Warfarin is the most widely prescribed oral anticoagulant used for the long-term treatment and prevention of thromboembolic events. Its administration is challenging as it may result in bleeding-related deaths, inadequate anticoagulation and fetal teratogenesis, including fetal warfarin syndrome. A number of environmental and genetic factors contribute to interindividual warfarin dosage variability. The CYP2C9 and VKORC1 genes explain 40- 50% of this variability. The aim of this study was to determine the frequency of known and any new variants in these genes in the SA black population, and correlate these variants and a small subset of environmental factors to dosage variability and pregnancy outcomes. I sequenced the exons and intron/exon boundaries of the CYP2C9 and VKORC1 genes in 100 random black control and 113 patient samples that had at least one pregnancy on warfarin. I observed six previously described CYP2C9 variants, 27 novel CYP2C9 variants, and three previously described VKORC1 variants. 14 of these variants were observed at an allele frequency of 0.02. Of these 14, six appear to decrease (all of which are CYP2C9 variants) and four increase (2 CYP2C9 variants and two VKORC1 variants) warfarin dosage requirement. These 14 CYP2C9 and VKORC1 variants along with a small subset of environmental factors account for 45.3% of warfarin dosage variability in the SA population. I observed an increase in the number of poor pregnancy outcomes in patients on high doses of warfarin. These results allow us to predict the maintenance dose of warfarin in SA black patients better, thereby reducing the risk of adverse effects, and identify those at risk of having a poor pregnancy outcome.

Faculty of Health Sciences School of Patholgy 8601804k erine.gregersen@nhls.ac.za / The oral anticoagulant, warfarin, when administered in pregnancy, can cause warfarin embryopathy, fetal central nervous system abnormalities, spontaneous abortion and fetal intrauterine death. Women with prosthetic heart valves usually require warfarin in pregnancy because of their high risk for thromboembolic complications. Anticoagulation regimens in pregnancy in these women aim to balance the fetal effects of warfarin with maternal risks of thromboembolism. This study was conducted by structured interview of 124 black urban South African women of childbearing age, who had at least one warfarin-exposed pregnancy. The study aimed to determine the pregnancy outcomes in this cohort, their awareness of the effects of warfarin in pregnancy, and what management practices, as reported by them, had occurred with regard to their anticoagulation in pregnancy and what genetic counselling they had received. There was a significant difference in outcome between warfarin-exposed and non-exposed pregnancies; 55.2% (123/223) of warfarin-exposed pregnancies ended in the birth of an abnormal baby, spontaneous abortion or intrauterine death. The warfarin embryopathy rate was estimated at 4.5 – 5.4%. Most women reported having been given information about warfarin in pregnancy, though their awareness about the personal and fetal effects of warfarin was often inaccurate. Of warfarin-exposed pregnancies, 95% were reportedly exposed during critical weeks six to ten of pregnancy, and >50% after 36 weeks. Only 5/124 (4%) interviewees had genetic counselling. Poor pregnancy outcomes, lack of awareness about the effects of warfarin in pregnancy, and management practices at odds with international regimens are all areas highlighted by this study that require urgent attention in this high-risk group of women.

A research report submitted in partial fulfilment of the requirements for the degree of Masters of Arts in Anthropology Department of Anthropology Faculty of Humanities University of the Witwatersrand March 2017 / This study explores the experiences of teenage pregnancy and motherhood among two generations of mothers living in Johannesburg, South Africa. This engagement with gendered subjectivity took the form of ethnographic fieldwork conducted with three older women (35 to 42 years old) who gave birth between the ages of 16 and 18; as well as five young women aged 18-19 who became mothers during their teenage years. Using a social constructionist framework, the study explores the gendered nature of teenage pregnancy by discussing the narratives of women before and after having their first child. It argues that gendered experiences of teenage pregnancy play a crucial role in local understandings and practices of good motherhood. In particular, being a good mother for the older women in the study meant doing their best as parents to prevent teenage pregnancy in the younger generation. The women saw this as the best way to safeguard their daughters’ social reputations and educational futures in a context that considers teenage pregnancy to be unacceptable. When their attempts at preventing pregnancy proved unsuccessful, the older women were cast as inadequate parents who were partly to blame for their daughters’ pregnancies. / MT2018

Teenage pregnancy in South Africa, especially amongst teenage learners has become a national crisis with an estimated average of 5000 girls between the ages of 12 and 19 falling pregnant in one school year (Headlines Africa, 2012). This study focused on how process drama was applied with adolescent learners at Supreme Educational College in Johannesburg, to investigate the causes and consequences of teenage pregnancy. Process drama requires participants to create and assume roles, identify and explore images and stories drawn from fictional worlds that relate to the participants’ own personal experiences. Through process drama workshops, teenagers were able to engage with challenging situations as a way of acquiring new knowledge about teenage pregnancy. Three major themes emerged as contributing factors to teenage pregnancy, namely, parental negligence and abuse, negative peer pressure and poverty. The learner’s engagement within the dramatic process was enhanced by means of dialogue, negotiation and reflection with the teacher adopting the role of facilitator and co-participant. The fictional world created by the drama enabled the learners to relate and identify with problematic aspects of teenage pregnancy. The study concludes that process drama offers an aesthetic space for teenagers to develop a deeper understanding of themselves in relation to their lived experiences. The study recommends process drama as a powerful interactive medium that needs to be implemented in schools to grapple with intractable issues such as teenage pregnancy.

The research report submitted to the Faculty of Humanities, University of Witwatersrand, Johannesburg in fulfilment of the requirements for awarding the degree of Masters of Arts in Demography and Population Studies, 2017 / GR2018

Este estudo define a inter-relação microvascular materno-fetal e o desenvolvimento dos hematomas placentários durante diferentes períodos gestacionais em cães SRD. Placentas de 20, 35, 45 e 55 dias da prenhez foram perfundidas e fixadas para a investigação histológica e confecção de moldes vasculares, injetados com Mercox, e submetidos a corrosão para análise ao microscópio eletrônico de varredura. Os componentes fetais da placenta endoteliocorial e zonária anular do cão são irrigadas por dois ramos arteriais do cordão umbilical, um endereçado à cinta placentária, e outro ao hematoma marginal. Da artéria principal central, originam-se colaterais destinados às lamelas e vilos do labirinto no sentido feto-uterino. O desenvolvimento lamelar mostrou-se progressivo com o avançar da prenhez. Os complexos capilares na periferia dos vilos têm a forma de tufos de pêlos, cujos capilares são contínuos com o sistema venoso. Da artéria hematomal organizam-se os lóbulos microvasculares circulares, que aparecem no septo ou barreiras entre o hematoma marginal e o labirinto. Os capilares placentários maternos dispõem-se de maneira a cruzar os capilares fetais. Conseqüentemente, o fluxo sangüíneo placentário de cães Sem Raça Definida é caracterizado por um tipo de sentido único de corrente cruzada simples. O desenvolvimento dos hematomas marginais foi quantificado por morfometria. Os primeiros traços dos hematomas apareceram entre o 18º a 20º dia da prenhez como áreas hemorrágicas, delimitadas por sincíciotrofoblasto e pelo tecido septal materno. Sua justaposição à artéria materna principal, confirma a origem de sangue extravasado como oriundo dos capilares endometriais. Entre 30 a 45 dias de prenhez, os hematomas são orientados no sentido alanto-uterino, alcançando a região das glândulas endometriais, caracterizando canais de sangue extravasado, organizados em hematomas marginais ou bolsas laterais à cinta placentária central. Mediante análise estatística (KS-400 Zeiss®) correlacionamos a área dos hematomas e da cintura placentária, utilizado o teste de Pearson, o que nos revelou que os hematomas crescem até 46º dia da gestação. Do 46º dia até o parto, o tamanho da cintura ultrapassou o desenvolvimento dos hematomas, sinalizando que a fonte de nutrição do feto de cães no terço final de gestação, depende da troca transplacentária, mesmo considerada a atividade fagocitária exercida pelos hematomas. / That study defines the maternal-fetal microvascular interrelationship and the placental hematomes development during different pregnant periods in the mongrel dog placenta. Placentae from 20, 35, 45 and 55 days of pregnancy were perfusion-fixed for histological investigation and vascular corrosion casts were prepared for scanning electron microscopy. Two main umbilical cord arterial branches irrigate the fetal components of annular zonary endotheliochorial dog placentae, one tributary to the centre of the girdle and the other one to the marginal hematome. From the central main artery many stem arteries arise and move through the lamellae or villi of the labyrinth in feto-maternal directions. The lamellar development showed increased substantially with progressing pregnancy. The capillary complexes at the periphery of the villi have the shape of hair tufts and lead into the venous drainage system. The hematomal artery supplies the circular lobules, which appear as a septum-like barrier between the marginal hematome and the labyrinth. The maternal placental capillaries, generally cross the fetal capillaries. Therefore, the placental blood flow in mongrel dogs is characterized by a one-way crosscurrent type interrelationship. Were analyzed the development of the marginal hematomes in dog placentae by morphometry. The first traces of hematomes appeared at 18-20 days of pregnancy as hemorrhagic area lines, and were delimited by syncytiotrophoblast and maternal septal tissue. Its location near the maternal stem artery confirms the endometrial capillary origin of the extravasated blood. Between 30-45 days of pregnancy, the hematomes were oriented in allantoic-uterine direction reaching the endometrial gland region, thus forming channels of extravasated blood, which were organized as marginal hematomes or lateral pockets to the placental girdle. Statistical analysis (KS-400 Zeiss®) was used to quantify the area of hematomes and placental labyrinth, and Pearson test correlation revealed that hematomes grow until 46 days of pregnancy. From day 46 until parturition, the size of the placental labyrinth increased and passed the development of the hematomes. We conclude that the supply of the dog fetus in the last third of pregnancy, depends more on transplacental exchange than on phagocytosis done by hematomes.

O consumo de álcool durante a gestação tem sido associado na literatura científica a uma maior intensidade de sofrimento psiquiátrico durante a gestação e no pós-parto. Este estudo teve como objetivo principal verificar se o consumo de álcool em gestantes está relacionado a um aumento de sintomas depressivos e/ou ao diagnóstico de depressão no pós-parto. Para tal foi realizado um estudo prospectivo, com dois tempos de coleta de dados. Foram convidadas a participar gestantes da rede pública de saúde da cidade de Juiz de Fora/MG. Inicialmente foram entrevistadas 260 mulheres no terceiro trimestre gestacional, das quais 177 foram entrevistadas entre 15 dias a 3 meses após o parto. Para avaliação do uso de álcool durante a gestação foram utilizados os instrumentos T-ACE (Tolerance, Annoyed, Cut down, Eye opener) e AUDIT C (Alcohol Use Disorders Identification Test C), além do relato das gestantes sobre a quantidade de álcool ingerida durante toda a gestação. Para avaliação de sintomas depressivos no pós-parto foi utilizado o instrumento EPDS (Edinburgh Postnatal Depression Scale) e para o diagnóstico de Episódio Depressivo Maior foi utilizada a entrevista diagnóstica MINI (Mini International Neuropsychiatric Interview). Os resultados obtidos apontaram para um aumento de sintomas depressivos no pós-parto proporcional ao aumento do consumo de álcool durante a gestação medido pelo total do AUDIT C (Spearman Correlation, r=0,251; p<0,001) e pelo total em gramas de álcool consumido durante toda a gestação (Spearman Correlation, r=0,185; p=0,01). Além disso, foi observado uma maior prevalência de depressão pós-parto entre as mulheres que tiveram pelo menos um binge alcoólico durante a gestação (Non-parametric Chi-Square, value=88,28, p< 0,001). Os dados apresentados permitem concluir que existe um aumento de sintomatologia depressiva no pós-parto à medida que aumenta o consumo de álcool na gestação e aumento de diagnóstico para aquelas que tiveram pelo menos um binge alcoólico durante a gestação. / Alcohol consumption during pregnancy, according to the scientific literature, has been associated to a higher intensity of psychiatric problems during the gestational period as well in the postpartum period. This study aimed to verify whether alcohol consumption in pregnancy is related to an increase of depressive symptoms and/or the diagnosis of depression in the postpartum period. For this purpose a prospective study was carried out, with two phases of data collection. Pregnant women assisted by public health services of the city of Juiz de Fora /MG were invited to participate. Initially 260 women in the third gestational trimester have been interviewed. For the second phase 177 were interviewed between 15 days to three months after childbirth. To assess alcohol use during the gestational period the research instruments T-ACE (Tolerance, Annoyed, Cut down, Eye-opener) and AUDIT C (Alcohol Use Disorders Identification Test C) have been used, besides of direct reports of the pregnant women about the amount of alcohol ingested during all the gestation. To evaluate postpartum depressive symptoms the instrument EPDS (Edinburgh Postnatal Depression Scale) was used and to determine the presence of a diagnosis of Major Depressive Episode the diagnostic interview MINI (Mini International Neuropsychiatric Interview) was used. The results pointed out to an increase of postpartum depressive symptoms proportional to the increase of alcohol consumption during the gestation measured by the total score of the AUDIT C (Spearman Correlation, r=0,251; p<0,001) and by the total amount (in grams) of alcohol ingested during all the gestational period (Spearman Correlation, r=0,185; p=0,01). Further, a higher prevalence of postpartum depression was found among the pregnant women who reported at least once a binge episode during the gestational period (Nonparametric Chi-Square, value=88,28; p< 0,001). The presented data allow concluding about the occurrence of an increase of depressive symptoms in the postpartum period related to higher alcohol consumption in pregnancy as well an increase of diagnosis among those pregnant women who have had at least one binge episode during all the gestational period.

Neste estudo caracterizamos a expressão de Mif nas células trofoblásticas (CT), placentárias e decidua (D) na gestação em camundongos.A imunolocalização foi realizada nos dias de gestação(dg) 7,5, 10,5, 13,5 e 17,5.Com cones ectoplacentários e placentas fetais (PL) realizou-se ensaios de Western blotting e qRT-PCR nos mesmos dg.D foram submetidas a qPCR.Aos 7,5 dg as CT gigantes e D apresentaram imunomarcação.Dos 10,5 ao 17,5 dg o Mif concentrou-se nas CTG e no espongiotrofoblasto.Na D, a imunomarcação foi menor que aos 7,5 dg.A expressão protéica na PL aumentou do 7,5 dg para o 10,5 dg (p=0,005) e para o 13,5 dg (p=0.03).A maior expressão gênica foi em 10,5 dg e diferente em 13,5 dg (p=0,048) e 17,5 dg (p=0,009).Na D, a maior expressão gênica foi em 7,5 dg e diferente dos 10,5 (0,012) e 13,5 (0,032) dg.O aumento da expressão de Mif na PL coincide com a organização em quatro camadas e com o início da circulação fetal.Esta distribuição temporal e tecido-específica sugere o MIF como modulador no início da placentação ou na sua adaptação ao ambiente uterino / The goal of this study was to characterize Mif expression by trophoblast (TC),fetal placenta (FP) and decidua (D) during mouse pregnancy.Mif was immunolocalized at TC and D on gestation days (gd) 7.5, 10.5, 13.5 and 17.5.Ectoplacental cones (EC) and FP were used for Western blotting and qPCR.D were also used for qRT-PCR.On gd 7.5,DC and TC giant (TGC) showed strong reactivity.On gds 10.517.5,were concentrated in TGC and spongiotrophoblast cells. D reactivity was weaker than 7.5 gd.Protein expression at FP increased from gd 7.5 to 10.5 (p=0.005) and to 13.5 (p=0.03).Higher mRNA expression was found on gd 10.5 and was different from gds 13.5 (p=0.048) and 17.5 (p=0.009).At D on gd 7.5 was greater than those on gds 10.5 (0,012) and 13.5 (0,032).The up-regulation of Mif coincides with the stage that placenta assumes its four-layered organization and the fetal blood circulation begins,This temporal tissue-specific distribution and expression data suggests that Mif may play a modulator role in the onset of placentation or in it adaptation to the uterine environment

A síndrome hipertensiva gestacional (SHG) afeta três milhões de mulheres por ano no mundo e pode resultar em inúmeras perdas fetais e perinatais, além de ser responsável pela morte de uma mulher a cada 6 minutos em todo o mundo. Durante uma crise hipertensiva na gestação ocorre vasoconstrição arteriolar generalizada e diminuição do fluxo útero placentário. A diminuição de fluxo na artéria uterina ocasiona déficit do aporte de oxigênio nas áreas de troca materno fetal submetendo o feto à regime de hipóxia transitória comprováveis na avaliação hemodinâmica. O labetalol e a hidralazina são anti hipertensivos de primeira escolha na gravidez, uma vez que aumentam o fluxo útero-placentário em decorrência da redução da resistência vascular uterina. Objetivos Avaliar as condições hemodinâmicas materno/fetais durante o período da crise hipertensiva e após seu tratamento com labetalol e/ou hidralazina. Pacientes e métodos Foram avaliadas 18 pacientes com quadro de crise hipertensiva com pressão arterial maior que 160x110mmHg, sem sintomas de eminência de eclâmpsia. Realizou-se estudo dopplervelocimétrico das artérias uterinas direita e esquerda materna, umbilical e cerebral média fetal. A avaliação hemodinâmica materno/fetal foi realizada no momento da crise hipertensiva e após o tratamento com labetalol e/ou hidralazina. A análise pós tratamento foi realizada após estabilização da pressão arterial < 150/100mmHg. Resultados A média de idade das pacientes foi de 29,11 anos e a idade gestacional média do estudo de 34,5 semanas. O valor médio da pressão arterial sistólica e diastólica durante a crise hipertensiva foi de 174,71 e 112,35mmHg, respectivamente. Os parâmetros dopplervelocimétricos avaliados na crise hipertensiva foram: IP da artéria uterina direita 1,24+-0,42; IP da artéria uterina esquerda 1,29+-0,40; IR da artéria cerebral média de 0,78+-0,06 e IR da artéria umbilical de 0,65+-0,12. Após o tratamento da crise hipertensiva a pressão arterial sistólica média foi de 146,47mmHg e a pressão arterial diastólica média de 87,06mmHg. Após o tratamento da crise hipertensiva, os parâmetros avaliados foram: IP da artéria uterina direita 1,26+-0,37; IP da artéria uterina esquerda 1,37+-0,36; IR da artéria cerebral média de 0,78+-0,09 e IR da artéria umbilical de 0,67+-0,09. Não houve diferenças estatísticas significativas nos parâmetros Doppler quando comprados os valores na crise hipertensiva e após o controle da pressão arterial. Conclusão As gestações de pacientes com síndromes hipertensivas são consideradas de alto risco e, devem ser alvo de observação rigorosa durante o pré-natal. A análise dopplervelocimétrica fetal (artéria cerebral média e umbilical) e materna (artérias uterinas) deve ser realizada para avaliação da vitalidade fetal nestas pacientes, inclusive durante de crise hipertensiva. Este estudo demonstrou não haver diferença na avaliação dos parâmetros dopplervelocimétricos materno e fetal, durante ou após a crise hipertensiva tratada com hidralazina/labetalol. / Introduction The gestational hypertension syndrome affects three million women a year worldwide and can result in a number of fetal losses and perinatal deaths, and was responsible for the death of one woman every 6 minutes throughout the world. During a hypertensive crisis in pregnancy is widespread arteriolar vasoconstriction and decreased placental flow uterus. The decrease in flow in the uterine artery causes deficit of oxygen supply in the areas of maternal fetal exchange subjecting the fetus to the regime of transient hypoxia in comparable hemodynamic evaluation. Labetalol and hydralazine are antihypertensive drugs of choice in pregnancy, they increase the uteroplacental flow due to the reduction of uterine vascular resistance. Objectives To evaluate the conditions maternal-fetal hemodynamics during the hypertensive crisis and after treatment with labetalol and/or hydralazine. Patients and methods Eighteen pregnant women with acute hypertensive were evaluated (blood pressure (BP) > 160x110mmHg, without imminent eclampsia symptoms). This study was performed by Doppler velocimetry of right and left uterine arteries, umbilical artery and fetal middle cerebral artery. Maternal-fetal hemodynamic assessment was performed at the time of hypertensive crisis and after treatment with labetalol and/ or hydralazine. Post treatment analysis was performed after blood pressure stabilization (BP< 150x100mmHg). Results Mean patients age was 29,11 years old and mean gestational age was 34.5 weeks. Mean systolic and diastolic blood pressure during hypertensive crisis was 174.71 and 112.35 mmHg, respectively. Doppler parameters evaluated in hypertensive crisis were: right uterine artery PI 1.24 ± 0.42; left uterine artery PI 1.29 ± 0.40; middle cerebral artery RI 0.78 ± 0,06 and umbilical artery RI 0.65 ± 0.12. After the hypertensive crisis treatment mean systolic blood pressure was 146.47 mmHg and diastolic 87.06 mmHg. Doppler parameters evaluated after hypertensive crisis were: right uterine artery PI 1.26 ± 0.37; left uterine artery PI 1.37 ± 0.36; middle cerebral artery RI 0.78 ± 0,09 and umbilical artery RI 0.67 ± 0.09. No statistical difference was observed in Doppler parameters during hypertensive crisis or after blood pressure control. Conclusion Hypertensive pregnancy disorders are considered high risk to disfavorable perinatal outcome and should be subject to close observation during prenatal by fetal Doppler velocimetry analysis (middle cerebral artery and umbilical cord) and maternal Doppler velocimetry analysis (uterine artery) to assess fetal well being. This study demonstrated no difference in maternal fetal Doppler parameters during or after hypertensive crisis treated with hydralazine/labetalol.

O assoalho pélvico é anatomicamente dividido em fáscia endopélvica, diafragma pélvico e diafragma urogenital e o músculo levantador do ânus é considerada a estrutura mais importante na manutenção da estática dos órgãos pélvicos. Durante a gravidez, altos níveis de progesterona e relaxina associadas às alterações anatômicas promovidas pelo crescimento uterino são fatores que contribuem para o aumento da prevalência de incontinência urinária durante a gravidez e o puerpério. O treinamento dos músculos do assoalho pélvico (TMAP) durante a gravidez tem sido tema de vários estudos que tentam comprovar a sua eficácia na prevenção e tratamento da incontinência urinária e nos resultados do trabalho de parto e do parto. Na literatura, encontram-se trabalhos que avaliaram as repercussões fetais associadas à realização de exercício físico aeróbico, porém não existem estudos que realizaram essa investigação com exercícios específicos do assoalho pélvico. O objetivo deste estudo foi, portanto, avaliar os efeitos do TMAP sobre os parâmetros doplervelocimétricos da hemodinâmica uteroplacentária e fetal. Realizou-se um estudo do tipo experimental, prospectivo, randomizado e controlado com gestantes de baixo risco gestacional. Um grupo foi submetido aos exercícios de TMAP através de sessões semanais durante 16 semanas (grupo exercício) e outro grupo não foi submetido aos exercícios (grupo controle). Os exames ultrassonográficos foram realizados com 28, 32 e 36 semanas sendo avaliados os índices de resistência (IR) e pulsatilidade (IP) das artérias uterinas maternas e artérias umbilical e cerebral média fetal antes e após os exercícios. Na análise estatística foi utilizado o modelo de regressão linear com efeitos mistos (efeitos aleatórios e fixos). Este procedimento foi realizado através do software SAS® 9.0, utilizando a PROC MIXED. Foram incluídas 26 gestantes no grupo exercício e 11 no grupo controle. A análise da artéria uterina mostrou diferença na comparação do estudo Doppler com redução significativa de IP e IR após o exercício na avaliação com 36 semanas. Com este resultado, é possível concluir que a execução de exercícios desse tipo de TMAP, durante a gestação, não altera IP e IR na artéria umbilical e cerebral média com 28, 32 e 36 semanas de gravidez e nas artérias uterinas com 28 e 32 semanas, porém ocorre redução com 36 semanas de gravidez. / The pelvic floor is anatomically divided into endopelvic fascia, pelvic diaphragm and urogenital diaphragm, and the levator ani muscle is considered to be the most important structure for the static maintenance of the pelvic organs. During pregnancy, the high levels of progesterone and relaxin, together with the anatomical changes promoted by uterine growth, are factors that contribute to the increased prevalence of urinary incontinence during pregnancy and the puerperium. Pelvic floor muscle training (PFMT) during pregnancy has been investigated in several studies that have attempted to prove its efficacy in the prevention and treatment of urinary incontinence and in the results of labor and delivery. Studies evaluating the fetal repercussions associated with aerobic physical exercise are available in the literature, but there are no studies that perform this investigation with specific exercises for the pelvic floor. Thus, the objective of the present study was to assess the effects of PFMT on the Doppler velocimetry and uteroplacental and fetal hemodynamic parameters. An experimental, prospective, randomized and controlled study was conducted on pregnant women of low gestational risk. One group (N = 26) performed PFMT exercises once a week for 16 weeks (exercise group) and the other (N = 11) did not perform exercises (control group). Ultrasound exams were performed at 20, 32 and 36 weeks for the evaluation of resistance index (RI) and pulsatility index (PI) of the maternal uterine arteries and of the fetal umbilical and middle cerebral arteries before and after exercise. A mixed effects linear regression model (random and fixed effects) was employed for statistical analysis using the PROC MIXED method of the SAS® 9.0 software. Analysis of the uterine artery showed a difference in the comparison of the Doppler study, with a significant reduction of PI and RI after exercise at the 36 week evaluation. With this result, it is possible to conclude that the execution of this type of PFMT exercises during pregnancy does not alter the PI or RI of the umbilical and middle cerebral arteries at 28, 32 and 36 weeks of pregnancy or of the uterine arteries at 28 and 32 weeks, although there was a reduction at 36 weeks of pregnancy.