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1.
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
2.
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
3.
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
4.
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
5.
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
6.
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
7.
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
8.
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
9.
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
10.
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
11.
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
12.
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
13.
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
14.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(4): 979-986, Oct.-Dec. 2021. tab
Article in English | LILACS | ID: biblio-1360723

ABSTRACT

Abstract Objectives: to describe the profile of women affected with premature childbirth and neonatal outcomes at a referral maternity in the city of Fortaleza-CE, Brazil. Methods: descriptive and retrospective documentary type study, with a quantitative approach, carried out from January to December, 2017, with 253 medical records of women who had premature childbirth in a referral maternity. Results: the average age was 28, with the prevalence of women living in a stable union, graduated from high school and without formal work. The gestational mean average was three pregnancies, gestational age of 34 weeks and three days, and six prenatal consultations, starting in the first trimester. The major intercurrence was pre-eclampsia. In relation to the neonatal data, there was a prevalence of male newborns, with an average of 2.251 kg and a score of seven on the 1-minute Apgar and eight on the 5-minute Apgar. Newborns in going to a hospital accommodation after childbirth and in room air, spending an average of 12.71 days in the hospital. Conclusion: in this case of this research, knowing the woman's profile and the outcomes in premature newborns is useful to encourage public policies and reduce the sequelae on mother and baby


Resumo Objetivos: descrever o perfil de mulheres acometidas por parto prematuro e os desfechos neonatais em maternidade de referência, na cidade de Fortaleza-CE, Brasil. Métodos: estudo do tipo documental, descritivo, retrospectivo, com abordagem quantitativa, realizadode janeiro a dezembro de 2017, com 253 prontuários de mulheres que tiveram parto prematuro em maternidade de referência. Resultados: média de idade de 28 anos, com prevalência de mulheres vivendo em união estável, ensino médio completo, sem trabalho formal. A média gestacional foi de três gravidezes, idade gestacional de 34 semanas e trêsdias e seis consultas de pré-natal, iniciando no primeiro trimestre. A maior intercorrência foi a pré-eclâmpsia. Relacionado aos dados neonatais, houve prevalência de recém-nascidos do sexo masculino, com média de 2,251 quilos e escore sete no Apgar do 1º minuto e oito, no Apgar do 5º minuto. Recémnascidos indo para alojamento conjunto após o parto e em ar ambiente, tendo passado, em média, 12,71 dias internados. Conclusões: no caso da pesquisa, conhecer o perfil dessa mulher e os desfechos do recém-nascido prematuro é útil para estimular as políticas públicas e diminuir as sequelas para mãe e bebê.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Pregnancy Complications/epidemiology , Risk Factors , Obstetric Labor Complications/epidemiology , Obstetric Labor, Premature/epidemiology , Apgar Score , Prenatal Care , Brazil/epidemiology , Medical Records , Postpartum Period
15.
Rev. bras. ginecol. obstet ; 43(2): 97-106, Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1156097

ABSTRACT

Abstract Cases of maternal near miss are those in which women survive severe maternal complications during pregnancy or the puerperium. This ecological study aimed to identify the temporal trend of near-miss cases in different regions of Brazil between 2010 and 2018, using data fromtheHospital Information System(HIS) of theUnified BrazilianHealth System (SUS, in the Portuguese acronym). Hospital admission records of women between 10 and 49 years old with diagnosis included in the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) and codes indicating nearmiss events were selected. From 20,891,040 admissions due to obstetric causes, 766,249 (3.66%) near-miss cases were identified, and 31,475 women needed admission to the intensive care unit (ICU). The cases were found to be more predominant in black women over 35 years old from the North and Northeast regions. There was a trend of increase in near-miss rates of ~ 13.5% a year during the period of the study. The trend presented a different behavior depending on the level of development of the region studied. The main causes of near miss were preeclampsia (47%), hemorrhage (24%), and sepsis (18%).


Resumo Casos de near miss materna são aqueles em que as mulheres sobrevivem a graves complicações maternas durante a gravidez ou o puerpério. Este estudo ecológico teve comoobjetivo identificar a tendência temporal de casos de near missemdiferentes regiões do Brasil entre 2010 e 2018, utilizando dados do Sistema de Informações Hospitalares (SIH) do Sistema Único de Saúde (SUS). Foram selecionados registros de internação demulheres entre 10 e 49 anos comdiagnóstico incluído na 10ª revisão daClassificação Internacional de Doenças e Problemas Relacionados à Saúde (CID-10) e códigos indicando eventos de near miss. Das 20.891.040 internações por causas obstétricas, 766.249 (3,66%) casos de near miss foram identificados, e 31.475mulheres necessitaramde internação na unidade de terapia intensive (UTI). Constatou-sequeos casos sãomaispredominantesemmulheres negras commais de 35 anos da região Norte e Nordeste. Houve uma tendência de aumento nas taxas de near miss de aproximadamente 13,5% ao ano durante o período do estudo. A tendência apresentou um comportamento diferente, dependendo do nível de desenvolvimento da região estudada. As principais causas de near miss foram pré-eclâmpsia (47%), hemorragia (24%), e sepse (18%).


Subject(s)
Humans , Male , Female , Pregnancy , Adolescent , Adult , Young Adult , Pregnancy Complications/epidemiology , Prenatal Care , Near Miss, Healthcare/statistics & numerical data , Obstetric Labor Complications/epidemiology , Patient Admission , Pregnancy Complications/prevention & control , Brazil/epidemiology , Demography , Maternal Mortality , Hospital Information Systems , Diagnosis-Related Groups , Near Miss, Healthcare/trends , Obstetric Labor Complications/prevention & control , Middle Aged
16.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 397-402, jan.-dez. 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1150638

ABSTRACT

Objetivo: Traçar o perfil das mulheres que tiveram uma gestação tardia, admitidas no ano de 2016 em uma maternidade pública no Norte de Minas Gerais. Metodologia: Trata-se de uma pesquisa documental, retrospectiva, descritiva e de analise quantitativa. Fizeram parte dessa pesquisa as gestantes que foram admitidas em uma maternidade pública localizada em um município no norte de Minas Gerais em 2016, por meio do acesso aos prontuários. Resultados: Foram encontradas 24 complicações prévias à gestação, sendo a mais frequente, a hipertensão arterial. Das comorbidades associadas a mais prevalente foi hipertensão gestacional com 14,75% do total de mulheres. 41 complicações do parto e pós-parto foram identificadas, sendo a indução do parto a que mais acometeu as pesquisadas. Conclusão: Observa-se a necessidade de aprimoramento das informações em banco de dados como possibilitando a uma melhor atuação da equipe multidisciplinar frente ao binômio mãe-bebê, evitando assim possíveis doenças


Objective: To outline the profile of women who had a late pregnancy, admitted in 2016 to a public maternity hospital in northern Minas Gerais. Methodology: This is a documentary research, retrospective, descriptive and quantitative analysis. This study included pregnant women who were admitted to a public maternity ward located in a municipality in the north of Minas Gerais in 2016, through access to medical records. Results: 24 complications were found prior to gestation, with the most frequent being hypertension. Of the associated comorbidities the most prevalent was gestational hypertension with 14.75% of the total of women. 41 complications of childbirth and postpartum were identified, and the labor induction was the one that most affected those surveyed. Conclusion: It is necessary to improve the information in the database as it allows a better performance of the multidisciplinary team against the binomial mother-baby, thus avoiding possible diseases


Objetivo: Trazar el perfil de las mujeres que tuvieron una gestación tardia, ingresó en 2016 a un hospital público de maternidad en el norte de Minas Gerais. Metodología: Se trata de una investigación documental, retrospectiva, descriptiva y de análisis cuantitativo. Las mujeres embarazadas que fueron admitidas en una maternidad pública ubicada en un municipio en el norte de Minas Gerais en 2016, a través del acceso a los prontuarios. Resultados: Se encontraron 24 complicaciones previas a la gestación, siendo la más frecuente, la hipertensión arterial. De las comorbilidades asociadas a más prevalente fue hipertensión gestacional con el 14,75% del total de mujeres. Se identificaron 41 complicaciones del parto y posparto, siendo la inducción del parto la que más afectó a las investigadas. Conclusión: Se observa la necesidad de perfeccionamiento de las informaciones en base de datos como posibilitando una mejor actuación del equipo multidisciplinario frente al binomio madre-bebé, evitando así posibles enfermedades


Subject(s)
Humans , Female , Pregnancy , Adult , Middle Aged , Maternal Age , Pregnancy, High-Risk , Pregnant Women , Hypertension, Pregnancy-Induced/epidemiology , Postpartum Period , Hypertension/epidemiology , Obstetric Labor Complications
17.
Rev. Investig. Salud. Univ. Boyacá ; 8(1): 91-111, 20210000.
Article in Spanish | LILACS, COLNAL | ID: biblio-1358963

ABSTRACT

Introducción: El trabajo de parto representa el acontecimiento más importante durante la culminación del periodo de gestación y, por lo tanto, la adecuada elección de su posición, ya sea vertical u horizontal, resulta indispensable para minimizar las complicaciones maternas y neonatales. Objetivo: Llevar a cabo una revisión de la literatura sobre el comportamiento clínico del parto vertical y horizontal, describiendo los principales resultados en diferentes países del mundo. Método: Revisión documental mediante la búsqueda de la literatura entre 2009 y 2020 en bases de datos especializadas. Resultados: La posición vertical se asoció con una menor duración del trabajo de parto, dolor referido y necesidad de episiotomía; no obstante, esta posición puede incrementar el riesgo de hemorragia posparto y daño perineal. Conclusión: La variedad de desenlaces obstétricos y neonatales asociados a las posiciones de parto vertical y horizontal hacen complejo definir una posición de parto óptima; por lo tanto, se recomienda la libre elección de acuerdo con las características que presente cada paciente


Introduction: Parturition represents the most important event during the culmination of the gestation period and, therefore, the appropriate choice of its position, whether vertical or horizontal, it is essential to minimize maternal and neonatal complications. Objective: To carry out a review of the literature on the clinical behavior of vertical and horizontal delivery, describing the main results in different countries of the world. Method: Document review by searching the literature between the years 2009 and 2020, available in Specialized Databases. Results: The vertical position was associated with a shorter duration of labor obstetric, referred pain, and episiotomy; however, this position may increase the risk of postpartum hemorrhage and perineal damage. Conclusion: The variety of obstetric and neonatal outcomes associated with vertical and horizontal delivery positions make it difficult to define an optimal delivery position and, therefore, free choice is recommended according to the characteristics of each patient


Introdução: O trabalho de parto representa o acontecimento mais importante no final do período gestacional e, portanto, a escolha apropriada da posição, seja vertical ou horizontal, é indispensável para minimizar as complicações maternas e neonatais. Objetivo: Realizar uma revisão bibliográfica sobre o comportamento clínico do parto vertical e hori-zontal, descrevendo os principais resultados em diferentes países do mundo. Método: Revisão documental através de pesquisa da literatura em bases de dados especializadas entre os anos 2009 e 2020. Resultados: A posição vertical foi associada a uma duração mais curta do parto, dor referida e ne-cessidade de episiotomía; contudo, esta posição pode aumentar o risco de hemorragia pós-parto e dano perineal. Conclusão: A variedade de resultados obstétricos e neonatais associados às posições de parto vertical e horizontal torna complexa a escolha de uma posição de parto ótima; por conseguinte, recomen-da-se a livre escolha de acordo com as caraterísticas de cada paciente


Subject(s)
Delivery, Obstetric , Obstetric Labor Complications , Labor Presentation
18.
Article in English | LILACS | ID: biblio-1359409

ABSTRACT

ABSTRACT: Objective: To investigate how women experienced perineal trauma during a humanized birth.Methods: A qualitative study with 22 postpartum women was performed from January to December 2018. The Husserlian phenomenology was used as theoretical framework using individual, in-depth interviews that were audio-taped and transcribed verbatim. Results: Twenty-four categories emerged from women ́s reports. During the prenatal phase, we found lack of information regarding perineal trauma, the alterity as a facilitating process to incentive women towards vaginal delivery and the perception of the beginning of an existential transition. During labor, it was noticed trust and attachment with the health professional giving physical and emotional support, the fear of the unknown linking to insecurity, the need for internal surrender to the process, empowerment as a result of trust and commitment, to give herself to the moment and no concerns with intrapartum injury but at the same time, having the possibility to share a decision-making process of suturing(or not). The postpartum period has shown the completion of the existential transition, the body as a place of estrangement, the loosening of some ties, but the construction of new networks of personal support to overcome postpartum. Conclusions: Most of women after humanized birth perceived perineal trauma as an existential transition that was initiated during antenatal period. (AU)


RESUMO: Objetivos: Investigar como as mulheres experienciaram o trauma perineal durante um parto humanizado. Métodos: Um estudo qualitativo com 22 mulheres pós-parto foi realizado de janeiro a dezembro 2018. A fenomenologia Husserliana foi usada como referencial teórico usando entrevistas individuais que foram audiogravadas e transcritas verbatim. Resultados: Vinte e quatro categorias emergiram durante os relatos. Durante o período pré-natal, a falta de informação sobre o trauma perineal, a alteridade como processo facilitador para incentivar as mulheres em direção ao parto vaginal e a percepção do começo de uma transição existencial. Durante o parto, a confiança e ligação com o(a) profissional de saúde com suporte físico e emocional, o medo do desconhecido e a insegurança, a necessidade de se entregar ao processo, o empoderamento como resultado de confiança e comprometimento, e o processo de tomada de decisão compartilhada da sutura (ou não). O período pós-parto mostra a completude da transição existencial, o corpo como local de estranhamento, o afrouxamento de alguns laços, mas a construção de novas redes de suporte pessoal para superar esse período. Conclusão: A maior parte das mulheres depois do parto humanizado percebe o trauma perineal como uma transição existencial que fora iniciada durante o período antenatal. (AU)


Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Humanizing Delivery , Postpartum Period , Obstetric Labor Complications
20.
Femina ; 49(3): 173-176, 2021. ilus
Article in Portuguese | LILACS | ID: biblio-1224083

ABSTRACT

A epilepsia, doença cerebral caracterizada pela predisposição à geração de crises epilépticas, representa a patologia neurológica grave mais frequente na gravidez. Quando não acompanhada corretamente, possui um acentuado nível de morbimortalidade materno-fetal, sendo especialmente relacionada a riscos de convulsão materna na gestação e malformações fetais. Este artigo discute o acompanhamento da gestante epiléptica, trazendo recomendações de cuidados no período pré-concepcional, manejo durante o pré-natal, condução do trabalho de parto, peculiaridades no puerpério e tratamento de crises convulsivas, quando necessário. Serão abordados tanto aspectos de tratamento farmacológico quanto de monitoramento e orientações gerais, com o objetivo de contribuir para um suporte mais abrangente e adequado a esse grupo mais vulnerável de pacientes sob o cuidado do médico ginecologista-obstetra e neurologista.(AU)


Epilepsy, which is a brain disease defined for a greater predisposition for epileptic crisis, represents the most frequent neurological pathology during pregnancy. Without proper monitoring it is related to high morbidity and mortality to both mother and baby, especially due to the risks of mother seizure during pregnancy and fetus malformation. This article discusses about health care giving and follow-up for the epileptic pregnant women, pointing recommendations for preconception care, prenatal management, labor conduct, peculiarities in puerperium and treatment of convulsive crisis when needed. There will be approached pharmacological and non-pharmacological aspects, such as follow up exams and general orientations, having as a goal to contribute to an more abrangent and proper support of this more vulnerable group of patients under the care responsibility of obstetrician-gynecologist ad neurologist doctors.(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/drug therapy , Epilepsy/complications , Epilepsy/prevention & control , Epilepsy/drug therapy , Prenatal Care/methods , Seizures/drug therapy , Carbamazepine/administration & dosage , Pregnancy, High-Risk , Postpartum Period/drug effects , Time-to-Pregnancy/drug effects , Lamotrigine/administration & dosage , Levetiracetam/administration & dosage , Obstetric Labor Complications/prevention & control , Anticonvulsants/administration & dosage
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