Percepción de la simulación en obstetricia y ginecología en el pregrado y posgrado de una universidad privada chilena / Perception of simulation in obstetrics and gynecology at the undergraduate and postgraduate levels of a private chilean university

Introducción: La simulación es una herramienta que promueve la confianza y desarrollo de habilidades en los participantes. En la evaluación de programas formativos la percepción de utilidad se vincula a la confianza y aprendizaje, y corresponde al primer nivel de evaluación según Kirkpatrick. Objetivo: Evaluar la percepción de internos y residentes de obstetricia y ginecología en escenarios de simulación. Material y métodos: Investigación descriptiva cuantitativa, en una muestra a conveniencia de internos y residentes, quienes contestaron una escala de valoración global y de preferencias sobre sus simulaciones. Resultados: Se obtuvieron 63 respuestas de internos (63%) y 7 de residentes (78%). La valoración promedio de las simulaciones fue de 6,42 en los internos y de 6,64 de los residentes. El 67% de los internos y el 86% de los residentes no eliminaría ninguna simulación. Los internos repetirían todas las simulaciones, en tanto que los residentes repetirían tres simulaciones de un total de 11. Conclusiones: La valoración de las simulaciones fue alta en ambos grupos, difiriendo en las actividades que prefieren repetir, lo cual puede relacionarse con las competencias inherentes al rol de especialista en comparación al rol del médico general o a las diferencias en autoconfianza de internos y residentes.

Introduction: Clinical simulation is a training tool that promotes confidence and the development of procedural skills in participants, from initial training to the training of professional teams. In the evaluation of training programs, the measurement of perceived usefulness is linked to confidence and learning and corresponds to a first level of evaluation of the quality of training according to Kirkpatricks model. Objective: To evaluate the perception of medical interns and Obstetrics and Gynecology fellows regarding simulation scenarios. Material and methods: Quantitative descriptive research, in a convenience sample of interns and fellows, who answered a scale of global assessment and preferences about simulations. Results: The average score was 6.42 for the interns and 6.64 for the scholarship recipients. With odd answers about the repetition of scenarios. 67% of the interns and 86% of the fellows responded that they would not eliminate any simulation. Conclusions: The evaluation of the scenarios was excellent and satisfactory by the participants.

Sangrado Uterino Anormal: hallazgos ecográficos / Abnormal Uterine Bleeding: ultrasound findings

Describir los hallazgos ecográficos de las pacientes que acudieron por sangrado uterino anormal al servicio de Ginecología y Obstetricia del Hospital Dr. Domingo Luciani durante el período enero 2021 a enero 2022. Métodos: Estudio observacional-descriptivo, de tipo retrospectivo. Muestra no probabilística e intencional, integrada por 99 pacientes. Variables involucradas: edad, raza, paridad, antecedentes personales, ciclo menstrual, duración del período menstrual, fecha última de menstruación, uso de algún medicamento, método anticonceptivo y hallazgos ecográficos. Resultados: Los hallazgos ecográficos evidenciaron diferentes causas que explican el sangrado uterino anormal de las pacientes que integraron la muestra de estudio; las tres más frecuentes fueron: miomatosis uterina, sangrado uterino anormal por leiomioma o por endometrio, sangrado uterino anormal tipo L y tipo E(AU)

Objective: To describe the ultrasound findings ofpatients who came for abnormal uterine bleeding to theGynecology and Obstetrics service of the Dr. Domingo LucianiHospital during the period January 2021 to January 2022.Methods: This was an observational-descriptive, retrospectivestudy. The sample was non-probabilistic and intentional,consisting of 99 patients. The data were collected in an Excelsheet for analysis to determine their percentage frequencyaccording to the variables involved: age, ethnicity, parity,personal history, menstrual cycle, duration of menstrual period,last date of menstruation, use of some medication, contraceptivemethod and ultrasound findings. Results: The ultrasoundfindings showed different causes to explain the abnormal uterinebleeding of the patients who made up the study sample; however,the three most frequent were: uterine myomatosis, sangradouterino anormal tipo L y tipo E(AU)

Diseño de la asignatura Obstetricia y Ginecología basada en la formación de competencias / Design of the Obstetrics and Gynecology subject based on competency training

Introducción: La sociedad contemporánea reclama la presencia de personas competentes, con la recursividad necesaria para acometer de manera innovadora las funciones y tareas para las que han sido preparadas desde el punto de vista teórico. Solo que esta preparación, como eslabón aislado, no garantiza la generación de sujetos competentes. La calidad de los servicios de salud se mide por el nivel de competencia de sus trabajadores. Dentro de los aspectos generales del sistema de educación superior, se mantiene que estos estarán en continuo perfeccionamiento. Es necesario diseñar estrategias didácticas en la asignatura Obstetricia y Ginecología para la formación basada en competencias para el desempeño. Objetivo: Diseñar los procesos didácticos para la formación de competencias en Obstetricia y Ginecología. Posicionamiento del autor: Se necesita diseñar estrategias didácticas en la asignatura de Obstetricia y Ginecología para la formación basada en competencias para el desempeño, para lo cual se realizó un análisis documental, histórico-lógico, de los programas de estudios de la asignatura de Obstetricia y Ginecología, previo a 2010, para proponer las transformaciones pertinentes en los procesos didácticos de la asignatura. Conclusiones: Los resultados mostraron las transformaciones realizadas al programa de la asignatura desde 2010 hasta 2020. El diseño estuvo basado en el modelo por competencias para el desempeño, por la necesidad de incrementar la calidad de los servicios de salud, a partir de los principios de la educación médica cubana como parte del sistema nacional de salud(AU)

Introduction: The contemporary society demands the presence of competent people, with the necessary resources to undertake, in an innovative way, the functions and tasks for which they have been trained from the theoretical point of view. However, this preparation, as an isolated link, does not guarantee the generation of competent individuals. The quality of health services is measured by the level of competence of workers. The general aspects of the higher education system maintain that workers will continuously improve professionally. It is necessary to design didactic strategies for the Obstetrics and Gynecology subject aimed at training based on performance competencies. Objective: To design the didactic processes for the formation of competencies in Obstetrics and Gynecology. Author's stand: It is necessary to design didactic strategies for the Obstetrics and Gynecology subject in view of training based on performance competencies, for which a documentary and historical-logical analysis of its syllabus was carried, prior to 2010, in order to propose the relevant transformations in the didactic processes of the subject. Conclusions: The results showed the transformations made to the syllabus of the subject from 2010 to 2020. The design was based on the performance competency model, due to the need to increase the quality of health services, based on the principles of Cuban medical education as part of the national health system(AU)

Consultas por sospecha de abuso sexual infantojuvenil en la sección de Ginecología de un hospital pediátrico: variaciones prepandemia e intrapandemia de COVID-19 / Consultations due to suspected child and adolescent sexual abuse at the Department of Gynecology of a children's hospital: pre- and intra-COVID-19 pandemic

Introducción. Se ha postulado que el aislamiento social debido a la pandemia de la enfermedad por el coronavirus 2019 (COVID-19, por su sigla en inglés) aumentaría la incidencia de abuso sexual infantojuvenil (ASIJ). Objetivo. Comparar la incidencia y las características de las consultas realizadas en Ginecología en relación con ASIJ antes y durante la pandemia de COVID-19. Materiales y métodos. Se realizó un estudio descriptivo, observacional y comparativo entre las situaciones de sospecha de ASIJ ocurridas durante la pandemia de COVID-19 en relación con las del mismo período del año previo en un hospital pediátrico de alta complejidad. Resultados. Se consignaron 122 consultas por sospecha de ASIJ, 78 en el período previo a la pandemia y 44 en la pandemia. El motivo de consulta al hospital más frecuente, en ambos grupos, fue el relato de ASIJ y, al Servicio de Ginecología en particular, la evaluación de genitales externos. La mayor parte presentó un examen físico normal. Se observó una mayor prevalencia de infecciones de transmisión sexual (ITS) en el grupo de pandemia. Se realizaron más internaciones y denuncias para protección de víctimas en dicho grupo. Se registró que el agresor era conocido de la víctima en casi el 90 % de las víctimas de ambos grupos. Conclusiones. Durante la pandemia se evidenció una disminución en el número total de consultas a Ginecología, de modo que aquellas por sospecha de ASIJ representaron un mayor porcentaje. Sin embargo, las características en relación con la presencia de lesiones graves, infecciones de transmisión sexual o embarazo no se vieron modificadas

Introduction. It has been suggested that the social isolation due to the coronavirus disease 2019 (COVID-19) may increase the incidence of child and adolescent sexual abuse (CASA). Objective. To compare the incidence and characteristics of medical consultations made to the Department of Gynecology due to CASA before and during the COVID-19 pandemic. Materials and methods. Descriptive, observational, and comparative study about suspected CASA events occurred during the COVID-19 pandemic compared to those occurred in the previous year at a tertiary care children's hospital. Results. One hundred and twenty-two medical consultations due to suspected CASA were recorded; 78 before and 44 during the pandemic. In both groups, the most common reason for consultation at the hospital was an account of CASA and, at the Department of Gynecology in particular, the external genitalia examination. Most subjects had a normal physical examination. There was a higher prevalence of STI in the pandemic group. In addition, there were also more hospitalizations and police reports for victims protection in this group. The abuser was known to the victim in almost 90% of cases in both groups. Conclusions. During the pandemic, the total number of medical consultations to the Department of Gynecology decreased so the percentage of those due to suspected CASA was higher. However, the presence of severe lesions, STIs or pregnancy did not change

Guiding significance of "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology (FU Qing-zhu Nyu Ke) for dealing with ovulation disorder infertility caused by hyperprolactinemia / 中国中药杂志

This paper discussed the guiding significance of "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) for dealing with ovulation disorder infertility caused by hyperprolactinemia(HPRL). FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) concentrates on the disease entities, main symptoms, pathogenesis, and syndrome differentiation, based on which the prescriptions are prescribed. This reflects the "disease-syndrome-symptom" mode, with the core lying in the "combination of disease with syndrome". The contained Discussion on Menstruation Regulation(Tiao Jing Pian) and Discussion on Getting Pregnant(Zhong Zi Pian) have important reference significance for later doctors in the diagnosis and treatment of inferti-lity, and many prescriptions are still in use due to good effects. It is believed in traditional Chinese medicine(TCM) that HPRL results from kidney deficiency and liver depression, among which kidney deficiency is the main cause. Liver depression accelerates the onset of HPRL, so the kidney-tonifying and liver-soothing herbs were mainly selected. The "disease-syndrome-symptom" mode in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) sheds enlightenment on the diagnosis and treatment of ovulation infertility caused by HPRL, in that it is not confined to disease entity and syndrome type. The integration of "disease-syndrome-symptom" highlights the main complaint of patients and emphasizes the main pathogenesis, thus giving full play to the overall advantage of syndrome differentiation. For multiple diseases in FU Qing-zhu's Obstetrics and Gynecology(FU Qing-zhu Nyu Ke) such as infertility due to liver depression, infertility due to obesity, delayed menstruation, and irregular menstruation, although the typical lactation symptom of HPRL is not mentioned, the medication can still be determined according to the chief complaint, syndrome type, and symptoms and signs, making up for the defects of excessive reliance on serum biochemical indicators in modern Chinese medicine. We should learn its diagnosis and treatment thoughts of paying attention to liver, spleen, kidney, and heart, holism, and strengthening body resistance to eliminate pathogenic factors.

60º CBGO: congresso brasileiro de ginecologia e obstetrícia: temas livres / 60th CBGO: Brazilian Congress of Gynecology and Obstetrics: free themes

Organizado pela Febrasgo está Edição especial foi dedicada à divulgação dos Temas Livres selecionados para apresentação no 60º Congresso Brasileiro de Ginecologia e Obstetrícia. Resumos dos temas discutidos sobre como tornar a sua prática ainda melhor, tanto para os profissionais atuantes quanto para os pacientes. Varios debates envolvendo as melhores práticas clinicas, técnicas, tecnologias, casos clínicos complexos e tratamentos, gerando muito aprendizado, vislumbrando melhorar a qualidade de vida das mulheres brasileiras

Bloqueio do Nervo Hipogástrico Superior (BNHS) para o manejo da dor após Embolização de Artérias Uterinas (EAU): revisão de literatura / Superior Hypogastric Nerve Block (SHNB) for pain management in Uterine Artery Embolization (UAE): a literature review

Introdução: a embolização de artérias uterinas (EAU) é uma opção terapêutica no tratamento de miomas uterinos sintomáticos; todavia, a dor pós-procedimento representa um grande desafio para essa técnica. Nesse contexto, o Bloqueio do Nervo Hipogástrico Superior (BNHS), já utilizado no tratamento de dor pélvica crônica associada à malignidade, apresenta-se como opção de intervenção intraprocedimento para melhorar a recuperação das pacientes e fomentar o uso da EAU na prática clínica. Objetivo: realizar uma revisão integrativa da literatura disponível sobre o BNHS no manejo de dor pós EAU. Métodos: bases de dados PubMed, The Cochrane Library, Lilacs e Medline foram avaliadas a partir da combinação dos termos "uterine artery embolization", "pain" e "superior hypogastric block". Foram incluídos estudos clínicos, disponíveis em texto completo, com pacientes adultas, submetidas à EAU, cujo objetivo era avaliar o uso do BNHS e seu impacto na dor pós-procedimento. Foram excluídos artigos de revisão, carta ao editor, e publicação em anais de congresso. Resultados: 8 artigos, em maior parte retrospectivos, indicaram consistência do BNHS em termos de sucesso terapêutico a curto prazo e redução da dor. Apenas uma complicação foi relatada, e evoluiu de forma satisfatória. Conclusões: BNHS tem potencial de aprimorar o manejo da dor após EAU, podendo impactar positivamente no tempo e na qualidade da recuperação, com redução da dor e consumo de opiodes no período pós-operatório. Esses benefícios valorizam o procedimento de embolização como uma alternativa a ser considerada no tratamento de leiomiomas sintomáticos para mulheres candidatas à preservação uterina.

Introduction: Uterine Artery Embolization (UAE) is a therapeutic option in the treatment of symptomatic uterine fibroids; however, post-procedure pain imposes as a great challenge in this technique. In this context, the Superior Hypogastric Nerve Block (SHNB), already used in the treatment of chronic pelvic pain associated with malignancy, presents itself as an option for intraprocedural intervention, to improve patients' recovery and to promote UAE in the clinical setting. Objective: to perform an integrative literature review about the effectiveness of SHNB in pain management after UAE. Methods: databases PubMed, The Cochrane Library, Lilacs and Medline were assessed using the combination of the terms "uterine artery embolization", "pain" and "superior hypogastric block". Clinical studies were included once available in full text, with adult patients submitted to UAE, whose objective was to evaluate the use of SHNB and its impact in post-procedure pain. Review articles, letters to the editor, and publication in conference proceedings were excluded. Results: 8 articles were found, most of them retrospective, indicated SHNB's consistency in terms of short-term therapeutic success and pain reduction. The single reported complication evolved satisfactorily. Conclusions: SHNB has the potential to improve pain management after UAE, which can positively impact recovery time and quality, with reduced pain and consumption of opioids in the postoperative period. Benefits like these can enhance the embolization procedure as an alternative to be considered for the treatment of symptomatic fibroids for women candidates for uterine preservation.

Recomendaciones para el diagnóstico y manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido / Recommendations for the diagnosis and management of cytomegalovirus infection in pregnant woman and newborn infant

Resumen La Sociedad Chilena de Infectología, a través de su Comité de Infecciones Neonatales, en conjunto con la Sociedad Chilena de Obstetricia y Ginecología, proponen un documento de diagnóstico y manejo de la Infección por Citomegalovirus en la Mujer Embarazada y el Recién Nacido. Esta guía aborda el manejo de la infección en el binomio, su enfrentamiento diagnóstico y terapéutico, orientado al equipo de salud que atiende a mujeres embarazadas y recién nacidos con infección por citomegalovirus (CMV) en Chile. Considera la situación epidemiológica global y latinoamericana, con recomendaciones para la evaluación clínica y de laboratorio; establece criterios de diagnóstico, propone enfoques terapéuticos de acuerdo a la situación clínica, analiza las medidas de prevención y establece una propuesta nacional para el seguimiento de esta enfermedad. Se ha puesto especial énfasis en entregar, de forma práctica, y con la mayor evidencia posible, las recomendaciones para el manejo del binomio con infección por CMV.

Abstract The Chilean Society of Infectology, through its Neonatal Infections Committee in conjunction with the Chilean Society of Obstetrics and Gynecology, propose a document for the Diagnosis and Management of Cytomegalovirus Infection in Pregnant Woman and Newborn Infant. This guideline suggests the management of mother and child infection, its diagnostic and therapeutic options. Considers the global and Latin American epidemiology, with recommendations for clinical and laboratory evaluation; diagnostic criteria, therapeutic approaches according to the clinical situation, analyzes prevention measures and establishes a national proposal for monitoring this disease.

Complementary and Alternative Medicine Attitudes of Gynecologic Patients: Experience in a Tertiary Clinic / Atitudes de pacientes ginecológicos em medicina alternativa e complementar: Experiência em uma clínica terciária

Abstract Objective To evaluate the knowledge, attitudes, and behaviors regarding complementary and alternative medicine methods of patients who were admitted to gynecology outpatient clinics. Methods In the present survey, a questionnaire on complementary and alternative medicine practices was applied on 1,000 women (ages between 18 and 83 years old) who were admitted to the gynecology outpatient clinic of a tertiarymaternity hospital. Demographic features and knowledge, attitudes, and behaviors about these methods were inquired in face-to-face interviews. Results While 80.7% of the total participants thought that complementary and alternative medicine was beneficial, only 37.5% of them had used these methods previously. The rate of prior knowledge on this subject was of 59.7% and the source of information was physicians for 8.5% of the patients. However, 72.4% of all participants wanted to obtain information on these methods and 93.7% wanted to be informed by physicians. In the decision tree model, having knowledge about complementary and alternative medicine was the most effective factor determining its use (p<0.001). Phytotherapy was found to be the most used method, with 91.4%. The most preferred plant was onion (18.9%), and the most common reasons for herbal use were stress (15.4%) and fatigue (15.2%). Conclusion More than one-third of the patients who applied to the gynecology outpatient clinics used one of the complementary and alternativemedicine methods at least once. As gynecologists and obstetricians, we need to be more knowledgeable about these methods to provide correct guidance to our patients for accessing accurate and effective information.

Resumo Objetivo Avaliar o conhecimento, as atitudes e os comportamentos em relação aos métodos de medicina complementar e alternativa de pacientes internadas em ambulatórios de ginecologia. Métodos Na presente pesquisa, um questionário sobre práticas de medicina complementar e alternativa foi aplicado a 1.000 mulheres (idades entre 18 e 83 anos) que foram admitidas nos ambulatórios de ginecologia de uma maternidade terciária. Características demográficas e conhecimento, atitudes e comportamentos sobre esses métodos foram investigados em entrevistas pessoais. Resultados Enquanto 80,7% do total de participantes achavam que a medicina complementar e alternativa era benéfica, apenas 37,5% deles haviam usado esses métodos anteriormente. A taxa de conhecimento prévio sobre o assunto foi de 59,7% e a fonte de informação foi médica para 8,5% dos pacientes. No entanto, 72,4% de todos os participantes queriam obter informações sobre esses métodos e 93,7% queriam ser informados por médicos. No modelo de árvore de decisão, ter conhecimento sobre medicina complementar e alternativa foi o fator mais eficaz para determinar seu uso (p<0,001). A fitoterapia foi o método mais utilizado, com 91,4%. A planta preferida foi a cebola (18,9%), e osmotivos mais comuns para o uso de ervas foram estresse (15,4%) e fadiga (15,2%). Conclusão Mais de um terço das pacientes que se inscreveram no ambulatório de ginecologia utilizaram um dos métodos de medicina complementar e alternativa pelo menos uma vez. Como ginecologistas e obstetras, precisamos ter mais conhecimento sobre estes métodos a fimde fornecer orientações corretas aos nossos pacientes para o acesso a informações precisas e eficazes.

Abnormal Uterine Bleeding in Adolescence: When Menarche Reveals other Surprises / Hemorragia uterina anormal na adolescência: Quando a menarca revela outras surpresas

Abstract Introduction Abnormal uterine bleeding is more frequent in adolescence. Although, most commonly, it has a non-structural etiology, it may be due to any cause described. Clinical case A 12-year-old adolescent, with no relevant personal history, menarche 1 month before, was observed in the emergency department for severemenstrual bleeding with progressive worsening, and hemodynamic repercussion in need of transfusion support. Physiological ovulatory dysfunction associated with possible previously unknown coagulopathy was considered to be the most likely diagnosis and medical treatment was initiated. Without response, the patient was submitted to sedated observation and uterine aspiration, which ultimately led to the diagnosis of a Burkitt Lymphoma. Discussion Although structural causes, and particularly malignancy, whether gynecological or not, are a rare cause of abnormal uterine bleeding in this age group, they must be considered, thus enhancing the fastest and most appropriate treatment.

Resumo Introdução A hemorragia uterina anormal é mais frequente na adolescência. Apesar de maioritariamente de etiologia não estrutural, pode dever-se a qualquer causa descrita. Caso clínico Adolescente de 12 anos, sem antecedentes pessoais relevantes, com menarca há 1 mês, observada no serviço de urgência por hemorragia menstrual grave com agravamento progressivo e repercussão hemodinâmica com necessidade de suporte transfusional. Foi colocada a hipótese de disfunção ovulatória fisiológica associada a eventual coagulopatia desconhecida previamente e foi instituído tratamento médico. Por ausência de resposta a tratamento médico, foi submetida a observação sob sedação e aspiração uterina que evidenciou tratar-se de um Linfoma de Burkitt. Discussão Apesar de as causas estruturais, e particularmente as neoplasias, do foro ginecológico ou não, serem uma causa rara de hemorragia uterina anormal nesta faixa etária, elas devem ser levadas em consideração potenciando assim um tratamento mais célere e adequado.

Manual para la realización de estudios ultrasonográficos en ginecología y obstetricia / Manual for performing ultrasonographic studies in gynecology and Obstetrics

En el Ministerio de Salud (MINSAL), la ultrasonografía es una herramienta accesible en la mayoría de los hospitales extendiéndose cada vez más dentro de la Redes integrales e integradas de Salud RIIS, por lo que, el presente manual tiene la finalidad de unificar criterios que servirán para el fortalecimiento de especialistas en el área de la ginecología y obstetricia

In the Ministry of Health (MINSAL), ultrasonography is an accessible tool in the most hospitals expanding more and more within the Comprehensive networks and integrated Health RIIS, therefore, this manual has the purpose of unifying criteria that will serve to strengthen specialists in the area of gynecology and obstetrics

Understanding How Health Providers Identify Women with Postpartum Hemorrhage: A Qualitative Study / Compreendendo como os profissionais de saúde identificam as mulheres com hemorragia pós-parto: um estudo qualitativo

Abstract Objective To identify how health providers recognize postpartum hemorrhage early and the difficulties involved in it. Methods An exploratory, descriptive study using a qualitative approach through a semi-structured interview technique. In total, 27 health professionals (nursing tech nicians, nurses, medical residents in Gynecology and Obstetrics, hired medical doctors, and medicine professors) working in a tertiary-level hospital of reference in women's health care in the State of São Paulo, Brazil, participated in the study through an invitation. After they accepted the invitation, they signed the free and informed consent form. All interviews were recorded and transcribed, and a thematic analysis was conducted. We found three analysis categories: a) perception of the severity: "there is something wrong with the women"; b) difficulties in the early diagnosis of postpartum hemorrhage; and c) the process to improve obstetrical care. Results Caregivers believe teamwork and communication should be improved. Besides the visual estimation of blood loss, the nursing team is attentive to behavioral symptoms like irritability, while the medical staff follow protocols and look for objective signs, such as altered vital signs. Conclusion Besides the objective evaluations, the subjective perceptions of the providers are involved in the clinical judgement regarding the diagnosis of postpartum hemorrhage, and this should be included in a broader diagnosis strategy.

Resumo Objetivo Identificar como os profissionais de saúde reconhecem precocemente os casos de hemorragia pós-parto e as suas dificuldades. Métodos Realizou-se um estudo exploratório, descritivo, com uma abordagem qualitativa por meio da técnica de entrevista semiestruturada. Por meio de um convite, participaram do estudo 27 profissionais saúde (técnicas de enfermagem, enfermeiras, residentes de Ginecologia e Obstetrícia, e médicos contratados e docentes) que trabalhavam em um hospital de nível terciário de referência no atendimento à saúde da mulher no estado de São Paulo. Depois que os participantes aceitaram o convite, eles assinaram o termo de consentimento livre e esclarecido. Todas as entrevistas foram gravadas, transcritas, e realizou-se uma análise temática. Identificaram-se três categorias de análise: a) percepção da gravidade: "há algo de errado com as mulheres"; b) dificuldades no diagnóstico precoce da hemorragia pós-parto; e c) o processo para melhorar a atenção em obstetrícia. Resultados Os profissionais de saúde acreditavam que o trabalho em equipe e a comunicação deviam ser aperfeiçoados. Além da estimativa visual da perda de sangue, a equipe de enfermagem estava atenta a sintomas comportamentais como irritabilidade, ao passo que o pessoal médico seguia protocolos e procurava sinais objetivos, como sinais vitais alterados. Conclusão Além das avaliações objetivas, as percepções subjetivas dos provedores estão envolvidas no julgamento clínico do diagnóstico de hemorragia pós-parto, e isto deve ser incluído em uma estratégia de diagnóstico mais ampla.

Representações sociais de aborto para ginecologistas e obstetras da Região Metropolitana de Belo Horizonte, Minas Gerais, Brasil / Social representations of abortion for gynecologists and obstetricians in the Metropolitan Region of Belo Horizonte in the State of Minas Gerais, Brazil

Resumo O objetivo deste estudo foi identificar e analisar as representações sociais de aborto para ginecologistas e obstetras. Para tal, foram realizadas entrevistas semiestruturadas com 20 ginecologistas e obstetras, 10 homens e 10 mulheres de 34 a 67 anos de idade, que atuavam em hospitais da Região Metropolitana de Belo Horizonte, Minas Gerais. Os resultados apontam que o aborto é recorrente no cotidiano dos entrevistados, mobilizando a elaboração de representações sociais que os ajudam a torná-lo um objeto familiar. Tipologicamente, as representações identificadas foram representações sociais polêmicas. A maioria dos participantes objetivava o aborto como Decisão/Direito, o ancorando em valores básicos, como a liberdade, que orientavam a realização do aborto e o apoio à sua legalização. Paralelamente, outra parcela dos participantes objetivou o aborto enquanto Assassinato, o ancorando em valores básicos considerados inquestionáveis, como a vida, o que implicava na defesa do feto e na objeção de consciência à realização do aborto.

Abstract The scope of this study was to identify and analyze the social representations of abortion for gynecologists and obstetricians. The methodology used was the Semi-Structured Interview with 20 gynecologists and obstetricians (10 males and 10 females) from 34 to 67 years of age, who worked in hospitals in the Metropolitan Region of Belo Horizonte in the State of Minas Gerais. The results showed that abortion is recurrent in the daily routine of the interviewees, mobilizing the elaboration of social representations that help them to make it a familiar topic. Typologically, the representations identified were polemic social representations. Most participants objectified the abortion as Decision/Right, anchoring it in basic values, such as liberty, which oriented the practice of abortion and support its legalization. In parallel, another group of participants configured abortion as Murder, anchoring it in basic values considered unquestionable, such as life, which implied in the defense of the fetus, and conscientious objection to the practice of abortion.