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Artigos Originais
Usefulness of a scoring system on perinatal outcomes in pregnant women with thrombophilia in the effectiveness of an enoxaparin-based intervention
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):459-465
12-20-2012
Summary
Artigos OriginaisUsefulness of a scoring system on perinatal outcomes in pregnant women with thrombophilia in the effectiveness of an enoxaparin-based intervention
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):459-465
12-20-2012DOI 10.1590/S0100-72032012001000005
Views104PURPOSES: To assess whether an enoxaparin-based intervention using a score system was effective in improving perinatal outcome in women with thrombophilia. METHODS: Study Design: Prospective, not randomized, uncontrolled, performed at a Clinic of High-Risk Pregnancy from November 2009 to November 2011. We included women with a diagnosis and therapeutic intervention for thrombophilia acquired and/or inherited in the current pregnancy. The obstetric and perinatal outcomes of pregnant women before the intervention were compared with outcomes after the intervention, and statistically analyzed using the χ2 test with Yates correction, considered significant when p<0.05. The initial dose of low-molecular-weight Heparin (LMWH) was guided by a scoring system based on the clinical and gestational history of the patients and screening tests for acquired and/or inherited thrombophilia. RESULTS: We included 84 pregnant women with 175 pregnancies before diagnosis, 20.0% of which resulted in fetal ou perinatal death, 40.0% resulted in abortion, 17.7% developed preeclampsia/eclampsia, 10.3% resulted in full-term births, and 29.7% in premature births. In the 84 pregnancies after intervention, 6.0% resulted in fetal ou perinatal death, 1.2% in abortion, 4.8% developed preeclampsia/eclampsia, 22.6% resulted in premature birth, and 70.2% in full-term birth. A significant reduction in the rate of stillbirths/perinatal death (p<0.05) and abortion (p<0.0001) and a significant increase (p<0.05) in the number of live births were observed after intervention. CONCLUSION: Enoxaparin-based intervention using a score system in pregnant women with thrombophilia is effective in improving perinatal outcome.
Key-words hematologicHeparinhigh-risklow-molecular-weightPregnancyPregnancy complicationsThrombophiliaSee moreViews104
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. Summary
Artigos OriginaisUsefulness of a scoring system on perinatal outcomes in pregnant women with thrombophilia in the effectiveness of an enoxaparin-based intervention
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):459-465
12-20-2012DOI 10.1590/S0100-72032012001000005
Views104PURPOSES: To assess whether an enoxaparin-based intervention using a score system was effective in improving perinatal outcome in women with thrombophilia. METHODS: Study Design: Prospective, not randomized, uncontrolled, performed at a Clinic of High-Risk Pregnancy from November 2009 to November 2011. We included women with a diagnosis and therapeutic intervention for thrombophilia acquired and/or inherited in the current pregnancy. The obstetric and perinatal outcomes of pregnant women before the intervention were compared with outcomes after the intervention, and statistically analyzed using the χ2 test with Yates correction, considered significant when p<0.05. The initial dose of low-molecular-weight Heparin (LMWH) was guided by a scoring system based on the clinical and gestational history of the patients and screening tests for acquired and/or inherited thrombophilia. RESULTS: We included 84 pregnant women with 175 pregnancies before diagnosis, 20.0% of which resulted in fetal ou perinatal death, 40.0% resulted in abortion, 17.7% developed preeclampsia/eclampsia, 10.3% resulted in full-term births, and 29.7% in premature births. In the 84 pregnancies after intervention, 6.0% resulted in fetal ou perinatal death, 1.2% in abortion, 4.8% developed preeclampsia/eclampsia, 22.6% resulted in premature birth, and 70.2% in full-term birth. A significant reduction in the rate of stillbirths/perinatal death (p<0.05) and abortion (p<0.0001) and a significant increase (p<0.05) in the number of live births were observed after intervention. CONCLUSION: Enoxaparin-based intervention using a score system in pregnant women with thrombophilia is effective in improving perinatal outcome.
Key-words hematologicHeparinhigh-risklow-molecular-weightPregnancyPregnancy complicationsThrombophiliaSee moreThis 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. -
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
12-20-2012
Summary
Artigos OriginaisStudy of ophthalmic artery hemodynamic pattern in pregnant women with gestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):473-477
12-20-2012DOI 10.1590/S0100-72032012001000007
Views97PURPOSES: 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.
Key-words Blood flow velocityDiabetesDiabetes mellitusGestationalHemodynamicsOphthalmic arteryPregnancySee moreViews97This 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. Summary
Artigos OriginaisStudy of ophthalmic artery hemodynamic pattern in pregnant women with gestational diabetes mellitus
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(10):473-477
12-20-2012DOI 10.1590/S0100-72032012001000007
Views97PURPOSES: 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.
Key-words Blood flow velocityDiabetesDiabetes mellitusGestationalHemodynamicsOphthalmic arteryPregnancySee moreThis 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. -
Artigos Originais
Sexual function and quality of life of low-risk pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):409-413
11-26-2012
Summary
Artigos OriginaisSexual function and quality of life of low-risk pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):409-413
11-26-2012DOI 10.1590/S0100-72032012000900004
Views126See morePURPOSE: To evaluate, in healthy women in the second trimester of pregnancy, a possible association between sexual function and quality of life, and between sexual function and sexual satisfaction. METHODS: This cross-sectional study involved 51 pregnant women managed at a low-risk antenatal care clinic. Sexual function was evaluated through the Sexual Quotient - Female Version (QS-F) questionnaire. Quality of life and sexual satisfaction were evaluated though the brief version of the World Health Organization Quality of Life questionnaire (WHOQOL-bref). Inclusion criteria were pregnancy between 15-26 weeks, maternal age 20 or more years, at least five years of scholling, in a relationship with a single partner for the last 6 months, having sexual intercourse with vaginal penetration in the last 15 days. We excluded women with a history of sexual violence, previous or current depression, habitual abortion or obstetric complications in the index pregnancy (premature rupture of membranes, preterm labor or hemorrhage). The χ² and Fisher exact tests were used for statistical analyses and p<0.05 was considered significant. RESULTS: Most of the participants (64.8%) obtained "regular to excellent" grades on the QS-F and 58.8% classified their quality of life as "good". As to sexual satisfaction, 35.3 and 15.7% declared that they were "satisfied" and "very satisfied" with their sexual life, respectively. The study detected significant associations between "bad to poor" QS-F grades with a "poor" quality of life (p=0.002), and with "regular to good" and "good to excellent" QS-F grades with "satisfaction" or "high" sexual satisfaction" (p<0.001). CONCLUSIONS: Sexual function is associated with quality of life and with sexual satisfaction in healthy women in the second trimester of pregnancy.
Views126This 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. Summary
Artigos OriginaisSexual function and quality of life of low-risk pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(9):409-413
11-26-2012DOI 10.1590/S0100-72032012000900004
Views126See morePURPOSE: To evaluate, in healthy women in the second trimester of pregnancy, a possible association between sexual function and quality of life, and between sexual function and sexual satisfaction. METHODS: This cross-sectional study involved 51 pregnant women managed at a low-risk antenatal care clinic. Sexual function was evaluated through the Sexual Quotient - Female Version (QS-F) questionnaire. Quality of life and sexual satisfaction were evaluated though the brief version of the World Health Organization Quality of Life questionnaire (WHOQOL-bref). Inclusion criteria were pregnancy between 15-26 weeks, maternal age 20 or more years, at least five years of scholling, in a relationship with a single partner for the last 6 months, having sexual intercourse with vaginal penetration in the last 15 days. We excluded women with a history of sexual violence, previous or current depression, habitual abortion or obstetric complications in the index pregnancy (premature rupture of membranes, preterm labor or hemorrhage). The χ² and Fisher exact tests were used for statistical analyses and p<0.05 was considered significant. RESULTS: Most of the participants (64.8%) obtained "regular to excellent" grades on the QS-F and 58.8% classified their quality of life as "good". As to sexual satisfaction, 35.3 and 15.7% declared that they were "satisfied" and "very satisfied" with their sexual life, respectively. The study detected significant associations between "bad to poor" QS-F grades with a "poor" quality of life (p=0.002), and with "regular to good" and "good to excellent" QS-F grades with "satisfaction" or "high" sexual satisfaction" (p<0.001). CONCLUSIONS: Sexual function is associated with quality of life and with sexual satisfaction in healthy women in the second trimester of pregnancy.
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. -
Artigos Originais
Perinatal factors associated with pH<7.1 in umbilical artery and Apgar 5 min <7.0 in term newborn
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(8):381-385
10-11-2012
Summary
Artigos OriginaisPerinatal factors associated with pH<7.1 in umbilical artery and Apgar 5 min <7.0 in term newborn
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(8):381-385
10-11-2012DOI 10.1590/S0100-72032012000800007
Views135See morePURPOSE: To assess perinatal factors associated with term newborns with pH<7.1 in the umbilical artery and 5th min Apgar score<7,0. METHODS: Retrospective case-control study carried out after reviewing the medical records of all births from September/1998 to March/2008, that occurred at the General Hospital of Caxias do Sul. The inclusion criterion was term newborns who presented a 5th min Apgar score <7.0 and umbilical artery pH<7.10. In the univariate analysis, we used the Student's t-test and the Mann-Whitney test for continuous variables, the c² test for dichotomous variables and risk estimation by the odds ratio (OR). The level of significance was set at p<0.05. RESULTS: Of a total of 15,495 consecutive births, 25 term neonates (0.16%) had pH<7.1 in the umbilical artery and a 5th min Apgar score <7.0. Breech presentation (OR=12.9, p<0.005), cesarean section (OR=3.5, p<0.01) and modified intrapartum cardiotocography (OR=7.8, p<0.02) presented a significant association with the acidosis event. Among the fetal characteristics, need for hospitalization in the neonatal intensive care unit (OR=79.7, p <0.0001), need for resuscitation (OR=12.2, p <0.0001) and base deficit were associated with the event (15.0 versus -4.5, p<0.0001). CONCLUSION: Low Apgar score at the 5th min of life associated with pH<7.1 in the umbilical artery can predict adverse neonatal outcomes.
Views135This 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. Summary
Artigos OriginaisPerinatal factors associated with pH<7.1 in umbilical artery and Apgar 5 min <7.0 in term newborn
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(8):381-385
10-11-2012DOI 10.1590/S0100-72032012000800007
Views135See morePURPOSE: To assess perinatal factors associated with term newborns with pH<7.1 in the umbilical artery and 5th min Apgar score<7,0. METHODS: Retrospective case-control study carried out after reviewing the medical records of all births from September/1998 to March/2008, that occurred at the General Hospital of Caxias do Sul. The inclusion criterion was term newborns who presented a 5th min Apgar score <7.0 and umbilical artery pH<7.10. In the univariate analysis, we used the Student's t-test and the Mann-Whitney test for continuous variables, the c² test for dichotomous variables and risk estimation by the odds ratio (OR). The level of significance was set at p<0.05. RESULTS: Of a total of 15,495 consecutive births, 25 term neonates (0.16%) had pH<7.1 in the umbilical artery and a 5th min Apgar score <7.0. Breech presentation (OR=12.9, p<0.005), cesarean section (OR=3.5, p<0.01) and modified intrapartum cardiotocography (OR=7.8, p<0.02) presented a significant association with the acidosis event. Among the fetal characteristics, need for hospitalization in the neonatal intensive care unit (OR=79.7, p <0.0001), need for resuscitation (OR=12.2, p <0.0001) and base deficit were associated with the event (15.0 versus -4.5, p<0.0001). CONCLUSION: Low Apgar score at the 5th min of life associated with pH<7.1 in the umbilical artery can predict adverse neonatal outcomes.
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. -
Artigos Originais
Alcohol use pattern in pregnant women cared for in a public university hospital and associated risk factors
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):296-303
08-28-2012
Summary
Artigos OriginaisAlcohol use pattern in pregnant women cared for in a public university hospital and associated risk factors
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):296-303
08-28-2012DOI 10.1590/S0100-72032012000700002
Views88See morePURPOSE: To determine the pattern of alcohol use before and during pregnancy and associated risk factors in puerperal women hospitalized in a public university hospital in Southeastern Brazil. METHODS: Between June and September 2009, 493 puerperae were consecutively evaluated. Those with cognitive impairment were excluded from the study. The AUDIT and CAGE questionnaires were used to diagnose alcohol use/abuse before pregnancy, in addition to the T-ACE during pregnancy. Another questionnaire was applied to collect sociodemographic data, such as age, educational level, marital status, and household income. The χ² test was used in the statistical analysis and the Odds Ratio (OR) and 95% confidence interval (95%CI) were calculated. A p-value <0.05 was considered to be significant. RESULTS: Before pregnancy, the CAGE was positive in 50/405 (12.3%) women and the AUDIT identified alcohol use in 331 (67.1%), which was of low risk in 233 (47.3%), risky in 73 (14.8%), and harmful or indicating possible alcohol dependence in 25 (5%). During pregnancy, the CAGE was positive in 53/405 (13.1%) women and the T-ACE in 84 (17%); the AUDIT identified alcohol use in 114 women, which was of low risk in 73 (14.8%), risky in 27 (5.5%), and harmful or indicating possible alcohol dependence in 14 (2.8%). During pregnancy, alcohol use was more frequent (OR=2.8; 95%CI 1.2 - 6.2) among women with a lower educational level (8.8 versus 3.3%) and more frequent (OR=3.8; 95%CI 1.3 - 11.1) among those who did not cohabit with a partner (6 versus 1.7%). Among pregnant women who drank alcohol, 49/114 (43%) were advised to stop drinking. CONCLUSIONS: Alarming alcohol use was observed during pregnancy, especially among pregnant women with a lower educational level and those who did not cohabit with a partner. There was a low frequency of counseling aimed at abstinence and the AUDIT was the instrument that most frequently diagnosed alcohol consumption.
Views88This 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. Summary
Artigos OriginaisAlcohol use pattern in pregnant women cared for in a public university hospital and associated risk factors
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(7):296-303
08-28-2012DOI 10.1590/S0100-72032012000700002
Views88See morePURPOSE: To determine the pattern of alcohol use before and during pregnancy and associated risk factors in puerperal women hospitalized in a public university hospital in Southeastern Brazil. METHODS: Between June and September 2009, 493 puerperae were consecutively evaluated. Those with cognitive impairment were excluded from the study. The AUDIT and CAGE questionnaires were used to diagnose alcohol use/abuse before pregnancy, in addition to the T-ACE during pregnancy. Another questionnaire was applied to collect sociodemographic data, such as age, educational level, marital status, and household income. The χ² test was used in the statistical analysis and the Odds Ratio (OR) and 95% confidence interval (95%CI) were calculated. A p-value <0.05 was considered to be significant. RESULTS: Before pregnancy, the CAGE was positive in 50/405 (12.3%) women and the AUDIT identified alcohol use in 331 (67.1%), which was of low risk in 233 (47.3%), risky in 73 (14.8%), and harmful or indicating possible alcohol dependence in 25 (5%). During pregnancy, the CAGE was positive in 53/405 (13.1%) women and the T-ACE in 84 (17%); the AUDIT identified alcohol use in 114 women, which was of low risk in 73 (14.8%), risky in 27 (5.5%), and harmful or indicating possible alcohol dependence in 14 (2.8%). During pregnancy, alcohol use was more frequent (OR=2.8; 95%CI 1.2 - 6.2) among women with a lower educational level (8.8 versus 3.3%) and more frequent (OR=3.8; 95%CI 1.3 - 11.1) among those who did not cohabit with a partner (6 versus 1.7%). Among pregnant women who drank alcohol, 49/114 (43%) were advised to stop drinking. CONCLUSIONS: Alarming alcohol use was observed during pregnancy, especially among pregnant women with a lower educational level and those who did not cohabit with a partner. There was a low frequency of counseling aimed at abstinence and the AUDIT was the instrument that most frequently diagnosed alcohol consumption.
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. -
Artigos Originais
Waist circumference measured before the 12th week of pregnancy: correlation with serum leptin levels
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(6):268-273
07-13-2012
Summary
Artigos OriginaisWaist circumference measured before the 12th week of pregnancy: correlation with serum leptin levels
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(6):268-273
07-13-2012DOI 10.1590/S0100-72032012000600005
Views103See morePURPOSE: To evaluate the correlation between maternal waist circumference measured before the 12th week of gestation and serum leptin levels during pregnancy, as well as to compare the leptin levels of women with and without abdominal obesity diagnosed in early pregnancy. METHODS: Prospective study including 40 pregnant women receiving low-risk prenatal care, older than 20 years, nonsmokers, with singleton pregnancies and without chronic disease. Waist circumference was measured before the 12th week and serum leptin levels were measured between the 9th and 12th, 25th and 28th and 34th and 37th weeks of gestation. According to waist circumference measurement, the cohort was divided into two groups: with and without abdominal obesity. The Mann-Whitney and χ² tests were used to assess the differences between groups. The Pearson correlation coeffient was used to assess the association between waist circumference and serum leptin levels during pregnancy. The level of significance was set at p<0.05. RESULTS: The mean weight and body mass index of patients with abdominal obesity (74.4±11.0 kg/28.9±4.1) was higher than that of patients without abdominal obesity (55.6±5.9 kg/21.1±2.4) (p=0.001). The mean leptin levels in pregnant patients with abdominal obesity (41.9±3.5 ng/mL) was higher than in patients without abdominal obesity (23.6±2.7 ng/mL) (p<0.0002). A positive correlation was obtained between the waist circumference measured during the same period and the mean serum leptin levels (r=0.7; p<0.0001). CONCLUSIONS: Waist circumference measured before the 12th week of pregnancy is a valid and simple method to predict the serum leptin levels throughout pregnancy. Pregnant women with abdominal obesity diagnosed before 12th week have higher mean serum leptin levels during pregnancy than those without abdominal obesity.
Views103This 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. Summary
Artigos OriginaisWaist circumference measured before the 12th week of pregnancy: correlation with serum leptin levels
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(6):268-273
07-13-2012DOI 10.1590/S0100-72032012000600005
Views103See morePURPOSE: To evaluate the correlation between maternal waist circumference measured before the 12th week of gestation and serum leptin levels during pregnancy, as well as to compare the leptin levels of women with and without abdominal obesity diagnosed in early pregnancy. METHODS: Prospective study including 40 pregnant women receiving low-risk prenatal care, older than 20 years, nonsmokers, with singleton pregnancies and without chronic disease. Waist circumference was measured before the 12th week and serum leptin levels were measured between the 9th and 12th, 25th and 28th and 34th and 37th weeks of gestation. According to waist circumference measurement, the cohort was divided into two groups: with and without abdominal obesity. The Mann-Whitney and χ² tests were used to assess the differences between groups. The Pearson correlation coeffient was used to assess the association between waist circumference and serum leptin levels during pregnancy. The level of significance was set at p<0.05. RESULTS: The mean weight and body mass index of patients with abdominal obesity (74.4±11.0 kg/28.9±4.1) was higher than that of patients without abdominal obesity (55.6±5.9 kg/21.1±2.4) (p=0.001). The mean leptin levels in pregnant patients with abdominal obesity (41.9±3.5 ng/mL) was higher than in patients without abdominal obesity (23.6±2.7 ng/mL) (p<0.0002). A positive correlation was obtained between the waist circumference measured during the same period and the mean serum leptin levels (r=0.7; p<0.0001). CONCLUSIONS: Waist circumference measured before the 12th week of pregnancy is a valid and simple method to predict the serum leptin levels throughout pregnancy. Pregnant women with abdominal obesity diagnosed before 12th week have higher mean serum leptin levels during pregnancy than those without abdominal obesity.
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. -
Artigos Originais
Self-reported adherence to prescribed medicines during pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(4):147-152
05-11-2012
Summary
Artigos OriginaisSelf-reported adherence to prescribed medicines during pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(4):147-152
05-11-2012DOI 10.1590/S0100-72032012000400002
Views51See morePURPOSE: To assess medication adherence therapeutic during pregnancy in a sample of Brazilian women during the post-partum period. METHODS: We conducted a cross-sectional study in the obstetric unit of a university hospital, Brazil, between August and November 2010. We recruited patients aged 18 years or more, with a gestational age of more than 22 weeks whose newborns weighed more than 500 g. Patients were excluded if they used sedatives or other mind-altering drugs. Data were collected after labor using a structured questionnaire containing questions about sociodemographic characteristics, medication use, number of previous pregnancies, contraceptive methods, prenatal care, and medication adherence. Medication adherence was assessed using the four-item Morisky medication adherence scale - MMAS-4, groups were compared by the Fisher exact Test and Kruskal-Wallis Test and Χ2 de Pearson Test. RESULTS: Mean age was 22.5 years (SD=6.5), and 53.8% of the pregnant women had initiated prenatal care during the first trimester of pregnancy. Of the 130 patients interviewed, 96.9% had used at least one prescribed drug during pregnancy, with an average of 2.8 drugs per patient. The major classes prescribed were antianemics (55.1%), analgesics, anti-inflammatories, and antipyretics (19.0%) and anti-infectives (7.2%). 71.6% took two to four drugs. Only 19.2% of patients were considered adherent. The variables that showed a negative influence on adherence were: higher level of education, having one's own income, earlier prenatal care and previous abortion. CONCLUSION: Our findings indicate that, although most of the patients used prescribed drugs during pregnancy, the rate of medication adherence was low, which indicates the need for further investigation about the impact of non-adherence during pregnancy and its causes.
Views51This 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. Summary
Artigos OriginaisSelf-reported adherence to prescribed medicines during pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(4):147-152
05-11-2012DOI 10.1590/S0100-72032012000400002
Views51See morePURPOSE: To assess medication adherence therapeutic during pregnancy in a sample of Brazilian women during the post-partum period. METHODS: We conducted a cross-sectional study in the obstetric unit of a university hospital, Brazil, between August and November 2010. We recruited patients aged 18 years or more, with a gestational age of more than 22 weeks whose newborns weighed more than 500 g. Patients were excluded if they used sedatives or other mind-altering drugs. Data were collected after labor using a structured questionnaire containing questions about sociodemographic characteristics, medication use, number of previous pregnancies, contraceptive methods, prenatal care, and medication adherence. Medication adherence was assessed using the four-item Morisky medication adherence scale - MMAS-4, groups were compared by the Fisher exact Test and Kruskal-Wallis Test and Χ2 de Pearson Test. RESULTS: Mean age was 22.5 years (SD=6.5), and 53.8% of the pregnant women had initiated prenatal care during the first trimester of pregnancy. Of the 130 patients interviewed, 96.9% had used at least one prescribed drug during pregnancy, with an average of 2.8 drugs per patient. The major classes prescribed were antianemics (55.1%), analgesics, anti-inflammatories, and antipyretics (19.0%) and anti-infectives (7.2%). 71.6% took two to four drugs. Only 19.2% of patients were considered adherent. The variables that showed a negative influence on adherence were: higher level of education, having one's own income, earlier prenatal care and previous abortion. CONCLUSION: Our findings indicate that, although most of the patients used prescribed drugs during pregnancy, the rate of medication adherence was low, which indicates the need for further investigation about the impact of non-adherence during pregnancy and its causes.
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. -
Artigos Originais
Photoprotection, melasma and quality of life in pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(5):228-234
05-11-2012
Summary
Artigos OriginaisPhotoprotection, melasma and quality of life in pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(5):228-234
05-11-2012DOI 10.1590/S0100-72032012000500007
Views71See morePURPOSE: To evaluate habits of sun exposure and sun protection of pregnant women in a public hospital, to assess orientation about photo protection during the prenatal care, and to detect the presence of melasma and its impact on their quality of life. METHODS: A descriptive cross sectional study conducted among women of 18 years old and older, after delivery, who participated in a program of prenatal care in the South Region of Brazil. The sample was non-probabilistic by convenience. Data collection occurred from July to August 2011 through direct interview using a structured questionnaire to obtain personal information and photo protection habits during pregnancy, skin assessment and photographic record of lesions through informed consent. The skin was classified per Fitzpatrick's phototypes and the melasma was diagnosed clinically. In the patients with melasma, the MELASQoL-PB version was applied. The analysis was performed using Statistica®, version 8.0, and the significance level of p<0.05. RESULTS: In the sample (109 mothers) predominated white women (60.6% phototype III), young (average age 24.4 years SD=6.1) and housewives (59.6%). The majority (80%) stayed exposed to sunlight for 1-2 hours per day between 10 am and 3 pm, and from those (72%) did not apply any photoprotection due to lack of sunscreen habit. Other physical means of sun protection were used by 15% of these patients. Information during prenatal care about the risks of sun exposure was reported by 34% of the mothers interviewed. There was a trend toward a significant association between prenatal guidance and daily use of sunscreen (p=0.088). About 20% of mothers had melasma. The average score MELASQol-PB (25) showed a negative impact on quality of life of these patients. CONCLUSION: In these women, sun exposure occurred at inappropriate times, without proper guidance and without the use of an effective sunscreen. The mothers with melasma complained about the appearance of their skin, frustration and embarrassment.
Views71This 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. Summary
Artigos OriginaisPhotoprotection, melasma and quality of life in pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2012;34(5):228-234
05-11-2012DOI 10.1590/S0100-72032012000500007
Views71See morePURPOSE: To evaluate habits of sun exposure and sun protection of pregnant women in a public hospital, to assess orientation about photo protection during the prenatal care, and to detect the presence of melasma and its impact on their quality of life. METHODS: A descriptive cross sectional study conducted among women of 18 years old and older, after delivery, who participated in a program of prenatal care in the South Region of Brazil. The sample was non-probabilistic by convenience. Data collection occurred from July to August 2011 through direct interview using a structured questionnaire to obtain personal information and photo protection habits during pregnancy, skin assessment and photographic record of lesions through informed consent. The skin was classified per Fitzpatrick's phototypes and the melasma was diagnosed clinically. In the patients with melasma, the MELASQoL-PB version was applied. The analysis was performed using Statistica®, version 8.0, and the significance level of p<0.05. RESULTS: In the sample (109 mothers) predominated white women (60.6% phototype III), young (average age 24.4 years SD=6.1) and housewives (59.6%). The majority (80%) stayed exposed to sunlight for 1-2 hours per day between 10 am and 3 pm, and from those (72%) did not apply any photoprotection due to lack of sunscreen habit. Other physical means of sun protection were used by 15% of these patients. Information during prenatal care about the risks of sun exposure was reported by 34% of the mothers interviewed. There was a trend toward a significant association between prenatal guidance and daily use of sunscreen (p=0.088). About 20% of mothers had melasma. The average score MELASQol-PB (25) showed a negative impact on quality of life of these patients. CONCLUSION: In these women, sun exposure occurred at inappropriate times, without proper guidance and without the use of an effective sunscreen. The mothers with melasma complained about the appearance of their skin, frustration and embarrassment.
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.
Pregnancy Archives - Revista Brasileira de Ginecologia e Obstetrícia
