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8 articles
  • Editorial

    Maternal mortality and the new objectives of sustainable development (2016-2030)

    Rev Bras Ginecol Obstet. 2015;37(12):549-551

    Summary

    Editorial

    Maternal mortality and the new objectives of sustainable development (2016-2030)

    Rev Bras Ginecol Obstet. 2015;37(12):549-551

    DOI 10.1590/SO100-720320150005526

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  • Original Article

    Sexual dysfunction in obese women is more affected by psychological domains than that of non-obese

    Rev Bras Ginecol Obstet. 2015;37(12):552-558

    Summary

    Original Article

    Sexual dysfunction in obese women is more affected by psychological domains than that of non-obese

    Rev Bras Ginecol Obstet. 2015;37(12):552-558

    DOI 10.1590/SO100-720320155443

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    Abstract

    PURPOSE:

    To compare differences in the occurrence and changed domains of sexual dysfunction in obese and non-obese Brazilian women.

    METHODS:

    Female Sexual Function Index, based on six domains, to investigate 31 sexual dysfunction incidence for obese compared to 32 non-obese women, was used. Statistical analysis using ANOVA and MANOVA were performed to compare total scores of Female Sexual Function Index among groups and to identify the differences among domains, Student t -test was used. Statistical significant level was established for all tests for p<0.05.

    RESULTS:

    No difference in female sexual dysfunction frequency between obese (25.8%) and non-obese women (22.5%) was found. However, an important distinction in which aspects of sexual life were affected was found. While the obese group was impaired in three domains of sexual life (desire, orgasm, and arousal), in the control group five aspects were dysfunctional (desire, orgasm, arousal, pain and lubrication). Future research exploring psychological outcomes in obese females, such as body image and measures of positive and negative effect, might better characterize the female sexual dysfunction in this group.

    CONCLUSIONS:

    Obesity does not appear to be an independent factor for allow quality of female sexual life. However, disturbance associated to obesity indicates a low frequency of disorder in physical domains, suggesting that psychological factors seem to be mainly involved in the sexual dysfunction in obese women.

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  • Original Article

    Telomerase activity associated with progression of cervical lesions in a group of Colombian patients

    Rev Bras Ginecol Obstet. 2015;37(12):559-564

    Summary

    Original Article

    Telomerase activity associated with progression of cervical lesions in a group of Colombian patients

    Rev Bras Ginecol Obstet. 2015;37(12):559-564

    DOI 10.1590/SO100-720320150005462

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    Abstract

    PURPOSE

    To analyze the relation between the cytological findings and telomerase activity (TA).

    METHODS

    Cervical samples were evaluated and classified according to the Bethesda System. Telomerase activity was measured total product generated values (TPG) using the TRAP assay (telomeric repeat amplification protocol); data were analyzed statistically using the χ2 test, with the level of significance set at p<0.05.

    RESULTS

    The study was conducted on 102 patients. Of these, 3.9% showed normal cytological findings, 8.8% showed cervicitis; 2% showed Atypical Squamous Cells of Undetermined Significance (ASCUS); 67.6% showed Low Grade Squamous Intraepithelial Lesion (LSIL); 11.8% showed High Grade Squamous Intraepithelial Lesion (H-SIL) and 5.9% showed Squamous Carcinoma. Among telomerase-positive samples, the TPG values were cervicitis

    CONCLUSION

    Results show increased telomerase activity with increasing severity of lesion, supporting the association between TA and type of lesion.

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    Telomerase activity associated with progression of cervical lesions in a group of Colombian patients
  • Original Article

    The influence of breastfeeding in postpartum oral glucose tolerance test in women with recent gestational diabetes mellitus

    Rev Bras Ginecol Obstet. 2015;37(12):565-570

    Summary

    Original Article

    The influence of breastfeeding in postpartum oral glucose tolerance test in women with recent gestational diabetes mellitus

    Rev Bras Ginecol Obstet. 2015;37(12):565-570

    DOI 10.1590/SO100-720320150005488

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    Abstract

    PURPOSE:

    To determine the influence of breastfeeding on the results of a postpartum oral glucose tolerance test in women recently diagnosed with gestational diabetes mellitus.

    METHODS:

    The data were obtained from the electronic medical records of the Endocrinopathy Sector during pregnancy, HCMED laboratory system ofHospital das Clínicas of São Paulo , and by telephone. According to the inclusion criteria adopted, 132 patients were eligible for the study. For statistical analysis, the patients were divided into two groups according to whether or not they breastfed. The results were analyzed by the Student t-test and by the Mann-Whitney, Chi-square and Fisher's exact tests, depending on the variable analyzed, with the level of significance set at p<0.05.

    RESULTS:

    Of the 132 patients included in the study, 114 breastfed and 18 did not. Most of the patients in both groups were overweight or obese. The breastfeeding group had a lower pre-pregnancy Body Mass Index than the non-breastfeeding group (p=0.006). Insulin was introduced earlier in the group that did not breastfeed (23.21±4.33 versus 28.84±6.17; p=0.04). The group that did not breastfeed had a higher mean postpartum fasting glucose value in the oral glucose tolerance test than the group that breastfed (91.3±8.7 versus 86.5±9.3; p=0.01). Breastfeeding acted as a protective factor against the development of glucose intolerance in the postpartum oral glucose tolerance test (OR=0.27; 95%CI 0.09-0.8). By logistic regression, breastfeeding was shown to be an independent protective factor.

    CONCLUSION:

    There was a statistically significant relationship between breastfeeding and a decreased risk of developing glucose intolerance. Breastfeeding should be encouraged because it is an effective, low cost intervention easily accessible to all patients during the postpartum period.

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    The influence of breastfeeding in postpartum oral glucose tolerance test in women with recent gestational diabetes mellitus
  • Original Article

    Nutritional and psychological factors associated with the occurrence of pica in pregnant women

    Rev Bras Ginecol Obstet. 2015;37(12):571-577

    Summary

    Original Article

    Nutritional and psychological factors associated with the occurrence of pica in pregnant women

    Rev Bras Ginecol Obstet. 2015;37(12):571-577

    DOI 10.1590/S0100-720320150005419

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    Abstract

    PURPOSE:

    To evaluate the nutritional and psychological factors associated with the occurrence of the practice of pica in pregnant women attending a public hospital in Rio de Janeiro, Brazil.

    METHODS:

    The study was based on a descriptive design with exploratory features, and conducted on 13 adult and adolescent pregnant women aged 16 to 40 years with a diagnosis of pica in the current pregnancy. Pica was diagnosed by a nutritionist in a standardized interview situation, when questions about the occurrence and frequency of pica, and types of substance ingestion were investigated. After signing the Informed Consent Form (ICF), all participants were evaluated by a nutritionist and seven of them were submitted to psychological assessment with standardized instruments to evaluate stress and anxiety, and to assess coping strategies.

    RESULTS:

    The type of pica most frequently reported was pagophagia (30.8%) and the consumption of fruit with salt (30.8%). The most prevalent coping strategies were "religious practice-focused" and "seeking social support", both presented by 42% of the pregnant women. We observed the occurrence of some degree of stress and anxiety in all pregnant women, as well as comorbidities (69.2%) and gastrointestinal symptoms (84.6%).

    CONCLUSION:

    Considering that pica may be associated with increased perinatal risk, it is very important to investigate this disorder during prenatal care, and to dopt obstetric, psychological and nutritional preventive practices to reduce the complications for mother and fetus.

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  • Original Article

    Reproductive outcome in pregnant women with recurrent pregnancy loss

    Rev Bras Ginecol Obstet. 2015;37(12):578-584

    Summary

    Original Article

    Reproductive outcome in pregnant women with recurrent pregnancy loss

    Rev Bras Ginecol Obstet. 2015;37(12):578-584

    DOI 10.1590/SO100-720320150005445

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    Abstract

    PURPOSE:

    To estimate the future pregnancy success rate in women with a history of recurrent pregnancy loss.

    METHODS:

    A retrospective cohort study including 103 women seen at a clinic for recurrent pregnancy loss (loss group) between January 2006 and December 2010 and a control group including 204 pregnant women seen at a low-risk prenatal care unit between May 2007 and April 2008. Both groups were seen in the university teaching hospital the Maternidade Climério de Oliveira, Salvador, Bahia, Brazil. Reproductive success rate was defined as an alive-birth, independent of gestational age at birth and survival after the neonatal period. Continuous variables Means and standard deviations (SD) were compared using Student's t-test and nominal variables proportions by Pearson χ2test.

    RESULTS:

    Out of 90 who conceived, 83 (91.2%) had reproductive success rate. There were more full-term pregnancies in the control than in the loss group (174/187; 92.1 versus 51/90; 56.7%; p<0.01). The prenatal visits number was satisfactory for 76 (85.4%) women in the loss group and 125 (61.3%) in the control (p<0.01). In this, the beginning of prenatal care was earlier (13.3; 4.2 versus 19.6; 6.9 weeks). During pregnancy, the loss group women increased the weight more than those in the control group (58.1 versus 46.6%; p=0.04). Although cervix cerclage was performed in 32/90 women in the loss group, the pregnancy duration mean was smaller (34.8 weeks; SD=5.6 versus 39.3 weeks; SD=1.6; p<0.01) than in the control group. Due to gestational complications, cesarean delivery predominated in the loss group (55/83; 64.7 versus 73/183; 39.5%; p<0.01).

    CONCLUSION:

    A very good reproductive success rate can be attributed to greater availability of healthcare services to receive pregnant women, through prenatal visits (scheduled or not), cervical cerclage performed on time, and available hospital care for the mother and newborn.

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  • Original Article

    Eating attitudes, attitudes related to weight gain, and body satisfaction of pregnant adolescents

    Rev Bras Ginecol Obstet. 2015;37(12):585-592

    Summary

    Original Article

    Eating attitudes, attitudes related to weight gain, and body satisfaction of pregnant adolescents

    Rev Bras Ginecol Obstet. 2015;37(12):585-592

    DOI 10.1590/S0100-720320150005481

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    Abstract

    PURPOSE:

    To assess attitudes about eating, weight gain and body image of pregnant adolescents.

    METHODS:

    Pregnant adolescents (n=67) were assessed using the Body Image Questionnaire, the Attitude towards Weight Gain during Pregnancy scale (AWGP) and questions about risk behaviors for eating disorders and unhealthy weight control practices. Associations between variables were analyzed by ANOVA, Kruskal-Wallis test, Pearson and Spearman tests. The influence of the independent variables regarding skipping meals, body satisfaction and binge eating was evaluated by logistic regression.

    RESULTS:

    The average age of the adolescents was 15.3 years (SD=1.14) and their average gestational age was 21.9 weeks (SD=6.53). The average AWGP score was 52.6 points, indicating a positive attitude towards weight gain, and 82.1% of the pregnant girls were satisfied with their bodies. Obese girls had more body dissatisfaction (p=0.001), and overweight girls thought more about food (p=0.02) and eating (p=0.03). The frequency of reported binge eating was 41.8%, and the frequency of skipping meals was 19%. Regression analysis showed that the current Body Mass Index (p=0.03; OR=1.18) and the importance of body awareness and fitness before pregnancy (p=0.03; OR=4.63) were predictors of skipping meals. Higher socioeconomic level (p=0.04; OR=0.55) and greater concern with weight gain (p=0.03; OR=0.32) predicted binge eating.

    CONCLUSION:

    Even though the majority of the pregnant adolescents had positive attitudes toward weight gain and body satisfaction, those heavier and more concerned with weight gain had a higher risk of unhealthy attitudes, while those of lower social class, less concerned with weight gain and less embarrassed about their bodies during pregnancy, had a lower risk of unhealthy attitudes.

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  • Case Report

    Renal vein thrombosis in the puerperium: case report

    Rev Bras Ginecol Obstet. 2015;37(12):593-597

    Summary

    Case Report

    Renal vein thrombosis in the puerperium: case report

    Rev Bras Ginecol Obstet. 2015;37(12):593-597

    DOI 10.1590/S0100-720320150005455

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    Abstract

    Pregnancy and puerperium are periods of blood hypercoagulability and, therefore, of risk for thromboembolic events. Renal vein thrombosis is a serious and infrequent condition of difficult diagnosis. This study reported a case of renal vein thrombosis in the puerperium, and described the clinical case, risk factors, diagnostic methods, and treatment instituted.

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    Renal vein thrombosis in the puerperium: case report

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