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Artigos Originais
Drug use during pregnancy in Natal, Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(1):12-18
04-08-2008
Summary
Artigos OriginaisDrug use during pregnancy in Natal, Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2008;30(1):12-18
04-08-2008DOI 10.1590/S0100-72032008000100003
Views64See morePURPOSE: to study the use of medicines by pregnant women during prenatal care in clinics of the national public health system in the city of Natal, Brazil. METHODS: a total of 610 pregnant women between the first and the third trimesters of pregnancy were interviewed in the public clinics of the four sanitary districts of Natal, from May to July 2006. The data were collected by a structured questionnaire, based in use-oriented and medicine-oriented questions. The drugs were classified according to the Anatomical Therapeutic Chemical Classification System (ATC), in agreement with the gestation risk criteria from the Food and Drugs Administration (FDA). The statistical analysis was made by the chi2 test. RESULTS: a total of 1,505 drugs were used, with an average of 2.4 medications per woman. The use of at least one drug was found in 86.6% of the women. The most frequently used drugs were anti-anemics (35.6%), analgesics (24.9%), drugs for gastrointestinal disorders (9.1%) and vitamins (7%). According to the FDA classification, 42.7% belonged to category A risk, 27.1% to category B, 29.3% to category C, 0.3% to category D and none to category X. The use of medicines during the first trimester of pregnancy amounted to 43.6%. The rate of drug use increased with higher schooling level and family income. Self-medication was found in 12.2% of the drug intake and this rate was higher in the first trimester of gestation and with women with low education level and previous gestations. CONCLUSIONS: pregnant women from Natal are being exposed to a variety of medicines with uncertain safety in pregnancy. Therefore, more careful prescription is needed, to avoid possible fetal damage.
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Relato de Caso
Septate uterus, cervical duplication and vaginal septum: a report of an uncommon malformation with normal term pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(11):588-592
02-27-2007
Summary
Relato de CasoSeptate uterus, cervical duplication and vaginal septum: a report of an uncommon malformation with normal term pregnancy
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(11):588-592
02-27-2007DOI 10.1590/S0100-72032007001100007
Views82See moreThis report describes an unusual case of spontaneous pregnancy in a patient with Müllerian anomaly. The patient was a 34-years old, white, nulligravida, with regular menstrual cycles, and suspected uterine septum observed during a routine ultrasonographic examination. The gynecological examination revealed a complete longitudinal vaginal septum and two uterine cervices. Three-dimensional pelvic ultrasonography showed cervix duplication, uterine septum from isthmus to endometrial cavity and absence of uterine body division, compatible with complete uterine septum and true dual cervices. She returned after one month and reported unprotected sexual intercourse and delayed menstrual period. She was pregnant, had a good pregnancy evolution, and delivered a healthy term baby girl, by cesarean section, at 37 weeks of pregnancy. This report describes a case of normal-term pregnancy in a patient with a rare anomaly (vaginal septum and two cervices) who became spontaneously pregnant without treatment.
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Artigos Originais
Association between pre-gestational nutritional status and prediction of the risk of adverse pregnancy outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):511-518
01-09-2007
Summary
Artigos OriginaisAssociation between pre-gestational nutritional status and prediction of the risk of adverse pregnancy outcome
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(10):511-518
01-09-2007DOI 10.1590/S0100-72032007001000004
Views90PURPOSE: to analyze the association between maternal pre-gestational nutritional status and maternal outcomes - hypertensive disorders of pregnancy, gestational diabetes, vitamin A deficiency, and anemia - and the newborn outcome - low birth weight. METHODS: cross-sectional study, with 433 adult puerperal women (> 20 years old) and their newborns, attending the Maternidade Escola of Universidade Federal do Rio de Janeiro (UFRJ). Data was collected through interviews and access to their medical records. Maternal pre-gestational nutritional status was established through pre-gestational body mass index according to the cut-offs for adult women defined by the World Health Organization (WHO), in 1995. The association between gestational outcomes and pre-gestational nutritional status was estimated through odds ratio (OR) and a 95% confidence interval (95%CI). RESULTS: frequency of pre-gestational weight deviation (low weight, overweight and obesity) was 31.6%. Considering the pre-gestational nutritional status, overweight and obese women presented a lower weight gain than eutrophic and low-weight women (p<0.05). Women with pre-gestational obesity presented a higher risk of developing hypertensive disordens of pregnancy (OR=6.3; 95%CI=1.9-20.5) and those with low pre-gestational weight were more likely to give birth to low birth weigh infants (OR=7.1; 95%CI=1.9-27.5). There was no evidence of the association between pre-gestational nutritional status and the development of anemia, vitamin A deficiency and gestational diabetes. The mean weight gain among overweight and obese pregnant women was significantly lower when compared to eutrophic and low-weight pregnant women (p=0.002, p=0.049, p=0.002, p=0.009). CONCLUSIONS: the high number of women with pre-gestational weight deviation reinforces the importance of a nutritional guidance that favors a good nutritional state and reduces the risks of maternal and newborn adverse outcomes.
Key-words AnthropometryBirth weightBody weightMaternal nutrition physiologyNutrition assessmentNutritional statusPregnancyRisk factorsSee more -
Artigos Originais
Validation of the Female Sexual Function Index in Brazilian pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):396-401
11-05-2007
Summary
Artigos OriginaisValidation of the Female Sexual Function Index in Brazilian pregnant women
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(8):396-401
11-05-2007DOI 10.1590/S0100-72032007000800003
Views100PURPOSE: to translate and to validate the Female Sexual Function Index (FSFI) for Brazilian pregnant women. METHODS: ninety-two pregnant women attended at a low risk prenatal clinic, with diagnosis of the pregnancy confirmed by precocious ultrasonography, participated in the research. Initially, we translated the FSFI questionnaire for Portuguese language (of Brazil) in agreement with the international criteria. Cultural, conceptual and semantics adaptations of FSFI were accomplished, because of the differences of the language, so that the pregnant women understood the subjects. All the patients answered FSFI twice, in the same day, with two different interviewers, with an hour interval from one to other interview. After 7 to 14 days, the questionnaire was applied again in a second interview. Reliability (internal intra and interobserver consistence) and the validity of the constructo (to demonstrate that questionnaire measures the sexual function) were appraised. RESULTS: Cultural adaptations were necessary for us to obtain the final version. The internal intra-observer (alpha of Chronbach) consistence of the several domains oscillated from moderate to strong (0,791 to 0,911) and the interobserver consistence varied from 0,791 to 0,914. In the validation of the constructo, were obtained moderate correlations to fort among the final scores (general) of FSFI and of Female Sexual Quotient (QS-F) that has the capacity to evaluate the feminine sexual function. CONCLUSIONS: FSFI was adapted to the Portuguese language and to the Brazilian culture, presenting significant reliability and validity; it could be included and used in future studies of the Brazilian pregnant sexual function.
Key-words DiagnosisPregnancyPregnant womenQuestionnairesReproducibility of resultsSexual dysfunctions, psychologicalWomen's healthSee more -
Artigos Originais
Insulinotherapy, maternal glycemic control and perinatal prognosis: difference between clinical and gestational diabetes
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):253-259
10-05-2007
Summary
Artigos OriginaisInsulinotherapy, maternal glycemic control and perinatal prognosis: difference between clinical and gestational diabetes
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):253-259
10-05-2007DOI 10.1590/S0100-72032007000500006
Views98See morePURPOSE: to evaluate the insulin therapy protocol and its maternal and perinatal outcome in patients with clinical or gestational diabetes in a high risk reference service. METHODS: descriptive and prospective study including 103 pregnant women with gestational or clinical diabetes treated with insulin and attended by the reference service from October 2003 to December 2005. Gemellarity, miscarriages, unfinished prenatal care and deliveries not attended by the service were excluded. The gestational age at the beginning of the treatment, dosage, doses/day, increment of insulin (UI/kg), glycemic index (GI) and perinatal outcomes were compared. ANOVA, Fisher’s exact test and Goodman’s test considering p<0.05 were used. RESULTS: multiparity (92 versus 67.9%), pre-gestational body mass index (BMI) >25 kg/m² (88 versus 58.5%), weight gain (WG) <8 kg (36 versus 17%) and a high increment of insulin characterized the gestational diabetes. For the patients with clinical diabetes, despite the highest GI (120 mg/dL (39.2 versus 24%)) at the end of the gestational period, insulin therapy started earlier (47.2 versus 4%), lasted longer (56.6 versus 6%) and higher doses of insulin (92 versus 43 UI/day) were administered up to three times a day (54.7 versus 16%). Macrosomia was higher among newborns from the cohort of patients with gestational diabetes (16 versus 3.8%), being the only significant neonatal outcome. There were no neonatal deaths, except for one fetal death in the cohort of patients with clinical diabetes. There were no differences in the other neonatal complications in both cohorts, and most of the newborns were discharged from hospital up to seven days after delivery (46% versus 55.8%). CONCLUSIONS: the analysis of these two cohorts has shown differences in the insulin therapy protocol in quantity (UI/day), dosage (UI/kg weight) and number of doses/day, higher for the clinical diabetes cohort, and in the increment of insulin, higher for the gestational diabetes cohort. Indirectly, the quality of maternal glycemic control and the satisfactory perinatal outcome have proven that the treatment protocol was adequate and did not depend on the type of diabetes.
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Artigo de Revisão
The use of sweeteners in pregnancy: an analysis of products available in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):267-275
10-05-2007
Summary
Artigo de RevisãoThe use of sweeteners in pregnancy: an analysis of products available in Brazil
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):267-275
10-05-2007DOI 10.1590/S0100-72032007000500008
Views111See moreSweeteners are frequently used by women of reproductive age. This is a narrative review about the sweeteners currently sold in the Brazilian commerce. There is a few information on the use of saccharin and cyclamates in pregnancy and their effects on the fetus. Due to the limited information available and their carcinogenic potential in animal species, saccharin and cyclamates should be avoided during pregnancy (risk C). Aspartame has been extensively studied in animals and it is considered safe for use during pregnancy (risk B), except by women homozygous for phenylketonuria (risk C). Sucralose and acessulfame-K are not toxic, carcinogenic or mutagenic in animals, but there are no controlled studies in humans. However, since these two sweeteners are not metabolized, it is unlikely that their use during pregnancy could be harmful (risk B). Stevia, a substance extracted from a native Brazilian plant, is innocuous in animal pregnancies, but there are no controlled studies in humans (risk B). Body agents found in the composition of artificial sweeteners (mannitol, sorbitol, xylitol, erithrol, lactilol, isomalt, maltilol, lactose, fructose, maltodextrin, dextrin, and inverted sugar) are substances generally regarded as safe for human consumption. In conclusion, according to the currently available evidence, aspartame, sucralose, acessulfame-K and stevia can be safely used during pregnancy.
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Trabalhos Originais
Delivery and Medical Attendance Types in Uberaba-MG
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(2):99-104
03-20-1999
Summary
Trabalhos OriginaisDelivery and Medical Attendance Types in Uberaba-MG
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(2):99-104
03-20-1999DOI 10.1590/S0100-72031999000200007
Views66See morePurpose: to study the actual conditions of medical assistance and types of delivery and factors contributing to their indication in Uberaba, MG. Method: the data of 4,294 puerperas who gave birth in the period from April 15, 1992 to April 14, 1993 in 7 maternities in Uberaba were studied. Results: it was seen that the Teaching Hospital had a greater participation in deliveries attending the younger population, probably the poorest and most unprepared regarding pregnancy. It was the only Hospital in which cesarean section rates were near those accepted by the who. Medical assistance in Uberaba was predominantly through Social Security (SUS), private health insurance and physicians representing a lower proportion. It was also verified that cesarean section frequency increased with age and type of medical assistance and the groups with private coverage presented a higher number of cesarean sections. Conclusion: it may be perhaps justified to consider the social factor as interfering with the indication of type of delivery.
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Trabalhos Originais
Effect of nipple stimulation on Bishop scores in term pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):13-17
03-15-1999
Summary
Trabalhos OriginaisEffect of nipple stimulation on Bishop scores in term pregnancies
Revista Brasileira de Ginecologia e Obstetrícia. 1999;21(1):13-17
03-15-1999DOI 10.1590/S0100-72031999000100003
Views59See morePurpose: to evaluate if the nipple stimulation performed by primigravidae, at 40 weeks, modifies Bishop index. Method: 64 primigravidae, without clinical or obstetrical complications were studied, in two groups. One group, called nipple stimulation group (N.S.G.) had 29 pregnant women. The other, named control group (C.G.) included 35 pregnant women. The N.S.G. performed the nipple stimulation test, bilaterally, from left to right, for two minutes followed by five minutes of rest, during thirty minutes. The test was done three times a day up to 41 weeks of pregnancy or beginning of labor. Statistical analysis of the results was performed using Student's t test, with 5 % significance. Results: once nipple stimulation was completed in the N.S.G., it was compared with the C.G. considering time of delivery. The results showed no significant differences between the groups regarding cervix modification, according to the Bishop index. Conclusions: there were no differences of the Bishop index in primigravidae, with more than 40 weeks of pregnancy, who performed nipple stimulation test, when compared with pregnant women of the control group.