Conclusion

    The mean sexual function score during pregnancy was classified as good, although most pregnant women reported at least one type of alteration in the sexual function domains, and the report of dissatisfaction was more frequent in women with lower schooling.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
    Prevalence of Sexual Dysfunctions and their Associated Factors in Pregnant Women in an Outpatient Prenatal Care Clinic
  • Original Article

    Pregnancy Among Women with Kidney Transplantation: A 20-Years Single-Center Registry

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(7):419-424
    08-15-2019

    Summary

    Original Article

    Pregnancy Among Women with Kidney Transplantation: A 20-Years Single-Center Registry

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(7):419-424
    08-15-2019

    DOI 10.1055/s-0039-1688834

    Views112

    Abstract

    Objective

    To assess maternal and perinatal outcomes in pregnancies after kidney transplantation in a tertiary center in Brazil.

    Methods

    Retrospective cohort of pregnancies in women with kidney transplantation at the Universidade Estadual de Campinas, from January 1995 until December 2017. Medical charts were reviewed, andmaternal and perinatal outcomes were described as means and frequencies. Renal function and blood pressure were evaluated during pregnancy and postpartum.

    Results

    A total of 22 women had at least 1 pregnancy during the considered timeinterval, and 3 of them had > 1 pregnancy, totalizing 25 pregnancies. The mean age at transplantation was of 24.6 ± 4.2 years old, and the mean time interval until pregnancy was of 67.8 ± 46.3months. Themost frequent complication during pregnancywas hypertension, which affected 11 (64.7%)women. The gestational age at delivery was 34.7 ± 4weeks, and 47% of these pregnancies were preterm (< 37 weeks). A total of 88.2% of the women delivered by cesarean section. Renal function, measured by serum creatinine, remained stable during pregnancy, and the systolic blood pressure increased significantly, while the diastolic blood pressure did not differ during pregnancy.

    Conclusion

    Pregnancy after kidney transplantation is a rare event. Pre-eclampsia and prematurity were frequent complications, and cesarean section rates were very high. A specialized antenatal and postpartum care with a multiprofessional approach and continuous monitoring of graft function are essential for the early diagnosis of complications and improved outcomes.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Prevalence and Association of Congenital Anomalies According to the Maternal Body Mass Index: Cross-Sectional Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):280-290
    06-27-2019

    Summary

    Original Article

    Prevalence and Association of Congenital Anomalies According to the Maternal Body Mass Index: Cross-Sectional Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(5):280-290
    06-27-2019

    DOI 10.1055/s-0039-1683971

    Views158

    Abstract

    Objective

    To evaluate and compare the prevalence of structural congenital anomalies (CAs) according to maternal body mass index (BMI).

    Methods

    The present cross-sectional study involved pregnant women with fetuses diagnosed with structural CAs through morphological ultrasonography between November 2014 and January 2016. The nutritional status of the pregnant women was classified according to the gross value of the body mass index. The pregnant women were categorized into four groups: low weight, adequate weight, overweight, and obesity. Statistical analysis was performed using Stata/SE version 12.0 (Stata Corporation, College Station, TX), with values of p ≤ 0.05 considered statistically significant.

    Results

    A total of 223 pregnant women had fetuses diagnosed with CAs. The prevalence of structural CAs in pregnant women with lowweight was of 20.18%, of 43.50% in pregnant women with adequate weight, of 22.87% in pregnant women with overweight, and of 13.45% in pregnant women with obesity. The prevalence of central nervous system (CNS) anomalies and of genitourinary systemanomalieswas high for the four groups of pregnant women. A positive association was observed between multiple anomalies in pregnant women with adequate weight (prevalence ratio [PR] = 1.65; p ≤ 0.004) and between anomalies of the lymphatic system in obese pregnant women (PR = 4.04, p ≤ 0.000).

    Conclusion

    The prevalence of CNS and genitourinary systemanomalies was high in all of the BMI categories. Obese pregnancies were associated with lymphatic system anomalies. Therefore, screening and identification of the risk factors for CAs are important, regardless of the maternal BMI. Our findings reinforce the importance of discussing with pregnant women maternal nutrition and its effect on fetal development and on neonatal outcome.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Articles

    Evaluation of Immunological Parameters in Pregnant Women: Low Levels of B and NK Cells

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):213-219
    06-19-2019

    Summary

    Original Articles

    Evaluation of Immunological Parameters in Pregnant Women: Low Levels of B and NK Cells

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):213-219
    06-19-2019

    DOI 10.1055/s-0039-1683903

    Views155

    Abstract

    Objective

    To describe the immunological and hematological reference intervals of low-risk pregnant women.

    Methods

    A cross-sectional retrospective database analysis of a basic and translational study analyzing the hematological evaluation blood counts and immunophenotyping of TCD3 + , TCD4 + , TCD8 + , B, and natural killer (NK) cells of the peripheral blood in 79 low-risk pregnant women and of 30 control women from the state of Pernambuco, Brazil, was performed.

    Results

    No significant differences were detected between the hematological profiles of the 2nd and 3rd trimesters. Nevertheless, the median level of B cells decreased significantly in the 2nd (174 x 103 μL; p < 0.002) and 3rd trimesters (160 x 103 μL; p < 0.001), compared with the control group (296 x 103 μL). Similarly, the median level of NK cells was lower in the 2nd (134 x 103 μL; p < 0.0004) and 3rd trimesters (100 x 103 μL, p < 0.0004), compared with the control group (183 x 103 μL). In contrast, relative TCD4+ and TCD8+ levels increased in the 2nd and 3rd trimesters compared with the controls (TCD4 + : 2nd trimester = 59%; p < 0.001; 3rd trimester = 57%; p < 0.01; control = 50%; and TCD8 + : 2nd trimester = 31%; p < 0.001; 3rd trimester = 36%; p < 0.01; control = 24%).

    Conclusion

    Low-risk pregnant women have ~ 40% less B and NK cells in the peripheral blood, compared with non-pregnant women. These parameters may improve health assistance for mothers and contribute to define reference values for normal pregnancies.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Articles

    Association between Dietary Glycemic Index and Excess Weight in Pregnant Women in the First Trimester of Pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):04-10
    04-15-2019

    Summary

    Original Articles

    Association between Dietary Glycemic Index and Excess Weight in Pregnant Women in the First Trimester of Pregnancy

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):04-10
    04-15-2019

    DOI 10.1055/s-0038-1676096

    Views151

    Abstract

    Objective

    To assess the association between dietary glycemic index (GI) and excess weight in pregnant women in the first trimester of pregnancy.

    Methods

    A cross-sectional study in a sample of 217 pregnant women was conducted at the maternal-fetal outpatient clinic of the Hospital Geral de Fortaleza, Fortaleza, state of Ceará, Brazil, for routine ultrasound examinations in the period between 11 and 13 weeks + 6 days of gestation.Weight and height were measured and the gestational body mass index (BMI) was calculated. The women were questioned about their usual body weight prior to the gestation, considering the prepregnancy weight. The dietary GI and the glycemic load (GL) of their diets were calculated and split into tertiles. Analysis of variance (ANOVA) or Kruskal-Walls and chi-squared (χ2) statistical tests were employed. A crude logistic regression model and a model adjusted for confounding variables known to influence biological outcomes were constructed. A p-value < 0.05 was considered significant for all tests employed.

    Results

    The sample group presented a high percentage of prepregnancy and gestational overweight (39.7% and 40.1%, respectively). InthetertilewiththehigherGIvalue, therewasa lower dietary intake of total fibers (p = 0.005) and of soluble fibers (p = 0.008). In the third tertile, the dietary GI was associated with overweight in pregnant women in the first trimester of gestation, both in the crude model and in the model adjusted for age, total energy intake, and saturated fatty acids. However, this association was not observed in relation to the GL.

    Conclusion

    A high dietary GI was associated with excess weight in women in the first trimester of pregnancy.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Articles

    The Influence of Light Exposure in Ambiance during Pregnancy inMaternal and Fetal Outcomes: An Experimental Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):24-30
    04-15-2019

    Summary

    Original Articles

    The Influence of Light Exposure in Ambiance during Pregnancy inMaternal and Fetal Outcomes: An Experimental Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(1):24-30
    04-15-2019

    DOI 10.1055/s-0038-1675610

    Views166

    Abstract

    Objective

    The aim of this study is to evaluate whether exposure to different environmental lighting conditions affects the reproductive parameters of pregnant mice and the development of their offspring.

    Methods

    Fifteen pregnant albino mice were divided into three groups: light/dark, light, and dark. The animalswere euthanized on day 18 of pregnancy following the Brazilian Good Practice Guide for Euthanasia of Animals.Maternal and fetal specimens weremeasured and collected for histological evaluation. Analysis of variance (ANOVA) test was used for comparison of the groups considering p ≤ 0.05 to be statistically significant.

    Results

    There was no significant difference in the maternal variables between the three groups. Regarding fetal variables, significant differences were observed in the anthropometric measures between the groups exposed to different environmental lighting conditions, with the highest mean values in the light group. The histological evaluation showed the same structural pattern of the placenta in all groups, which was within the normal range. However, evaluation of the uterus revealed a discrete to moderate number of endometrial glands in the light/dark and light groups, which were poorly developed in most animals. In the fetuses, pulmonary analysis revealed morphological features consistent with the transition from the canalicular to the saccular phase in all groups.

    Conclusion

    Exposure to different environmental lighting conditions had no influence on the reproductive parameters of female mice, while the offspring of mothers exposed to light for 24 hours exhibited better morphometric features.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Exercise in Pregnancy: The Impact of an Intervention Program in the Duration of Labor and Mode of Delivery

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):68-75
    02-01-2019

    Summary

    Original Article

    Exercise in Pregnancy: The Impact of an Intervention Program in the Duration of Labor and Mode of Delivery

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):68-75
    02-01-2019

    DOI 10.1055/s-0038-1675613

    Views193

    Abstract

    Objective

    To access the benefits or harms of an exercise program, based on the current American College of Obstetricians and Gynecologists guidelines, on the mode of delivery, duration and onset of labor.

    Methods

    A study performed at the Hospital Senhora da Oliveira between October 2015 and February 2017. This was a quasi-experimental study involving 255 women divided into two groups: an intervention group engaged in a controlled and supervised exercise program during pregnancy (n = 99), and a control group that did not participate in the exercise program (n = 156). Data were collected in two stages: during the 1st trimester biochemical screening (before the beginning of the program), through a written questionnaire, and after delivery, from the medical files of the patients. The significance level in the present study was 5% (p = 0.05).

    Results

    The control group had higher odds of induced labor (odds ratio [OR] 2.71; 95% confidence interval [CI]: 1.42-5.17; p = 0.003), when compared with women who underwent the intervention. No differences were found between the groups in instrumental vaginal deliveries, cesarean rate, time until the beginning of the active phase, duration of the active phase, and duration of the second stage of labor.

    Conclusion

    The implementation of a controlled and supervised exercise program in pregnancy was associated with significantly lower odds of induced deliveries.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article

    Syphilis in Pregnancy: The Reality in a Public Hospital

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):90-96
    02-01-2019

    Summary

    Original Article

    Syphilis in Pregnancy: The Reality in a Public Hospital

    Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(2):90-96
    02-01-2019

    DOI 10.1055/s-0038-1676569

    Views243

    Abstract

    Objective:

    The present study assessed epidemiological and obstetrical data from pregnant women with syphilis at the Hospital de Clínicas of the Universidade Federal do Triângulo Mineiro (UFTM, in the Portuguese acronym), describing this disease during pregnancy and its vertical transmission for future healthcare actions.

    Methods:

    Records from pregnant women who had been admitted to the Obstetrics Department of the Hospital de Clínicas of the UFTM and were diagnosed with syphilis between 2007 and 2016 were reviewed. A standardized form was used to collect epidemiological, obstetric data and outcomes of congenital infection. The present research has been authorized by the Ethics Committee of the institution.

    Results:

    There were 268 women diagnosed with syphilis, with an average age of 23.6 years old. The majority of the patients were from Uberaba. Inadequate prenatal care was observed in 37.9% of the pregnant women. Only 34.2% of the patients completed the treatment according to the guidelines issued by the Ministry of Health of Brazil, and 19.8% of the partners of the patients underwent adequate syphilis treatment; 37 (13.8%) couples (patients and partners) underwent correct treatment. Regarding the obstetric outcomes, 4 (1.5%) patients had a miscarriage and 8 (3.4%) had fetal losses (from the fetal loss group, 7 had no adequate treatment); 61 (25.9%) patients had premature births - this prematurity has been significantly correlated to inadequate or incomplete treatment in 49 (27.9%) patients, compared with 12 (13.0%) patients with premature births and adequate treatment (p = 0.006). The average live newborn weight was 2,840 g; 25.3% had a birth weight < 2,500 g; 74.2% had congenital syphilis, a data with heavy correlation to inadequate or incomplete prenatal care, prematurity, and low birth weight.

    Conclusion:

    Public awareness policies on adequate prenatal care, intensification of serological screening, and early treatment of syphilis are needed, considering the rise of cases diagnosed during gestation and its potentially preventable deleterious consequences related to congenital transmission.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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