Anelise Riedel Abrahão

Assistência multiprofissional à vítima de violência sexual: a experiência da Universidade Federal de São Paulo

This article discusses the importance of multidisciplinary care for victims of sexual assault in order to mitigate the respective physical, psychological, and social harm. The article begins with a brief description of the activities by various professionals involved in the care of victims treated at the Womens Health Center of the Federal University in Sao Paulo, and presents the outcome of some cases treated at this institution in its five years of experience. The article provides the socio-demographic profile of female rape victims since the beginning of this womens health service, with the number of women who became pregnant, those who underwent abortion, and the number of court suits filed.

A violência doméstica como indicador de risco no rastreamento da depressão pós-parto

PURPOSE: to assess the prevalence of the risk of post-partum depression in women in the post-natal ward of a hospital in Sao Paulo city, in the southeastern region of Brazil, and analyze the associated factors, including domestic violence (DV). METHODS: this was a descriptive, cross-sectional study. The participants were 133 women with at least 20 weeks of gestation age, who delivered their babies from August to September 2005 in a tertiary maternity in the city of Sao Paulo (Brazil). They were interviewed using the Portuguese version of the Abuse Assessment Screen for the diagnosis of violence and filled out a self-evaluation questionnaire for post-partum depression (Edinburgh Postnatal Depression Scale). Variables were presented as absolute and relative frequencies. The c2 or Fisher exact tests were used to analyze possible associations between the variables of interest and post-partum depression. The value of 5% was considered significant. RESULTS: risk for post-partum depression was detected in 24 women (18%). A total of 38.3% of the participants interviewed had a history of abuse. There was an association between DV after they were 15 years old and risk of depression (p=0.036). The prevalence of abuse in the group of women at risk for post-partum depression was 58.3% and this was significantly higher than the 33.9% observed in the control group. CONCLUSIONS: the probability of presenting depression was high among the post-partum women attended at a tertiary maternity in the southeast of Brazil. The DV after they were 15 years old was significantly associated with risk of post-partum depression.

Complicações obstétricas em gestações com feto portador de anomalia incompatível com a sobrevida neonatal

Objective: To describe the most common obstetric complications encountered during periods of pregnancy, childbirth and puerperium, in pregnancies with fetuses that presented anomalies incompatible with life. Methods: This is a descriptive study, which assessed 78 medical charts of patients in the Prenatal Fetal Medicine Division of the Federal University of Sao Paulo; the women gave birth at the same institution, between 2000 and 2006. Results: The major obstetric complications identified were: variation in the volume of amniotic fluid (68%), miscarriage, pre-term labor and prolonged pregnancy were present in 6.4%, 55.1% and 3.8% of pregnancies, respectively; intrauterine fetal death, 17.9%, abruptio placenta occurred in 6.4% and hysterectomy in 2.6%. Conclusion: These results suggest that fetus with severe anomalies presented an increase of the risk for pregnancies, which demonstrates the need for expert evaluation in each case. Descriptors: Pregnancy complications; Pregnancy, high-risk; Congenital abnormalities; Genetic counselingABSTRACT Objective: To describe the most common obstetric complications encountered during periods of pregnancy, childbirth and puerperium, inpregnancies with fetuses that presented anomalies incompatible with life. Methods: This is a descriptive study, which assessed 78 medicalcharts of patients in the Prenatal Fetal Medicine Division of the Federal University of Sao Paulo; the women gave birth at the sameinstitution, between 2000 and 2006. Results: The major obstetric complications identified were: variation in the volume of amniotic fluid(68%), miscarriage, pre-term labor and prolonged pregnancy were present in 6.4%, 55.1% and 3.8% of pregnancies, respectively; intra-uterine fetal death, 17.9%, abruptio placenta occurred in 6.4% and hysterectomy in 2.6%. Conclusion: These results suggest that fetus withsevere anomalies presented an increase of the risk for pregnancies, which demonstrates the need for expert evaluation in each case. Descriptors: Pregnancy complications; Pregnancy, high-risk; Congenital abnormalities; Genetic counseling

Prevalência de violência por parceiro íntimo relatada por puérperas

OBJECTIVES: Estimating the prevalence of intimate partner violence reported by puerperal women, classifying the type of violence, the period of pregnancy and childbirth in the occurrence and characterizing the profile of partners. METHODS: Cross-sectional study of 207 postpartum women. The survey instrument used was based on the model proposed by Schraiberet. RESULTS: The prevalence of intimate partner violence before, during and/or after pregnancy was 51.2%. The profile of partners was characterized as a young group, with good education, worker and non-user of licit or illicit drugs. CONCLUSION: The prevalence of occurrence of intimate partner violence reported by puerperal women was 51.2%.

Repercussões maternas do diagnóstico pré-natal de anomalia fetal

Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brazil. Conflicts of interest: there are no conflicts of interest to declare. Abstract Objective: To compare coping strategies for congenital abnormalities pre-natal diagnosis of viable and nonviable fetuses. Methods: Quantitative cross-sectional study of 120 pregnant women, conducted in a center of excellence of fetal medicine, from January to December, 2014. Data were obtained through the following: semi-structured interviews which included socio-demographic information, personal and obstetrics history, and use of the coping strategies inventory. The tests used to compare categorical variations between viable and non-viable malformations were the chi-squared test, and Fisher’s exact test or likelihood ratios. Student’s t-test was used for continuous variables, and when necessary, it the Analysis of Variance was used. Results: There were significant differences in the self-control strategy between pregnant women diagnosed with a non-viable fetus compared to those diagnosed with a viable fetus. Conclusion: Pregnant women diagnosed with a non-viable fetal anomaly presented a greater tendency to use the self-control strategy than those diagnosed with a viable fetus.

Depression in Women with Recurrent Miscarriages - an Exploratory Study

Objective To assess depression, domestic violence and the use of substances in women with recurrent miscarriages. Methods The Abuse Assessment Screen (AAS), the Edinburgh Postnatal Depression Scale (EPDS) and the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) were used to assess violence, depression and the use of substances among women with recurrent miscarriages. The population corresponded to patients receiving prenatal care from June to August 2014. Multiple logistic regression was used to assess the multivariable relationship between depression and sociodemographic, psychosocial and medical characteristics (p < 0,10). Results The prevalence of depression was of 41.3% (95% confidence interval [CI] = 28.3-55.7%). One third of the pregnant women (32.6%) reported emotional or physical violence, and 13% were classified as abusing or addicted to tobacco according to ASSIST. History of psychiatric diseases was associated with depression (p = 0.005). Violence during life demonstrated a modest association (p = 0.073) with depression, as well as the number of miscarriages (p = 0.071). Conclusion Depression is a frequent disease among pregnant women with recurrent miscarriages. The results of this investigation suggest that a systematic assessment of depression and its associated conditions, such as domestic violence and the use of substances, should be part of the prenatal follow-up visits for women with recurrent miscarriages.

Domestic Violence in Pregnant Women: A Study Conducted in the Postpartum Period of Adolescents and Adults.

The aim of this study was to estimate the prevalence of domestic violence in adolescent and adult mothers who were admitted to obstetrics services centers in Brazil and to identify risk factors of domestic violence and any adverse obstetric and perinatal outcomes. Researchers used standardized interviews, the questionnaire Abuse Assessment Screen, and a review of patients’ medical records. Descriptive statistical analyses were also used. The prevalence of domestic violence among all participants totaled 40.1% (38.5% of adolescents, 41.7% of adults). Factors associated with domestic violence during pregnancy were as follows: a history of family violence, a greater number of sexual partners, and being a smoker. No statistically significant association was found for adverse obstetric and perinatal outcomes. Results showed that, in Vitória, Espírito Santo, Brazil, pregnancy did not protect a woman from suffering domestic violence.

Association of gestational age with the option of pregnancy termination for fetal abnormalities incompatible with neonatal survival

ABSTRACT Objective: To identify the profile of women seen in a Fetal Medicine unit, diagnosed with fetal abnormality incompatible with neonatal survival in their current pregnancy, and to check the association of gestational age upon diagnosis with the option of pregnancy termination. Methods: This is a retrospective cohort study carried out in the Fetal Medicine Outpatients Clinic of a university hospital, in the city of São Paulo (SP), Brazil, using medical records of pregnant women with fetus presenting abnormalities incompatible with neonatal survival. The sample comprised 94 medical records. The Statistical Package for the Social Sciences (SPSS), version 19, was used for the data statistical analysis. Results: The population of the study included young adult women, who had complete or incomplete high school education, employed, with family income of one to three minimum wages, single, nonsmokers, who did not drink alcoholic beverages or used illicit drugs. Women with more advanced gestational age upon fetal diagnosis (p=0.0066) and/or upon admission to the specialized unit (p=0.0018) presented a lower percentage of termination of pregnancy. Conclusion: Due to characteristics different from those classically considered as of high gestational risk, these women might not be easily identified during the classification of gestational risk, what may contribute to a late diagnosis of fetal diseases. Early diagnosis enables access to specialized multiprofessional care in the proper time for couples counseling on the possibility of requesting legal authorization for pregnancy termination.

Obstetric complications in pregnancies with fetal anomalies incompatible with neonatal survival

Objective: To describe the most common obstetric complications encountered during periods of pregnancy, childbirth and puerperium, in pregnancies with fetuses that presented anomalies incompatible with life. Methods: This is a descriptive study, which assessed 78 medical charts of patients in the Prenatal Fetal Medicine Division of the Federal University of Sao Paulo; the women gave birth at the same institution, between 2000 and 2006. Results: The major obstetric complications identified were: variation in the volume of amniotic fluid (68%), miscarriage, pre-term labor and prolonged pregnancy were present in 6.4%, 55.1% and 3.8% of pregnancies, respectively; intrauterine fetal death, 17.9%, abruptio placenta occurred in 6.4% and hysterectomy in 2.6%. Conclusion: These results suggest that fetus with severe anomalies presented an increase of the risk for pregnancies, which demonstrates the need for expert evaluation in each case. Descriptors: Pregnancy complications; Pregnancy, high-risk; Congenital abnormalities; Genetic counselingABSTRACT Objective: To describe the most common obstetric complications encountered during periods of pregnancy, childbirth and puerperium, inpregnancies with fetuses that presented anomalies incompatible with life. Methods: This is a descriptive study, which assessed 78 medicalcharts of patients in the Prenatal Fetal Medicine Division of the Federal University of Sao Paulo; the women gave birth at the sameinstitution, between 2000 and 2006. Results: The major obstetric complications identified were: variation in the volume of amniotic fluid(68%), miscarriage, pre-term labor and prolonged pregnancy were present in 6.4%, 55.1% and 3.8% of pregnancies, respectively; intra-uterine fetal death, 17.9%, abruptio placenta occurred in 6.4% and hysterectomy in 2.6%. Conclusion: These results suggest that fetus withsevere anomalies presented an increase of the risk for pregnancies, which demonstrates the need for expert evaluation in each case. Descriptors: Pregnancy complications; Pregnancy, high-risk; Congenital abnormalities; Genetic counseling

Complicaciones obstétricas en gestaciones con feto portador de anomalía incompatible con la sobrevivencia neonatal

Objective: To describe the most common obstetric complications encountered during periods of pregnancy, childbirth and puerperium, in pregnancies with fetuses that presented anomalies incompatible with life. Methods: This is a descriptive study, which assessed 78 medical charts of patients in the Prenatal Fetal Medicine Division of the Federal University of Sao Paulo; the women gave birth at the same institution, between 2000 and 2006. Results: The major obstetric complications identified were: variation in the volume of amniotic fluid (68%), miscarriage, pre-term labor and prolonged pregnancy were present in 6.4%, 55.1% and 3.8% of pregnancies, respectively; intrauterine fetal death, 17.9%, abruptio placenta occurred in 6.4% and hysterectomy in 2.6%. Conclusion: These results suggest that fetus with severe anomalies presented an increase of the risk for pregnancies, which demonstrates the need for expert evaluation in each case. Descriptors: Pregnancy complications; Pregnancy, high-risk; Congenital abnormalities; Genetic counselingABSTRACT Objective: To describe the most common obstetric complications encountered during periods of pregnancy, childbirth and puerperium, inpregnancies with fetuses that presented anomalies incompatible with life. Methods: This is a descriptive study, which assessed 78 medicalcharts of patients in the Prenatal Fetal Medicine Division of the Federal University of Sao Paulo; the women gave birth at the sameinstitution, between 2000 and 2006. Results: The major obstetric complications identified were: variation in the volume of amniotic fluid(68%), miscarriage, pre-term labor and prolonged pregnancy were present in 6.4%, 55.1% and 3.8% of pregnancies, respectively; intra-uterine fetal death, 17.9%, abruptio placenta occurred in 6.4% and hysterectomy in 2.6%. Conclusion: These results suggest that fetus withsevere anomalies presented an increase of the risk for pregnancies, which demonstrates the need for expert evaluation in each case. Descriptors: Pregnancy complications; Pregnancy, high-risk; Congenital abnormalities; Genetic counseling