Pregnancy Archives - Page 25 of 25 - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Syphilis in Pregnancy: The Reality in a Public Hospital

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

    Summary

    Original Article

    Syphilis in Pregnancy: The Reality in a Public Hospital

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

    DOI 10.1055/s-0038-1676569

    Views54

    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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    Syphilis in Pregnancy: The Reality in a Public Hospital
  • 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

    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

    DOI 10.1055/s-0038-1675613

    Views33

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

    Association between Caffeine Consumption in Pregnancy and Low Birth Weight and Preterm Birth in the birth Cohort of Ribeirão Preto

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):749-756

    Summary

    Original Article

    Association between Caffeine Consumption in Pregnancy and Low Birth Weight and Preterm Birth in the birth Cohort of Ribeirão Preto

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(12):749-756

    DOI 10.1055/s-0038-1675806

    Views20

    Abstract

    Objective

    To describe caffeine consumption during pregnancy and its association with low birth weight (LBW) and preterm birth in the birth cohort of Ribeirão Preto, state of São Paulo, Brazil, in 2010.

    Methods

    Cohort study, with descriptive and analytical approach. Data included 7,607 women and their newborns in Ribeirão Preto, state of São Paulo, Brazil. The women answered standardized questionnaires about reproductive health, prenatal care, life habits, sociodemographic conditions, and information about coffee intake. The independent variable was high caffeine consumption (≥300 mg/day) from coffee during pregnancy, and the dependent variables were LBW (birth weight < 2,500 g) and preterm birth (< 37 weeks of gestational age). Four adjusted polytomous logistic regression models, relative risk (RR) and 95% confidence interval (CI) were fitted: biological and sociodemographic conditions; obstetric history; current gestational conditions; and all variables included in the previous models.

    Results

    A total of 4,908 (64.5%) mothers consumed caffeine, 143 (2.9%) of whom reported high consumption. High caffeine intake was significantly associated with reduced education and with the occupation of the head of the family, nonwhite skin color, not having a partner, higher parity, previous abortion and preterm birth, urinary tract infection, threatened abortion, alcohol consumption and smoking. No association was found between high caffeine consumption and LBW or preterm birth in both

    Conclusion

    In this cohort, high caffeine intake was lower than in other studies and no association with LBW or preterm birth was found.

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  • Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis

    . ;

    Summary

    Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis

    . ;

    DOI

    Views7
    Abstract Objective Does the use of metformin have an influence on the outcomes of preeclampsia (PE)? Sources of Data The descriptors pregnancy, metformin, treatment, and preeclampsia associated with the Boolean operators AND and OR were found in the MEDLINE, LILACS, Embase and Cochrane databases. A flowchart with exclusion criteria and inclusion strategy using the Preferred […]
    Key-words Pregnancy
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    Evaluation of Preeclampsia Results after Use of Metformin in Gestation: Systematic Review and Meta-analysis
  • Original Article

    Systemic Lupus Erythematosus and Pregnancy: A Single-Center Observational Study of 69 Pregnancies

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(10):587-592

    Summary

    Original Article

    Systemic Lupus Erythematosus and Pregnancy: A Single-Center Observational Study of 69 Pregnancies

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(10):587-592

    DOI 10.1055/s-0038-1672136

    Views4

    Abstract

    Objective

    To evaluate the effects of pregnancy in systemic lupus erythematosus (SLE) patients.

    Methods

    The present article is a retrospective cohort study. Datawere collected from medical records of pregnant women with SLE from January 2002 to December 2012 at Universidade Estadual de Campinas, in the city of Campinas, state of São Paulo, Brazil. Systemic lupus erythematosus and disease activity were defined according to the American College of Rheumatology and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) criteria respectively. The means, standard deviations (SDs), percentages and correlations were performed using the SAS software, version 9.4 (SAS Institute Inc., Cary, NC, US).

    Results

    We obtained data from 69 pregnancies in 58 women. During pregnancy, a new flare was observed in 39.2% (n = 27). The manifestations were most common in patients with prior kidney disease, and mainly occurred during the third quarter and the puerperium. Renal activity occurred in 24.6% (n = 17), and serious activity, in 16% (n = 11). Of all deliveries, 75% (n = 48) were by cesarean section. Twomaternal deaths occurred (3%). Preterm birth was themain complication in the newborns. The abortion rate was 8.7%. Severe SLEDAI during pregnancy was associated with prematurity (100%) and perinatal death (54%).

    Conclusion

    Thematernal-fetal outcome is worse in SLE when thewomen experience a flare during pregnancy. The best maternal-fetal outcomes occur when the disease is in remission for at least 6 months before the pregnancy.

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  • Original Articles

    Risk Assessment for Preterm Delivery using the Fetal Fibronectin Test Associated with the Measurement of Uterine Cervix Length in Symptomatic Pregnant Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):507-512

    Summary

    Original Articles

    Risk Assessment for Preterm Delivery using the Fetal Fibronectin Test Associated with the Measurement of Uterine Cervix Length in Symptomatic Pregnant Women

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(9):507-512

    DOI 10.1055/s-0038-1667185

    Views6

    Abstract

    Objective

    To analyze the use of the measurement of uterine cervix length (MUCL) and the fetal fibronectin (fFN) rapid test as predictors of preterm delivery (PTD) in symptomatic pregnant women assisted at the Santa Casa de Misericórdia de Sobral Maternity Hospital.

    Methods

    This was a prospective and analytic study involving 53 parturients assisted between September of 2015 and July of 2016; the participants were between 24 and 34 weeks of gestational age (GA) and presented complaints related to preterm labor (PTL) prodromes. Vaginal secretion was collected for fFN testing, and the MUCL was obtained via transvaginal ultrasonography.

    Results

    A total of 58.49% of the subjects showed MUCL < 25 mm, and 41.51% were positive in the fFNrapid test.Atotal of 48 patients were followed-up until their delivery date, and 54.17% resulted in PTL. The relative risk (RR) for PTD in patients with MUCL < 25 mm was 1.83 (p = 0.09, 0.99-3.36, 95% confidence interval [CI]), with a mean time before delivery of 2.98 weeks. Based on fFN positive results, the RR was 3.50 (p = 0.002, 1.39- 8.79, 95%CI) and themean time until delivery was 1.94weeks. The RRwas 2.70 (p = 0.002, 1.08-6.72, 95%CI) when both tests were used. The RR of PTD within 48 hours, and 7 and 14 days were, respectively, 1.30 (p = 0.11, 95% CI 1.02-1.67), 1.43 (p = 0.12, 95% CI % 0.99-2.06), and 2.03 (p = 0.008, 95% CI 1.26-3.27), when based on the MUCL, and 1.75 (p = 0.0006, 95% CI 1.20-2.53), 2.88 (p = 0.0001, 95% CI, 1.57-5.31), and 3.57 (p = 0.0002, 95% CI 1.63-7.81) when based on positive fFN results. The RR at 48 hours and 7 and 14 days considering both tests was 1.74 (p = 0.0001, 95% CI 1.14-2.64), 2.22 (p = 0.0001, 95% CI 1.22-4.04), and 2.76 (p = 0.0002, 95% CI 1.27-5.96), respectively.

    Conclusion

    In symptomatic pregnant women, we concluded that the MUCL < 25 mm associated with positive fFN rapid test indicate increased the risk for PTD. Further studies with larger sample sizes could contribute in supporting the results presented in the current study.

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  • Drug Use during Pregnancy and its Consequences: A Nested Case Control Study on Severe Maternal Morbidity

    . ;

    Summary

    Drug Use during Pregnancy and its Consequences: A Nested Case Control Study on Severe Maternal Morbidity

    . ;

    DOI

    Views13
    Abstract Objective To assess the relationship between the use of psychoactive substances during pregnancy and the occurrence of severe maternal morbidity (SMM), perinatal outcomes and repercussions on the neuropsychomotor development of exposed children. Methods A case-control study nested within a cohort of severe maternal morbidity (COMMAG) was performed. Women with SMM were considered cases. Controls […]
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    Drug Use during Pregnancy and its Consequences: A Nested Case Control Study on Severe Maternal Morbidity
  • Original Article

    Hazards of Repeat Pregnancy during Adolescence: A Case-control Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):437-443

    Summary

    Original Article

    Hazards of Repeat Pregnancy during Adolescence: A Case-control Study

    Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(8):437-443

    DOI 10.1055/s-0038-1666811

    Views12

    Abstract

    Objective

    To evaluate the social, obstetric and psychological risk factors related to repeat pregnancy in teenagers.

    Methods

    A case control study conducted at Centro de Atenção à Saúde Integral da Mulher (Caism, in the Portuguese acronym), in Campinas, Brazil, from 2015 to 2017. Three groups were selected: a case-group of adolescents who had repeat pregnancy and two control-groups, one consisting of adolescents who had delivered at first time and another one of adult women with more than one deliveries. Participants were asked about habits, socio-demographics characteristics, reproductive and obstetric history and assessed psychological issues.

    Results

    Ninety women were enrolled, 30 in each study group. Adolescents with repeat pregnancy have lower self-esteem scores and more ineffective contraceptive use. When compared with teens at first delivery, they had less schooling level (odds ratio [OR] 4.03 [1.37-11.8]), more school abandon (OR 8.16 [2.36-28.2]) and drugs use (OR 4.97[1.39-17.8]). Non-white skin color (OR 6.2 [1.15-41.0]), drugs use (OR 17.5 [2.62-116.6]) and first sexual intercourse under 15y (OR 18.0[2.82-115.0]) were found as higher risk factors for repeat pregnancy when comparing adolescents and adults.Moreover, adolescents withmore than one gestation had lower self-esteem and greater susceptibility to unplanned pregnancy.

    Conclusion

    There was an association between repeat pregnancy among adolescents and lower education, early onset of sexual activity, non-white skin color, low use of contraception and increased use of drugs.

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