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Revista Brasileira de Ginecologia e Obstetrícia. 12-21-2020;42(10):597-606
, , , , , The purpose of the present study was to evaluate the quality of mother-child bonding in three different contexts related to the labor, that is, vaginal delivery, elective cesarean section, and intrapartum cesarean section.
This was an observational, cross-sectional clinical study conducted in two cities within the state of São Paulo, Brazil. The study sample consisted of 81 babies born without any major complications during pregnancy and labor, aged 3 to 4 months, and their respective mothers, aged between 20 and 35 years old, primiparous, living in the cities of Palmital and Ourinhos, state of São Paulo, Brazil. The evaluation of the quality of the maternal-filial interaction was performed through video-image analysis, using the Mother-baby Interaction Observation Protocol from 0 to 6 months (POIMB 0-6, in the Portuguese acronym).
Mothers who had vaginal delivery had higher amount of visual contact or attempted visual contact (p = 0.034), better response to the social behavior of the child (p = 0.001) and greater sensitivity (p = 0.007) than the others. Their children also showed more interaction with them, as they looked more frequently at the mother's face (p ≤ 0.008) and responded more frequently to the mother's communicative stimulus (p < 0.001).
Considering the occurrence of vaginal delivery, it is concluded that the interaction between the mother-child dyad is quantitatively larger and qualitatively better when compared with intrapartum or elective cesarean section.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 12-21-2020;42(10):597-606
, , , , , The purpose of the present study was to evaluate the quality of mother-child bonding in three different contexts related to the labor, that is, vaginal delivery, elective cesarean section, and intrapartum cesarean section.
This was an observational, cross-sectional clinical study conducted in two cities within the state of São Paulo, Brazil. The study sample consisted of 81 babies born without any major complications during pregnancy and labor, aged 3 to 4 months, and their respective mothers, aged between 20 and 35 years old, primiparous, living in the cities of Palmital and Ourinhos, state of São Paulo, Brazil. The evaluation of the quality of the maternal-filial interaction was performed through video-image analysis, using the Mother-baby Interaction Observation Protocol from 0 to 6 months (POIMB 0-6, in the Portuguese acronym).
Mothers who had vaginal delivery had higher amount of visual contact or attempted visual contact (p = 0.034), better response to the social behavior of the child (p = 0.001) and greater sensitivity (p = 0.007) than the others. Their children also showed more interaction with them, as they looked more frequently at the mother's face (p ≤ 0.008) and responded more frequently to the mother's communicative stimulus (p < 0.001).
Considering the occurrence of vaginal delivery, it is concluded that the interaction between the mother-child dyad is quantitatively larger and qualitatively better when compared with intrapartum or elective cesarean section.
, , , , , Summary
Revista Brasileira de Ginecologia e Obstetrícia. 10-23-2020;42(9):588-592
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 10-23-2020;42(9):588-592
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 07-22-2019;41(6):371-378
The aim of this study was to determine the content and face validity of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) questionnaire cross-culturally adapted to Brazilian Portuguese.
The MCSRS is a questionnaire with 34 items related to childbirth satisfaction. The forward- and back-translated versions were compared with the original material, and 10 experts analyzed each item according to the following criteria: clarity, semantic equivalence, appropriateness, and cultural relevance. The final version was presented to 10 mothers for face validation to ensure the questionnaire would suit the target population.
The total of 34 items assessed by experts for clarity, semantic equivalence, appropriateness, and relevance showed positive agreement of 0.85, 0.92, 0.97 and 0.97; negative agreement of 0.13, 0.09, 0.04 and 0.04; and total agreement of 0.75; 0.85, 0.94 and 0.94, respectively. Multilevel linear modeling was applied with crossed random effects and with nested random effects for each judge. The intercept of each criterion was as follows: clarity, 0.87; semantic equivalence, 0.92; appropriateness, 0.96; and cultural relevance, 0.96. The overall mean of agreement was 92.8%. The face validity measurement yielded 80% of agreement on the items, all of them clearly understood.
The final version of the Brazilian Portuguese MCSRS questionnaire had face and content validity confirmed. This instrument of evaluation of maternal satisfaction during childbirth was validated to be applied in the Brazilian female population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 07-22-2019;41(6):371-378
The aim of this study was to determine the content and face validity of the Mackey Childbirth Satisfaction Rating Scale (MCSRS) questionnaire cross-culturally adapted to Brazilian Portuguese.
The MCSRS is a questionnaire with 34 items related to childbirth satisfaction. The forward- and back-translated versions were compared with the original material, and 10 experts analyzed each item according to the following criteria: clarity, semantic equivalence, appropriateness, and cultural relevance. The final version was presented to 10 mothers for face validation to ensure the questionnaire would suit the target population.
The total of 34 items assessed by experts for clarity, semantic equivalence, appropriateness, and relevance showed positive agreement of 0.85, 0.92, 0.97 and 0.97; negative agreement of 0.13, 0.09, 0.04 and 0.04; and total agreement of 0.75; 0.85, 0.94 and 0.94, respectively. Multilevel linear modeling was applied with crossed random effects and with nested random effects for each judge. The intercept of each criterion was as follows: clarity, 0.87; semantic equivalence, 0.92; appropriateness, 0.96; and cultural relevance, 0.96. The overall mean of agreement was 92.8%. The face validity measurement yielded 80% of agreement on the items, all of them clearly understood.
The final version of the Brazilian Portuguese MCSRS questionnaire had face and content validity confirmed. This instrument of evaluation of maternal satisfaction during childbirth was validated to be applied in the Brazilian female population.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 12-01-2017;39(12):670-675
To describe the experience of a distance education course on sexual issues during pregnancy and after birth for residents.
This prospective educational intervention study was conducted by investigators from the Universidade Federal de São Paulo, Brazil, between April and September 2014. The participants were 219 physicians (residents from the 1st to the 6th years). The duration of the course was of 24 hours (10 video lectures and online chats). At baseline, the participants answered questions about their training, attitude and experience regarding sexual issues during pregnancy and after birth; before and after the course, they answered questions to assess their knowledge about the topic; at the end of the course, they answered questions on the quality of the course. The Student t-test was used to compare the before and after scores of the knowledge tests; values of p < 0.05 were considered statistically significant.
A total of 143 residents concluded the course; most were in their 1st (27.2%) or 3rd (29.4%) years of residency. There was a significant increase in themean scores of the questionnaires that assessed the knowledge of the topic: 4.4 (1.6) versus 6.0 (1.3; maximum score: 10), before and after the course respectively (p < 0.0001). Most of the participants (74.1%) declared that the quality of the course as a whole reached their expectations, and 81.1% would recommend the course to a friend.
The online Sexology course for Obstetrics and Gynecology residents increased their knowledge about the sexual issues during pregnancy and after birth, and fulfilled the participants’ expectations. The experience described heremay serve as a model for other sexuality courses targeting similar audiences.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 12-01-2017;39(12):670-675
To describe the experience of a distance education course on sexual issues during pregnancy and after birth for residents.
This prospective educational intervention study was conducted by investigators from the Universidade Federal de São Paulo, Brazil, between April and September 2014. The participants were 219 physicians (residents from the 1st to the 6th years). The duration of the course was of 24 hours (10 video lectures and online chats). At baseline, the participants answered questions about their training, attitude and experience regarding sexual issues during pregnancy and after birth; before and after the course, they answered questions to assess their knowledge about the topic; at the end of the course, they answered questions on the quality of the course. The Student t-test was used to compare the before and after scores of the knowledge tests; values of p < 0.05 were considered statistically significant.
A total of 143 residents concluded the course; most were in their 1st (27.2%) or 3rd (29.4%) years of residency. There was a significant increase in themean scores of the questionnaires that assessed the knowledge of the topic: 4.4 (1.6) versus 6.0 (1.3; maximum score: 10), before and after the course respectively (p < 0.0001). Most of the participants (74.1%) declared that the quality of the course as a whole reached their expectations, and 81.1% would recommend the course to a friend.
The online Sexology course for Obstetrics and Gynecology residents increased their knowledge about the sexual issues during pregnancy and after birth, and fulfilled the participants’ expectations. The experience described heremay serve as a model for other sexuality courses targeting similar audiences.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 08-01-2015;37(8):359-365
DOI 10.1590/SO100-720320150005415
To compare sleep quality of overweight versus normal weight women in the second and third trimesters of pregnancy.
A cross-sectional study involving 223 women with 14 or more weeks of pregnancy, 105 of them overweight (pre-pregnancy body mass index - BMI - ≥25.0 kg/m2) and 118 of normal weight (BMI 18.5-24.9 kg/m2), attending the prenatal care clinic. The Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire was used to evaluate sleep quality. The Student t-test and the chi-square test were used to compare differences between groups and a p value <0.05 was considered statistically significant.
Most of the participants (67.7%) were poor sleepers (total score >5); this proportion was significantly higher among overweight (80/105) versus normal weight (67/118) women (76.2 versus 56.8%, p=0,004). During the second trimester, this difference did not reach statistical significance (72.5 versus 53.7%, respectively, p=0.06) but mean total PSQI-BR scores were significantly higher among overweight participants (7.0±3.8 versus 5.5±3.2, p=0.02). In the 2nd trimester, overweight women also had higher scores for sleep latency (1.4±1.0 versus 1.0±0.9, p=0.02) and subjective sleep quality (1.3±0.8 versus 0.8±0.8, p=0.02). In the third trimester, the proportion of women with poor sleep quality was significantly higher in the overweight group, but did not reach statistical significance (79.6 versus 60.8%, p=0.06). During this period, total mean scores were similar for women with and without excess weight (9.4±4.2 versus 8.3±4.6, p=0.2). However, overweight women had higher mean scores for sleep disturbance (2.3±0.7 versus 2.0±0.8, p=0.04).
Overweight women had a poorer sleep quality than normal weight women in the second and third trimesters of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 08-01-2015;37(8):359-365
DOI 10.1590/SO100-720320150005415
To compare sleep quality of overweight versus normal weight women in the second and third trimesters of pregnancy.
A cross-sectional study involving 223 women with 14 or more weeks of pregnancy, 105 of them overweight (pre-pregnancy body mass index - BMI - ≥25.0 kg/m2) and 118 of normal weight (BMI 18.5-24.9 kg/m2), attending the prenatal care clinic. The Brazilian version of the Pittsburgh Sleep Quality Index (PSQI-BR) questionnaire was used to evaluate sleep quality. The Student t-test and the chi-square test were used to compare differences between groups and a p value <0.05 was considered statistically significant.
Most of the participants (67.7%) were poor sleepers (total score >5); this proportion was significantly higher among overweight (80/105) versus normal weight (67/118) women (76.2 versus 56.8%, p=0,004). During the second trimester, this difference did not reach statistical significance (72.5 versus 53.7%, respectively, p=0.06) but mean total PSQI-BR scores were significantly higher among overweight participants (7.0±3.8 versus 5.5±3.2, p=0.02). In the 2nd trimester, overweight women also had higher scores for sleep latency (1.4±1.0 versus 1.0±0.9, p=0.02) and subjective sleep quality (1.3±0.8 versus 0.8±0.8, p=0.02). In the third trimester, the proportion of women with poor sleep quality was significantly higher in the overweight group, but did not reach statistical significance (79.6 versus 60.8%, p=0.06). During this period, total mean scores were similar for women with and without excess weight (9.4±4.2 versus 8.3±4.6, p=0.2). However, overweight women had higher mean scores for sleep disturbance (2.3±0.7 versus 2.0±0.8, p=0.04).
Overweight women had a poorer sleep quality than normal weight women in the second and third trimesters of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 11-01-2014;36(11):519-524
DOI 10.1590/S0100-720320140005100
To validate a questionnaire to be applied in order to learn and describe the perceptions of specialists in obstetrics and gynecology about their experience and self-confidence in the emergency care for vaginal delivery.
This was a prospective study for the validation of an instrument that contains statements about emergency obstetrical care: breech delivery (n=23), shoulder dystocia (n=20), postpartum haemorrhage (n=24), forceps delivery (n=32), and vacuum extractor (n=5). Participants gave their opinions on each item by applying the Likert scale (0=strongly disagree, 1=partially disagree, 2=indifferent, 3=partially agree and 4=strongly agree). The questionnaire was applied to 12 specialists in obstetrics and gynecology and it was expected to be found a level of comprehension exceeding 80%. A five-point scale was used to assess the understanding of each question (from 0=did not understand anything to 5=understood perfectly and I have no doubt). A score above 4 was considered to indicate sufficient understanding. The instrument used was specially designed to suit the specific demands. The analysis of internal reliability was done using the Cronbach alpha coefficient. For external validation, we calculated the proportion of items with full understanding for each subscale. For research purposes, the alpha should be greater than 0.7.
Participants had a mean age of 33.3 years, with 5.0 standard deviation (SD), and an average interval time since graduation from medical school of 5.8 years (SD=1.3 years). All were specialists with residency in obstetrics and gynecology. The mean proportion of participants who fully understood the items in each emergency was 97.3% for breech delivery, 96.7% for shoulder dystocia, 99.7% for postpartum hemorrhage, 97.4% for forceps delivery, and 98.3% for the use of a vacuum extractor. The results of Cronbach's alpha for the items in each emergency studied were: 0.85 for breech delivery, with 0.72 lower limit of 95% confidence interval ((%%CI), 0.74 for shoulder dystocia (lower limit of 95%CI=0.51), 0.79 for postpartum hemorrhage (lower limit of 95%CI=0.61), 0.96 for forceps delivery (lower limit of 95%CI=0.92), and 0.90 for the vacuum extractor (lower limit of 95%CI=0.79).
The validated questionnaire is useful for learning and describing the perception of physicians about their experience and self-confidence in emergency care for vaginal births.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 11-01-2014;36(11):519-524
DOI 10.1590/S0100-720320140005100
To validate a questionnaire to be applied in order to learn and describe the perceptions of specialists in obstetrics and gynecology about their experience and self-confidence in the emergency care for vaginal delivery.
This was a prospective study for the validation of an instrument that contains statements about emergency obstetrical care: breech delivery (n=23), shoulder dystocia (n=20), postpartum haemorrhage (n=24), forceps delivery (n=32), and vacuum extractor (n=5). Participants gave their opinions on each item by applying the Likert scale (0=strongly disagree, 1=partially disagree, 2=indifferent, 3=partially agree and 4=strongly agree). The questionnaire was applied to 12 specialists in obstetrics and gynecology and it was expected to be found a level of comprehension exceeding 80%. A five-point scale was used to assess the understanding of each question (from 0=did not understand anything to 5=understood perfectly and I have no doubt). A score above 4 was considered to indicate sufficient understanding. The instrument used was specially designed to suit the specific demands. The analysis of internal reliability was done using the Cronbach alpha coefficient. For external validation, we calculated the proportion of items with full understanding for each subscale. For research purposes, the alpha should be greater than 0.7.
Participants had a mean age of 33.3 years, with 5.0 standard deviation (SD), and an average interval time since graduation from medical school of 5.8 years (SD=1.3 years). All were specialists with residency in obstetrics and gynecology. The mean proportion of participants who fully understood the items in each emergency was 97.3% for breech delivery, 96.7% for shoulder dystocia, 99.7% for postpartum hemorrhage, 97.4% for forceps delivery, and 98.3% for the use of a vacuum extractor. The results of Cronbach's alpha for the items in each emergency studied were: 0.85 for breech delivery, with 0.72 lower limit of 95% confidence interval ((%%CI), 0.74 for shoulder dystocia (lower limit of 95%CI=0.51), 0.79 for postpartum hemorrhage (lower limit of 95%CI=0.61), 0.96 for forceps delivery (lower limit of 95%CI=0.92), and 0.90 for the vacuum extractor (lower limit of 95%CI=0.79).
The validated questionnaire is useful for learning and describing the perception of physicians about their experience and self-confidence in emergency care for vaginal births.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 05-01-2014;36(5):228-232
DOI 10.1590/S0100-7203201400050008
It was to assess the quality of life (QOL) of HIV-infected pregnant women using the HIV/AIDS - Targeted Quality of Life (HAT-QoL) questionnaire.
A descriptive study of 60 pregnant women attended at the Multidisciplinary Nucleus of Infectious Diseases During Pregnancy (NUPAIG) - UNIFESP/EPM and in the referral network of the Municipal Office of São Paulo, conducted from February 2011 to October 2012. Sociodemographic and clinical variables were collected from 60 HIV-infected pregnant women who answered the HAT-QoL questionnaire, which included 34 questions about quality of life.
The average age was 30 years and the average period of HIV infection was 5.7 years. Only 8.3% of patients had a CD4 cell score of ≤200 cells/mm³ and 45% showed undetectable viral load. The average domain scores ranged from 47.5 to 83.7. The domains with the lowest scores were financial concerns and concerns about secrecy. The domains with the highest scores and lower impact on quality of life were concerns about medication and confidence in the professional.
In this initial study with 60 pregnant women, we concluded that the HAT-QOL can contribute to the assessment of quality of life in the population of HIV-infected pregnant women in Brazil.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 05-01-2014;36(5):228-232
DOI 10.1590/S0100-7203201400050008
It was to assess the quality of life (QOL) of HIV-infected pregnant women using the HIV/AIDS - Targeted Quality of Life (HAT-QoL) questionnaire.
A descriptive study of 60 pregnant women attended at the Multidisciplinary Nucleus of Infectious Diseases During Pregnancy (NUPAIG) - UNIFESP/EPM and in the referral network of the Municipal Office of São Paulo, conducted from February 2011 to October 2012. Sociodemographic and clinical variables were collected from 60 HIV-infected pregnant women who answered the HAT-QoL questionnaire, which included 34 questions about quality of life.
The average age was 30 years and the average period of HIV infection was 5.7 years. Only 8.3% of patients had a CD4 cell score of ≤200 cells/mm³ and 45% showed undetectable viral load. The average domain scores ranged from 47.5 to 83.7. The domains with the lowest scores were financial concerns and concerns about secrecy. The domains with the highest scores and lower impact on quality of life were concerns about medication and confidence in the professional.
In this initial study with 60 pregnant women, we concluded that the HAT-QOL can contribute to the assessment of quality of life in the population of HIV-infected pregnant women in Brazil.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 04-14-2014;36(4):152-156
DOI 10.1590/S0100-720320140050.0004
It was to compare pregnant women who experienced recurrent spontaneous abortion (RSA) and those who did not in terms of the prevalence of depressive symptoms and sexual behavior.
A prospective case-control study was carried out. The first group consisted of women with RSA and the second, of primigravidae. The Beck Depression Inventory (BDI), the Female Sexual Function Index (FSFI) and one more questionnaire, developed by the authors themselves, about emotional aspects resulting from sexual intercourse during pregnancy were applied. The Student t-test was used to compare quantitative variables with normal distribution, and categorical variables were compared by the chi-square test or Fisher's exact test. The level of significance was set at p<0.05.
The BDI showed (19.9 versus 10.0%) approximately twice the incidence of depression in the RSA group. Regarding sexual function, the average scores of the FSFI were 21.1 and 16.4 (p<0.05) for the study and control groups, respectively, although no significant difference was observed only in the desire domain (average 3.4±1.3 for the RSA group and 3.7±1.1 for control group) (p=0.1). We observed that, regardless the presence or absence of an RSA history among the pregnant women, the higher the depression score, the lower the sexuality score (r=-0,3).
The RSA pregnant group often experiences twice higher depression and more impaired sexual function. There is an inverse association between depression and sexual function.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 04-14-2014;36(4):152-156
DOI 10.1590/S0100-720320140050.0004
It was to compare pregnant women who experienced recurrent spontaneous abortion (RSA) and those who did not in terms of the prevalence of depressive symptoms and sexual behavior.
A prospective case-control study was carried out. The first group consisted of women with RSA and the second, of primigravidae. The Beck Depression Inventory (BDI), the Female Sexual Function Index (FSFI) and one more questionnaire, developed by the authors themselves, about emotional aspects resulting from sexual intercourse during pregnancy were applied. The Student t-test was used to compare quantitative variables with normal distribution, and categorical variables were compared by the chi-square test or Fisher's exact test. The level of significance was set at p<0.05.
The BDI showed (19.9 versus 10.0%) approximately twice the incidence of depression in the RSA group. Regarding sexual function, the average scores of the FSFI were 21.1 and 16.4 (p<0.05) for the study and control groups, respectively, although no significant difference was observed only in the desire domain (average 3.4±1.3 for the RSA group and 3.7±1.1 for control group) (p=0.1). We observed that, regardless the presence or absence of an RSA history among the pregnant women, the higher the depression score, the lower the sexuality score (r=-0,3).
The RSA pregnant group often experiences twice higher depression and more impaired sexual function. There is an inverse association between depression and sexual function.