Jorge Andalaft Neto

The Closer You Are, the Better You Understand: The Reaction of Brazilian Obstetrician—Gynaecologists to Unwanted Pregnancy

Abstract In Brazil, abortion is legally restricted but highly prevalent. The objective of this study was to obtain data on the opinions of obstetrician—gynaecologists regarding abortion and to verify whether there is consistency between their personal opinion with respect to abortion and their private decision when confronted personally with an unwanted pregnancy or with a request for abortion from a patient or relative. A structured questionnaire was sent to obstetrician—gynaecologists, members of the Brazilian Federation of Gynaecological and Obstetrical Societies (FEBRASGO). A total of 4,261 physicians responded, a 30% response rate. Almost a quarter of female physicians and a third of male physicians had had an unwanted pregnancy, and 80% of these were aborted. Even among those for whom religion was very important, almost 70% chose abortion when personally faced with an unwanted pregnancy. Twice as many respondents accepted abortion as a solution for themselves or their partners as for their patients. The difference was much smaller only if the physician had personally experienced abortion. Thus, the closer physicians are to the problem of abortion, the greater their understanding that there are circumstances under which abortion is the best or only alternative. We expect the publication of these data to contribute towards liberalisation of the abortion law in Brazil. Résumé Au Brésil, l’avortement est limité par la loi, mais très fréquent. Cette étude souhaitait recueillir l’avis des gynécologues-obstétriciens sur l’avortement et déterminer si leurs opinions personnelles étaient cohérentes avec leurs décisions privées quand ils ont été confrontés personnellementàune grossesse non désirée ouàla demande d’avortement d’une patiente ou parente. Un questionnaire structuré a été adressé aux adhérents de la Fédération brésilienne des sociétés de gynécologie et d’obstétrique (FEBRASGO). Au total, 4261 médecins ont répondu, soit 30%. Près d’un quart des femmes médecins et un tiers des hommes médecins avaient été confrontésàdes grossesses non désirées, et 80% s’étaient terminées par un avortement. MÁme parmi ceux pour qui la religion était très importante, près de 70% avaient choisi l’avortement. Deux fois plus de répondants acceptaient l’avortement comme solution pour eux-mÁmes ou leurs partenaires que pour leurs patientes. La différence était beaucoup plus faible seulement si le médecin avait connu personnellement un avortement. Ainsi, plus les médecins étaient proches du problème de l’avortement, mieux ils comprenaient qu’il existe des circonstances dans lesquelles l’avortement est la meilleure ou la seule solution. Nous pensons que la publication de ces données contribueraàla libéralisation de la législation sur l’avortement au Brésil. Resumen En Brasil, el aborto es legalmente restringido pero muy frecuente. Este estudio procura obtener datos sobre las opiniones de los gineco-obstetras respecto al aborto y determinar si éstas son consecuentes con sus decisiones privadas cuando enfrentan personalmente un embarazo no deseado o una solicitud de aborto de una paciente o pariente. Se envió un cuestionario estructurado a los gineco-obstetras afiliados a la Federación Brasileña de Sociedades de Ginecologáa y Obstetricia (FEBRASGO). Un total de 4,261 médicos respondieron, con un ándice de respuesta del 30%. Casi una cuarta parte de las médicas y una tercera parte de los médicos habáan enfrentado un caso de embarazo no deseado, y el 80% de éstos fueron abortados. Aun entre aquéllas para quienes la religión es muy importante, casi el 70% optó por interrumpir un embarazo no deseado. El doble de los respondedores aceptó el aborto como una solución tanto para ellos mismos o sus parejas como para sus pacientes. La diferencia fue mucho menor sólo si el médico habáa experimentado un aborto personalmente. Por tanto, mientras más se acercaban los médicos al problema del aborto, mayor era su entendimiento de que existen circunstancias en las que el aborto es la mejor o única opción. Esperamos que la publicación de estos datos contribuya hacia la liberalización de la ley de aborto en Brasil.

Conhecimento, opinião e conduta de ginecologistas e obstetras brasileiros sobre o aborto induzido

PURPOSE: to evaluate knowledge, opinion and practice of gynecologists/obstetricians regarding induction of abortion. Method: a pretested, structured questionnaire was sent to gynecologists/obstetricians affiliated to FEBRASGO. They were asked to answer and return the questionnaire in a self-addressed, prepaid envelope, without identification of the respondent so as to preserve anonymity. Knowledge about the legal situation of abortion in Brazil, opinion about it and practice if confronted with abortion requests were questioned. RESULTS: approximately 90% of the respondents believed that abortion is legal for pregnancy resulting from rape or in case of risk to a womans life and for 31.8% in case of severe fetal malformation. In their opinion abortion should be permitted in the case that pregnancy is a risk for a womans life (79.3%), fetal malformation (77.0%) and after rape (76.6%), added to 9.9% who expressed that abortion should be permitted in all circumstances. Two thirds wrongly thought that a judicial order is required to practice a legal abortion and only 27.4% knew that a written request by the woman is required. Confronted with unwanted pregnancy, 77.6% of female gynecologists/obstetricians and 79.9% of partners of male respondents had an abortion, 40% would help a client and 48.5% a relative in the same situation. CONCLUSION: gynecologists/obstetricians lack knowledge on the legal situation of abortion although their opinion and practice are favorable.

Efeitos do Uso Crônico de Acetaminofeno na Prenhez da Rata

Purpose: to evaluate the effects of acetaminophen on the pregnancy of female albino rats. Methods: forty pregnant rats were separated into four groups. All the animals received daily by gavage 1 ml of acetaminophen solution from the first day (day zero) until the 20th day of pregnancy: group I - only distilled water (control); groups II, III and IV, respectively, 125, 500 and 1,500 mg/kg body weight of acetaminophen dissolved in distilled water. The animals were weighed on days 0, 7, 15 and 20 of pregnancy. Results: our results showed that the rats that received the medication presented a reduction in weight when compared to the control group. The incidence of reabsorption of the embryos was 2.0, 3.5 and 7.0 times higher than in the control, in groups II, III and IV, respectively. Groups GII and GIV showed a clear reduction in the weight of the concepts. In GIV there was a 50% reduction in weight increase of fetuses and placentas when compared to the control, and 15.7% of external malformations were also found. Conclusions: the continuous use of acetaminophen should be avoided at doses higher than 70 mg/kg per during pregnancy.