Female sexual function during pregnancy and after childbirth.

Sexual Health during Pregnancy and the Postpartum (CME)

Introduction and hypothesis
Data on the effect of pregnancy and mode of delivery on postpartum sexual function are very heterogenic and inconclusive. The aim of this review is to examine the current literature for reliable data on the role of pregnancy and the route of delivery on sexual health and different dysfunctions.

Pregnancy, childbirth, and sexual function: perceptions and facts

Changes in the Sexual Function During Pregnancy

The purpose of this review was to examine and synthesize the available quality evidence to provide researchers, educators, and clinicians an overview of what is known about sexual behaviors during pregnancy and the year after childbirth. Search engines were used to identify peer-reviewed, English-language articles that met the inclusion criteria. A total of 56 prospective, retrospective, and qualitative studies published after 1996 were reviewed. A gradual decline in vaginal intercourse from prepregnancy to first trimester to third trimester was found. Most couples resume vaginal intercourse by eight weeks after childbirth, but this behavior does not occur at prepregnancy frequencies until closer to 12 months postchildbirth. Future studies should consider assessing sexual behaviors beyond vaginal intercourse and increase efforts in recruitment of diverse samples including non-White, nonheterosexual pregnant individuals, and partners of pregnant individuals.

The Impact of Pregnancy and Childbirth on Sexual Behaviors: A Systematic Review

OBJECTIVE: This study aims to evaluate the sexual function and to determine the prevalence of sexual dysfunction among teenagers and adult women during pregnancy using the Female Sexual Function Index (FSFI). METHODS: A cohort study was conducted with 271 healthy pregnant women presenting a stable relationship with their partners. These women contributed to the survey since the laboratory diagnosis of their present pregnancy. Anonymous questionnaires evaluated aspects of sexual activity and female sexual function. This last item was assessed through the FSFI questionnaire. RESULTS: The women sexual function showed a similar pattern during the first and second trimesters; however, it presented a significantly clear decrease in the third trimester. There was a significant difference in the scores of all FSFI domains when comparing the second and third trimesters. The sexual dysfunction among pregnant teenagers was rated 40.8% in the first trimester, 31.2% in the second and 63.2% in the third. For pregnant adults, the dysfunction was rated, respectively, 46.6%, 34.2% and 73.3%. CONCLUSION: The sexual function is affected during pregnancy with a significant decrease in all FSFI domains in the third trimester considering both pregnant teenagers and adults. Prevalence of sexual dysfunction is high during pregnancy and reaches higher levels in the third trimester in both age groups; however, teenagers presented better sexual function ratings.

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Prevalence of sexual dysfunction during pregnancy

OBJETIVO: traduzir e validar o Female Sexual Function Index (FSFI) para gravidas brasileiras. METODOS: participaram da pesquisa 92 gestantes assistidas em ambulatorio de pre-natal de baixo risco, com diagnostico da gravidez confirmado por ultra-sonografia precoce. Inicialmente, traduzimos o questionario FSFI para a lingua portuguesa (do Brasil), de acordo com os criterios internacionais. Foram realizadas adaptacoes culturais, conceituais e semânticas do FSFI, em funcao das diferencas da lingua, para que as gestantes compreendessem as questoes. Todas as pacientes responderam duas vezes ao FSFI, no mesmo dia, com dois entrevistadores diferentes, com intervalo de uma hora de uma entrevista para a outra. Em seguida, 7 a 14 dias depois, o questionario foi novamente aplicado numa segunda entrevista. Foram avaliadas a confiabilidade (consistencia interna intra e interobservador) e a validade do construto (para demonstrar que o questionario avalia a funcao sexual). RESULTADOS: adaptacoes culturais foram necessarias para obtermos a versao final. A consistencia interna intra-observador (alfa de Chronbach) dos diversos dominios oscilou de moderada a forte (0,791 a 0,911) e a consistencia interobservador variou de 0,791 a 0,914. Na validacao do construto, foram obtidas correlacoes de moderada a forte entre os escores finais (gerais) do FSFI e do Quociente Sexual Feminino (QS-F), que tem a capacidade de avaliar a funcao sexual feminina. CONCLUSOES: o FSFI foi adaptado a lingua portuguesa e a cultura brasileira, apresentando significante confiabilidade e validade, podendo ser incluido e utilizado em futuros estudos da funcao sexual de gravidas brasileiras.

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Validação do índice da função sexual feminina em grávidas brasileiras

PURPOSE: To assess the prevalence of bacterial vaginosis and to compare the accuracy of testing pH and KOH with the Nugent gradient, the gold standard for the diagnosis of bacterial vaginosis (BV) in asymptomatic and symptomatic pregnant women at low risk. METHODS: We conducted a cross-sectional study on 321 pregnant women with gestational age between 14 and 26 weeks, 218 of them asymptomatic and 103 with vaginal complaints suggestive of bacterial vaginosis. All women were assessed by the criteria of Nugent and subjected to the measurement of vaginal pH and to the 10% KOH test. The Kappa coefficient was used to evaluate the methods in terms of diagnostic agreement. RESULTS: Most patients were adolescents (mean age 21.0±5.6 years), nulliparous and mulattos. The prevalence of bacterial vaginosis was 33.3% as estimated by the pH and KOH method and 35.5% by the Nugent method. Excellent agreement of the methods was found among asymptomatic pregnant women, with 72.5% of them showing negative results to both tests, which resulted in a high Kappa coefficient (k=0.82). The group of symptomatic women showed 49.5% positivity to both diagnostic methods, with excellent agreement (k=0.74). CONCLUSION: The prevalence of bacterial vaginosis determined by both the pH and KOH method and the Nugent score was high. The pH and KOH method can diagnose bacterial vaginosis as accurately as the Nugent criterion.

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Ana Aurélia Salles Campos

Papers

Prevalence of sexual dysfunction during pregnancy

Validação do índice da função sexual feminina em grávidas brasileiras

Estudo comparativo entre o teste do pH e do KOH versus escore de Nugent para diagnóstico da vaginose bacteriana em gestantes.

Tratamento das vulvovaginites na gravidez