Gesta??o: uma perspectiva sobre sexualidade e desfechos obst?tricos desfavor?veis relacionados a vulvovaginites

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Bibliographic Details
Main Author: Monteiro, Michelly N?brega
Other Authors: 42252725400
Language:Portuguese
Published: PROGRAMA DE P?S-GRADUA??O EM CI?NCIAS DA SA?DE 2017
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Online Access:https://repositorio.ufrn.br/jspui/handle/123456789/24195
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Summary:Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-11-01T21:08:44Z No. of bitstreams: 1 MichellyNobregaMonteiro_DISSERT.pdf: 1837082 bytes, checksum: c97ddf8e7cc05cebab2f4ff050a93a61 (MD5) === Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-11-07T00:07:27Z (GMT) No. of bitstreams: 1 MichellyNobregaMonteiro_DISSERT.pdf: 1837082 bytes, checksum: c97ddf8e7cc05cebab2f4ff050a93a61 (MD5) === Made available in DSpace on 2017-11-07T00:07:27Z (GMT). No. of bitstreams: 1 MichellyNobregaMonteiro_DISSERT.pdf: 1837082 bytes, checksum: c97ddf8e7cc05cebab2f4ff050a93a61 (MD5) Previous issue date: 2016-08-19 === O Programa de P?s-Gradua??o em Ci?ncias da Sa?de da Universidade Federal do Rio Grande do Norte constitui uma proposta multidisciplinar onde temos a oportunidade de trocar ideias, e conhecer experi?ncias e receber contribui??es de diversos profissionais da ?rea, incluindo disciplinas que ampliam o nosso campo de vis?o. Os objetivos deste trabalho foram avaliar o comportamento sexual e a preval?ncia de vulvovaginites na gesta??o, efic?cia dos m?todos diagn?sticos dispon?veis e risco de complica??es perinatais. Um estudo observacional prospectivo realizado entre outubro de 2014 e julho de 2015, com material vaginal coletado de 225 mulheres entre 26 e 34 semanas de gesta??o foi, e nestas amostras, feitos exames microbiol?gico a fresco e corado pelo Gram, Papanicolau, cultura, teste das aminas e mensura??o do pH vaginal. Nestas pacientes foi aplicado o question?rio FSFI (Female Sexual Function Index) para avalia??o da resposta sexual feminina. Inicialmente, a an?lise uni variada da amostra foi feita. Vari?veis quantitativas e categ?ricas absolutas e relativas foram descritas. As m?dias dos dom?nios de acordo com o risco de disfun??o sexual (FSFI?26,5) foram comparadas pelo teste T para amostras independentes. A magnitude da associa??o entre disfun??o sexual e todas as vari?veis sociodemogr?ficas, cl?nicas e comportamentais foram mensuradas pelo teste do qui-quadrado (?2) e exato de Fisher. Foram aferidos os Riscos Relativos e seus respectivos intervalos de confian?a para a an?lise bivariada. Foram considerados significativos os valores de p inferiores a 0,05. Como resultados, aproximadamente dois ter?os das gestantes estudadas (66,7%) apresentaram risco de disfun??o sexual (FSFI?26,5). Analisando o desfecho disfun??o sexual em fun??o dos dom?nios, o FSFI?26,5 (ou seja, indicador de disfun??o sexual) foi estatisticamente significativo (p<0,001) em todos os componentes (desejo, excita??o, lubrifica??o, orgasmo, satisfa??o, e dor). Em rela??o aos dom?nios do FSFI, constatou-se que as m?dias mais baixas observadas foram em desejo (2,67), satisfa??o (2,71) e excita??o (2,78). A presen?a de Vaginose Bacteriana (p=0,001; RR 3,542) e Tricomon?ase (p=0,010; RR 2,577) foi associada a trabalho de parto pr?-tremo (p=0,001; RR 2,897) e peso fetal ao nascer inferior a 2.500g (p valor=0,001; RR 2,175). Vaginose Bacteriana e Tricomon?ase parece ter tido rela??o com desfecho obst?trico desfavor?vel (parto prematuro e fetos com baixo peso ao nascer). === The Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte is a multidisciplinary proposal where we have the opportunity to exchange ideas, and to know experiences and receive contributions from several professionals of the area, including disciplines that expand our field of vision. The objectives of this study were to evaluate the sexual behavior and the prevalence of vulvovaginitis during pregnancy, the efficacy of the available diagnostic methods and the risk of perinatal complications. A prospective observational study conducted between October 2014 and July 2015, with vaginal material collected from 225 women between 26 and 34 weeks' gestation, and in these samples, the samples were microbiologically fresh and stained by Gram, Papanicolau, culture, amine test and vaginal pH measurement. In these patients, the FSFI (Female Sexual Function Index) questionnaire was applied to assess the female sexual response. Initially, the univariate analysis of the sample was done. Absolute and relative quantitative and categorical variables were described. The domains averages according to the risk of sexual dysfunction (FSFI ?26.5) were compared by the T test for independent samples. The magnitude of the association between sexual dysfunction and all sociodemographic, clinical, and behavioral variables was measured by the chi-square test (?2) and Fisher's exact test. From this perspective, the Relative Risks and their respective confidence intervals were evaluated for the bivariate analysis. Values of p less than 0.05 were considered significant. As a result, approximately two-thirds of the pregnant women studied (66.7%) presented a risk of sexual dysfunction (FSFI?26.5). FSFI ?26.5 (i.e., indicator of sexual dysfunction) was statistically significant (p <0.001) in all components (desire, excitation, lubrication, orgasm, satisfaction, and pain). In relation to the areas of the FSFI, it was found that the lowest means observed were desire (2.67), satisfaction (2.71) and excitation (2.78). The presence of Bacterial Vaginosis (p = 0.001, RR 3,542) and Trichomoniasis (p = 0.010; RR 2,577) was associated with preterm labor (p = 0.001; RR 2,897) and fetal birth weight below 2,500g p value = 0.001, RR 2,175). Bacterial Vaginosis and Trichomoniasis appears to have had an adverse fetal outcome (preterm delivery and fetal low birth weight).