ObjectiveIn Brazil, although the assessment of maternal nutritional status is recommended using body mass index (BMI), this is only possible in settings adequately prepared. Midupper arm circumference (MUAC) is another biological variable identified as a tool for rapid assessment of nutritional status that is correlated with BMI. Therefore, we aim to surrogate BMI by MUAC cut-offs for rapid screening of maternal nutritional status starting at midpregnancy.DesignAnalysis of the multicentre cohort study entitled ‘Preterm SAMBA’ using an approach of validation of diagnostic test.SettingOutpatient prenatal care clinics from five tertiary maternity hospitals from three different Brazilian regions.Participants1165 pregnant women attending prenatal care services from 2015 to 2018 and with diverse ethnic characteristics who were enrolled at midpregnancy and followed in three visits at different gestational weeks.Primary and secondary outcome measuresSensitivity, specificity, positive and negative predictive values, likelihood ratio and accuracy of MUAC being used instead of BMI for the assessment of nutritional status of women during pregnancy.ResultsWe found a strong correlation between MUAC and BMI, in the three set points analysed (r=0.872, 0.870 and 0.831, respectively). Based on BMI categories of nutritional status, we estimated the best MUAC cut-off points, finding measures according to each category: underweight <25.75 cm (19–39 weeks); overweight 28.11–30.15 cm (19–21 weeks), 28.71–30.60 cm (27–29 weeks) and 29.46–30.25 cm (37–39 weeks); and obese >30.15 cm (19–21 weeks), >30.60 cm (27–29 weeks) and >30.25 cm (37–39 weeks) per gestational week. Therefore, we defined as adequate between 25.75–28.10 cm (19–21 weeks), 25.75–28.70 cm (27–29 weeks) and 25.75–29.45 cm (37–39 weeks) of MUAC.ConclusionWe conclude that MUAC can be useful as a surrogate for BMI as a faster screening of nutritional status in pregnant women.

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Introduction: Pregnancy is a unique situation and involves changes in sexuality. The aim is to evaluate sexual function and satisfaction in pregnant women under prenatal care provided by the public health system. Method: Cross-sectional study with pregnant women receiving ambulatory care in the public health system in the Southern region of Brazil conducted between November 2014 and September 2015. Results: 283 pregnant women were studied. The mean age was 27.7 ± 6.3 years; 64% were white and 31.1% were nulliparous. In the total sample, 8.50% were in the first trimester of pregnancy, 37.4% were in the second trimester, and 54.1% were in the third trimester. The rate of global sexual dysfunction (score < 26 points) was 55.5%, following the application of The Female Sexual Function Index (FSFI). Sexual dysfunction was significantly more prevalent in the third trimester (62%) compared to the first (33.3%) and second (50.9%) trimesters (p = 0.015). There was a significant difference in all domains, except in the desired domain, according to the trimester. Pregnant women in the third trimester showed significantly lower scores compared to those in the first trimester in the domains with significance. Conclusion: The prevalence of sexual dysfunction among pregnant women in the public system was high. Knowing that more than 50% of the pregnant women presented sexual dysfunction, it is essential to approach sexuality during prenatal care involving the couple.

Objectives: There have been no investigations on the association between previous abdominopelvic MRI experience without placental MRI experience and diagnostic accuracy of placenta accreta spectrum (PAS). To evaluate the diagnostic performance of radiologists with different experience levels in interpreting PAS-related MRI findings. Methods: This retrospective study included 60 women who underwent MRI for placental assessment between 2016 and 2020. MR images were reviewed by four radiologists who were blinded to the clinical outcomes and had different experience levels in interpreting PAS-related MRI findings. The radiologists’ diagnostic performance was evaluated according to the pathologic and surgical outcomes. Simple κ statistics were calculated to determine agreement among the radiologists. Results: Of 60 women, 46 were diagnosed with PAS. The maternal age mean ± SD was 33.0 years ± 5.0 for the PAS absent group and 36.0 ± 4.3 for the PAS present group (p = 0.013). Overall, the most experienced radiologist had the highest sensitivity (100%, 95% confidence interval (CI): 92.3–100%) and NPV (100%, 95% CI: 63.1–100%) in PAS diagnoses. However, the PPV and specificity were independent of experience. The most experienced radiologist had the highest diagnostic accuracy in PAS (90%, 95% CI: 79.5–96.2%) and placenta percreta (95%, 95% CI: 86.1–99.0%). There was a strong association between definitive PAS diagnoses and the highest experience level. The κ values for the interobserver agreement regarding PAS diagnoses were 0.67 for the most experienced radiologist (p < 0.001) and 0.38, 0.40, and 0.43 for the other radiologists (p = 0.001) and regarding placenta percreta diagnoses were 0.87 for the senior radiologist (p < 0.001) and 0.63, 0.57, and 0.62 for the other radiologists (p < 0.001). Conclusion: Previous experience in interpreting PAS-related MRI findings plays a significant role in accurately interpreting such imaging findings. Previous abdominopelvic MRI experience without specific placental MRI experience did not improve diagnostic performance. Advances in knowledge: We believe that our study makes a significant contribution to the literature and that this paper will be of interest to the readership of your journal because to the best of our knowledge, this study is the first in which the correlation between previous experience in abdominopelvic MRI with no specific experience in PAS-related MRI and diagnostic accuracy of radiologists has been explored. Our results could aid in setting up specialized multidisciplinary teams to assist women with PAS disorders.