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1.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 899-906, jan.-dez. 2021. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1248172

ABSTRACT

Objetivo: analisar a produção científica brasileira sobre boas práticas relacionadas ao cuidado do recém-nascido com boa vitalidade na sala de parto. Métodos: revisão integrativa realizada em cinco recursos informacionais, mediante associação dos descritores: recém-nascido; assistência perinatal; e, parto humanizado, em português, inglês e espanhol. Resultados: 12 publicações compuseram a análise interpretativa, nas quais contato pele a pele imediato mãe-bebê, aleitamento materno precoce e clampeamento oportuno do cordão umbilical são reconhecidos como boas práticas ao recém-nascido na sala de parto. A adesão ou não a essas condutas associam-se a fatores como tipo de parto, presença de acompanhante, vínculo com a equipe de saúde, infraestrutura, disponibilidade de recursos e hospital intitulado Amigo da Criança. Conclusão: é necessária uma mudança de paradigma vislumbrando o fortalecimento do vínculo entre mãe e bebê, logo, são necessários profissionais capacitados e sensibilizados para a humanização das condutas na sala de parto


Objective: to analyze the Brazilian scientific production on good practices related to the care of newborns with good vitality in the delivery room. Method: integrative review carried out on five information resources, using the association of descriptors: newborn; perinatal care; and humanized birth, in Portuguese, English and Spanish. Results: 12 publications comprised the interpretative analysis, in which mother-infant immediate skin-to-skin contact, early breastfeeding, and timely umbilical cord clamping are recognized as good practices for the newborn in the delivery room. Adherence or not to these behaviors is associated with factors such as type of delivery, presence of companion, bond with the health team, infrastructure, availability of resources and hospital called Child Friendly


Objetivo: analizar la producción científica brasileña sobre buenas prácticas relacionadas con el cuidado de recién nacidos con buena vitalidad en la sala de partos. Método: revisión integradora en cinco recursos de información, utilizando la asociación de descriptores: recién nacido; cuidado perinatal; y nacimiento humanizado, en portugués, inglés y español. Resultados: 12 publicaciones comprendieron el análisis interpretativo, en el cual el contacto inmediato piel a piel de la madre y el bebé, la lactancia temprana y el pinzamiento oportuno del cordón umbilical se reconocen como buenas prácticas. El cumplimiento de estas se asocia a tipo de parto, presencia de acompañante, vínculo con equipo de salud, infraestructura, disponibilidad de recursos y hospital llamado Child Friendly. Conclusión: se necesita un cambio de paradigma para prever el fortalecimiento del vínculo entre la madre y el bebé, por lo tanto, se necesitan profesionales capacitados y sensibilizados para humanizar la conducta en la sala de partos


Subject(s)
Humans , Male , Female , Infant, Newborn , Perinatal Care/methods , Humanizing Delivery , Delivery Rooms/trends , Breast Feeding , Neonatal Nursing/methods , Mother-Child Relations
2.
Rev. bras. ginecol. obstet ; 42(9): 562-568, Sept. 2020.
Article in English | LILACS | ID: biblio-1137873

ABSTRACT

Abstract Objective The present comprehensive review aims to show the full extent of what is known to date and provide a more thorough view on the effects of SARS-CoV2 in pregnancy. Methods Between March 29 and May, 2020, the words COVID-19, SARS-CoV2, COVID- 19 and pregnancy, SARS-CoV2 and pregnancy, and SARS and pregnancy were searched in the PubMed and Google Scholar databases; the guidelines from well-known societies and institutions (Royal College of Obstetricians and Gynaecologists [RCOG], American College of Obstetricians and Gynecologists [ACOG], International Society of Ultrasound in Obstetrics & Gynecology [ISUOG], Centers for Disease Control and Prevention [CDC], International Federation of Gynecology and Obstetrics [FIGO]) were also included. Conclusion The COVID-19 outbreak resulted in a pandemic with > 3.3 million cases and 230 thousand deaths until May 2nd. It is caused by the SARS-CoV2 virus and may lead to severe pulmonary infection and multi-organ failure. Past experiences show that unique characteristics in pregnancy make pregnant women more susceptible to complications from viral infections. Yet, this has not been reported with this new virus. There are risk factors that seem to increase morbidity in pregnancy, such as obesity (body mass index [BMI] > 35), asthma and cardiovascular disease. Current reports describe an increased rate of pretermbirth and C-section. Vertical transmission


Resumo Objetivo A presente revisão detalhada busca fornecer dados objetivos para avaliar o que se sabe até o momento e possibilitar uma visãomais ampla dos efeitos do SARSCoV2 na gravidez. Métodos Entre 29 demarço e 2 de maio de 2020, foi realizada uma busca nos bancos de dados PubMed e Google Scholar com as palavras COVID-19, SARS-CoV2, COVID-19 e gravidez, SARS-CoV2 e gravidez, e SARS e gravidez. As recomendações dos principais órgãos sobre o tema também foram acessadas. Conclusão O surto de COVID-19 resultou em uma pandemia com> 3.3 milhões de casos e 230 mil mortes até 2 de maio. É uma condição causada pelo vírus SARS-CoV2 e pode levar ao acometimento pulmonar difuso e à falência de múltiplos órgãos. Características únicas da gestante tornam essa população mais propensas a complicações de infecções virais. Até o momento, essa tendência não foi observada para esse novo vírus. Os fatores que parecem estar associados à maior morbidade materno-fetal são obesidade (índice demassa corporal [IMC] > 35), asma e doença cardiovascular. Há descrição de aumento de parto prematuro e parto cesáreo. Não se pode descartar a possibilidade de transmissão vertical da doença, devido a relatos de positividade de reação em cadeia de polimerase (RT-PCR) de swab nasal, RT-PCR de líquido amniótico e imunoglobulina M (IgM) de recém-nascidos. Tratamentos devem ser analisados caso a caso, dada a falta de qualidade de estudos que comprovem a sua eficácia e segurança na gravidez. O corpo clínico deve utilizar equipamentos de proteção individual (EPI) ao manusear pacientes suspeitos ou confirmados e ficar atento aos sinais de descompensação respiratória.


Subject(s)
Humans , Female , Pregnancy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Pneumonia, Viral/transmission , Pneumonia, Viral/epidemiology , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/epidemiology , Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Coronavirus Infections/epidemiology , Pandemics , Betacoronavirus/isolation & purification , Cesarean Section/statistics & numerical data , Global Health , Risk Factors , Infection Control/methods , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Perinatal Care/methods , Infectious Disease Transmission, Vertical/prevention & control , Premature Birth/epidemiology , Premature Birth/virology , SARS-CoV-2 , COVID-19
3.
Rev. chil. pediatr ; 91(3): 398-404, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1126178

ABSTRACT

Resumen: Introducción: Las masas congénitas de cabeza y cuello se asocian a asfixia perinatal e injuria cerebral con elevada mortalidad. La técnica EXIT (Ex Útero Intrapartum Treatment) consiste en asegurar la vía aérea del neonato, sin interrumpir la oxigenación y perfusión materno-fetal a través del soporte placentario. Esta técnica no ha sido estandarizada en países de medianos ingresos. Objetivo: Describir el caso clínico de 2 neonatos manejados mediante la técnica EXIT. Caso Clínico: Se reportan dos casos, uno con malformación linfática diagnosticada a la semana 20 gestación y el segundo con tiromegalia y polihidramnios diagnosticados a la semana 35 de gestación. En ambos casos, duran te la cesárea se realizó la técnica EXIT con un equipo conformado por neonatólogo, ginecólogo, anestesiólogo, cirujano pediatra, otorrinolaringólogo, enfermero y terapeuta respiratorio. En los dos pacientes se logró asegurar la vía aérea mediante intubación orotraqueal al primer intento. En el caso 1 se confirmó la malformación linfática y recibió escleroterapia, y en el caso 2 se diagnosticó hipotiroidismo congénito asociado a bocio, que fue manejado con levotiroxina. Los pacientes se mantuvieron 7 y 9 días con ventilación mecánica invasiva respectivamente y egresaron sin complicaciones respiratorias. Conclusiones: La técnica EXIT en estos casos fue un procedimiento seguro, llevado a cabo sin inconvenientes. Se necesita un equipo multidisciplinario y la disponibilidad de una unidad de cuidados intensivos neonatales, con el objetivo de reducir potenciales complica ciones y garantizar el manejo postnatal. Para lograr su ejecución, es indispensable el diagnóstico prenatal oportuno.


Abstract: Introduction: Congenital head and neck masses are associated with perinatal asphyxia and brain injury, increasing the risk of death. The EXIT (Ex Utero Intrapartum Treatment) technique con sists of ensuring the newborn's airway while is still receiving placental support. This technique has not been standardized in developing countries. Objective: To describe the clinical outcomes of two infants who underwent the EXIT technique. Clinical Case: We present two cases, one with lymphatic malformation diagnosed at 20 weeks of gestational age (WGE) and the second one, a preterm newborn with thyromegaly and polyhydramnios, diagnosed at 35 WGE. In both cases, during the C-section, the EXIT technique was performed with a team of a neonatologist, a gyne cologist, an anesthesiologist, a pediatric surgeon, an otolaryngologist, a nurse, and a respiratory therapist. In both patients, the neonatologist achieved to secure the airway through orotracheal intubation at the first attempt. In the first case, lymphatic malformation was confirmed and re ceived sclerotherapy, and the second one was diagnosed with congenital hypothyroidism which was managed with levothyroxine. The patients needed invasive mechanical ventilation for 7 and 9 days, respectively, and were discharged without respiratory complications. Conclusions: In these patients, the EXIT technique was a safe procedure, carried out without inconvenience. A multi disciplinary approach and the availability of a neonatal intensive care unit are needed to reduce potential complications and ensure postnatal management. Timely prenatal diagnosis is essential to perform this technique.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Thyroid Gland/pathology , Cesarean Section , Perinatal Care/methods , Congenital Hypothyroidism/therapy , Lymphatic Abnormalities/therapy , Airway Management/methods , Prenatal Diagnosis , Colombia , Congenital Hypothyroidism/diagnosis , Congenital Hypothyroidism/pathology , Lymphatic Abnormalities/diagnosis , Tertiary Care Centers , Hypertrophy/diagnosis , Hypertrophy/therapy , Neck
4.
Rev. bras. ginecol. obstet ; 42(6): 349-355, June 2020. tab
Article in English | LILACS | ID: biblio-1137837

ABSTRACT

Abstract The new coronavirus (severe acute respiratory syndrome-related coronavirus 2, SARSCoV- 2) is a virus that causes a potentially serious respiratory disease that has spread in several countries, reaching humans in all age groups, including pregnant women. The purpose of this protocol is to provide technical and scientific support to Brazilian obstetricians regarding childbirth, postpartum and abortion care during the pandemic.


Resumo O novo coronavírus (severe acute respiratory syndrome-related coronavirus 2, SARS-CoV- 2) é umvírus que causa uma doença respiratória potencialmente grave que se espalhou por vários países, acometendo seres humanos de todas as faixas etárias, incluindo gestantes. O propósito deste protocolo é fornecer apoio técnico e científico aos obstetras brasileiros com relação aos cuidados no parto, pós-parto e aborto durante a pandemia.


Subject(s)
Humans , Female , Pregnancy , Pneumonia, Viral/diagnosis , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Pneumonia, Viral/epidemiology , Infection Control/methods , Infection Control/organization & administration , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Coronavirus Infections/drug therapy , Coronavirus Infections/therapy , Coronavirus Infections/epidemiology , Perinatal Care/methods , Disease Transmission, Infectious/prevention & control , Clinical Laboratory Techniques/methods , Delivery, Obstetric/methods , Pandemics/prevention & control , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/prevention & control , Pregnancy Complications, Infectious/therapy , Pregnancy Complications, Infectious/epidemiology , Brazil , Comorbidity , Abortion, Legal/methods , Risk Assessment/methods , Betacoronavirus/isolation & purification , COVID-19 Testing , SARS-CoV-2 , COVID-19
5.
Medicina (B.Aires) ; 80(supl.2): 47-52, mar. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1125106

ABSTRACT

Este trabajo tiene el propósito de revisar el efecto de las intervenciones basadas en mindfulness sobre la salud mental perinatal. Se efectuó una búsqueda de la literatura publicada hasta septiembre 2019 en la base de datos Web of Science (WOS). Teniendo en cuenta los criterios de inclusión y exclusión y después de leer el título y abstracts de los artículos encontrados, se han seleccionado 26 de ellos, de los que se han escogido solo ocho por tratarse de ensayos controlados y aleatorizados (RCTs) que estudian datos de ansiedad, depresión, estrés percibido y mindfulness pre y post-intervención y con datos de seguimiento. Los resultados encontrados muestran que las intervenciones basadas en mindfulness (IBMs) son más eficaces que la asistencia sanitaria habitual (TAU) para la mujer embarazada a la hora de reducir la sintomatología depresiva, ansiosa y estrés percibido e incrementar sus niveles de mindfulness post-intervención. Para futuras investigaciones se consideraría interesante realizar el seguimiento de estas variables en el posparto e incluir otras como la calidad del vínculo madre-bebé, la adherencia a la lactancia materna y el desarrollo evolutivo del recién nacido.


This article is intended to review the effect of mindfulness-based interventions on perinatal mental health. A search of the literature published until September 2019 in the Web of Science (WOS) database was carried out. Taking into account the inclusion and exclusion criteria and after reading the title and abstracts of the articles found, 26 of them have been selected. Finally we only analyzed randomized controlled trials (RCTs) that show data on anxiety, depression, perceived stress and mindfulness before and after intervention and with follow-up data. The results found show that mindfulness-based interventions (IBMs) are more effective than the usual healthcare (TAU) that pregnant women receive for the reduction of depressive, anxious and perceived stress symptoms as well as increasing their post-intervention mindfulness levels. For future research, a postpartum follow-up would be considered interesting taking into account variables such as the quality of the mother-baby attachment, adherence to breastfeeding and the evolutionary development of the newborn.


Subject(s)
Humans , Female , Pregnancy , Anxiety/therapy , Pregnant Women/psychology , Depression/therapy , Mindfulness/methods , Anxiety/psychology , Pregnancy Complications/psychology , Pregnancy Complications/therapy , Treatment Outcome , Perinatal Care/methods , Depression, Postpartum/psychology , Depression, Postpartum/therapy , Depression/psychology
6.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(2): 140-148, Apr.-June 2019. tab
Article in English | LILACS | ID: biblio-1013293

ABSTRACT

ABSTRACT Objective: To describe the structure and the processes of care for pregnant women/newborn infants, including the Essential Newborn Care (ENC), in maternity hospitals in Sergipe State, Brazil. Methods: A cross-sectional study carried out between June 2015 and April 2016 in all maternity hospitals of Sergipe with more than 500 deliveries/year (n=11). A questionnaire on the existing structure and work processes was administered to the managers. Subsequently, a representative number of postpartum women from these hospitals were interviewed (n=768). Their medical records, as well as newborn infants' records, were also analyzed. Results: Sergipe has 78 beds of Neonatal Intensive Care Unit (NICU) and 90 beds of Intermediate Care Unit (IMCU) to meet spontaneous and programmed demand. Only six maternity hospitals (54.5%) performed the risk classification, and four (36.3%) had protocols for high-risk parturient care. Regarding the ENC components, only 41% (n=315) of the women had early skin-to-skin contact with their babies, 33.1% (n=254) breastfed in the first hour of life, and 18% (n=138) had a companion always during birth. Conclusions: The distribution of NICU beds between capital city and other cities of the State is adequate, considering Brazilian guidelines. However, there was a low adherence to the protocols for hypertensive and hemorrhagic emergencies, and a low coverage of humanization policies, pregnancy risk classification and ENC practices, especially breastfeeding in the first hour of life, and companion always during birth.


RESUMO Objetivo: Descrever a estrutura e os processos de atendimento a gestante/recém-nascido, incluindo os componentes do Essential Newborn Care (ENC), das maternidades de Sergipe, Brasil. Métodos: Estudo transversal realizado entre junho de 2015 e abril de 2016 em todas as maternidades de Sergipe (n=11) com mais de 500 partos/ano. Foi aplicado um questionário aos gestores sobre a estrutura e os processos de trabalhos existentes. Posteriormente, um número representativo de puérperas desses hospitais foi entrevistado (n=768) e seus prontuários, bem como o dos recém-nascidos, foram analisados. Resultados: Sergipe conta com 78 leitos de Unidade de Terapia Intensiva Neonatal (UTIN) e 90 de Unidade Intermediária (UI) para atendimento da demanda espontânea e programada. Somente seis maternidades (54,5%) realizam a classificação de risco e quatro (36,3%) possuem protocolos para atendimento das parturientes de alto risco. No que se refere aos componentes do ENC, apenas 41% (n=315) das mulheres tiveram contato pele a pele precoce com seu filho, 33,1% (n=254) amamentaram na primeira hora de vida e 18% (n=138) tiveram a presença do acompanhante em todos os momentos do parto. Conclusões: A distribuição de leitos de UTIN entre capital/interior é adequada no Estado, levando-se em consideração a legislação vigente no país. Entretanto, houve baixa adesão aos protocolos das emergências hipertensivas e hemorrágicas, e baixa cobertura das políticas de humanização, da classificação de risco para a gestante e das práticas do ENC, principalmente quanto à amamentação na primeira hora de vida e à presença do acompanhante na parturição.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adult , Intensive Care Units, Neonatal/standards , Clinical Protocols , Guideline Adherence/statistics & numerical data , Patient Care Management/methods , Patient Care Management/organization & administration , Practice Patterns, Physicians'/standards , Practice Patterns, Physicians'/organization & administration , Brazil , Cross-Sectional Studies , Pregnancy, High-Risk , Perinatal Care/methods , Perinatal Care/organization & administration , Health Services Needs and Demand , Hospitals, Maternity/standards , Hospitals, Maternity/statistics & numerical data
7.
Cad. Saúde Pública (Online) ; 35(10): e00111218, 2019. tab
Article in Portuguese | LILACS | ID: biblio-1039380

ABSTRACT

Resumo: O PRENACEL é uma pesquisa que incorpora duas abordagens inovadoras para a saúde materna e perinatal: a necessidade de melhorar os níveis de satisfação das mulheres com a experiência do parto; e, a avaliação de impactos do uso de tecnologias de informação e comunicação em saúde. Trata-se de um programa de comunicação via mensagens curtas de textos no celular desenvolvido para gestantes brasileiras atendidas no pré-natal do Sistema Único de Saúde. Nesta análise, pretende-se determinar se o programa contribui positivamente para a percepção das mulheres de sentirem-se melhor preparadas para o parto. Um ensaio aleatorizado por conglomerados foi realizado em 20 unidades de saúde da atenção primária de Ribeirão Preto, São Paulo, entre 2015 e 2016. Dados de entrevista e revisão de prontuários foram coletados de 1210 mulheres. Estes foram submetidos a dois modelos de análise, por protocolo e intenção de tratamento. Receber informações do programa PRENACEL durante a gestação foi associado a um aumento na percepção das mulheres de se sentirem melhor preparadas para o parto, e na percepção de que o pré-natal colabora para que se sintam mais preparadas. Também foram observados impactos positivos no estabelecimento do contato pele a pele e aleitamento materno em sala de parto e no conhecimento sobre intervenções obstétricas. Não foram encontradas diferenças nos demais desfechos maternos e perinatais avaliados, incluindo a satisfação das mulheres com o atendimento ao parto. O PRENACEL pode contribuir com a ampliação do acesso das mulheres a informações que lhes sejam estratégicas para que se sintam mais bem preparadas para a experiência do parto.


Resumen: PRENACEL es una investigación que incorpora dos abordajes innovadores para la salud materna y perinatal: la necesidad de mejorar los niveles de satisfacción de las mujeres que han vivido la experiencia de un parto; además de la evaluación de los impactos del uso de tecnologías de la información y comunicación en salud. Se trata de un programa de comunicación vía mensajes cortos de texto en el móvil, desarrollado para gestantes brasileñas atendidas en el servicio prenatal del Sistema Único de Salud. En este análisis se pretende determinar si el programa contribuye positivamente a la percepción de las mujeres respecto a sentirse mejor preparadas para el parto. Se realizó un ensayo aleatorizado por conglomerados en 20 unidades de salud de atención primaria en Ribeirão Preto, São Paulo, entre 2015 y 2016. Los datos de entrevista y revisión de registros médicos se recogieron con 1.210 mujeres. Estos se sometieron a dos modelos de análisis, por protocolo e intención de tratamiento. Recibir información del programa PRENACEL durante la gestación se asoció a un aumento de la percepción de las mujeres en cuanto a sentirse mejor preparadas para el parto, y desde la percepción de que el periodo prenatal presta apoyo para que se sientan más preparadas. También se observaron impactos positivos en el establecimiento del contacto piel con piel, lactancia materna en sala de parto, y en el conocimiento sobre intervenciones obstétricas. No se observaron diferencias en los demás desenlaces maternos y perinatales evaluados, incluyendo la satisfacción de las mujeres con la atención durante el parto. PRENACEL puede contribuir a la ampliación del acceso de las mujeres a información que les resulte estratégica para que se sientan mejor preparadas durante la experiencia del parto.


Abstract: PRENACEL is a study that incorporates two innovative approaches to maternal and perinatal health: the need to improve women's level of satisfaction with the birthing experience and an assessment of the impacts of information and communication technologies in health. The approaches involve a communication program via short cellphone text messages, developed for Brazilian pregnant women in prenatal care in the Brazilian Unified National Health System. The analysis aims to determine whether the program contributes positively to women's perceived preparedness for childbirth. A randomized cluster trial was performed in 20 primary care units in Ribeirão Preto, São Paulo State, in 2015 and 2016. Data were collected for 1,210 women from interviews and patient charts. The data were submitted to two analytical models, per protocol and intention-to-treat. Women that had received information from the PRENACEL program during pregnancy were more likely to feel prepared for labor and delivery and to feel that prenatal care had helped them feel more prepared. There were also positive impacts on bonding with the newborn and breastfeeding in the delivery room and on knowledge of obstetric interventions. No differences were seen in the other maternal and perinatal outcomes, including women's satisfaction with the birthing care. PRENACEL can help expand women's access to strategic information for them to feel better prepared for the birthing experience.


Subject(s)
Humans , Female , Adolescent , Prenatal Care/methods , Telemedicine/instrumentation , Perinatal Care/methods , Text Messaging/instrumentation , Brazil , Health Knowledge, Attitudes, Practice , Gestational Age , Communication , Information Dissemination , Parturition , Cell Phone , Pregnant Women , Maternal Health
8.
J. pediatr. (Rio J.) ; 94(4): 368-373, July-Aug. 2018. tab
Article in English | LILACS | ID: biblio-954639

ABSTRACT

Abstract Objective: To evaluate the effectiveness of a thermoregulation bundle for preventing admission hypothermia in very low-birth weight preterm infants. Methods: Interventional study with retrospective evaluation of data undertaken in a tertiary neonatal unit including all very low-birth weight preterm infants (<1500 g) born at and admitted to the unit. Two periods were compared: before intervention (PI; 01/01/2012 to 02/28/2014_ and after intervention (PII; 04/01/2014 to 11/30/2016). The intervention started in March 2014. At PI procedures in the delivery room were: placement in a crib with a radiant heat source, doors always closed, polyethylene body plastic bag, double cap (plastic and cotton mesh), room temperature between 24 to 27 ºC and transport to neonatal unit in a pre-heated incubator (36-37.0 ºC). At PII, there was a reinforcement on not opening the plastic bag during the entire resuscitation process, even at an advanced stage, and the anthropometric measures and routine care were performed in the neonatal unit. Maternal, delivery, and neonatal variables were compared. Admission hypothermia was considered when admission axillary temperature was <36.0 ºC. Periodic results were shown to the team every six months and results were discussed. Results: The incidence of admission hypothermia was reduced significantly in PII (37.2 vs. 14.2%, p < 0.0001) and admission temperature medians were higher (36.1 vs. 36.5 ºC, p < 0.001). At PII, there was an increase in the number of infants transported with oxygen (49.5 vs. 75.5%, p < 0.0001). No differences were observed regarding birth weight and gestational age. Conclusion: There was a very important reduction in admission hypothermia incidence and a higher median admission temperature after continued protocol implementation.


Resumo Objetivo: Avaliar a efetividade de um programa de medidas para prevenção de hipotermia à admissão em recém-nascidos pré-termo de muito baixo peso. Métodos: Estudo de intervenção com coleta retrospectiva de dados em unidade neonatal terciária que incluiu todos os recém-nascidos pré-termo de muito baixo peso (< 1.500 g) nascidos e admitidos na unidade. Foram comparados dois períodos: antes da intervenção PI - 01/01/2012 a 28/02/2014 e depois da intervenção PII - 01/04/2014 a 30/11/2016. O mês de março de 2014 foi o início da intervenção. Em PI as medidas em sala de parto foram: recepção em berço de calor radiante, portas sempre fechadas, uso de saco plástico corporal, colocação de dupla touca (plástico e malha) na cabeça, temperatura ambiental entre 24-27 ºC e transporte em incubadora aquecida (36-37,0 ºC). No PII reforçou-se a não abertura do saco plástico durante toda reanimação mesmo que avançada e dados antropométricos e cuidados rotineiros realizados na unidade de internação. Variáveis maternas, de parto e neonatais foram comparadas entre os dois períodos. Hipotermia à admissão foi considerada quando temperatura axilar < 36,0 ºC. Resultados parciais foram apresentados e discutidos com a equipe semestralmente. Resultados: A incidência da Hipotermia à admissão diminuiu significativamente em PII (37,2 x14,2%, p < 0,0001) e a mediana de temperatura foi mais elevada (36,1x36,5º C, p < 0,001). Houve aumento significativo do número de crianças transportadas com oxigênio em PII (49,5 x 75,5%, p < 0,0001). Não houve diferenças para peso ao nascer e idade gestacional. Conclusão: Houve redução acentuada de Hipotermia à admissão e melhora na mediana da temperatura de admissão hospitalar em recém-nascidos pré-termo de muito baixo peso após implantação do protocolo.


Subject(s)
Humans , Male , Female , Infant, Newborn , Body Temperature Regulation , Infant, Premature , Infant, Very Low Birth Weight , Hypothermia/prevention & control , Retrospective Studies , Risk Factors , Perinatal Care/methods
9.
Rev. cuba. obstet. ginecol ; 43(2): 1-8, abr.-jun. 2017. tab
Article in Spanish | LILACS, CUMED | ID: biblio-901301

ABSTRACT

Introducción: la anemia durante el embarazo se produce como resultado de deficiencias nutricionales y constituye un problema de salud. Es una de las afecciones coincidentes con más frecuencia en el embarazo. Objetivo: describir los resultados perinatales en pacientes con diagnóstico de anemia en el momento de la captación del embarazo. Métodos: se realizó un estudio observacional, descriptivo, longitudinal y prospectivo, en 543 pacientes con anemia atendidas en la consulta de nutrición del Hospital Ginecobstétrico Eusebio Hernández Pérez de La Habana, Cuba, desde enero de 2015 hasta diciembre de 2016. La recolección de la información se realizó mediante entrevista, examen físico, las investigaciones diagnósticas realizadas y las historias clínicas. Resultados: casi la mitad de las pacientes estuvieron representadas por las adolescentes y las mayores de 35 años (45,4 por ciento). Las multíparas iniciaron la gestación con anemia para un 36,6 por ciento. Las nulíparas presentaron infecciones durante el embarazo para un 59,2 por ciento. El 83,9 por ciento de las pacientes con partos anteriores tenían un periodo intergenésico corto. El parto antes del término y el recién nacido con bajo peso al nacer estuvo presente en 15,4 por ciento. No hubo mortalidad materno-fetal. Hubo tres muertes neonatales precoces. Conclusiones: la multiparidad y el período intergenésico corto fueron antecedentes frecuentes en las gestantes con anemia en la captación. La prematuridad y el bajo peso al nacer fueron bajas y no se produjeron muertes maternas ni fetales. La mortalidad perinatal fue a expensas de los recién nacidos menores de siete días(AU)


Introduction: Anemia during pregnancy occurs as a result of nutritional deficiencies and is a health problem. It is one of the most frequently encountered conditions in pregnancy. Objective: Describe the perinatal outcomes in patients with anemia at the beginning of pregnancy. Methods: An observational, descriptive, longitudinal and prospective study was conducted in 543 patients with anemia treated at the nutrition clinic of the Eusebio Hernández Pérez Ginecobstetric Hospital, Havana, Cuba, from January 2015 to December 2016. The collection of information was made through interview, physical examination, diagnostic investigations and clinical records. Results: Almost half of the patients were represented by adolescents and those over 35 (45.4 percent). The multiparous women started gestation with anemia (36.6 percent). Nulliparous women had infections during pregnancy (59.2 percent).83.9 percent of the patients with previous deliveries had short intergenic period. Preterm birth and low birth weight newborns were present in 15.4 percent. There was no maternal-fetal mortality but only three early neonatal deaths. Conclusions: Multiparity and short intergenic period were frequent antecedents in pregnant women with anemia at the beginning of pregnancy. Prematurity and low birth weight incidence were low and there were no maternal or fetal deaths. Perinatal mortality was at the expense of infants younger than seven days(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/blood , Perinatal Care/methods , Anemia, Iron-Deficiency/complications , Epidemiology, Descriptive , Prospective Studies , Longitudinal Studies , Early Diagnosis , Observational Study
10.
Femina ; 44(4): 224-232, 20161230. ilus
Article in Portuguese | LILACS | ID: biblio-1050869

ABSTRACT

Ocrescimento intrauterino restrito (CIUR) é uma inibição patológica do crescimento fetal, acometendo 5-10% das gestações e está associado ao aumento da morbimortalidade perinatal. Este estudo tem como objetivo realizar uma revisão não sistemática sobre os eventos adversos perinatais dos fetos com CIUR tardio e alteração seletiva do Doppler da artéria cerebral média (ACM). A pesquisa bibliográfica foi realizada através da base de dados do PubMed, obtendo um total de 25 referências, que serviram de base para o presente artigo. Conclui-se que a artéria cerebral média possui valor particular na identificação e predição de resultados adversos nestes fetos, os quais possuem risco aumentado de desenvolvimento neurológico anormal ao nascimento e aos dois anos de idade.(AU)


Intrauterine growth restriction (IUGR) is a pathological inhibition of the fetal growth that affects 5-10% of pregnancies and it is associated with an increase of perinatal morbidity and mortality. This study aims to conduct a non-systematic review of perinatal adverse events of fetuses with late-onset IUGR and selective changes in middle cerebral artery (MCA) Doppler. A literature search was performed using the PubMed database. A total of 25 references, which were the basis for this article was obtained. It concludes the middle cerebral artery has a particular value in the identification and prediction of adverse outcomes in these fetuses, which has an increased risk of abnormal neurological performance at birth and at two years of age.(AU)


Subject(s)
Humans , Female , Pregnancy , Ultrasonography, Doppler, Transcranial , Middle Cerebral Artery/physiopathology , Middle Cerebral Artery/diagnostic imaging , Fetal Growth Retardation/physiopathology , Fetal Growth Retardation/diagnostic imaging , Placenta Diseases/diagnostic imaging , Databases, Bibliographic , Perinatal Care/methods , Fetal Development , Dilatation, Pathologic , Cerebrum/blood supply
11.
Rev. pediatr. electrón ; 13(3): 5-11, oct. 2016. ilus
Article in Spanish | LILACS | ID: biblio-836297

ABSTRACT

El compromiso obstructivo de la vía aérea en el recién nacido se asocia a hipoxia, acidosis, morbilidad neurológica y alta mortalidad. La causa más frecuente de obstrucción son los tumores cervicales y la obstrucción congénita de la vía aérea. Las lesiones cervicales más comunes son las malformaciones linfáticas, teratoma, higroma quístico, hemangiomas, bocio, quistes de plexo braquial, neuroblastomas y hemartomas. El preparar un nacimiento en el que obstetras, pediatras, neonatólogos, cardiólogos, anestesistas y cirujanos infantiles se coordinen con la intención de obtener una vía aérea permeable y segura, mientras permanece intacta la circulación placentaria, es lo que entendemos como terapia fetal intraparto ex útero o EXIT. Este manejo puede cambiar el pronóstico en pacientes críticos, en los que sin una adecuada preparación, la obstrucción de vía aérea se transformaría en una emergencia para el recién nacido.


The commitment obstructive airway in the newborn is associated with hypoxia, acidosis, neurologic morbidity and high mortality. The most common cause of obstruction are cervical tumors and congenital obstruction of the airway. The most common injuries are cervical lymphatic malformations, teratoma, cystic hygroma, hemangioma, goiter, brachial plexus cysts, neuroblastomas and hamartomas. Preparing a birth in which obstetricians, pediatricians, neonatologists, cardiologists, anesthesiologists and pediatrics surgeons are coordinated with the intention of obtaining a patent and safe airway, while remaining intact placental circulation, it is what we understand as intrapartum fetal therapy ex - uterus or EXIT. This management can change the prognosis in critically ill patients, in which without adequate preparation, airway obstruction would become an emergency for the newborn.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Perinatal Care/methods , Cesarean Section/methods , Airway Obstruction/prevention & control , Airway Obstruction/surgery , Airway Obstruction/diagnosis
12.
Rev. eletrônica enferm ; 18: 1-9, 20160331. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-832816

ABSTRACT

Sanches4RESUMOObjetivou-se avaliar a assistência do enfermeiro obstetra do acolhimento ao parto, baseando-se nas boas práticas obstétricas. Trata-se de um estudo descritivo, retrospectivo e documental, de abordagem quantitativa por meio da análise de 500 prontuários. A pesquisa identificou que houve a realização da episiotomia em 12,2%, amniotomia em 13%, o uso de ocitocina em 42,8%, os métodos não farmacológicos para alívio da dor foram aplicados em 75,4% e o contato pele a pele foi estimulado em 91,6%. Verificou-se que o uso das boas práticas obstétricas recomendadas pela Organização Mundial da Saúde foram utilizadas pelo enfermeiro obstetra na assistência do acolhimento ao parto na sua maioria e está próxima do preconizado pelas evidências científicas.


The objective of this study is to assess the obstetric nurse's care from admission to delivery based on good obstetric practices. It is a descriptive, retrospective, and documentary study, with a quantitative approach based on the analysis of 500 medical records. The research identified that an episiotomy was done in 12.2%, an amniotomy in 13%, oxytocin was used in 42.8%, non-pharmacological methods for pain relief were applied in 75.4%, and skin-to-skin contact was used to stimulate in 91.6%. Most of the good obstetrical practices recommended by the World Health Organization were observed to be used by the obstetric nurses when providing care from admission to delivery and this is close to what has been recommended by scientific evidence


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Obstetric Nursing , Perinatal Care/methods , User Embracement , Maternal Health
13.
Rev. cuba. hig. epidemiol ; 53(1): 0-0, ene.-abr. 2015. tab
Article in Spanish | LILACS | ID: lil-775533

ABSTRACT

La identificación de la morbilidad materna extrema grave ofrece una oportunidad para la investigación de muertes maternas. El cumplimiento de los procesos de atención y determinación de los posibles riesgos asociados, es indispensable para evitarla. Objetivo: describir los procesos de atención de las gestantes con morbilidad materna extremadamente grave en la atención prenatal en el 2009. Método: se realizó un estudio descriptivo cuyo universo fueron las 63 gestantes que se diagnosticaron con morbilidad materna extremadamente grave en los servicios de ginecobstetricia de los hospitales generales y maternos de La Habana. La información se obtuvo de los registros hospitalarios y las historias clínicas de las gestantes en la atención prenatal y hospitalaria; esta se recogió a través de un instrumento creado al efecto y se introdujo en una base de datos en Access. Resultados: los principales riesgos identificados fueron la hipertensión arterial, la anemia, la infección vaginal y la pre eclampsia. La consulta de reevaluación realizada por el especialista en ginecobstetricia se reflejó en un 33 por ciento, el promedio de 10 consultas durante el embarazo se constató en el 69,8 por ciento de las gestantes. La complicación por shock hipovolémico ocupó el primer lugar, seguido del shock séptico y la eclampsia. Conclusiones: la identificación de riesgos en la atención prenatal probablemente intervenga en la evolución de la MMEG en la Habana(AU)


Identification of extremely severe maternal morbidity provides an opportunity for research into maternal death. Fulfillment of care processes and determination of potential associated risks are indispensable to prevent extremely severe maternal morbidity. Objective: describe the prenatal care processes applied to pregnant women with extremely severe maternal morbidity in 2009. Method: a descriptive study was conducted with a universe of 63 pregnant women diagnosed with extremely severe maternal morbidity at gynecobstetric services of general and maternal hospitals in Havana. A dedicated tool was used to collect data from prenatal and hospital registries and medical records of the pregnant women. The data were stored in an Access database. Results: the main risks identified were hypertension, anemia, vaginal infection and preeclampsia. Re-evaluation by a gynecobstetrician was conducted in 33 percent of the cases. The average 10 prenatal consultations were performed with 69.8 percent of the pregnant women. Hypovolemic shock ranked first among complications, followed by septic shock and eclampsia. Conclusions: risk identification during prenatal care may play a role in the evolution of extremely severe maternal morbidity in Havana(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/epidemiology , Risk Factors , Perinatal Care/methods , Epidemiology, Descriptive , Morbidity Surveys
14.
Einstein (Säo Paulo) ; 13(1): 58-64, Jan-Mar/2015. tab
Article in English | LILACS | ID: lil-745870

ABSTRACT

Objective To clarify if older pregnant women were more likely to have adverse perinatal outcomes when compared to women at an ideal age to have a child. Methods The groups were divided according to age groups: under 20 years, ≥20 to <40 years, and ≥40 years. Results During the period from January 1st, 2008, to December 31st, 2008, there were 76 births from patients younger than 20 years and 91 births from patients aged 40 years or over. To form a third group with intermediate age, the data of 92 patients aged 20 to 40 years were obtained, totaling 259 patients. Patients aged 40 or older had a statistically greater number of cesarean sections and less use of forceps or normal deliveries (p<0.001). The use of spinal anesthesia was statistically higher among those aged 40 years or more (p<0.001). The frequency of male newborns was statistically higher in older patients, a group with statistically fewer first pregnancies (p<0.001). The frequency of premature newborns was statistically higher in patients aged 40 years or more (p=0.004). Conclusion It is crucial to give priority to aged women, so that prenatal care will be appropriate, minimizing maternal complications and improving perinatal outcomes in this unique group. .


Objetivo Esclarecer se as gestantes em idade avançada estiveram mais propensas a terem resultados perinatais adversos quando comparadas àquelas em idade reprodutiva ideal. Métodos Os grupos foram divididos segundo grupos etários: idade menor que 20 anos; idade maior ou igual a 20 anos e menor que 40 anos; e idade maior ou igual a 40 anos. Resultados No período compreendido entre 1o de janeiro de 2008 a 31 de dezembro de 2008, ocorreram 76 partos de pacientes com idade menor que 20 anos e 91 partos de pacientes com idade maior ou igual a 40 anos. Para a formação de um terceiro grupo de faixa etária intermediária, foram coletados os dados de 92 pacientes com idade maior ou igual a 20 anos e menor que 40 anos, totalizando 259 pacientes. As pacientes com 40 anos ou mais apresentaram estatisticamente maior quantidade de partos cesárea e menos parto a fórcipe ou normais (p<0,001). A aplicação de raquianestesia foi estatisticamente maior nas gestantes com 40 anos ou mais (p<0,001). A frequência de recém-nascido do sexo masculino foi estatisticamente maior nas pacientes mais velhas, que também eram estatisticamente menos primigestas (p<0,001). A frequência de recém-nascido pré-termo foi estatisticamente maior em pacientes com 40 anos ou mais (p=0,004). Conclusão A priorização no atendimento das gestantes em idade avançada é imprescindível para que o pré-natal seja realizado com segurança, minimizando as complicações maternas e melhorando os resultados perinatais deste grupo tão particular. .


Subject(s)
Adult , Female , Humans , Infant, Newborn , Male , Middle Aged , Pregnancy , Young Adult , Maternal Age , Pregnancy Outcome , Perinatal Care/statistics & numerical data , Age Factors , Analysis of Variance , Birth Weight , Delivery, Obstetric/statistics & numerical data , Gestational Age , Premature Birth , Prenatal Care , Perinatal Care/methods , Pregnancy Complications/prevention & control , Risk Factors , Time Factors
15.
Rev. saúde pública ; 48(2): 304-313, abr. 2014. tab
Article in Portuguese | LILACS | ID: lil-711850

ABSTRACT

OBJETIVO Comparar os modelos colaborativo e tradicional na assistência ao parto e nascimento. MÉTODOS Estudo transversal realizado com 655 primíparas em quatro hospitais do sistema único de saúde em Belo Horizonte, MG, em 2011 (333 mulheres do modelo colaborativo e 322 do modelo tradicional, incluindo aquelas com trabalho de parto induzido e prematuro). Os dados foram coletados em entrevistas e levantamento de prontuários. Foram aplicados os testes Qui-quadrado para comparação e regressão logística múltipla para determinar associação entre o modelo e os desfechos analisados. RESULTADOS Houve diferenças significativas entre os modelos em relação ao nível de escolaridade e trabalho remunerado. No modelo colaborativo houve menor utilização da ocitocina (50,2% no modelo colaborativo versus 65,5% no modelo tradicional; p < 0,001), da ruptura artificial das membranas (54,3% no modelo colaborativo versus 65,9% no modelo tradicional; p = 0,012) e da taxa de episiotomia (16,1% no modelo colaborativo versus 85,2% no modelo tradicional; p < 0,001), e maior utilização de métodos não farmacológicos para alívio da dor (85,0% no modelo colaborativo versus 78,9% no modelo tradicional; p = 0,042). A associação entre o modelo colaborativo e a redução no uso da ocitocina, da ruptura artificial das membranas e da episiotomia manteve-se após o ajuste para fatores de confundimento. O modelo assistencial não esteve associado a complicações neonatais ou maternas nem à utilização de analgesia de condução. CONCLUSÕES Os resultados sugerem que o modelo colaborativo poderá reduzir as intervenções na assistência ao trabalho de parto e parto com resultados perinatais semelhantes. .


OBJECTIVE To compare collaborative and traditional childbirth care models. METHODS Cross-sectional study with 655 primiparous women in four public health system hospitals in Belo Horizonte, MG, Southeastern Brazil, in 2011 (333 women for the collaborative model and 322 for the traditional model, including those with induced or premature labor). Data were collected using interviews and medical records. The Chi-square test was used to compare the outcomes and multivariate logistic regression to determine the association between the model and the interventions used. RESULTS Paid work and schooling showed significant differences in distribution between the models. Oxytocin (50.2% collaborative model and 65.5% traditional model; p < 0.001), amniotomy (54.3% collaborative model and 65.9% traditional model; p = 0.012) and episiotomy (collaborative model 16.1% and traditional model 85.2%; p < 0.001) were less used in the collaborative model with increased application of non-pharmacological pain relief (85.0% collaborative model and 78.9% traditional model; p = 0.042). The association between the collaborative model and the reduction in the use of oxytocin, artificial rupture of membranes and episiotomy remained after adjustment for confounding. The care model was not associated with complications in newborns or mothers neither with the use of spinal or epidural analgesia. CONCLUSIONS The results suggest that collaborative model may reduce interventions performed in labor care with similar perinatal outcomes. .


Subject(s)
Adolescent , Adult , Female , Humans , Young Adult , Cooperative Behavior , Nurse Midwives , Perinatal Care/methods , Brazil , Cross-Sectional Studies , Midwifery , Outcome and Process Assessment, Health Care , Physician-Nurse Relations , Risk Factors , Socioeconomic Factors
16.
Ter. psicol ; 31(2): 249-261, jul. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-684052

ABSTRACT

La depresión perinatal constituye un trastorno de alta prevalencia con repercusiones negativas en la madre y en el bebé. A partir de estos antecedentes se revisa la literatura existente sobre intervenciones psicológicas focalizadas en reducir la depresión y/o favorecer un vínculo madre-infante positivo desde el embarazo hasta los dos años del niño/a. Se consideran 27 estudios publicados entre los años 1996 y 2012, que incluyen grupos experimental y control. Los resultados muestran que un mayor número de intervenciones se focalizan en la depresión perinatal como variable, distinguiendo entre intervenciones en el embarazo y postparto. Un menor número de estudios se dirige a la calidad del vínculo madre-infante y a ambas variables. Las intervenciones reportadas como exitosas, incluyen intervenciones grupales e individuales dirigidas a favorecer la sensibilidad materna y técnicas corporales.


Perinatal depression constitutes a high prevalence disorder, with negative repercussions in the mother and the baby. From these precedents, this article reviews different psychological interventions developed to reduce depression and/or to promote a mother-infant bond-quality, from pregnancy to children's second year of life. There are considered 27 studies published between 1996 and 2012, with inclusion of experimental and control groups. Results show that most of the interventions are focused in perinatal depression as a variable, differentiating between interventions during pregnancy and at postpartum. A minor number of studies focused on the mother-baby bond quality and to modify both variables in a simultaneous way. Interventions that were reported to be successful considered group and individual interventions focused on promoting maternal sensitivity and corporal techniques.


Subject(s)
Humans , Female , Pregnancy , Adult , Depression/psychology , Depression/therapy , Mother-Child Relations , Psychotherapy/methods , Perinatal Care/methods , Depression, Postpartum/prevention & control , Depression, Postpartum/psychology , Object Attachment , Psychotherapy, Group/methods
17.
Interface comun. saúde educ ; 17(45): 393-404, abr.-jun. 2013.
Article in Portuguese | LILACS | ID: lil-678221

ABSTRACT

Foram investigados vínculos entre profissionais de saúde e pacientes em hospital materno-infantil terciário e público, especializado em gravidez de alto risco fetal e doenças de alta complexidade na infância e adolescência, visando verificar se intervenções que "tocam" (mães/bebês) poderiam minimizar o estresse do ambiente hospitalar e interferir positivamente no processo terapêutico. Referimo-nos às ações que contribuem para os vínculos entre profissional de saúde, paciente e bebê, que incluem cuidado profissional técnico e afetivo, conforto ambiental, espaços para expressão dos sentimentos e comunicação. A pesquisa, de natureza empírico-operativa, utilizou metodologia qualitativa (observação participante e análise de discurso), tendo como sujeitos mães, familiares e profissionais. Resultados indicam a importância do acolhimento e vínculo entre profissionais de saúde e gestantes que vivem gravidez de alto risco fetal no ambiente hospitalar investigado, podendo favorecer a construção do vínculo possível entre pais e bebês em situações adversas.


The links between patients and health professionals in a public hospital specialized in high cliff fetal pregnancy and high complexity diseases were investigated, aiming to found the actions that could positively contribute to the therapeutic process in the mental health field, concerning the links between patients and health professionals that include professional and affective care, warm atmosphere and communication spaces the hospital setting. The research used qualitative methodology (participant observation and speech analysis), focusing the attendance routines in this maternity. The investigation subjects were mothers, families and professionals. Results indicate the importance of the attention and the link between health professionals and pregnant women, and could contribute to the construction of a possible link between parents and babies in adverse situations.


Se investigaron los vínculos entre profesionales de la salud y pacientes en hospital maternal-infantil terciario y público, especializado en embarazo de alto riesgo fetal y en enfermedades de alta complejidad en la infancia y en la adolescencia, con el objetivo de verificar si las intervenciones que son "afectivas" (madres/bebés) podrían minimizar el estrés del ambiente de hospital e interferir positivamente en el proceso terapéutico. Nos referimos a las acciones que contribuyen con los vínculos entre el profesional de salud, paciente y bebé, que incluyen el cuidado profesional técnico y afectivo, el confort ambiental, los espacios para expresión de los sentimientos y comunicación. La investigación, de naturaleza empírico-operativa, utilizó metodología cualitativa (observación participante y análisis de discurso), teniendo como sujetos a madres, familiares y profesionales. Los resultados indican la importancia de la acogida y del vínculo entre profesionales de la salud y mujeres embarazadas que viven un embarazo de alto riesgo fetal en el ambiente de hospital investigado, pudiendo favorecer la construcción del vínculo posible entre padres y bebés en situaciones adversas.


Subject(s)
Humans , Male , Female , Perinatal Care/methods , Hospital Care , Object Attachment , Physician-Patient Relations
18.
Rev. chil. pediatr ; 84(2): 138-144, abr. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-687169

ABSTRACT

Introducción: Lactancia materna exclusiva (LME) es la mejor alternativa para alimentar a los recién nacidos y lactantes, reportándose beneficios para el niño(a), la madre, familia y sociedad. Existen "co-variables" positivas y negativas que influyen en el inicio y mantención de LME. Objetivo: Evaluar los efectos de las "co-variables" en la mantención de LME a los dos meses, según modalidad de atención. Pacientes y Método: Ensayo clínico aleatorio controlado con seguimiento de puérperas e hijos(as), respecto de prevalencia de LME a las 8 sem, y las co-variables positivas y negativas para LME en dos modalidades de asistencia de parto. Muestra: 649 puérperas (330 modalidad integral y 319 modalidad tradicional). Resultados: Prevalencia de LME a las 8 sem correspondió a 56,1 por ciento en modalidad integral y 48,9 por ciento en modalidad tradicional (p = 0,06). Existen diferencias significativas en resultados de LME a las 8 sem según edad, paridad, escolaridad, entre ambas modalidades. Las "co-variables" positivas para LME se presentan en mayor proporción en modalidad integral (p < 0,0001). Conclusión: Si bien, no existen variables que afecten de manera independiente el inicio y duración de LME a las 8 sem, la modalidad integral en su conjunto actuaría a su favor.


Introduction: Exclusive breastfeeding (EBF) is the best alternative for feeding newborns and infants, benefiting the child, the mother, family and society. There are positive and negative covariates influencing the initiation and maintenance of EBF. Objective: To assess the effects of covariates in maintaining EBF after two months, according to type of care received. Patients and Method: Randomized controlled clinical trial with follow-up of women and children regarding prevalence of EBF after 8 weeks, and positive and negative EBF covariates in the two forms of delivery. Sample: 649 postpartum women (330 received comprehensive care and 319 traditional form of care). Results: Prevalence of EBF at 8 weeks corresponded to 56.1 percent in comprehensive mode and 48.9 percent in traditional mode (p = 0.06). There are significantly different EBF results at 8 weeks according to age, birth type and education between both cares. The positive EBF covariates are greater reported for the comprehensive care (p < 0.0001). Conclusion: Although there are no variables that independently affect the EBF initiation and duration at 8 weeks, the comprehensive care benefits them.


Subject(s)
Humans , Adult , Female , Pregnancy , Infant, Newborn , Perinatal Care/methods , Breast Feeding , Comprehensive Health Care , Parturition , Follow-Up Studies , Prevalence , Socioeconomic Factors , Time Factors
19.
Egyptian Journal of Histology [The]. 2013; 36 (3): 660-680
in English | IMEMR | ID: emr-187234

ABSTRACT

Background: Thyroid hormone plays a key role in the development of the cerebellar cortex. Selenium is a nutritional element with antioxidant and neuroprotective properties


Aim: The aim of this study was to investigate the effect of selenium on the structural impairment of postnatal rat cerebellar cortex development induced by perinatal experimental hypothyroidism


Materials and methods: Pups from 20 pregnant rats were divided into four equal groups: group I: negative control group, group II: methimazole-induced hypothyroid group, group III: selenium-supplemented hypothyroid group, and group IV: selenium-supplemented group [positive control]. Treatment continued from gestational day 14 to postnatal day [P] 14. At P7, P14, and P28, blood samples were collected for assessment of serum thyroid hormone and right cerebellar hemisphere specimens were processed for histological, immunohistochemical, and morphometric procedures


Results: Pups of hypothyroid group showed a retarded postnatal cerebellar cortex development, more apparent at P7 and P14, evidenced by increased thickness of the external granular layer and delayed alignment and differentiation of Purkinje cells in addition to reduced proliferating cell nuclear antigen and increased caspase 3-immunoreactivity. At P28, dark cell degeneration of most Purkinje cells was observed. A significant decrease in the thickness of the molecular and internal granular layers and of the number and surface area of Purkinje cells was observed in all postnatal ages studied. Glial fibrillary acidic protein immunostaining showed increased positive astrocytes with twisting and thickening of their glial fibers. Selenium caused a marked amelioration of most of these structural alterations


Conclusion: Perinatal hypothyroidism impaired postnatal cerebellar cortex development. Selenium should be used as a dietary supplement during pregnancy, particularly in hypothyroid conditions


Subject(s)
Female , Animals, Laboratory , Hypothyroidism , Perinatal Care/methods , Cerebellar Cortex/pathology , Immunohistochemistry , Selenium/therapeutic use , Rats , Female , Treatment Outcome
20.
Rev. obstet. ginecol. Venezuela ; 72(2): 83-88, jun. 2012. tab
Article in Spanish | LILACS | ID: lil-664602

ABSTRACT

Determinar la incidencia de admisiones antenatales en gestantes portadoras de enfermedades severas que implican un tratamiento intrahospitalario, revelando así la morbilidad materna, además de conocer sus repercusiones perinatales. Estudio observacional, descriptivo, analítico realizado durante el trienio 2008-2010. Hubo 5 815 nacimientos, 1 033 admisiones antenatales, 230 neonatos con morbilidad neonatal y 34 muertes feto-neonatales. Las embarazadas debían tener 20 semanas o más de gestación, hospitalizadas 2 días o más, fueron dadas de alta sin parir y luego regresaron para su asistencia obstétrica definitiva. Departamento de Obstetricia y Ginecología, Hospital "Dr. Adolfo Prince Lara", Departamento Clínico Integral de la Costa, Universidad de Carabobo. Puerto Cabello. Hubo una incidencia de 17,76 pacientes hospitalizadas antenatalmente por cada 100 nacimientos o 1 cada 5,6 nacimientos. Las patologías más frecuentes fueron las propias del embarazo (57,41 por ciento): la amenaza de parto prematuro (18,20 por ciento), preeclampsia (9,78 por ciento), hemorragia placentaria (6,68 por ciento), oligohidramnios (6,58 por ciento) y anemia (5,52 por ciento). Las patologías asociadas al embarazo (33,98 por ciento): infección urinaria (14,13 por ciento) y diabetes(9,49 por ciento) La morbilidad neonatal global fue 22,26 por ciento, aportada principalmente por patologías propias del embarazo: amenaza parto pretérmino (20,43 por ciento), preeclampsia (13,04 por ciento), y hemorragia placentaria (10 por ciento); de las asociadas: infección urinaria 14,35 por ciento y diabetes 14,35 por ciento. La mortalidad feto-neonatal fue de 3,3 por ciento, contribuyendo predominante prematurez y malformación fetal (29,41 por ciento), preeclampsia (26,47 por ciento), el desprendimiento prematuro de placenta y la placenta previa (17,65 por ciento). Hubo una incidencia elevada de admisiones antenatales, causadas por entidades que obligan a un diagnóstico precoz...


To determine the incidence of antenatal admissions in pregnant women carrying a severe illness involving hospital management, revealing maternal morbidity, in addition to knowing their impact perinatal outcomes. An observational, descriptive, analytical study, made during the 2008-2010 period. There were 5 815 births, 1 033 antenatal admissions, 230 infants with neonatal morbidity and 34 fetal and neonataldeaths. Pregnant women should take 20 weeks or more gestation, hospitalized 2 days or more, were discharged without giving birth and then returned for final delivery care. Department of Obstetrics and Gynecology, Hospital "Dr. Adolfo Prince Lara". Departamento Clinico de la Costa. University of Carabobo. Puerto Cabello, Estado Carabobo, Venezuela. There was an incidence of patients hospitalized antenatally 17.76 per 100 births or 1 in 5.6 children. The most frequent pathologies were typical of pregnancy (57.41 percent): preterm delivery threatens (18.20 percent), pre-eclampsia (9.78 percent), placental hemorrhage (6.68 percent), oligohydramnios (6.58 percent) and anemia (5.52 percent). Pregnancy-associated pathologies (33.98 percent): urinary tract infection (14.13 percent) and diabetes (9.49 percent). Neonatal morbidity rate was 22.26 percent, contributed mainly by pathologies of pregnancy: preterm delivery threatens (20.43 percent), pre-eclampsia (13.04 percent), and placental hemorrhage (10 percent), associated: urinary tract infection 14.35 percent and diabetes 14.35 percent. Feto-neonatal mortality was 3.3 percent, contributing predominant: prematurity and fetal malformation (29.41 percent), pre-eclampsia (26.47 percent), abruptio placenta and placenta previous (17.65 percent). There was a high incidence of antenatal admissions caused by entities that require early diagnosis and better management in order to lessen the economic impact and the serious repercussions hospital perinatal evidenced


Subject(s)
Humans , Male , Female , Infant, Newborn , Perinatal Care/methods , Perinatal Care/trends , Pregnancy Complications/pathology , Myasthenia Gravis, Neonatal/pathology , Maternal Mortality/trends , Neonatology , Obstetrics
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