Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo102
01-23-2025
The study investigates the influence of positive-approach counseling through both online and face-to-face group therapy on the sexual intimacy of women after benign complete abdominal hysterectomy, addressing challenges such as the loss of femininity and other psychosexual complications that disrupt the couple’s relationship post-surgery.
This is a parallel clinical trial, conducted in 2023 in Yazd, Iran; with sixty-six participants post- benign complete abdominal hysterectomy were randomly assigned to online and face-to-face counseling groups. Each group had eight 90-minute sessions, and data were collected using demographic and intimacy scale (IS) questionnaires at baseline, eighth week, and twelfth week follow-up. Statistical analysis used SPSS version 23 (P < 0.05).
In the Online Group, the mean sexual intimacy score significantly increased from 72.42 ± 9.05 to 87.06 ± 7.98 at eight weeks and 90.30 ± 8.23 at twelve weeks (P < 0.001). In the Face-to-Face Group, the mean score increased from 70.21 ± 6.75 to 81.24 ± 5.55 at eight weeks and 85.03 ± 5.40 at twelve weeks (P < 0.001). Online counseling proved more effective than face-to-face counseling in enhancing sexual intimacy (P = 0.043).
Online and face-to-face counseling based on the positive approach improved sexual intimacy in women with a history of benign hysterectomy. Moreover, it seems that online counseling was more effective, so it is recommended that this method be employed in follow-up sessions after hysterectomy. Iranian Registry of Clinical Trials - IRCT20230209057373N1
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2025;47:e-rbgo99
01-23-2025
The aim of the study was to identify non-pharmacological therapeutic resources used by physiotherapists for pain relief during labor and childbirth.
This is a cross-sectional study conducted from January to March 2021, followed the STROBE guidelines. It included Brazilian physiotherapists with a minimum of two years in obstetric care experience. Data were collected using a 33-item online questionnaire, which covered sociodemographic details and the utilization of non-pharmacological resources. Descriptive analysis was used to determine participant characteristics. Associations between sociodemographic variables, specialist titles, participation in scientific events, and methods for pain relief methods during childbirth were assessed using chi-square or Fisher’s exact tests. Data were analyzed using SPSS version 23.0, with a significance level set at 5% (p < 0.05).
A total of 114 Brazilian physiotherapists participated in this study. Participants chose to utilize non-pharmacological therapies and resources that are within the scope of physiotherapists’ practice for labor pain. Kinesiotherapy with the use of devices was the most employed technique for pain relief during the birthing process.
The study highlights the prevalent use of non-pharmacological therapeutic resources, particularly kinesiotherapy with devices, among Brazilian physiotherapists for labor pain relief.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo78
10-23-2024
To traslate and validate of the Brazilian version of the SDI-2.
This was a cross-sectional study. The cultural adaptation considered the stages of initial translation, synthesis of translations, evaluation by a committee of experts from different regions of Brazil, back-translation, and pre-test. The content validity and psychometric proprieties was assessed.
Ten specialists participated in the cultural adaptation of the SDI-2. The content validity showed a Content Validity Ratio (CVR) ≥ 0.75 (p = 0.05). A total of 674 subjects participated in the field study. The Exploratory Factorial Analysis (EFA) presented factor loads ≥ 0.445, and commonalities ≥ 0.40; and two dimensions represented 77% of the total variance explained. The Confirmatory Factorial Analysis CFA presented X2/df = 4.265; the Root Mean Square Error of Approximation RMSEA = 0.110; the Non-Normed Fit Index NNFI = 0.946; the Comparative Fit Index (CFI) = 0.963; the Goodness of Fit Index GFI = 0.986; and the Adjusted Goodness of Fit Index AGFI = 0.979 for a two-factor model. The coefficient values for the total SDI-2 score were 0.91 for Cronbach's alpha, 0.91 for McDonald's Omega, and 0.97 for the Greatest Lower Bound GLB coefficients. The invariance between sexes was 0.01 for the ΔCFI and ΔRMSEA, showing model stability for these two populations.
The Brazilian version of the SDI-2 is self-report, valid, reliable and invariant across sex.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo87
10-23-2024
To compare access and suitability of antenatal care between years 2020 and 2022 among postpartum individuals at a Hospital in Florianopolis, and evaluate factors associated with antenatal suitability.
Observational, cross-sectional, and quantitative study carried out in 2022. Collected data were compared with the database of a previous similar study carried out in the same setting in 2020. Data were extracted from medical records and prenatal booklets, in addition to a face-to-face questionnaire. Adequacy was measured using the Carvalho and Novaes index and health access was qualitatively evaluated. Socio-demographic and antenatal variables were analyzed. A statistical significance level of 0.05 was considered. Open-ended questions were categorized for analysis.
395 postpartum individuals were included. Antenatal care was adequate for 48.6% in 2020 and 69.1% in 2022. Among the barriers to access, 56% reported difficulty in scheduling appointments and/or exams and 23% complained of reduced healthcare staff due to strikes, COVID-19, among others. Adequate antenatal care was associated with being pregnant in 2022, being referred to high-risk units (PNAR), and not reporting difficulties in access. Also, it was associated with twice the chance of investigation for gestational diabetes (GDM) and syphilis.
The 2022 post-vaccination period showed higher antenatal adequacy. The main difficulty for postpartum individuals was scheduling appointments and/or exams. Having antenatal care in 2022, no reports of difficulty in access, and follow-up at a high-risk unit were associated with antenatal adequacy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo56
07-26-2024
This study aimed to translate and validate the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese language, as we hypothesized that this tool would be consistent for addressing the specific context of hormonal symptoms in menopause.
In a cross-sectional study, a total of 119 women with Genitourinary Syndrome of Menopause (GSM) and 119 climacteric women without GSM were included. The EASQ-W was translated, and its psychometric properties were rigorously examined. Participants completed questionnaires covering sociodemographic details, the EASQ-W, and the Menopause Rating Scale (MRS). A subgroup of 173 women was re-invited after 4 weeks for test-retest analysis of the EASQ-W. Additionally, the responsiveness of the questionnaire was evaluated in 30 women who underwent oral hormonal treatment.
The internal consistency of the EASQ-W was found to be satisfactory in both GSM and control groups (Cronbach’s alpha ≥ 0.70). Notably, a floor effect was observed in both groups; however, a ceiling effect was only evident in the sexual domain of the GSM group. Construct validity was established by comparing the EASQ-W with the MRS, yielding statistically significant correlations (0.33831-0.64580, p < 0.001). The test-retest reliability over a 4-week period was demonstrated to be satisfactory in both the GSM and control groups (ICC 0.787-0.977). Furthermore, the EASQ-W exhibited appropriate responsiveness to oral hormonal treatment (p < 0.001).
This study successfully translated and validated the Estro-Androgenic-Symptom Questionnaire in Women (EASQ-W) into Brazilian Portuguese, with satisfactory internal consistency, test-retest reliability, and construct validity.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo42
06-27-2024
To evaluate the effects of surgical treatment of deep endometriosis on the metabolic profile, quality of life and psychological aspects.
Prospective observational study, carried out with women of reproductive age diagnosed with deep endometriosis, treated in a specialized outpatient clinic, from October/2020 to September/2022, at a University Hospital in Fortaleza - Brazil. Standardized questionnaires were applied to collect data on quality of life and mental health, in addition to laboratory tests to evaluate dyslipidemia and dysglycemia, at two moments, preoperatively and six months after surgery. The results were presented using tables, averages and percentages.
Thirty women with an average age of 38.5 years were evaluated. Seven quality of life domains showed improved scores: pain, control and impotence, well-being, social support, self-image, work life and sexual relations after surgery (ES ≥ 0.80). There was an improvement in mental health status with a significant reduction in anxiety and depression postoperatively. With the metabolic profile, all average levels were lower after surgery: total cholesterol 8.2% lower, LDL 12.8% lower, triglycerides 10.9% lower, and fasting blood glucose 7.3% lower (p < 0.001).
Surgical treatment of deep endometriosis improved the quality of life and psychological aspects of patients. The lipid profile of patients after laparoscopy was favorable when compared to the preoperative lipid profile.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo25
04-09-2024
Fertility preservation is a priority in oncology for female cancer patients. However, there is a lack of communication between infertility specialists and oncologists. This study aimed to evaluate infertility specialists’ perceptions and experiences regarding fertility preservation.
Conduct an online survey to profile infertility specialists. Participants were infertility affiliated with the Brazilian Federation of Gynecology and Obstetrics Associations (FEBRASGO). The specialists received an online survey, which response rate were 30.9%, most of whom were in southern and southeastern. The survey consisted on 14 questions about the infertility specialists’ location, techniques in clinical practice, treatment successful rate, patients idea, etc.
The average experience in human reproduction were 15.5 ± 10.2 years (mean ± standard deviation, range 1-40). Among reproductive-aged female cancer patients recommended for fertility preservation, 60.3 ± 28.8% (range 10-100%) underwent preservation procedures. Main barriers were cost (41%), oncologists’ knowledge or acceptance (35%) and accessibility (9%). Most infertility specialists (58%) considered 40 years the limit for fertility preservation. Leukemia, lymphoma, breast and ovarian cancers were prioritized for fertility preservation, while lung, thyroid, gastric, and brain cancers were less relevant.
This is the first Brazilian study about infertility specialists’ perceptions on oncology patients access to fertility preservation. These patients primarily receive treatment in the public health system, while infertility specialists mainly work in the private healthcare. This healthcare mode is currently fragmented, but integrating these experts is enhancing patient access to fertility preservation. Studies on this topic are still warranted.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2024;46:e-rbgo32
04-09-2024
To ascertain how screening for preterm birth is performed among obstetricians working in public and private practice in a middle-income country.
Cross-sectional study of 265 obstetrician-gynecologists employed at public and private facilities. An online questionnaire was administered, with items designed to collect data on prematurity screening and prevention practices.
The mean age of respondents was 44.5 years; 78.5% were female, and 97.7% had completed a medical residency program. Universal screening (i.e., by ultrasound measurement of cervical length) was carried out by only 11.3% of respondents in public practice; 43% request transvaginal ultrasound if the manual exam is abnormal, and 74.6% request it in pregnant women with risk factors for preterm birth. Conversely, 60.7% of respondents in private practice performed universal screening. This difference in screening practices between public and private practice was highly significant (p < 0.001). Nearly all respondents (90.6%) reported prescribing vaginal progesterone for short cervix.
In the setting of this study, universal ultrasound screening to prevent preterm birth was used by just over half of doctors in private practice. In public facilities, screening was even less common. Use of vaginal progesterone in cervical shortening was highly prevalent. There is an unmet need for formal protocols for screening and prevention of preterm birth in middle-income settings.