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1.
Rev. cuba. med. mil ; 53(1)mar. 2024.
Article in Spanish | LILACS, CUMED | ID: biblio-1569893

ABSTRACT

La hemorragia puerperal produce el incremento en el número de ingresos en las unidades de cuidados intensivos, que a su vez requiere de una mayor y mejor atención por parte del personal de enfermería. Este trabajo tiene como objetivo, reflexionar sobre los principales elementos a tener en cuenta para el cuidado de enfermería de puérperas con hemorragia, en el contexto de la unidad de cuidados intensivos. El plan de cuidados en puérperas con hemorragia debe estar basado en los diagnósticos de enfermería, que logren un enfoque más hacia la enfermedad; en el que la planificación de acciones sea más específica a puérperas con hemorragia. Asimismo, combinar lo estandarizado con la individualización, para lograr una mayor efectividad en la atención a esta complicación grave principal causa de la mortalidad materna en el mundo. Por ello el cuidado de enfermería deberá asumir acciones frente a la seguridad de la paciente, desde la promoción del trabajo en equipo, hasta fortalecimiento de competencias para la implementación guías de prácticas que garanticen un accionar más rápido y eficiente(AU)


Puerperal hemorrhage causes an increase in the number of admissions to intensive care units, which in turn requires greater and better care from nursing staff. This work aims to reflect on the main elements to take into account for nursing care of postpartum women with hemorrhage, in the context of the intensive care unit. The care plan for postpartum women with hemorrhage should be based on nursing diagnoses that focus more on the disease; in which action planning is more specific to postpartum women with hemorrhage. Likewise, combine standardization with individualization, to achieve greater effectiveness in the care of this serious complication, the main cause of maternal mortality in the world. Therefore, nursing care must take actions regarding patient safety, from promoting teamwork to strengthening skills for the implementation of practice guides that guarantee faster and more efficient action(AU)


Subject(s)
Humans , Postpartum Period , Patient Safety , Postpartum Hemorrhage/nursing , Obstetric Labor Complications/diagnosis , Nursing Care , Nursing Care/methods , Nursing Diagnosis , Intensive Care Units
2.
Femina ; 52(1): 26-40, 20240130. ilus
Article in Portuguese | LILACS | ID: biblio-1532475

ABSTRACT

É imprescindível retomar o ensino da versão cefálica externa e das manobras tocúrgicas no parto pélvico vaginal, tanto em litotomia quanto na posição vertical. A adoção de protocolos rígidos para o parto pélvico vaginal planejado correlaciona-se com taxa de sucesso de aproximadamente 70% e taxas de resultados adversos inferiores a 7%. A morbimortalidade fetal e neonatal é semelhante à de cesárea planejada. Gestantes elegíveis para o parto pélvico vaginal devem concordar com a via de parto, possuir baixo risco de complicações e ser assistidas por profissionais com experiência em parto vaginal de apresentações anômalas e suas manobras obstétricas. Cesariana prévia e prematuridade entre 32 e 36 semanas não são contraindicações absolutas ao parto pélvico vaginal, devendo ser individualmente avaliadas na decisão da via de parto. Neonatologistas devem estar presentes no nascimento de fetos pélvicos, e um exame neonatal completo deve ser realizado. A rotação posterior do dorso fetal, o prolapso de cordão umbilical, a deflexão dos braços e/ou do polo cefálico e o encarceramento da cabeça derradeira são as principais distocias relacionadas à assistência ao parto pélvico por via vaginal. Todo profissional que assiste parto pélvico vaginal deve estar capacitado para a resolução adequada desses eventos. No parto pélvico vaginal em litotomia, as principais manobras para o auxílio ao desprendimento da pelve fetal são a tração inferior bidigital na prega inguinal e a manobra de Pinard; para o desprendimento do tronco fetal, as de Rojas, Deventer-Miler e Pajot; e para o desprendimento da cabeça derradeira, as de Mauriceau, Bracht, Champetier de Ribes e Praga e o parto vaginal operatório com o fórcipe de Piper. As posições não litotômicas no parto pélvico vaginal se associam à redução dos períodos de dilatação e expulsão, da taxa de cesariana, da necessidade de manobras para extração fetal e da taxa de lesões neonatais. No parto pélvico vaginal assistido na posição de quatro apoios, os aspectos a serem observados durante o desprendimento do corpo fetal incluem o tônus dos membros inferiores fetais, a rotação correta do tronco fetal (abdome fetal voltado para o dorso materno), o ingurgitamento vascular do cordão umbilical, a presença dos cotovelos e das pregas do tórax fetal e a dilatação anal materna. No parto pélvico vaginal assistido na posição de quatro apoios, mais da metade dos fetos se desprendem sem a necessidade de nenhuma manobra. Habitualmente, apenas duas manobras podem ser necessárias: uma para auxílio à saída dos ombros ("rotação 180°-90°") e outra para desprendimento da cabeça fetal ("Frank nudge").


Subject(s)
Humans , Female , Pregnancy , Midwifery/methods , Prolapse , Version, Fetal/education , Health Personnel , Dystocia , Neonatologists/education , Obstetric Labor Complications , Obstetrics/methods
3.
Rev. cuba. med. mil ; 52(4)dic. 2023. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1559846

ABSTRACT

Introducción: La hemorragia obstétrica es considerada una causa mayor de mortalidad materna. El reconocimiento de las mujeres con riesgo de desarrollar complicaciones durante la hemorragia obstétrica, es la primera acción para promover un tratamiento optimizado y evitar la muerte. Objetivo: Identificar los factores de riesgo de complicaciones en pacientes con hemorragia obstétrica. Métodos: Estudio observacional, analítico de casos y controles, con 12 casos (con complicaciones) y 24 controles (sin complicaciones). Se aplicó las medidas resúmenes para cada tipo de variables y la determinación de los factores de riesgos mediante la aplicación del odds ratio (OR), se utilizó el paquete estadístico SPSS versión 26.0, con un intervalo de confianza (IC) del 95 por ciento. Resultados: La combinación del choque hipovolémico, más la insuficiencia renal aguda, fue la complicación más frecuente para un 13,8 por ciento. Predominó la atonía uterina para un 50,0 por ciento como causa de hemorragia.Las variables predictivas de complicaciones fueron: el valor de creatinina ≥ 113 µmol/L (OR= 19,08; IC: 2,75-138,36), índice internacional normalizado ≥ 2 (OR= 4,66; IC: 1,46-14,90), hematocrito < 0,23 (OR= 4,00; IC: 1,76-9,08) y hemoglobina < 70 g/L (OR= 2,22; IC: 1,25-3,95). Conclusiones: La creatinina ≥ 113 µmol/L, índice internacional normalizado ≥ 2, hematocrito < 0,23 y hemoglobina < 70 g/L son los principales factores de riesgo identificados para el desarrollo de complicaciones durante la hemorragia obstétrica(AU)


Introduction: Obstetric hemorrhage is considered a major cause of maternal mortality. Recognition of women at risk of developing complications during obstetric hemorrhage is the first action to promote optimized treatment and avoid death. Objective: Identify risk factors for complications in patients with obstetric hemorrhage. Methods: Observational, analytical case-control study, with 12 cases (with complications) and 24 controls (without complications). The summary measures were applied for each type of variables and the determination of the risk factors by applying the odds ratio (OR), the SPSS statistical package version 26.0 was used, with a confidence interval (CI) of 95 percent. Results: The combination of hypovolemic shock, plus acute renal failure, was the most frequent complication for 13.8 percent. Uterine atony predominated for 50.0 percent as the cause of hemorrhage. The predictive variables of complications were: creatinine value ≥ 113 µmol/L (OR= 19.08; CI: 2.75-138.36), international normalized ratio ≥ 2 (OR= 4.66; CI: 1. 46-14.90), hematocrit < 0.23 (OR= 4.00; CI: 1.76-9.08) and hemoglobin < 70 g/L (OR= 2.22; CI: 1.25-3.95). Conclusions: Creatinine ≥ 113 µmol/L, international normalized ratio ≥ 2, hematocrit < 0.23 and hemoglobin < 70 g/L are the main risk factors identified for the development of complications during obstetric hemorrhage(AU)


Subject(s)
Humans , Risk Factors , Postpartum Hemorrhage/diagnosis , Obstetric Labor Complications/etiology , Case-Control Studies , Observational Study , Intensive Care Units
4.
Cambios rev. méd ; 22 (2), 2023;22(2): 928, 16 octubre 2023. ilus, tabs
Article in Spanish | LILACS | ID: biblio-1516529

ABSTRACT

El procedimiento quirúrgico cesárea con miras a la historia es considerada como un avance de suma importancia en la dismi-nución del riesgo de mortalidad materna y perinatal1.Es la intervención más realizada a nivel de especialidad lo que conlleva riesgos inherentes, quirúrgicos y anestésicos2,3.En el año 2015 la incidencia en el Ecuador de terminación del embarazo por cesárea es del 29,3% en el sector público, 49,9% en Seguridad Social y 69,9% en clínicas privadas4. Para la Or-ganización Mundial de la Salud (OMS) en el mismo año refiere que "En ninguna región del mundo se justifica la incidencia de cesárea superior al 10- 15%"5. La variabilidad de indicación de cesárea, hace que sea necesaria la creación de guías y protocolos, para de esta manera unificar los criterios médicos, de acuerdo a la mejor evidencia científica disponible.


The cesarean section surgical procedure is historically considered a very important advance in reducing the risk of maternal and perinatal mortality1.It is the most frequently performed intervention at the specialty level, which entails inherent surgical and anesthetic risks2,3.In 2015, the incidence in Ecuador of termination of pregnancy by cesarean section is 29,3% in the public sector, 49,9% in Social Security and 69,9% in private clinics4. For the World Health Or-ganization (WHO) in the same year, it states that "In no region of the world is the incidence of cesarean section higher than 10-15% justified" 5.The variability of the indication for cesarean section makes it ne-cessary to create guidelines and protocols, in order to unify me-dical criteria, according to the best scientific evidence available.


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications , Obstetric Surgical Procedures , Pregnancy , Cesarean Section , Parturition , Emergencies , Risk Management , Maternal Mortality , Pregnancy, High-Risk , Ecuador , Perinatal Mortality , Obstetric Labor Complications
5.
Rev. argent. coloproctología ; 34(3): 17-21, sept. 2023. ilus
Article in Spanish | LILACS | ID: biblio-1552492

ABSTRACT

Las lesiones obstétricas del esfínter anal pueden ocurrir durante el parto vaginal espontáneamente o secundariamente a la episiotomía. Su riesgo se estima en un 26% y son la causa más frecuente de incontinencia anal en mujeres jóvenes. Las lesiones de grado 4 de Sultan, también llamadas cloaca traumática, implican la ruptura completa del esfínter y la comunicación de la cavidad vaginal con el canal anal. La reparación es siempre quirúrgica, para lo que se han descrito diferentes técnicas, aunque ninguna ha demostrado ser superior. Presentamos el caso de una paciente primípara de 23 años con una cloaca traumática posparto. La reparación quirúrgica se realizó de inmediato con una técnica de overlapping. El postoperatorio fue sin complicaciones y al año presenta continencia anal completa. (AU)


Obstetric anal sphincter injuries can occur spontaneously or as a consequence of an episiotomy during vaginal delivery. Their risk is estimated at 26% and they are the most frequent cause of anal incontinence in young women. Sultan grade 4 injuries, also called traumatic cloaca, involve complete rupture of the sphincter and communication of the vaginal cavity with the anal canal. The repair is always surgical, for which different techniques have been described, although none have proven to be superior. We present the case of a 23-year-old primiparous patient with a postpartum traumatic cloaca. Surgical repair was performed immediately with an overlapping technique. The postoperative period was without complications and one year later she presents complete anal continence. (AU)


Subject(s)
Humans , Female , Pregnancy , Young Adult , Anal Canal/surgery , Fissure in Ano/etiology , Obstetric Labor Complications , Fecal Incontinence , Sphincterotomy/methods
6.
Rev. obstet. ginecol. Venezuela ; 83(3): 310-317, jul. 2023. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1573208

ABSTRACT

Objetivo: Determinar las consecuencias del tipo de parto en las gestantes con cesárea anterior, atendidas en el Hospital Universitario "Dr. Luis Razetti", Barcelona, estado Anzoátegui, durante octubre de 2019. Métodos: Estudio retrospectivo, con nivel descriptivo, de diseño de campo no experimental y corte transversal cuya muestra fue de 130 pacientes gestantes con cesárea anterior. Utilizando una guía de análisis de historia clínica como instrumento de recolección de datos. Resultados: En cuanto al tipo de parto, predominó la cesárea (52,3 % versus 47,7 %). No obstante, el 68,9 % de las complicaciones se presentó en aquellas con parto vaginal, siendo las más frecuentes desgarros vaginales (33,3 %), retención placentaria (8,9 %) e hipotonía uterina (8,9 %). En contraste, en el grupo de gestantes de cesárea se identificaron como complicaciones más frecuentes infecciones del sitio quirúrgico (17,8 %) y anemia (8,9 %). Conclusiones: Los resultados de esta investigación indican que tanto el parto vaginal como la cesárea son seguros, pero la decisión final depende de la evaluación clínica individual de cada gestante(AU)


Objective: To determine the consequences of the type of delivery in pregnant women with previous cesarean section, attended at the Hospital Universitario "Dr. Luis Razetti", Barcelona, Anzoátegui state, during October 2019. Methods: Retrospective study, with descriptive level, of documentary design and cross-sectional cut, with a sample of 130 pregnant patients with previous cesarean section. A clinical history analysis guide was used as a data collection instrument. Results: Regarding the type of delivery, cesarean section predominated (52.3 versus 47.7%), however, 68.9% of the complications occurred in those with vaginal delivery, the most frequent being vaginal tears (33.3%), retained placenta (8.9%) and uterine hypotonia (8.9%). In contrast, in the group of pregnant women with cesarean section, surgical site infections (17.8%) and anemia (8.9%) were identified as the most frequent complications. Conclusions: The results of this research indicate that both vaginal delivery and cesarean section are safe, but the final decision depends on the individual clinical evaluation of each pregnant woman(AU)


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Middle Aged , Labor, Obstetric , Medical Records , Vaginal Birth after Cesarean , Cesarean Section, Repeat , Surgical Wound Infection , Data Collection , Retrospective Studies , Pregnant Women , Obstetric Labor Complications
7.
Femina ; 51(7): 436-442, 20230730. graf, ilus, tab
Article in Portuguese | LILACS | ID: biblio-1512452

ABSTRACT

Objetivo: Analisar a tendência temporal de nascimentos prematuros no estado de Santa Catarina entre 2011 e 2021. Métodos: Estudo observacional ecológico de tendência temporal realizado com informações do banco de dados do Sistema de Informação sobre Nascidos Vivos do estado de Santa Catarina (2011-2021), disponibilizado pela Diretoria de Vigilância Epidemiológica. Foram analisados todos os nascidos vivos prematuros segundo o ano de processamento e o local de residência em Santa Catarina (110.422). Foram incluídos os nascidos vivos de gestação com menos de 37 semanas completas. As taxas de nascimentos prematuros foram calculadas proporcionalmente à totalidade de nascimentos e calculadas segundo macrorregião, idade materna, número de consultas do pré-natal, instrução materna e cor de pele. Para o cálculo da tendência temporal, foi utilizada a regressão linear simples, com intervalo de confiança de 95% (p ≤ 0,05). Resultados: A taxa média de nascimentos prematuros no estado de Santa Catarina foi de 10,57%, com tendência estável (p < 0,001). Maiores taxas específicas foram encontradas nas macrorregiões Meio Oeste e Serra e Planalto Norte e Nordeste (11,46%), extremos de idade (10-14 anos e 45-64 anos) e menor escolaridade. Maior número de consultas de pré-natal apresentou taxa de prematuridade menor (7,69%). Tendências crescentes das taxas foram apenas encontradas na macrorregião Grande Oeste, faixa etária materna entre 40-44 anos e entre 4-6 consultas de pré-natal. Conclusão: A tendência da taxa de prematuridade manteve-se estável em Santa Catarina. Baixo número de consultas de pré-natal, extremos de idades e baixa escolaridade mostraram taxas maiores de prematuridade. (AU)


Objective: Analyzing the temporal trend of premature births in the state of Santa Catarina between 2011 and 2021. Methods: Observational ecological temporal trend study carried out with information from the database of the Information System on Live Births in the state of Santa Catarina (2011-2021), made available by the Epidemiological Surveillance Directorate. All premature live births were analyzed according to the year of processing and place of residence in Santa Catarina (110,422). Live births of less than 37 completed weeks were included. The rates of premature births were calculated in proportion to the total number of births and calculated according to macro-region, maternal age, number of prenatal consultations, maternal education and skin color. Simple linear regression was used to calculate the temporal trend, with a confidence interval of 95% (p ≤ 0.05). Results: The average rate of premature births in the state of Santa Catarina was 10.57%, with a stable trend (p < 0.001). Higher specific rates were found in the Midwest and Serra, North Plateau and Northeast macro-regions (11.46%), age extremes (10-14 years and 45-64 years) and lower schooling. A greater number of prenatal consultations had a lower prematurity rate (7.69%). Increasing trends in rates were only found in the Grande Oeste macro-region, maternal age group between 40-44 years and between 4-6 prenatal consultations. Conclusion: The prematurity rate trend remained stable in Santa Catarina. Low number of prenatal consultations, extremes of age and low education showed higher rates of prematurity. (AU)


Subject(s)
Infant, Premature , Pre-Eclampsia , Prenatal Care/statistics & numerical data , Women's Health , Socioeconomic Disparities in Health , Obstetric Labor Complications/prevention & control
8.
Rev. bras. ciênc. vet ; 30(2): 73-79, abr./jun. 2023. il.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1562876

ABSTRACT

O objetivo deste trabalho foi realizar um estudo retrospectivo de cinco casos de cesarianas em éguas, atendidos no Hospital Veterinário da Universidade Estadual de Maringá, campus Umuarama (HVGA-UEM), no período de 2019 a 2021, em quatro éguas da raça Quarto de Milha e uma da Crioula, com queixa principal de parto prolongado e distocias por diferentes motivos. Destes, três casos (60%) tiveram alta médica (3/5), enquanto 40% (2/5) em consequência de complicações pós-operatórias e pela gravidade do quadro clínico evoluíram para o óbito. As distocias são raras em éguas, quando comparados com outras espécies e, essa particularidade, pode ser justificada pela conformação anatômica do sistema reprodutivo e a classificação placentária das éguas, que propiciam contrações rápidas e efetivas facilitando a progressão do parto normal. Dessa forma, nos casos de distocia, em que as manobras obstétricas são incapazes de corrigir o mau posicionamento fetal, a cesariana passa a ser o procedimento de eleição, no presente estudo, nenhuma égua apresentou dilatação suficiente para que fosse conduzida a fetotomia. Como medida complementar, norteada pelos princípios de bem-estar animal, foi sugerido aos proprietários, que não colocassem esses animais na estação reprodutiva seguinte, restringindo-se a sua utilização somente como doadoras de embriões. Portanto, foi possível concluir que a sobrevida das éguas submetidas a cesariana é de 60% nas condições deste estudo, o monitoramento das éguas gestantes é um fator determinante sobre os índices de mortalidade materno-fetal.


The objective of this study was to make a descriptive analysis of 5 cases of caesarean sections in mares. The five reported cases were treated at the Veterinary Hospital of the State University of Maringa, campus Umuarama (HVGA-UEM), from 2019 to 2021. Four Quarter Horse mares and one Crioula, complaining of prolonged delivery and dystocia due to different reasons. Of these, three cases were discharged 60% (3/5), while the other three 40% (2/5), due to postoperative complications and the severity of the clinical condition, progressed to death. Dystocia births are rare in mares, when compared to other species, this particularity, can be justified by the anatomical conformation of the reproductive system and the placental classification of mares, which provide rapid and effective contractions, which facilitate the progression of normal or eutocia birth. Thus, in cases of dystocia in mares, those in which obstetric maneuvers are unable to correct fetal malposition, cesarean section becomes the emergency procedure of choice. As a complementary measure, guided by the principles of animal welfare, owners were suggested not to place these animals in the next reproductive season, restricting their use only as embryo donors. Thus, it was possible to conclude that the survival of mares undergoing cesarean is 60% under the conditions of this study, uses had no vital signs at the time of the procedure and/or evolved to death during the post-surgical period immediate.


Subject(s)
Animals , Pregnancy, Animal , Cesarean Section/veterinary , Maternal Mortality , Parturition , Dystocia/veterinary , Stillbirth/veterinary , Horses/abnormalities , Obstetric Labor Complications/veterinary
9.
Rev. int. sci. méd. (Abidj.) ; 25(1): 49-54, 2023. tables, figures
Article in French | AIM | ID: biblio-1438528

ABSTRACT

Contexte. En dépit des progrès médicaux, les complications obstétricales occasionnent de nombreuses admissions en réanimation et sont des sources de létalité importante. L'objectif de cette étude était d'analyser les causes et les caractéristiques des décès secondaires à une complication obstétricale en réanimation. Méthodes. Etude prospective, descriptive et analytique sur vingt-quatre mois incluant toutes patientes admises en réanimation pour une complication obstétricale. Les paramètres épidémiologiques, cliniques et thérapeutiques ont été recueillis. Les comparaisons statistiques étaient basées sur le test de Fischer (p<0,05). Résultats. Nous avons colligés 153 dossiers sur 653 soit 23,543%. L'âge moyen était de 27,26 ± 7,43 ans. Le transport était non médicalisé dans 95,42% des cas. Les patientes provenaient du bloc opératoire pour 62,02% d'entre elles. Pour 81,70% d'entre elles, il n'y avait aucun antécédent et 56,21% étaient à moins de 37 SA. Le trouble de la conscience était le principal motif d'admission. La pathologie hypertensive et ses complications étaient le diagnostic le plus observé. Celles qui ont pu être transfusées représentaient 13/21 patientes soit 61,90%. L'intubation orotrachéale a concerné 9,15% des patientes. La létalité était de 39,87%. Cette dernière était observée surtout pendant la garde et avait lieu au bout de 48H. La tranche d'âge [31-45 ans], le long délai d'admission (≥ 2 jours), l'instabilité hémodynamique à l'admission, l'existence de complications, la garde sont des facteurs de mauvais pronostics (P<0,05). Conclusion. La mortalité maternelle demeure élevée. L'identifi cation des facteurs de mauvais pronostic devrait améliorer la prise en charge des patientes.


Subject(s)
Humans , ABO Blood-Group System , Critical Care , Obstetric Labor Complications , Resuscitation , Pregnancy
10.
Psicol. ciênc. prof ; 43: e252071, 2023. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1440790

ABSTRACT

Este artigo analisou a percepção e os sentimentos de casais sobre o atendimento recebido nos serviços de saúde acessados em função de perda gestacional (óbito fetal ante e intraparto). O convite para a pesquisa foi divulgado em mídias sociais (Instagram e Facebook). Dos 66 casais que contataram a equipe, 12 participaram do estudo, cuja coleta de dados ocorreu em 2018. Os casais responderam conjuntamente a uma ficha de dados sociodemográficos e uma entrevista semiestruturada, realizada presencialmente (n=4) ou por videochamada (n=8). Os dados foram gravados em áudio e posteriormente transcritos. A Análise Temática indutiva das entrevistas identificou cinco temas: sentimento de impotência, iatrogenia vivida nos serviços, falta de cuidado em saúde mental, não reconhecimento da perda como evento com consequências emocionais negativas, e características do bom atendimento. Os achados demonstraram situações de violência, comunicação deficitária, desvalorização das perdas precoces, falta de suporte para contato com o bebê falecido e rotinas pouco humanizadas, especialmente durante a internação após a perda. Para aprimorar a assistência às famílias enlutadas, sugere-se qualificação profissional, ampliação da visibilidade do tema entre diferentes atores e reorganização dos serviços, considerando uma diretriz clínica para atenção ao luto perinatal, com destaque para o fortalecimento da inserção de equipes de saúde mental no contexto hospitalar.(AU)


This study analyzed couples' perceptions and feelings about pregnancy loss care (ante and intrapartum fetal death). A research invitation was published on social media (Instagram and Facebook) and data collection took place in 2018. Of the 66 couples who contacted the research team, 12 participated in the study by filling a sociodemographic questionnaire and answering a semi-structured interview in person (n=04) or by video call (n=08). All interviews were audio recorded, transcribed, and examined by Inductive Thematic Analysis, which identified five themes: feelings of impotence, iatrogenic experiences in health services, lack of mental health care, not recognizing pregnancy loss as an emotionally overwhelming event, and aspects of good healthcare. Analysis showed experiences of violence, poor communication, devaluation of early losses, lack of support for contact with the deceased baby, and dehumanizing routines, especially during hospitalization after loss. Professional qualification, extended pregnancy loss visibility among different stakeholders, and reorganization of health services are needed to improve the care offered to grieving families, considering a clinical guideline for perinatal grief care with emphasis on strengthening the insertion of mental health teams in the hospital context.(AU)


Este estudio analizó las percepciones y sentimientos de parejas sobre la atención recibida en los servicios de salud a los que accedieron debido a la pérdida del embarazo (muerte fetal ante e intraparto). La invitación al estudio se publicó en las redes sociales (Instagram y Facebook). De las 66 parejas que se contactaron con el equipo, 12 participaron en el estudio, cuya recolección de datos se realizó en 2018. Las parejas respondieron un formulario de datos sociodemográficos y realizaron una entrevista semiestructurada presencialmente (n=4) o por videollamada (n=08). Los datos se grabaron en audio para su posterior transcripción. El análisis temático inductivo identificó cinco temas: Sentimiento de impotencia, experiencias iatrogénicas en los servicios, falta de atención a la salud mental, falta de reconocimiento de la pérdida como un evento con consecuencias emocionales negativas y características de buena atención. Los hallazgos evidenciaron situaciones de violencia, comunicación deficiente, desvalorización de las pérdidas tempranas, falta de apoyo para el contacto con el bebé fallecido y rutinas poco humanizadas, especialmente durante la hospitalización tras la pérdida. Para mejorar la atención a las familias en duelo, se sugiere capacitación profesional, ampliación de la visibilidad del tema entre los diferentes actores y reorganización de los servicios, teniendo en cuenta una guía clínica para la atención del duelo perinatal, enfocada en fortalecer la inserción de los equipos de salud mental en el contexto hospitalario.(AU)


Subject(s)
Humans , Male , Female , Pregnancy , Adult , Middle Aged , Child Health Services , Mental Health , Humanization of Assistance , Fetal Death , Pain , Parents , Pediatrics , Perinatology , Placenta Diseases , Prejudice , Prenatal Care , Psychology , Psychology, Medical , Public Policy , Quality of Health Care , Reproduction , Syndrome , Congenital Abnormalities , Torture , Uterine Contraction , Birth Injuries , Maternity Allocation , Labor, Obstetric , Trial of Labor , Adaptation, Psychological , Abortion, Spontaneous , Child Care , Maternal-Child Nursing , Refusal to Treat , Women's Health , Patient Satisfaction , Parenting , Parental Leave , Health Care Quality, Access, and Evaluation , Privacy , Depression, Postpartum , Credentialing , Affect , Crying , Curettage , Reproductive Techniques, Assisted , Access to Information , Ethics, Clinical , Humanizing Delivery , Abortion, Threatened , Denial, Psychological , Prenatal Nutritional Physiological Phenomena , Parturition , Labor Pain , Premature Birth , Prenatal Injuries , Fetal Mortality , Abruptio Placentae , Violence Against Women , Abortion , User Embracement , Ethics, Professional , Stillbirth , Evaluation Studies as Topic , Nuchal Cord , Resilience, Psychological , Reproductive Physiological Phenomena , Fear , Female Urogenital Diseases and Pregnancy Complications , Fertility , Fetal Diseases , Prescription Drug Misuse , Hope , Prenatal Education , Courage , Psychological Trauma , Professionalism , Psychosocial Support Systems , Frustration , Sadness , Respect , Psychological Distress , Obstetric Violence , Family Support , Obstetricians , Guilt , Health Services Accessibility , Hospitals, Maternity , Obstetric Labor Complications , Labor, Induced , Anger , Loneliness , Love , Midwifery , Mothers , Nursing Care
11.
Psicol. ciênc. prof ; 43: e244244, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1448957

ABSTRACT

Com os avanços tecnológicos e o aprimoramento da prática médica via ultrassonografia, já é possível detectar possíveis problemas no feto desde a gestação. O objetivo deste estudo foi analisar a prática do psicólogo no contexto de gestações que envolvem riscos fetais. Trata-se de um estudo qualitativo sob formato de relato de experiência como psicólogo residente no Serviço de Medicina Fetal da Maternidade Escola da Universidade Federal do Rio de Janeiro (UFRJ). Os registros, feitos por observação participante e diário de campo, foram analisados em dois eixos temáticos: 1) intervenções psicológicas no trabalho em equipe em consulta de pré-natal, exame de ultrassonografia e procedimento de amniocentese; e 2) intervenções psicológicas em casos de bebês incompatíveis com a vida. Os resultados indicaram que o psicólogo nesse serviço é essencial para atuar de forma multiprofissional na assistência pré-natal para gravidezes de alto risco fetal. Ademais, a preceptoria do residente é relevante para sua formação e treinamento para atuação profissional no campo da psicologia perinatal.(AU)


Face to the technological advances and the improvement of medical practice via ultrasound, it is already possible to detect possible problems in the fetus since pregnancy. The objective of this study was to analyze the psychologist's practice in the context of pregnancies which involve fetal risks. It is a qualitative study based on an experience report as a psychologist trainee at the Fetal Medicine Service of the Maternity School of UFRJ. The records, based on the participant observation and field diary, were analyzed in two thematic axes: 1) psychological interventions in the teamwork in the prenatal attendance, ultrasound examination and amniocentesis procedure; and 2) psychological interventions in cases of babies incompatible to the life. The results indicated that the psychologist in this service is essential to work in a multidisciplinary way at the prenatal care for high fetal risk pregnancies. Furthermore, the resident's preceptorship is relevant to their education and training for professional performance in the field of Perinatal Psychology.(AU)


Con los avances tecnológicos y la mejora de la práctica médica a través de la ecografía, ya se puede detectar posibles problemas en el feto desde el embarazo. El objetivo de este estudio fue analizar la práctica del psicólogo en el contexto de embarazos de riesgos fetal. Es un estudio cualitativo basado en un relato de experiencia como residente de psicología en el Servicio de Medicina Fetal de la Escuela de Maternidad de la Universidade Federal do Rio de Janeiro (UFRJ). Los registros, realizados en la observación participante y el diario de campo, se analizaron en dos ejes temáticos: 1) intervenciones psicológicas en el trabajo en equipo, en la consulta prenatal, ecografía y los procedimientos de amniocentesis; y 2) intervenciones psicológicas en casos de bebés incompatibles con la vida. Los resultados señalaron como fundamental la presencia del psicólogo en este servicio trabajando de forma multidisciplinar en la atención prenatal en el contexto de embarazos de alto riesgo fetal. Además, la tutela del residente es relevante para su educación y formación para el desempeño profesional en el campo de la Psicología Perinatal.(AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Pregnancy, High-Risk , Psychosocial Intervention , Heart Defects, Congenital , Anxiety , Orientation , Pain , Parent-Child Relations , Parents , Paternity , Patient Care Team , Patients , Pediatrics , Placenta , Placentation , Pregnancy Complications , Pregnancy Maintenance , Prognosis , Psychoanalytic Theory , Psychology , Puerperal Disorders , Quality of Life , Radiation , Religion , Reproduction , Reproductive and Urinary Physiological Phenomena , General Surgery , Syndrome , Congenital Abnormalities , Temperance , Therapeutics , Urogenital System , Bioethics , Physicians' Offices , Infant, Premature , Labor, Obstetric , Pregnancy , Pregnancy, Animal , Pregnancy Outcome , Adaptation, Psychological , Pharmaceutical Preparations , Echocardiography , Magnetic Resonance Spectroscopy , Family , Abortion, Spontaneous , Child Rearing , Child Welfare , Mental Health , Family Health , Survival Rate , Life Expectancy , Cause of Death , Ultrasonography, Prenatal , Chromosome Mapping , Parental Leave , Mental Competency , Polycystic Kidney, Autosomal Recessive , Down Syndrome , Perinatal Care , Comprehensive Health Care , Chemical Compounds , Depression, Postpartum , Neurobehavioral Manifestations , Disabled Children , Diagnostic Techniques and Procedures , Gravidity , Crisis Intervention , Affect , Cytogenetic Analysis , Spirituality , Complicity , Value of Life , Humanizing Delivery , Death , Decision Making , Defense Mechanisms , Abortion, Threatened , Delivery of Health Care , Dementia , Uncertainty , Organogenesis , Qualitative Research , Pregnant Women , Early Diagnosis , Premature Birth , Nuchal Translucency Measurement , Child Mortality , Depression , Depressive Disorder , Postpartum Period , Diagnosis , Diagnostic Techniques, Obstetrical and Gynecological , Ethanol , Ego , Emotions , Empathy , Environment , Humanization of Assistance , User Embracement , Ethics, Professional , Cell Nucleus Shape , Prenatal Nutrition , Cervical Length Measurement , Family Conflict , Family Therapy , Resilience, Psychological , Reproductive Physiological Phenomena , Female Urogenital Diseases and Pregnancy Complications , Gestational Sac , Brief, Resolved, Unexplained Event , Fetal Death , Embryonic and Fetal Development , Multimodal Imaging , Mortality, Premature , Clinical Decision-Making , Pediatric Emergency Medicine , Child, Foster , Freedom , Burnout, Psychological , Birth Setting , Frustration , Sadness , Respect , Psychological Distress , Genetics , Psychological Well-Being , Obstetricians , Guilt , Happiness , Health Occupations , Hospitalization , Hospitals, Maternity , Hospitals, University , Human Development , Human Rights , Imagination , Infections , Infertility , Anencephaly , Jurisprudence , Obstetric Labor Complications , Licensure , Life Change Events , Life Support Care , Loneliness , Love , Medical Staff, Hospital , Intellectual Disability , Morals , Mothers , Narcissism , Congenital, Hereditary, and Neonatal Diseases and Abnormalities , Neonatology , Nervous System Malformations , Object Attachment
12.
Rev. Bras. Saúde Mater. Infant. (Online) ; 22(4): 923-932, Oct.-Dec. 2022. tab
Article in English | LILACS | ID: biblio-1422681

ABSTRACT

Abstract Objectives: measuring the prevalence of interventions and/or complications based on the Maternity Safety Thermometer (MST) criteria and verifying associations with sociodemographic, clinical, and obstetric factors. Methods: prospective observational study conducted with postpartum women admitted to the maternity ward of a tertiary hospital, from October 10th to December 30th, 2020. Data were collected from medical records and self-administered questionnaires from 260 patients. Results: harm-free care was detected in 17.7% of participants, 66.9% had low-temperature damage (one or less intervention/complication) and 33.1% of patients had elevated temperature damage (two or more intervention/complication). The most frequent intervention was the "scar", given that 38.5% had abdominal scarring (cesarean section) and 26.5% had perineal scarring (2nd-degree tear or greater - spontaneous or by episiotomy). The second most frequent MST item was related to the perception of safety (30%), followed by complications to the newborn (12.3%), infection (11.2%), and hemorrhage (9.2%). Factors related to high temperature were: being of social class A or B, having a previous cesarean section, and being hospitalized during pregnancy. Conclusions: one-third of the participating women had two or more complications/interventions (high temperature by the MST), factors that are related to this temperature were: being of social class A or B, having a previous cesarean section, and being hospitalized during pregnancy.


Resumo Objetivos: mensurar a prevalência de intervenções e/ou complicações a partir dos critérios estabelecidos pelo Termômetro de Segurança da Maternidade (TSM) e avaliar associações com fatores sociodemográficos, clínicos e obstétricos. Métodos: estudo observacional prospectivo realizado com puérperas internadas na maternidade de hospital terciário, de 10 de outubro a 30 de dezembro de 2020. Foram coletados dados do prontuário e de questionários autoaplicáveis de 260 pacientes. Resultados: um cuidado livre de intervenções/complicações foi detectado em 17,7% das participantes, 66,9% apresentaram baixa temperatura (até uma intervenção/complicação) e 33,1% tiveram alta temperatura de intervenções/complicações (2 ou mais). A intervenção mais frequente foi a denominada "cicatriz", sendo que 38,5% tiveram cicatriz abdominal (cesariana) e 26,5% tiveram "cicatriz" perineal (laceração de 2º grau ou mais - espontânea ou por episiotomia). O segundo dano mais frequente foi o relacionado à percepção de segurança (30%), seguido de complicações do recémnascido (12,3%), infecção (11,2%), e hemorragia (9,2%). Houve associação de ter alta temperatura com ser de classe social A ou B, ter cesárea anterior e ser internada na gestação. Conclusões: das mulheres participantes, um terço teve duas ou mais complicações/intervenções (alta temperatura no TSM), estiveram relacionados a essa temperatura: ser de classe social A ou B, ter cesárea anterior e ser internada ao longo da gestação.


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Maternal-Child Health Services , Patient Safety , COVID-19 , Hospitals, Maternity , Obstetric Labor Complications/epidemiology , Midwifery , Tertiary Healthcare , Brazil , Sociodemographic Factors
13.
Rev. enferm. vanguard. (En línea) ; 10(2): 38-43, jul.-dic. 2022. tab
Article in Spanish | LILACS, LIPECS | ID: biblio-1411013

ABSTRACT

El Objetivo fue identificar los factores de riesgo de las complicaciones del parto en adolescentes atendidas en el hospital Augusto Hernández Mendoza de Ica-Perú. Material y Métodos: Para el desarrollo se utilizó la metodología de tipo observacional, retrospectivo, transversal, analítico de nivel relacional. La muestra fue de tipo probabilístico 34 casos y 34 controles con partos atendidos en el hospital con la hipótesis de que algunos de los factores de riesgo están más vinculado a las complicaciones del parto en adolescentes. Resultados: Encontrando los siguientes resultados: El síndrome hipertensivo odds ratio (2,4), el desgarro vaginal odds ratio (2,1), la desproporción céfalo pélvica odds ratio (3,3) y la anemia no es un factor de riesgo ni de protección. Conclusiones: La preeclampsia, el desgarro vaginal y la desproporción céfalo pélvica son factores de riesgo; la anemia no es un factor de riesgo, para las complicaciones del parto en adolescentes. (AU)


The Objective was to identify the risk factors for childbirth complications in adolescents treated at the Augusto Hernández Mendoza Hospital in Ica-Peru. Material and Methods: For the development, the observational, retrospective, cross-sectional, analytical, relational level methodology was used. The sample was of a probabilistic type, 34 cases and 34 controls with deliveries attended in the hospital with the hypothesis that some of the risk factors are more linked to delivery complications in adolescents. Results:Finding the following results: Hypertensive syndrome odds ratio (2.4), vaginal tear odds ratio (2.1), cephalopelvic disproportion odds ratio (3.3) and anemia is not a risk factor or of protection. Conclusions: Preeclampsia, vaginal tear and cephalopelvic disproportion are risk factors; anemia is not a risk factor for complications of childbirth in adolescents. (AU)


Subject(s)
Risk Factors , Adolescent , Obstetric Labor Complications , Cross-Sectional Studies , Retrospective Studies , Observational Studies as Topic
14.
Medisan ; 26(2)abr. 2022. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1405786

ABSTRACT

Introducción: La adolescencia comprende entre los 10 y 19 años de edad, periodo donde el embarazo tiene mayor riesgo de complicaciones en la madre y el neonato. La COVID-19 incrementa la posibilidad de aparición de complicaciones psicológicas, que de no ser atendidas, inciden negativamente en el embarazo y el parto. En el presente estudio las pacientes fueron tratadas mediante hipnoterapia. Objetivo: Evaluar la efectividad del modelo hipnoterapéutico para el logro de adecuados indicadores del parto en adolescentes gestantes con síntomas psicológicos derivados de la COVID-19. Métodos: Se realizó un estudio de intervención hipnoterapéutica en 9 gestantes adolescentes con síntomas psicológicos derivados de la COVID - 19, ingresadas en el Hospital Nutricional Materno Este de Santiago de Cuba, desde abril hasta junio del 2020. Las pacientes tuvieron seguimiento hasta después del parto. Resultados: Se halló que 7 embarazadas (77,8 %) tuvieron parto eutócico y percibieron el dolor de este como mediano; en 66,7 % no hubo necesidad de usar analgésicos y 8 de ellas (88,9 %) no presentaron complicaciones. Además, todos los neonatos tuvieron un apgar normal. Conclusiones: El modelo hipnoterapéutico para el tratamiento de las gestantes adolescentes con síntomas psicológicos derivados de la COVID-19 logró mejorar indicadores del parto y otros parámetros asociados a este.


Introduction: The adolescence covers between the 10 and 19 years, period in which the pregnancy has higher risk of complications in the mother and the newborn. The COVID-19 increases the possibility of emergence of psychological complications that impact negatively in pregnancy and childbirth if they are not assisted. In this study the patients were treated by means of hypnotherapy. Objective: To evaluate the effectiveness of the hipnotherapeutic pattern for the achievement of appropriate indicators of childbirth in pregnant adolescents with psychological symptoms derived from the COVID-19. Methods: A study of hipnoterapeutic intervention was carried out in 9 pregnant adolescents with psychological symptoms derived from the COVID - 19, admitted to the Eastern Maternal Nutritional Hospital in Santiago de Cuba, from April to June, 2020. The patients had follow up until after the childbirth. Results: It was found that 7 pregnant women (77.8 %) had eutocic childbirth and perceived the pain as medium; in 66.7 % there was not necessity to use analgesic and 8 of them (88.9 %) didn't present complications. Also, all the newborns had a normal apgar. Conclusions: The hipnotherapeutic pattern for the treatment of pregnant adolescents with psychological symptoms derived from the COVID-19 was able to improve indicators of childbirth and other parameters associated with it.


Subject(s)
Pregnancy in Adolescence , Pregnant Women , Hypnosis , Adolescent , COVID-19 , Obstetric Labor Complications
15.
Rev. bras. ginecol. obstet ; Rev. bras. ginecol. obstet;44(4): 327-335, Apr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1387895

ABSTRACT

Abstract Objective Determine the predictive criteria for success in inducing labor for live fetuses using misoprostol in pregnant women. Secondarily, the objective is to determine the rates of vaginal or cesarean delivery, duration of induction, interval of administration of misoprostol, the main causes of induction of labor and indication for operative delivery. Methods Medical records of 873 pregnant women admitted for cervical maturation from January 2017 to December 2018 were reviewed in a descriptive observational study of retrospective analysis, considering the following response variables: age, parity, Bishop Index, doses of misoprostol, labor induction time. Logistic regression models were used to predict success with misoprostol in non-operative deliveries. Results Of the 873 patients evaluated, 72% evolved with vaginal delivery, 23% of the cases were cesarean, 5% forceps or vacuum-extractor. For non-operative delivery the predictive variables at admission were age, parity, gestational age and dilation. During hospitalization, fewer vaginal touches,amniotomy or amniorrhexis with clear fluid lead to a shorter induction time and a greater chance of non-operative delivery. False positives and false negatives of the model were always below 50% and correct answers above 65%. Conclusion At admission, age less than 24 years, previous normal births, lower the gestational age and greater the dilation, were predictive of greater probability of nonoperative delivery. During hospitalization, the less vaginal touches and occurrence of amniotomy/amniorrhexis with clear liquid indicate shorter induction time. Future studies with a prospective design and analysis of other factors are necessary to assess the replicability, generalization of these findings.


Resumo Objetivo Determinar os critérios preditivos para o sucesso na indução do trabalho de parto para fetos vivos utilizando misoprostol em gestantes. Em segundo lugar, o objetivo é determinar as taxas de parto vaginal ou cesáreo, duração da indução, intervalo de administração de misoprostol, as principais causas de indução do trabalho de parto e indicação para parto operatório. Métodos Foram revisados os prontuários de 873 gestantes internadas para amadurecimento cervical entre janeiro de 2017 e dezembro de 2018 em um estudo descritivo observacional de análise retrospectiva, considerando as variáveis-resposta: idade, paridade, Índice de Bishop, doses de misoprostol, tempo de indução do trabalho de parto. Modelos de regressão logística foram utilizados para prever o sucesso com misoprostol em partos não operatórios. Resultados Dos 873 pacientes avaliados, 72% evoluíram com parto vaginal, 23% dos casos foram cesáreos, 5% fórceps ou vácuo-extrator. Para o parto não operatório as variáveis preditivas na internação foram idade, paridade, idade gestacional e dilatação. Durante a internação, um menor número de toques vaginais, amniotomia ou amniorrexe com líquido claro, levam a menor tempo de indução e maior chance de parto não operatório. Falsos positivos e falsos negativos do modelo sempre foram inferiores a 50% e respostas corretas acima de 65%. Conclusão Na internação, idade menor que 24 anos, ocorrência de partos normais anteriores, menor idade gestacional e maior dilatação, foram preditivos de maior probabilidade de parto não-operatório. Durante a internação, o menor número de toques vaginais, amniotomia/amniorrexe com líquido claro indicam menor tempo de indução. Estudos futuros com design prospectivo e análise de outros fatores são necessários para avaliar a replicabilidade, generalização desses achados.


Subject(s)
Humans , Female , Pregnancy , Misoprostol/administration & dosage , Obstetric Labor Complications , Labor, Induced
16.
J. coloproctol. (Rio J., Impr.) ; 42(1): 77-84, Jan.-Mar. 2022. tab, ilus
Article in English | LILACS | ID: biblio-1375760

ABSTRACT

Introduction: Anal incontinence is defined as the loss of voluntary control of fecal matter or gases with a recurrence period longer than 3 months in individuals aged ≥ 4 years; it has a female predominance. Among the treatment modalities is pelvic physiotherapy, the second line of treatment, which promotes the reeducation, coordination, and strengthening of the muscles of the pelvic floor to enable patients to return to their regular activities of daily living. Objective: To perform a systematic review on the physiotherapeutic treatments used in women between the ages of 18 and 65 years with a diagnosis of anal incontinence. Material and methods Clinical studies written in Portuguese, Spanish and English were searched on the the following databases: Science Direct, Medical Literature Analysis and Retrieval System Online (Medline) via PubMed, Physiotherapy Evidence Database (PEDro), Scientific Electronic Library Online (SciELO), and Scopus. Results: Of the 998 articles found, only 4 studies met the inclusion criteria of the present systematic review. The physiotherapeutic approaches to treat women with anal incontinence are biofeedback, Kegel exercises, electrostimulation, and training of the pelvic floor muscles. The average score on the PEDro scale was of 6.25, which indicates that the methodological quality was good. Conclusion: Although pelvic physiotherapy is effective to treat anal incontinence, it must be promoted through the performance of evidence-based scientific research. (AU)


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Middle Aged , Aged , Physical Therapy Modalities , Fecal Incontinence/rehabilitation , Obstetric Labor Complications/therapy , Fecal Incontinence/etiology
17.
Afr. J. reprod. Health (online) ; 26(11): 23-31, 2022. tables
Article in English | AIM | ID: biblio-1411995

ABSTRACT

The Japanese Red Cross Society (JRCS) and the Uganda Red Cross Society (URCS) implemented the Safe Motherhood project topromote mother-friendly society in northern Uganda from 2010 to 2016. The follow-up study has not been conducted and the information on achievements and challenges after the project were limited. To review the safe motherhood project in northern Uganda, the purpose of the study was to explore the stakeholders' perceived achievements and challenges after the project. Study design was qualitative content analysis using interview guides. After the approval of Institutional Review Board Clearance, the study was started (Approval Number: 2017-034). The subjects were informed about the ethical considerations (informed consent, participation on free will, confidentiality, and anonymity) in participating in the research, and they participated after signing the consent form. Six volunteers, 2 health center staff, and 2 former Uganda Red Cross staff were interviewed. Achievements were the acquisition of knowledge, attitudes changes, behavioural changes, linkage of all stakeholders, and positive influence on Safe Motherhood in community. Challenges of sociocultural barriers, attitudes toward women, accessibility and human resources, incentives and facilities, and sustainability of the project were derived from the interview. The study revealed that the project linked all stakeholders to achieve Safe Motherhood in community and all the developed registration systems were taken over. Long-term support is necessary for Safe Motherhood to take root


Subject(s)
Risk Factors , Follow-Up Studies , Delivery, Obstetric , Obstetric Labor Complications , Red Cross , Birth Registration , Health Gains
18.
Int. j. morphol ; 40(2): 384-388, 2022. tab
Article in Spanish | LILACS | ID: biblio-1385632

ABSTRACT

RESUMEN: El estado nutricional materno determina las condiciones de salud y nutricionales del recién nacido, así como las complicaciones durante el embarazo y el parto. Se realizó el estudio en 894 mujeres que tuvieron su parto en los Hospitales de la ciudad de Loja Ecuador durante el periodo enero - junio del 2019. Se determinó la antropometría de la madre y de su hijo, así como se tomó datos de complicaciones durante el embarazo y el parto, de su historia clínica. Además, se efectuó la correlación entre el estado nutricional pre-gestacional de la madre con el recién nacido, de igual forma con el estado de salud de la madre. El objetivo de este trabajo fue determinar el estado nutricional pre-gestacional y su relación con la condición de salud y nutricional del niño. El IMC pre-gestacional reportó 47,3 % de sobrepeso y obesidad y 2,6 % de bajo peso. En un porcentaje mayor al 10 % las madres con sobrepeso y obesidad tuvieron hijos grandes para la edad gestacional, de igual forma las madres con bajo peso tuvieron el 26,1 % recién nacidos pequeños. Las principales complicaciones de las madres relacionadas con sobrepeso y obesidad fueron: diabetes gestacional, hemorragia postparto y pre-eclampsia durante el embrazo. Importante señalar la alta frecuencia de infecciones de las vías urinarias 53,9 % (478); y vaginitis 22,3 % (199); aunque estas no están directamente relacionadas con procesos metabólicos como etiología, más si están favorecidos por ellos. Durante el parto la complicación más frecuente fue el parto distócico con un 8,9 % (77), además del total de partos el 41,8 % (374) terminaron en cesárea, de estos el 51, 6 % (193) corresponden a sobrepeso y obesidad. Las complicaciones del recién nacido fueron: Síndrome de dificultad respiratoria aguda, asfixia neonatal e hipoglicemia. En conclusión, el estado nutricional pre-gestacional de la madre está relacionado directamente con el estado de salud y nutricional del recién nacido.


SUMMARY: The maternal nutritional status determines the health and nutritional conditions of the newborn, as well as complications during pregnancy and childbirth. The study was carried out in 894 women who had their delivery in the Hospitals of the city of Loja Ecuador during the period January - June 2019. The anthropometry of the mother and her child was determined, as well as data on complications during pregnancy and delivery, from their clinical history. In addition, the correlation was made between the pre-gestational nutritional status of the mother with the newborn, in the same way with the health status of the mother. The objective of this work was to determine the pre-gestational nutritional status and its relationship with the health and nutritional condition of the child. The pre-gestational BMI reported 47.3 % overweight and obesity and 2.6 % underweight. In a percentage higher than 10 %, mothers with overweight and obesity had large children for gestational age, in the same way, mothers with low weight had 26.1 % small newborns. The main complications of the mothers related to overweight and obesity were: gestational diabe- tes, postpartum hemorrhage and pre-eclampsia during pregnancy. It is important to note the high frequency of urinary tract infections 53.9% (478); and vaginitis 22.3% (199; although these are not directly related to metabolic processes such as etiology, more if they are favored by them. During delivery, the most frequent complication was dystocic delivery with 8.9 % (77), in addition to the total deliveries 42.5 % (374) that ended in cesarean section, of which 51.6 % (193) correspond to overweight and obesity. The complications of the newborn were: Acute respiratory distress syndrome, neonatal asphyxia and hypoglycemia. In conclusion, the pre-gestational nutritional status of the mother is directly related to the health and nutritional status of the newborn.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pregnancy Complications , Nutritional Status , Infant, Low Birth Weight , Body Mass Index , Infant, Newborn, Diseases/etiology , Obstetric Labor Complications , Mothers
19.
Belo Horizonte; s.n; 2022. 72 p.
Thesis in Portuguese | LILACS, InstitutionalDB | ID: biblio-1566046

ABSTRACT

Introdução: A hemorragia pós-parto (HPP) é um agravo prevalente de saúde e associado a grande morbi-mortalidade. A mortalidade materna por HPP é um importante indicador de saúde de uma nação, já que evidencia desigualdades no acesso aos serviços de saúde e de políticas públicas direcionadas à saúde materna e perinatal. Objetivo: Analisar os casos de HPP ocorridos em mulheres que tiveram o parto em uma maternidade de referência e comparar os casos com e sem HPP. Secundariamente, avaliar a ocorrência de HPP por grupos de risco, a seguir da implementação de um sistema de classificação à admissão. Método: Trata-se de uma coorte retrospectiva, envolvendo um banco de dados com todos os partos ocorridos no Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG) no período de setembro de 2019 a dezembro de 2020. A classificação do Programa Zero Morte Materna por Hemorragia (PZMMH) foi implantada nesta maternidade em setembro de 2019. A classificação em baixo, médio e alto risco para HPP foi realizada automaticamente por meio de um prontuário eletrônico denominado SISMater®. A ocorrência de HPP foi calculada e comparada entre as participantes, agrupadas de acordo com características obstétricas e clínicas e fatores de risco. Resultados: Mil novecentos e trinta e seis mulheres que deram à luz foram incluídas na análise. A prevalência de HPP foi de 6,8% (131 participantes). De acordo com a análise multivariada, a chance de HPP foi significativamente maior nas participantes que apresentaram gravidez múltipla (Rch 2,88, IC 95% 1,28 a 6,49), sangramento ativo na admissão (Rch 6,12, IC 95% 1,20 a 4,65), apresentação não cefálica (Rch 2,36, IC 95% 1,20 a 4,65), placenta retida (Rch 9,39, IC 95% 2,90 a 30,46) e descolamento prematuro da placenta (Rch 6,95, IC 95% 2,06 a 23,48). O parto vaginal foi considerado fator de proteção (Rch 0,58, IC 95% 0,34 a 0,98). Em relação à estratégia de estratificação de risco para HPP adotada na admissão da participante, não foi demonstrada relação com significância estatística entre as classificações "alto", "médio" e "baixo" risco e a ocorrência de HPP (p=0.119). Conclusões: A principal contribuição do nosso estudo foi reforçar a magnitude da HPP em uma amostra de gestantes brasileiras numa maternidade de referência e levantar fatores de risco à admissão hospitalar. É possível que a ausência de relação entre a categoria da classificação de risco e a frequência de HPP indique algum efeito das ações do PZMM.


Introduction: Postpartum hemorrhage (PPH) is a prevalent health problem and is associated with significant morbidity and mortality. Maternal mortality from PPH is an important indicator of a nation's health, as it highlights inequalities in access to health care, as well as a lack of public health policies towards maternal and perinatal health. Objective: To analyze the cases of PPH that occurred in women who gave birth in a reference maternity hospital and compare those who presented PPH with those who did not. . Secondly, to assess the occurrence of PPH by risk groups, following the implementation of a classification system at admission. Method: This is a retrospective cohort study, involving a database with all deliveries that took place at the Hospital das Clínicas of the Federal University of Minas Gerais (UFMG) from September 2019 to December 2020. The classification of the Zero Maternal Death due to Hemorrhage Program (ZMDHP) was implemented in this maternity hospital in September 2019. The classification into low, medium and high risk for PPH was performed automatically through an electronic medical record called SISMater®. The occurrence of PPH was calculated and compared among the participants, grouped according to obstetric and clinical characteristics and risk factors. Results: One thousand nine hundred and thirty six women who gave birth were included in the analysis. The prevalence of postpartum hemorrhage was 6,8% (167 participants). According to multivariate analysis, the odds for PPH was significantly higher in participants who presented multiple pregnancy (OR 2.88, 95% CI 1.28 to 6.49), active bleeding on admission (OR 6.12, 95% CI 1.20 to 4.65), non-cephalic presentation (OR 2.36, 95% CI 1.20 to 4.65), retained placenta (OR 9.39, 95% CI 2.90 to 30.46) and placental abruption (OR 6.95, 95% CI 2.06 to 23.48). Vaginal delivery figured out as a protective factor (OR 0.58, 95% CI 0.34 to 0.98). Regarding the risk stratification strategy adopted at the admission, there was no statistically significant relationship between the "high", "medium" and "low" risk classifications and the occurrence of PPH (p=0.119). Conclusions: The main contribution of our study was reinforcing the magnitude of the PPH in a sample of Brazilian pregnant women in a reference maternity and rising risk factors at hospital admission. It is possible that the absence of a relationship between the risk rating category and the frequency of PPH indicates some effect of the ZMDP actions


Subject(s)
Maternal Mortality , Risk Factors , Electronic Health Records , Postpartum Hemorrhage , Obstetric Labor Complications
20.
Article in Portuguese | LILACS, CONASS, ColecionaSUS, SES-GO | ID: biblio-1358554

ABSTRACT

Objetivos: Verificar os fatores que influenciam a parturiente na decisão da via de parturição e identificar a preferência da via de parto em uma próxima gestação. Metodologia: Trata-se de uma revisão integrativa da literatura com artigos datados de 2010 a 2020, retirado nas bases da SCIELO (Scientific Electronic Library Online) e LILACS (Literatura Latino-Americana e do Caribe em Ciências e Saúde). Resultados: Sete dimensões refletem os fatores que influenciam a parturiente no momento da decisão da via de parto: dor ou ausência de dor no momento do parto; dor ou ausência de dor no pós-parto; recuperação no pós-parto; risco de infecção e de hemorragia; experiência prévia; influência da família e médicos, e pelo desejo de realizar a laqueadura. As perguntas norteadoras da pesquisa estão expressas em: quais são os fatores que influenciam a parturiente no momento da decisão da via de parto? E, qual é a via de parto em uma nova gestação? Considerações finais: Os fatores que mais influenciam as gestantes na decisão da via de parto são o medo da dor no parto e a recuperação no pós parto. Em uma nova gestação, acabam optando pela mesma via de parto anterior, devido à segurança, por já terem vivenciado a experiência


Objectives: This study aims to verify the factors that influence the decision of the parturition method and identify the preferred route of parturition in the next pregnancy. Methodology: This is an integrative literature review with articles dated from 2010 to 2020, taken from the SCIELO (Scientific Electronic Library Online) and LILACS (Latin American and Caribbean Literature in Science and Health) databases. Results: Seven dimensions reflect the factors that influence the parturient when deciding the parturition method: pain or absence at the time of parturition; postpartum pain or absence; postpartum recovery; risk of infection and bleeding; previous experience; influence of family and doctors and tubal ligation. The guiding questions of this research are expressed in: What are the factors that influence the parturient when deciding the parturition method? And what is the preferred parturition method a new pregnancy? Final considerations: The factors that most influence pregnant women while deciding the mode of parturition are fear of pain during childbirth and postpartum recovery. In a new pregnancy, they end up opting for the same birth route as the previous one due to the safety of having lived through the experience


Subject(s)
Humans , Female , Pregnancy , Pain, Postoperative , Parturition , Labor Pain , Fear , Brazil , Cesarean Section , Vaginal Birth after Cesarean , Obstetric Labor Complications , Natural Childbirth/rehabilitation , Nursing Care
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