Gestación en la mujer obesa: consideraciones especiales / Pregnancy in the obese woman: special considerations

La obesidad sería el problema de salud más común en las mujeres en edad reproductiva. Los embarazos complicados con obesidad se relacionan con diabetes gestacional, preeclampsia, parto pretérmino, partos instrumentados y cesáreas, así como infecciones y hemorragia en el posparto. Y el bebe tiene mayor riesgo de malformaciones congénitas, ser grande/macrosómico, complicarse con distocia de hombros y muerte fetal. Las implicancias relacionadas al manejo de la obesidad en el embarazo no son muy conocidas por la falta de opciones de manejo basadas en la evidencia. El manejo de la obesidad debería empezar desde antes del embarazo, siguiendo el precepto de que una mujer debe estar en las mejores condiciones físicas y mentales si desea gestar. El profesional de la salud encargado del control prenatal necesita del apoyo de un nutricionista y/o endocrinólogo. Se debe tener en cuenta que las mujeres obesas pueden tener más dificultades en el parto, por lo que requieren de infraestructura y manejo especiales, por médicos especializados. En esta revisión se considera los problemas de salud relacionados en la madre y el hijo.

Obesity would be the most common health problem for women of reproductive age. Pregnancies complicated with obesity are associated with gestational diabetes, preeclampsia, preterm birth, instrumental delivery and cesarean section, infections and postpartum hemorrhage. And the baby is at higher risk of congenital malformations, macrosomia, shoulder dystocia, and fetal death. The implications related to the management of obesity in pregnancy are not well understood due to lack of evidence-based management options. The management of obesity should start before the woman gets pregnant, following the rule that a woman should be in the best physical and mental conditions if she wants to have a baby. The health provider in charge of the prenatal care needs the support of a dietitian or an endocrinologist. Obese women are more likely tohave difficulties during labor and delivery and require both special infrastructure and care by specialized physicians. Future health problems of mother and baby are considered in this review.

Analysis of 51 528 cases of perinatal birth defect monitoring in Hakka,Guangxi Zhuang Autonomous Region / 中国基层医药

Objective To investigate and analyze the monitoring status of birth defects of perinatal infants in Hakka of Guangxi Zhuang Autonomous Region,and to provide evidence for reducing the incidence of birth defects and improving prevention decision for the quality of birth.Methods The data of 51 528 cases of perinatal birth defects monitoring were analyzed in Bobai and Luchuan counties in 2015.Results The distribution of birth defects in the perinatal infants of Hakka was more than 75.14%,28.8% of the birth defects occurred in 28 weeks,51 528 cases of perinatal birth in hospital,birth defects of ≥28 weeks in 384 cases.The incidence rate of birth defects was 28.5%, the rate of birth was 7.45‰.The birth defect of ≥28 weeks was diagnosed,35 cases were fetal edema syndrome, accounted for 9.11%.34 cases were congenital heart disease,accounted for 8.85%,30 cases were cleft lip with cleft palate,accounted for 7.81%.Congenital hydrocephalus in 5 cases,accounted for 1.30%;other in 251 cases,accoun-ted for 65.35%.The diagnosed time distribution of birth defects of ≥28 weeks:prenatal diagnosis accounted for 21.18%,postnatal 7 days accounted for 78.82%.The outcome of ≥28 weeks of perinatal birth defects in Hakka:live birth accounted for 73.18%,fetal death accounted for 20.57%,stillbirth accounted for 1.30%,seven days of death accounted for 4.94%.Conclusion The perinatal birth defects in Hakka is live births to the main,the prevention of perinatal birth defects in children live birth measures should be strengthened,the detection of birth defects should be strengthened and the pregnancy of artificial birth defects should be terminated,so as to improve the quality of the birth population.

Un nuevo instrumento diagnóstico en situaciones perinatales: la entrevista psicológica de diseño óptico / A new diagnostic tool in perinatal situations: optical design of psychologist interview

Se presenta un modelo de entrevista psicológica con diseño óptico para ser aplicado en el posparto inmediato.El equipo esta formado por un grupo de profesionales que realizan el acompañamiento psicológico de la madre y su bebé durante las primeras interacciones, cuando los acontecimientos se desarrollan normalmente, pero también cuando sobreviven incidentes, amenazas de partos prematuros, muerte fetal , nacimiento prematuro y descompensación postnatal.Se elaboró una lista de temas preocupantes que surgen del discurso materno a partir de la aplicación del instrumento.