Perceptions of the Brazilian obstetrics physicians about the term obstetric violence: a cross-sectional study

SUMMARY INTRODUCTION: We observe a growing global discussion about the practices considered "obstetric violence" against women during pregnancy and childbirth. Otherwise, the indiscriminate subjective and lay interpretation of the term "obstetric violence" can lead to a misunderstanding among medical professionals. OBJECTIVE: This study aimed to describe the obstetrician's perceptions about the term "obstetric violence" and the medical groups affected negatively by the topic. METHODS: A cross-sectional study applied to Brazilian obstetrics physicians regarding their perceptions of "obstetric violence." RESULTS: From January to April 2022, we sent about 14,000 direct mail nationwide. A total of 506 participants responded. We observed that 374 (73.9%) participants consider the term obstetric violence nocive or harmful to professional practice. Furthermore, after Poisson regression, we described that the respondents who graduated before 2000 and from a private institution were significant and independent groups for the full or partial agreement that the term is nocive for the obstetricians in Brazil. CONCLUSION: We observed that almost three in four obstetrician participants consider the term "obstetric violence" nocive or harmful to professional practice, particularly in those who graduated before 2000 and from a private institution. The findings are relevant to propose further debates and strategies to mitigate the possible harms caused to the obstetrician team by the indiscriminate use of the term obstetric violence.

Prediction and reasons for COVID-19 second dose vaccine hesitation: a cross-sectional study in a municipality of Brazil

ABSTRACT BACKGROUND: Hesitation and refusal to take a second dose of the vaccine for coronavirus disease 19 (COVID-19) are prevalent. OBJECTIVES: We aimed to identify predictive factors for hesitation or refusal and describe groups with higher rates of vaccine hesitancy. DESIGN AND SETTING: A cross-sectional study in Assis City, Brazil. METHODS: The study included adults who passed the due date for taking the COVID-19 second dose vaccine. Participants were recruited in December 2021 using a mobile-based text message. Sociodemographic and clinical data and reasons for hesitance were collected. The outcome was the attitude towards completing the recommended second dose of the vaccine. Bivariate and multivariate Poisson analyses were performed to determine the adjusted predictors. RESULTS: Participants between 30-44 years of age had a 2.41 times higher prevalence of hesitation than those aged 18-29 years. In addition, people who had adverse events or previously had COVID-19 had 4.7 and 5.4 times higher prevalences of hesitation, respectively (P value < 0.05). CONCLUSION: We found a significant group of adults aged between 30-44 years who refused the second dose of the COVID-19 vaccine. Furthermore, those who reported adverse effects after the first dose and those who had COVID-19 previously were a significant group for refusal.

Assessment of Pelvic Floor Disorders due to the Gestational Diabetes Mellitus Using Three-Dimensional Ultrasonography: A Narrative Review / Avaliação das desordens do assoalho pélvico decorrentes do diabetes gestacional usando a ultrassonografia tridimensional: Uma revisão narrativa

Abstract Gestational diabetes mellitus (GDM)is an entity with evolving conceptual nuances that deserve full consideration. Gestational diabetes leads to complications and adverse effects on the mother's and infants' health during and after pregnancy. Women also have a higher prevalence of urinary incontinence (UI) related to the hyperglycemic status during pregnancy. However, the exact pathophysiological mechanism is still uncertain. We conducted a narrative review discussing the impact of GDM on the women's pelvic floor and performed image assessment using three-dimensional ultrasonography to evaluate and predict future UI.

Resumo O diabetes gestacional (DG)é uma entidade com nuances conceituais em evolução que merecem total consideração. O DG leva a complicações e efeitos adversos na saúde da mãe e do bebê durante e após a gravidez. As mulheres também apresentam maior prevalência de incontinência urinária (IU) relacionada ao estado hiperglicêmico durante a gravidez. No entanto, o mecanismo fisiopatológico exato ainda é incerto. Realizamos uma revisão narrativa discutindo o impacto do DG no assoalho pélvico das mulheres e utilizamos o exame de ultrassonografia tridimensional para avaliar e predizer a ocorrência de IU.

Achados laparoscópicos na infertilidade / Infertility and laparoscopic finding

O objetivo deste trabalho é rever retropectivamente os achados laparoscópicos em mulheres infertéis. Entre 1990 e 1997 foram realizadas 115 laparoscopias em mulheres com queixa de infertilidade, seguidas no ambulatório de Esterelidade da Faculdade de Medicina de Londrina/UEL. Deste total, 100 mulheres foram analisadas quanto a idade, paridade, tipos de partos e abortos anteriores, presença de prenhez ectópica anteiror ao procedimento laparóscopico, história prévia de doença inflamatória pélvica (DIP) e dismenorréia. A seguir as pacientes foram avaliadas quanto ao achado laparoscópio, sendo os mais freqüentes endometriose (54 por cento) e aderências pélvicas (49 por cento). Ainda foram encontradas 22 pacientes com laqueadura tubária prévia e nove pacientes com mioma. Deste universo de pacientes 39 tiveram cromotubagens positivas, 34 cromotubagens negativas, 20 cromotubagens positiva uniteralmente e sete inconclusivas

Hemorragia Subaracnóide na gestaçäo: evoluçäo e conduta / Subarachnoid hemorrhage in pregnancy: evolution and management

Relata-se um caso de hemorragia subaracnóide espontânea grau I na classificaçao de Hunt e Hess em uma gestante de 33 semanas ecográfica. Com diagnóstico realizado através de tomografia e punçao lombar, a paciente foi submetida a cesariana e clampeamento do aneurisma no mesmo ato cirúrgico. Ambos, recém-nascido e mae permaneceram com quadro estável pós-operatório e receberam alta em boas condiçoes. Discute-se as diferentes condutas de acordo com a gravidade do quadro hemorrágico, lembrando que sempre é uma situaçao muito grave, apesar da sua raridade.