ABSTRACT
Abstract Objectives: to analyze adverse outcomes in teaching maternity hospitals in Maceió, Alagoas, Brazil. Methods: a cross-sectional, retrospective and analytical study was carried out with a random sample of 480 medical records of postpartum women in 2016 using the Adverse Outcome Index: in-hospital maternal death, neonatal in-hospital death> 2500g and> 37 weeks, uterine rupture, unplanned maternal admission to intensive care unit, delivery trauma to the newborn, return to the operating room, admission to an intensive neonatal unit with >2500g and > 37 weeks for more than one day, Apgar <7 at the fifth minute, maternal hemotransfusion and fourth-degree perineal laceration. The data were analyzed using the Statistical Package for Social Sciences software version 22.0. Results: the results showed a 21% rate of adverse outcomes, at a rate of 26.4 for every 1,000 births, with a greater occurrence of neonatal intensive care admission with>2500g and>37 weeks for more than one day (52. 5%), maternal blood transfusion (20.8%) and unplanned maternal admission in intensive care (17.8%). Conclusions: the evaluation of adverse outcomes evidenced a high proportion of births with undesirable results, which allowed the analysis of the outlook of unfavorable outcomes related to safety in maternity wards through the use of indicators.
Resumo Objetivos: analisar os resultados adversos em maternidades de ensino de Maceió, Alagoas, Brasil. Métodos: estudo transversal, retrospectivo e analítico, com amostra aleatória de 480 prontuários de puérperas de parto cirúrgico de 2016, utilizando-se o Adverse Outcome Index: morte materna intra-hospitalar, morte neonatal intra-hospitalar >2500g e >37 semanas, rotura uterina, admissão materna não planejada em unidade de terapia intensiva, trauma de parto no recém-nascido, retorno à sala cirúrgica, admissão em unidade intensiva neonatal com >2500g e >37 semanas por mais de um dia, Apgar <7 no quinto minuto, hemotransfusão materna e laceração perineal de 4º grau. Os dados foram analisados por meio do software Statistical Package for the Social Sciences versão 22.0. Resultados: a taxa de resultados adversos foi 21%, na proporção de 26,4 para cada 1000 partosdia, com maior ocorrência de admissão neonatal em terapia intensiva com >2500g e >37 semanas por mais de um dia (52,5%), hemotransfusão materna (20,8%) e admissão materna não planejada em terapia intensiva (17,8%). Conclusão: evidenciou uma elevada parcela de nascimentos com resultados não desejáveis, o que proporcionou a análise do panorama dos desfechos desfavoráveis relacionados à segurança em maternidades através do uso de indicadores.
Subject(s)
Humans , Female , Pregnancy , Outcome Assessment, Health Care , Perinatal Care , Quality Indicators, Health Care , Adverse Outcome Pathways , Hospitals, Maternity , Brazil , Intensive Care Units, Neonatal , Cross-Sectional Studies , Postpartum Period , Patient Safety , Maternal Death , Perinatal DeathABSTRACT
La gingivitis es la enfermedad más prevalente, pues afecta entre un 5% y un 70% de la población mundial, y puede incluso llegar hasta un 90%. En cambio, la enfermedad periodontal (EP) alcanza un promedio del 30% al 80%, y es más frecuente a partir del segundo trimestre de embarazo. En América Latina, afecta entre un 30% y un 40% de la población. Se estima que durante el embarazo hay un mayor riesgo a contraer enfermedad periodontal en una proporción de 1 de cada 5 mujeres. La enfermedad periodontal es una enfermedad inflamatoria que perjudica a los tejidos de soporte del diente (encía, cemento radicular, ligamento periodontal y hueso alveolar).Se ha demostrado que existe una relación directa entre el agravamiento de la EP con el embarazo. Esto se debe a la variación hormonal que ocurre en este periodo, la cual promueve el crecimiento excesivo de microorganismos patógenos responsables de la inflamación gingival. Entre estos microorganismos patógenos encontramos a Prevotella intermedia y Porphyromonas gingivalis. Esta última, junto a Fusobacterium nucleatum, son capaces de atravesar la barrera placen-taria y causar infecciones y resultados adversos en el embarazo, tales como parto prematuro, preeclampsia y muerte fetal. (AU)
Gingivitis is the most prevalent disease worldwide, affecting from 5 to 70% of the population and reaching up to 90%. On the other hand, the mean prevalence of periodontal disease (PD) is 30 to 80%, being more frequent in the second trimester of pregnancy. Periodontal disease is an inflammatory disease of the tissues supporting (gingiva, root cement, periodontal ligament and alveolar bone). In Latin America, PD affects between 30 and 40% of the population, and it is estimated that 1 to 5 women will develop PD during pregnancy. It has been shown that there is a direct relationship between the aggravation of PD and pregnancy. This is due to hormonal changes during gestation, which promote the excessive growth of pathogenic microorganisms responsible for gingival inflammation.These pathogenic microorganisms include Prevotella intermedia and Porphyromonas gingivalis. The latter, together with Fusobacterium nucleatum. are able to cross the placental barrier causing infections and adverse preg-nancy outcomes, such as premature birth, preeclampsia, fetal death and metrial arteritis. (AU)
Subject(s)
Humans , Female , Periodontal Diseases , Pregnancy , Microbiota , Adverse Outcome Pathways , GingivitisABSTRACT
Background. Policy initiatives in South Africa are directed at promoting the educational and developmental outcomes of girls and young women (age 15 - 24 years). These include decreasing the incidence of HIV infection, teenage pregnancy and gender-based violence, and increasing school attendance and economic empowerment. This article explores the contexts of pregnancy, motherhood and schooling in a sample of young mothers in an urban area in Johannesburg, South Africa. Methods. This ethnographic study, based in a poor urban area in Johannesburg, South Africa, recruited 30 young mothers aged 18 - 20 years with whom open-ended interviews were conducted. Each mother was contacted 3 months after the first interview, and again 3 months later. In addition to the first round of 30 interviews, 9 young mothers were interviewed in the second round, and 6 young mothers in a third round. A total of 45 interviews were conducted. Results. The findings illustrate how young mothers mediate constraints and challenges to continue and complete their schooling when confronted with a mistimed and unintended pregnancy. A combination of factors converges to facilitate or impede school continuation and completion. Key barriers include school policy and discrimination against pregnant learners, limited options for childcare, and high levels of poverty and unemployment that strain existing scarce family resources. Conclusions. The pathway to school completion is complex and non-linear. Three particular interventions that support school attendance and completion for young mothers have value: the child support grant, the availability of crèches in the community, and a school policy that upholds the principle of inclusivity for pregnant learners and young mothers