Avaliação normativa do atendimento obstétrico emergencial na prevenção da COVID-19 / Evaluación normativa de la asistencia obstétrica de emergencia en la prevención de COVID-19 / Normative evaluation of emergency obstetric care in the prevention of COVID-19

Resumo Objetivo Avaliar a estrutura e o fluxo assistencial do acolhimento - classificação de risco e emergência obstétrica em uma maternidade pública no contexto da COVID-19. Métodos Estudo do tipo avaliação normativa e observacional nos setores de Acolhimento (Classificação de Risco e Emergência Obstétrica) de uma maternidade pública no Rio de Janeiro. A coleta de dados foi realizada de junho a agosto de 2020 por 480 horas de observação direta não participante, com registros sistematizados em checklist contendo variáveis relacionadas à disponibilidade e conformidade dos recursos estruturais, e à conformidade do fluxo assistencial. Os dados foram organizados em planilhas (Microsoft Excel® 2010) e analisados usando a estatística descritiva. Resultados A avaliação da estrutura obteve 80,3% de disponibilidade, resultando em classificação de alta disponibilidade e 91,1% de conformidade, obtendo conformidade adequada. O fluxo assistencial mostrou 72,7% de conformidade total; 9,1% de conformidade parcial e 18,2% de não cumprimento, configurando-se como alta conformidade. Conclusão A avaliação normativa indicou altas disponibilidade e conformidade em estrutura e fluxo assistencial nos cenários estudados.

Resumen Objetivo Evaluar la estructura y el flujo de asistencia de recepción, clasificación de riesgo y emergencia obstétrica, en una maternidad pública en el contexto del COVID-19. Métodos Estudio tipo evaluación normativa y observacional en los sectores de Recepción (clasificación de riesgo y emergencia obstétrica) de una maternidad pública en Rio de Janeiro. La recopilación de datos se realizó de junio a agosto de 2020 durante 480 de observación directa no participante, con registros sistematizados en una checklist con variables relacionadas con la disponibilidad y conformidad de los recursos estructurales y con la conformidad del flujo de asistencia. Los datos se organizaron en planillas (Microsoft Excel® 2010) y se analizaron usando la estadística descriptiva. Resultados La evaluación de la estructura obtuvo un 80,3 % de disponibilidad, que tuvo como resultado una clasificación de alta disponibilidad, y un 91,1 % de conformidad, con una conformidad adecuada. El flujo de asistencia mostró un 72,7 % de conformidad total, un 9,1 % de conformidad parcial y un 18,2 % de no cumplimiento, lo que se configura como alta conformidad. Conclusión La evaluación normativa indicó alta disponibilidad y alta conformidad en estructura y flujo de asistencia en los escenarios estudiados.

Abstract Objective Evaluate the structure and care flow - risk classification and obstetric emergency in a public maternity hospital in the context of COVID-19. Methods Normative and observational evaluation study in the Care sectors (Risk Classification and Obstetric Emergency) of a public maternity hospital in Rio de Janeiro. Data collection was carried out from June to August 2020 for 480 hours of non-participant direct observation, with records systematized in a checklist containing variables related to the availability and compliance of structural resources, and the compliance of the care flow. Data were organized into spreadsheets (Microsoft Excel® 2010) and analyzed using descriptive statistics. Results The framework assessment scored 80.3% availability, resulting in a high availability rating, and 91.1% compliance, achieving adequate compliance. The care flow showed 72.7% of total compliance; 9.1% of partial compliance and 18.2% of non-compliance, configuring high compliance. Conclusion Normative evaluation indicated high availability and compliance in structure and care flow in the studied scenarios.

Contexto y Dinámicas de Atención Prenatal para Mujeres con Violencia de Pareja / Context and dynamics of prenatal care for women with intimate partner violence

Introducción: Las mujeres tienen necesidades en salud que varían de acuerdo con el curso de vida y la violencia de pareja íntima. Objetivo: identificar las características del contexto en el cual se brinda la atención prenatal a las mujeres identificadas con violencia de pareja. Materiales y Métodos: estudio cualitativo con el diseño de etnografía y observación participante focalizada. Realizado en las sesiones del curso de preparación para el parto y en salas de espera de cinco instituciones de salud en Cali, Colombia. Resultados: se identificaron tres dimensiones que sobre el contexto de atención: (a) El Ambiente donde se brinda la Atención, (b) Relaciones de poder y (c) Dinámicas de la atención. Los resultados muestran un contexto tradicional en la atención prenatal con predominio de un modelo biomédico. Discusión: Los hallazgos muestran la complejidad de la atención en las instituciones de salud y un contexto tradicional en la atención prenatal con predominio de un modelo biomédico. Conclusión: en el encuentro de las mujeres con el personal de salud no se identifica la violencia de pareja que sufren las mujeres, puesto que, la relación se ve medida por: desconocer necesidades, relaciones verticales, el poder y la comunicación no asertiva. Para la adopción de acciones de apoyo y acompañamiento, es necesario, reconocer la importancia de una atención en salud con enfoque de perspectiva de género, diferencial, e interseccional. Además, en favor de la autonomía y la dignidad de las mujeres se debe fortalecer la cultura del respeto y de empatía hacia las usuarias.

Introduction: Women have health needs that vary according to their life course and intimate partner violence. Objective: To identify the contextual characteristics in which prenatal care is provided to women with intimate partner violence. Materials and Methods: A qualitative ethnographic study based on participant-focused observation was conducted throughout childbirth preparation course sessions and waiting rooms in five healthcare institutions in Cali, Colombia. Results: The following three dimensions were identified in the care context: (a) environment where care is provided, (b) power relations and (c) care dynamics. Findings suggest a traditional context in prenatal care with a predominance of a biomedical model. Results: three dimensions were identified regarding the care context: (a) The Environment where the Care is provided, (b) Power Relationships and (c) Dynamics of Care. The results show a traditional context in prenatal care with a predominance of a biomedical model. Discussion: The findings show the complexity of care in health institutions and a traditional context in prenatal care with a predominance of a biomedical model. Conclusions: During sessions held between women and healthcare personnel, intimate partner violence was not identified as the relationship was measured by a lack of knowledge of their needs, vertical relationships, power and non-assertive communication. For the adoption of support and accompaniment actions, it is necessary to recognize the importance of healthcare with a gender, differential and intersectional approach. In addition, in favor of women's autonomy and dignity, it is necessary to strengthen the culture of respect and empathy towards users.

Introdução: As mulheres têm necessidades de saúde que variam de acordo com sua trajetória de vida e violência por parceiro íntimo. Objetivo: identificar as características do contexto em que são prestados cuidados pré-natais a mulheres identificadas com violência do parceiro. Materiais e Métodos: estudo qualitativo usando etnografia e observação focalizada das participantes. Foi realizado nas sessões do curso de preparação ao parto e nas salas de espera de cinco instituições de saúde em Cali, Colômbia. Resultados: Foram identificadas três dimensões do contexto dos cuidados: (a) o ambiente onde os cuidados são prestados, (b) as relações de poder e (c) a dinâmica dos cuidados. Os resultados mostram um contexto tradicional nos cuidados pré-natais com predomínio de um modelo biomédico. Discussão: Os achados mostram a complexidade do cuidado nas instituições de saúde e um contexto tradicional no pré-natal com predominância do modelo biomédico. Conclusão: no encontro entre as mulheres e o pessoal de saúde, a violência dos parceiros sofrida pelas mulheres não é identificada, uma vez que a relação é medida por: ignorância das necessidades, relações verticais, poder e comunicação não assertiva. Para a adoção de ações de apoio e acompanhamento, é necessário reconhecer a importância dos cuidados de saúde com uma perspectiva de gênero, diferencial e intersetorial. Além disso, em prol da autonomia e dignidade das mulheres, é necessário reforçar uma cultura de respeito e empatia para com as pacientes.

Produção sobre a assistência pré-natal nas dissertações e teses das ciências da saúde: estudo bibliométrico / Production on prenatal care in health science dissertations and theses: a bibliometric study / Producción sobre la atención prenatal en disertaciones y tesis de ciencias de la salud: estudio bibliométrico

Objetivo: descrever a produção científica brasileira das dissertações e teses das ciências da saúde acerca da assistência prénatal no Brasil. Método: estudo bibliométrico das produções disponibilizadas no Portal de Teses e Dissertações da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior. Foram aplicadas as Leis de Lotka, Bradford e Zipf e estatística descritiva. Resultados: das 864 produções incluídas, 682 (78,9%) eram dissertações, a maioria produzida na região Sudeste (44,6%), por autores enfermeiros (45,7%), orientadores médicos (39,9%) e enfermeiros (32,5%). Predominaram estudos descritivoexploratórios (75%), com abordagem quantitativa (64%), que investigaram a assistência/avaliação pré-natal (25%), com as gestantes como população (66%) e a Unidade Básica de Saúde como principal cenário (50,8%). A palavra-chave mais frequente foi cuidado pré-natal. Conclusão: observou-se a predominância de estudos do tipo descritivo, quantitativos, oriundos das regiões Sudeste e Sul, nível de evidência 6.

Objective: to describe Brazilian scientific production in health science dissertations and theses on prenatal care in Brazil. Method: this bibliometric study examined the production available on the Theses and Dissertations Portal of Brazil's Coordination for the Improvement of Higher Education Personnel, applying Lotka, Bradford and Zipf Laws and descriptive statistics. Results: of the 864 productions included, 682 (78.9%) were dissertations, most produced in the Southeast region (44.6%), by nurse authors (45.7%), medical and nursing advisors and nurses (39,9% and 32.5%, respectively). Descriptiveexploratory studies predominated (75%), with quantitative approaches (64%), investigating prenatal care/assessment (25%), in populations of pregnant women (66%) and with primary health care facilities as the main scenarios (50.8%). The most frequent keyword was "prenatal care". Conclusion: the studies were predominantly descriptive, quantitative, from the Southeast and South regions and at evidence level 6.

Objetivo: describir la producción científica brasileña de disertaciones y tesis en ciencias de la salud sobre la atención prenatal en Brasil. Método: estudio bibliométrico de las producciones puestas a disposición en el Portal de Tesis y Disertaciones de la Coordinación para el Perfeccionamiento del Personal de Educación Superior. Se aplicaron las leyes Lotka, Bradford y Zipf y la estadística descriptiva. Resultados: de las 864 producciones incluidas, 682 (78,9%) fueron disertaciones, la mayoría producidas en el Sureste (44,6%), por enfermeras autoras (45,7%), asesores médicos y de enfermaría (39,9%, 32,5% respectivamente). Predominaron los estudios descriptivos-exploratorios (75%), con abordaje cuantitativo (64%), que investigaron la atención / valoración prenatal (25%), con gestantes como población (66%) y la Unidad Básica de Salud como escenario principal (50,8%). La palabra clave más frecuente fue atención prenatal. Conclusión: se observó el predomínio de estudios descriptivos, cuantitativos, provenientes de las regiones Sudeste y Sur, nivel de evidencia 6.

Investigation on iodine nutritional status and thyroid function of women in early pregnancy after the implementation of a new standard of iodized salt in Chengde / 公共卫生与预防医学

Objective To investigate the iodine nutritional status and thyroid function of women in early pregnancy after the implementation of a new standard of iodized salt in Chengde. Methods A total of 136 early pregnancy women who had lived in Chengde were randomly selected in this study from January 2018 to March 2020. A questionnaire survey was conducted. The iodized salt, urine and blood samples of the pregnant women were collected to analyze the salt iodine concentration, serum iodine, urinary iodine, serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4). Results In 2018 and 2019, the iodized salt coverage rates were 96.97% and 98.57%, the non-iodized salt rates were 3.03% and 1.43%, the iodized salt qualification rates were 95.45% and 97.14%, and the qualified iodized salt consumption rates were 93.94% and 92.86%, respectively. In addition, the median of iodized salt consumption was 22.20 mg/kg and 25.51 mg/kg, in 2018 and 2019, respectively. There was a statistically significant difference in the median urine iodine from 2018 to 2019 among women in early pregnancy (P0.05). Conclusion After the implementation of a new standard of iodized salt in Chengde, the iodine nutritional status of early pregnant women in 2019 was significantly improved, but there was still a small amount of insufficient iodine intake. The incidence of thyroid diseases in early pregnant women with abnormal iodine intake was higher than that in early pregnant women with appropriate iodine intake.

Experiencia vivida frente al aborto inducido en un grupo de mujeres en Bogotá, Colombia / Lived Experience with Induced Abortion of a Group of Women in Bogotá, Colombia / Experiência com o aborto provocado em um grupo de mulheres em Bogotá, Colômbia

Introducción: frente al aborto inducido se han establecido diferentes posturas que muchas veces se basan en perspectivas morales, filosóficas y religiosas, cuando deberían estar centradas en lo que implica esta situación de salud en la vida de las mujeres Metodología: se desarrolló una investigación fenomenológica para establecer los diálogos desde la perspectiva de las propias protagonistas sobre el aborto inducido con una participación de siete mujeres, mayores de 18 años en Bogotá. Resultados: las experiencias de las mujeres son variadas, pero se identificaron algunos aspectos similares o comunes. Sin embargo, cada vivencia es particular y tiene como marco el contexto en el que cada una habitaba en el momento del aborto. Se identificaron las siguientes categorías de análisis: aborto como consecuencia de un embarazo no deseado, aborto como experiencia frente a una decisión autónoma, aborto, culpa y pecado, cambios asociados a la experiencia, maternidad, materialización del deseo y aborto no debe ser considerado como un delito. Conclusiones: la vivencia del aborto no puede ser generalizable, y para su entendimiento debe tenerse en cuenta aspectos que solo atañen a la mujer como experta en su vida y en su situación. El aporte de la presente investigación fue recuperar la vivencia de las mujeres sobre el aborto para contribuir al cuidado de la salud en la población femenina

Introdução: sobre o aborto provocado têm-se estabelecido diferentes posturas, muitas vezes baseadas em perspectivas morais, filosóficas e religiosas, quando deveriam estar focadas no que implica essa situação de saúde na vida das mulheres. Metodologia: desenvolveu-se uma pesquisa fenomenológica para estabelecer os diálogos na perspectiva das próprias protagonistas sobre o aborto provocado com a participação de sete mulheres, maiores de 18 anos, em Bogotá. Resultados: as experiências das mulheres são variadas, mas alguns aspectos semelhantes ou comuns foram identificados. Porém, cada experiência é particular e se enquadra no contexto em que cada uma permanecia no momento do aborto. Foram identificadas as seguintes categorias de análise: aborto como consequência de uma gravidez indesejada, aborto como experiência diante de uma decisão autônoma, aborto, culpa e pecado, mudanças associadas à experiência, maternidade, materialização do desejo e aborto não deve ser considerado como um crime. Conclusões: a experiência do aborto não pode ser generalizável e, para sua compreensão, devem ser considerados aspectos que dizem respeito apenas à mulher como especialista em sua vida e em sua situação. A contribuição desta pesquisa foi resgatar as vivências de mulheres sobre o aborto para contribuir com a atenção à saúde da população feminina.

Introduction: Regarding induced abortion, different positions have been adopted, often based on moral, philosophical, and religious perspectives, when they should be focused on what this health situation implies for women's lives. Method: A phenomenological research was conducted to establish dialogues from the own protagonists' perspective of induced abortion, where seven women over 18 years of age in Bogotá participated. Results: Women's experiences are varied, but some similar or common aspects were identified. However, each experience is specific and is framed within the context where each woman lived at the time of the abortion. The following categories of analysis were identified: Abortion as a consequence of unwanted pregnancy, abortion as an experience versus an autonomous decision, abortion, guilt and sin, changes associated with the experience, maternity, desire materialization, and abortion should not be considered a crime. Conclusions: Abortion experience cannot be generalized, and for its understanding, aspects that only concern women as the experts on their lives and situations must be taken into account. This research contribution was to restore women's abortion experiences to advance female population health care

Thyroid Function Change in Pregnant Women with Different Types of Gestational Diabetes Mellitus / 中山大学学报(医学科学版)

[Objective] To investigate the relationship of different types of gestational diabetes mellitus (GDM) and thyroid function.[Methods] A Total of 3846 cases,which received prenatal examination,delivered in the Eastern Hospital of the First Affiliated Hospital,Sun Yat-sen University and performed a 75 g oral glucose tolerance test (75 g 0GTT) at 24-28 gestational weeks,from Jan 1st,2014 to Dec 31st,2015,were divided into 2 groups.Normal blood glucose group:the result of OGTT (fasting plasma glucose,1 hour glucose and 2 hour glucose) was normal;Gestational diabetes mellitus group (GDM group):the result of 0GTT was abnormal.GDM group were divided into Ⅰ,Ⅱ,and lⅢ.GDM Ⅰ defined as one abnormal blood glucose of result.GDM Ⅱ:two abnormal blood glucose.GDM Ⅲ:three abnormal blood glucose.1868 cases of healthy pregnant women were reselected as the control group.TSH,FT4 and TPO Ab were detected in two groups.Analysis of Variance,Mann-Whitney U test,Kruskal Wallis rank test or Fisher's test was used for statistical analysis.[Result] There were statistically significant difference in TSH,FT4 between GDM subgroup and control group (P =0.012,P =0.002).TSH median trend to increase in GDM Ⅱ,and FT4 median trend to decrease in GDM Ⅱ.The Prevalence of hypothyroidism in GDM Ⅱ and GDM Ⅲ were higher than those in control group.[Conclusion] The GDM group with two or three abnormal blood glucose had a higher incidence thyroid gland dysfunction,especial with subclinical hypothyroidism.We should fully test the thyroid function,treat diabetes as early as possible and improve the pregnancy outcome as we could.

Screening situation analysis on pregnant woman toxoplasma gondii infection in 2003-2010 in Shanghai / 上海预防医学

Objective To ascertain the usage of Toxoplasma Gondii(T.gondii) test kit,and analyze the trends of T.gondii infection in Shanghai pregnant women so as to provide scientific evidence for effective intervention measures to prevent congenital toxoplasmosis.Methods The data were collected on methods and results of screening T.gondii infection in pregnant women in Shanghai from 2003 to 2010,and analysis of T.gondii infection was made on pregnant women in this city.Results During 2003 and 2010,in 30 hospitals of the City was carried out the screening test for pregnant women T.Gontii infection.The overall serological positive rate to T.gondii was 1.46% from the 30 hospitals.The positive rates of IgG antibody was 2.46%(1.48%-4.96%) in 277 523 persons,that of IgM antibody was 0.83%(0.38%-1.48%) in 439 868 person.The IgM or both IgG and IgM positive pregnancy cases accounted for 41.74% of the total positive cases which appeared in pregnant women from 2008 to 2010.There were also significant differences in the positive rates among different hospitals so as seasons.ELISA and MEIA were more detected for T.gondii antibody detection,and their detection rates of IgG and IgM were significantly different.Imported kit has higher positive rate of detection T.gondii IgM antibody,but lower positive rate of screening IgG antibody than domestic kit.Conclusion The seroprevalence of T.gondii in pregnant women from 2003 to 2010 were close to the average level investigated in the past in Shanghai,but more attention should be paid to the higher proportion of IgM antibody positive,and stable and reliable test kits should be selected for detecting T.gondii IgG and IgM antibodies to avoid leak and mistaken diagnosis.

Nutrient Intake according to Weight Gain during Pregnancy, Job Status, and Household Income

The objective of this study was to investigate the association of nutrient intake and pregnancy outcome mediated by weight gain during pregnancy, job status, and household income. Maternal age, educational level, self-reported pre-pregnancy weights, educational level, and household income were collected from the women at 2 months postpartum. For each offspring, weight at birth, length at birth, and gestational age were collected. Participants were asked to report the frequency of consumption of foods between 28–42 weeks into the pregnancy. Diet was assessed by using a validated 106-item semi-quantitative food-frequency questionnaire (SQFFQ) and women were asked portions and quantities based on pictures, food models, and measuring tools such as cups or teaspoons. Results showed that women who gained below the recommended weight gain during pregnancy, within, and over were 25.3%, 38.7%, 36.0%, respectively. In comparison to weight gain and the offspring's length and weight at birth, the offspring of mothers with a lower weight gain had a higher length. Energy, protein, vitamin B2, vitamin C, calcium, and potassium were significantly lower at employed group. We did not observe a significant difference between birth characteristics and maternal nutrient intake by income. Infants with a higher ponderal index at birth were born to women with a higher pre-pregnancy body mass index (BMI).

Effect of IKAP theory on twin pregnancy women′s psychological states, satisfaction and childbirth ;outcomes / 中国实用护理杂志

Objective To evaluate the effect of IKAP(Information-Knowledge-Attitude-Practice) theory on twin pregnancy women′s psychological states, satisfaction and childbirth outcomes. Methods One hundred twin pregnancy women who had made registrations and antenatal examination were divided into the intervention group and the control group with 50 women in each group according to randorn digit table. The twin pregnancy women in the control group received routine antenatal examinations. In addition, the twin pregnancy women in the intervention group received a special health education with IKAP theory. The twin pregnancy women′s anxiety, depression, birth outcomes and satisfaction were measured and compared between the two groups. Results The score of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) in the intervention group was 27.64±2.86 and 26.53±2.96 one week after delivery, significantly lower than those upon admission, 44.18 ±2.53 and 47.42 ±4.82, the difference was statistically significant (t=5.41, 4.49, P0.05). In the intervention group the rate of cesarean section was 29.17% (14/48), and the score of satisfaction was (9.01±0.78), they were also significantly higher than those of the control group, 53.06%(26/49), (7.82±1.44), the difference was significant (χ2=7.701, t=4.806, P0.05). Conclusions The IKAP theory on twin pregnancy women can decrease the anxiety, depression and the rate of cesarean section, and increase patient satisfaction.

Mastite granulomatosa lobular idiopática: relato de caso / Idiopatic lobular granulomatous mastitis: case report

Introdução: A mastite granulomatosa lobular idiopática (MGLI) é uma doença inflamatória crônica rara, benigna e autolimitada, cuja etiologia é desconhecida. A incidência permanece incerta, geralmente acomete mulheres em idade fértil com história recente de gestação e aleitamento. Relato de caso: Paciente com 37 anos, feminina, branca. Referia nodularidade em mama direita associada à dor há três meses. Fez uso de antibiótico por trinta dias sem melhora do quadro. Negava febre ou trauma local, não estava amamentando. Ao exame, palpava-se área endurecida, irregular, com, aproximadamente, 11,Ox12,O cm em quadrante superior interno. À ultrassonografia (US) mamária havia diversas coleções em quadrante superior interno e periareolar. Realizada drenagem de coleções em mama direita, bem como biópsia de parênquima mamário. O anatomopatológico foi compatível com MGLI com formação de abscesso. Conclusão: A MGLI é uma condição inflamatória que pode mimetizar neoplasia e abscesso mamários. Os achados do exame físico e radiológicos são inespecíficos. A histopatologia confirma o diagnóstico na presença de granuloma não caseoso em unidades lobulares. Em virtude da tendência à recorrência e à resolução lenta, seguimento prolongado é indispensável.

Introduction: The idiopathic lobular granulomatous mastitis (ILGM) is a rare chronic inflammatory disease, benign and self-limited, whose etiology is unknown. The incicknce remains uncertain, usually affects women of childbearing age with a recent history of pregnancy and lactation. Case report: A 37-year-old, white woman reported nodularity in the right breast associated with pain ftr three months. She used antibiotic ftr thirty days without improvement. Fever or local trauma was not nursing. On examination, there was hardened and irregular area with approximately 11.Oxl2. 0 em in the upper inner quadrant. At ultrasound (US), breast had several collections in the upper inner quadrant and periareolar. The lesion was biopsied and drained. The pathology was compatible with ILGM with abscess. Conclusion: ILGM is an inflammatory condition that can mimic cancer and breast abscess. The findings of physical examination and radiological findings are nonspecific. Histopathology confirms the diagnosis in the presence of noncaseating granuloma in lobular units. Given the tendency to recurrence and slow recovery, extenckd ftllow-up is essential.

Discussion on the influence and treatment of hypertensive disorder complicating pregnancy / 中国基层医药

Objective To investigate the influence and treatment of hypertensive disorder complicating pregnancy(HDCP).Methods 178 HDCP cases are selected as observation group,and 178 normal patients as comparison group.Results Fetal growth restriction was 25 cases in disease group and 1 case in normal group(P＜0.01);20 cases are fetal growth restriction in 77 cases with severity pre-eclampsia,which had notability discrepancy compared with mild pre-eclampsia(P＜0.01).Premature delivery was 21 cases(25.33%)in severity pre-eclampsia,which had significant diffcrence.When compared with the rest three groops(P＜0.01).When fetal age is equal to or above 37 weeks,the livability reached to 100%(P＜0.01).Conclusion We should prevent transformation actively,avoid pre-eclampsia and complication to severe pre-eclampsia of mother and baby.

Adequação da assistência pré-natal em gestantes atendidas em dois hospitais de referência para gravidez de alto risco do Sistema Unico de Saúde, na cidade de Recife, Estado de Pernambuco / Adequacy of the antenatal care for pregnant women seen at the two references services for women with high risk pregnancies at maternity hospitals of the Brazilian Public Health System in the city of Recife, in the State of Pernambuco

OBJETIVOS: investigar a adequação da assistência pré-natal realizada por gestantes usuárias do Sistema Unico de Saúde (SUS) da cidade do Recife, Pernambuco. MÉTODOS: estudo de corte transversal de 612 mulheres atendidas por ocasião do parto em duas unidades do SUS, referências para gravidez de alto risco no Recife, no período de junho a outubro de 2004. A avaliação do Pré-Natal foi baseada nos critérios do Programa de Humanização do Pré-Natal e Nascimento do Ministério da Saúde. RESULTADOS: a cobertura de pré-natal foi de 96,1 por cento, sendo a média de consultas de 5,3. Apenas 38,0 por cento das mulheres iniciaram o pré-natal até o quarto mês de gestação e realizaram seis ou mais consultas. Dentre as entrevistadas, 31 por cento tiveram peso, pressão arterial, altura uterina e os batimentos cardiofetais aferidos em todas as consultas. A atenção pré-natal foi considerada adequada em 17,8 por cento e não-adequada em 82,2 por cento dos casos. CONCLUSÕES: A assistência pré-natal disponível para as gestantes na cidade do Recife, apesar de apresentar elevada cobertura, deve ser revista do ponto de vista qualitativo.

OBJECTIVES: to asses antenatal care adequacy offered to pregnant women in the Brazilian Public Health System (BPHS), in the city of Recife, in the State of Pernambuco. METHODS: a cross-sectional study of 612 women seen assisted during delivery in two BPHS units, with high risk pregnancies referrals in Recife, from June to October 2004. Antenatal care assessment was based on the criteria of the Humane Antenatal and Delivery Program of the Ministry of Health. RESULTS: antenatal coverage averaged 96.1 percent and the median of medical visits was of 5.3. Only 38.0 percent of the women initiated antenatal care by the fourth month of pregnancy and made six or more medical consults. Among the respondents, 31 percent had weight, arterial pressure, uterine fundus height and cardiofetal heartbeats measured in all medical visits. Antenatal care was considered adequate in 17.8 percent of the cases and inadequate in 82.2 percent of the cases. CONCLUSIONS: available antenatal care for pregnant women in Recife city has ample coverage, but it should be reviewed from a quality standpoint.

Pregnant Women's Attitude and Satisfaction for Sexuality / 간호학회지

The relationship between the attitude and satisfaction for sexuality of pregnant women was observed to provide rationales of nursing intervention to help promote healthy sexual lifestyles. Questionnaires were collected from 211 obstetric outpatients of H university hospital in C city, Korea from February to May 1999. The research tools were D.S.F.I (Derogatis Sexual Function Inventory in Korean, Chronbach's alpha= 0.710) and Sexuality Satisfaction Method (Kim, 1997, Chronbach's alpha =0.864). Data was analyzed for frequency, mean, standard deviation, Pearson correlation, t-test and ANOVA by Windows SAS. The results of this study were as follows: Mean age of the subjects were 29.8; the average score of attitude to sex was moderate (27.60), and that of satisfaction sex was high (54.11); the positive relationship was shown between attitude and satisfaction for sexuality (r=0.51, p=.000); the higher educational and income levels of pregnant women and their husbands, were the better the attitude and satisfaction for was; professional women had better attitude than housewives. According to the results, it is suggested that the study is necessary to develop an effective nursing intervention related with the sexuality of pregnant women.