Cambios de adiposidad corporal entre la captación del embarazo y el posparto a corto plazo / Changes in Body Adiposity between the First Antenatal Visit and the Short-Term Postpartum

Introducción: Las acumulaciones excesivas de tejido adiposo, general o regional, constituyen hallazgos de valor clínico en el seguimiento nutricional y cardiometabólico durante la gestación y en el período posparto. Objetivo: Describir los cambios en la adiposidad corporal trascurridos 18 meses después del parto. Método: Se realizó un estudio observacional descriptivo de la adiposidad corporal, entre enero 2017 y agosto 2018, en 119 mujeres en el posparto a corto plazo, cuya adiposidad corporal se había estudiado al momento de la captación en el policlínico Chiqui Gómez Lubián. Resultados: En el posparto con respecto al momento de la captación, se observó una disminución de las mujeres sin adiposidad general de 28,6 por ciento a 21,8 por ciento y de las mujeres con adiposidad general intermedia de 62,2 por ciento a 53,8 por ciento; con un aumento marcado de aquellas con adiposidad general alta de 9,2 por ciento a 24,4 por cdiento. Aumentó la cantidad de mujeres con adiposidad central alta de 35,3 por ciento a 43,7 por ciento y disminuyeron las mujeres sin adiposidad central de 64,7 por ciento a 56,3 por ciento. Conclusiones: Evaluar los cambios de la adiposidad corporal por técnicas antropométricas sencillas y de fácil acceso, durante el embarazo y en el posparto a corto plazo, puede ofrecer información de utilidad para una mejor orientación del seguimiento de la salud cardiometabólica de la mujer(AU)

Introduction: Excessive accumulations of adipose tissue, whether general or regional, are findings of clinical value in nutritional and cardiometabolic follow-up during pregnancy and in the postpartum period. Objective: To describe the changes in body adiposity at eighteenth months after delivery. Methods: A descriptive and observational study of body adiposity was carried from January 2017 to August 2018 in 119 women in the short-term postpartum period, whose body adiposity had been studied during the first antenatal visit at Chiqui Gómez Lubián Polyclinic. Results: In the postpartum period, with respect to the first antenatal visit, a decrease was observed in the number of women without general adiposity (from 28.6 percent to 21.8 percent) and of women with intermediate general adiposity (from 62.2 percent to 53.8 percent), with a marked increase in the number of women with high general adiposity (from 9.2 percent to 24.4 percent). The number of women with high central adiposity increased (from 35.3 percent to 43.7 percent), while the number of women without central adiposity decreased (from 64.7 percent to 56.3 percent). Conclusions: To evaluate the changes in body adiposity by simple and easily accessible anthropometric techniques, during pregnancy and in the short-term postpartum period, may provide useful information for designing better the follow-up of cardiometabolic health of women(AU)

Proceso de enfermería a embarazada con infección de vías urinarias y amenaza de aborto / A Nursing Process for a Pregnant Woman with Urinary Tract Infection and Threatened Miscarriage

Introducción: La infección de vías urinarias es recurrente en el embarazo y generadora de complicaciones. Objetivo: Presentar un plan de cuidados enfermero a una mujer con diagnóstico infección de vías urinarias y amenaza de aborto Métodos: Caso clínico de paciente admitida en unidad de Ginecología y Obstetricia del Hospital General de Teziutlán, Puebla, México, durante 2019. Siguiendo la lógica del proceso de enfermería, la valoración se fundamentó en los patrones funcionales de salud de Marjory Gordon. Fueron utilizadas las terminologías normalizadas de enfermería: Diagnósticos (NANDA.int). Resultados (NOC) e Intervenciones (NIC). Resultados: Se identificaron cuatro diagnósticos de enfermería: deterioro de la eliminación urinaria, gestión ineficaz de la propia salud, disposición para mejorar la nutrición y riesgo de alteración de la díada materno/fetal, este último diagnóstico principal. Además, un Resultado NOC (Conocimiento: Control de Infección), cuatro indicadores y la escala de nunca a siempre demostrado; cuatro Intervenciones NIC, con 19 actividades. La evaluación transitó desde 12 (puntuación inicial) a 19 (puntuación final), de 20 como puntuación diana. Conclusión: La integración de las taxonomías NANDA, NIC, NOC y los patrones funcionales de salud de Marjory Gordon permitió diseñar el plan de cuidado de la embarazada, fueron articulados diagnósticos, resultados e intervenciones de enfermería que favorecieron la relación enfermera-paciente-contexto sociocultural, para llevar el cuidado hasta una concepción sistémica que permita el seguimiento y control de la embarazada(AU)

Introduction: Urinary tract infection is recurrent in pregnancy and causes complications. Objective: To present a nursing care plan provided to a woman with a diagnosis of urinary tract infection and threatened miscarriage. Methods: Clinical case of a patient admitted to the gynecology and obstetrics unit of General Hospital of Teziutlán (Puebla, Mexico) during 2019. Following the logic of the nursing process, the assessment was based on Marjory Gordon's functional health patterns. The standard nursing terminologies were used: diagnostics (NANDA-I), outcomes (NOC) and interventions (NIC). Results: Four nursing diagnoses were identified: deterioration of urinary elimination, ineffective self-health management, willingness to improve nutrition, and risk for alterations in maternal-fetal dyad, the latter being the main diagnosis. In addition, a NOC outcome (knowledge: infection control), four indicators and the never-to-always scale upon demonstration, as well as four NIC interventions, with nineteen activities, were obtained. Evaluation ranged from twelve (initial score) to nineteen (final score), with twenty as target score. Conclusion: The integration of the NANDA, NIC and NOC taxonomies together with the Marjory Gordon's functional health patterns allowed the design of the pregnant woman's care plan, with an articulation between nursing diagnoses, outcomes and interventions, which favored the nurse-patient-sociocultural context relationship, up to considering care based on a systemic conception that allows monitoring and control of the pregnant woman(AU)

Diagnóstico de leucemia mieloide aguda durante el embarazo. Reporte de caso / Acute myeloid leukemia diagnosed during pregnancy. Case report

Resumen ANTECEDENTES: La leucemia mieloide aguda es el cuarto cáncer diagnosticado con más frecuencia durante el embarazo. En la actualidad, su tratamiento en las distintas etapas del embarazo sigue suponiendo un desafío diagnóstico y terapéutico para los obstetras, oncólogos y hematólogos. OBJETIVO: Reportar el caso clínico de una paciente embarazada a quien se diagnosticó leucemia mieloide aguda en el primer trimestre, el seguimiento efectuado y el tratamiento propuesto. Además, se revisa la bibliografía existente en relación con este cáncer. CASO CLÍNICO: Paciente de 33 años, embarazada, con 12 + 5 semanas de amenorrea. Se envió al servicio de Hematología debido al hallazgo de pancitopenia en los estudios de laboratorio del primer trimestre. Enseguida de completar el estudio y tomar una biopsia de médula ósea, se estableció el diagnóstico de leucemia mieloblástica aguda NMP1 y FLT-3 negativos, con 20% de blastos. El embarazo finalizó sin contratiempos a las 15 semanas, mediante interrupción voluntaria, luego de recibir información del diagnóstico, pronóstico y riesgo de teratogenia del tratamiento. En la actualidad, la paciente permanece en lista de espera para trasplante de médula ósea histocompatible. CONCLUSIONES: La correcta atención al control de los análisis de laboratorio, propios del embarazo, puede permitir un diagnóstico temprano que permita iniciar un tratamiento inmediato, decisivo para el pronóstico. Todo esto, además de la atención y asesoramiento multidisciplinario, resulta esencial para asegurar el bienestar de la madre y del feto.

Abstract BACKGROUND: Acute myeloid leukemia is the fourth most frequently cancer in association with pregnancy. Nowadays, clinical management of AML occurring during pregnancy is a diagnostic and therapeutic challenging. OBJECTIVE: To report the unpublished case of pregnant diagnosed with acute myeloid leukemia in the first trimester of pregnancy, as well as the follow-up carried out and the proposed treatment. We also review the existing literature in relation to this entity. CLINICAL CASE: 33-year-old patient, at 12+5 weeks of pregnancy. She was admitted to the hematology service due to the discovery of pancytopenia in the laboratory tests performed in the first trimester. After completing the study and performing a bone marrow biopsy, the patient was diagnosed with NMP1 and FLT-3 Negative acute myeloblastic leukemia, with 20% blasts. The pregnancy ended without incident at 15 weeks, by means of a voluntary interruption of the pregnancy, after receiving information on the diagnosis, prognosis and risk of teratogenicity from the treatment. Currently, the patient is on the waiting list for histocompatibility bone marrow transplant. CONCLUSIONS: The importance of analytical control during pregnancy can allow an early diagnosis, to establish an immediate treatment, key for the prognosis. All this, in addition to the multidisciplinary approach and advice, is essential to ensure maternal and fetal well-being.

Identify Prognostic Risk Factor of Breast Cancer in North West of Iran

@#Introduction: Breast cancer is the most common cancer and it is the second leading cause of cancer mortality for women after lung cancer in Iran. Given the high prevalence of breast cancer, it is of crucial importance to determine reproductive risk factors of breast cancer. Methods: A total of 139 female patients suffering from breast cancer (the case group) and 279 healthy females (the control group) who were age-matched participated in the study over the period from March 2018 to March 2019. Demographic and reproductive variables, including the number of pregnancies, breastfeeding, history of oral contraceptive use, abortion history, age at first menstruation and age at first childbirth, were all recorded via survey. Conditional Logistic regression was employed to calculate OR (CI: 95%). Results: The mean age of breast cancer patients was 50.8 ± 8.31. First degree family history of breast cancer, History of oral contraceptive use and delaying first pregnancy drastically increased the chance of breast cancer whereas breastfeeding and menstruation after the age of 14 reduced the chance of breast cancer. Conclusion: The findings of this study reveal that the age at first birth, use of oral contraceptives, first degree family history of breast cancer and lack of breastfeeding have a significant relationship with breast cancer. Thus, women who have experienced such factors are susceptible to breast cancer and need to be prioritized for preventive treatments and screening.

Analysis of oral health care behavior and associated factors among women in the 1st trimester / 中华健康管理学杂志

Objective@#To explore oral health care behavior and related factors among women in their 1st trimester.@*Methods@#Our analysis included 7 014 women in their 1st trimester aged 16 years or above from the baseline survey of the Chinese Pregnant Women Cohort Study (CPWCS). Data on socio-demographic characteristics and oral health care behavior were collected using an electronic questionnaire. Multiple-factors Logistic regression was used to analyze factors associated with oral health care behavior.@*Results@#The results revealed that 5 134 (73.20%), 2 482 (35.39%), and 1 046 (14.91%) pregnant women brushed their teeth twice a day or more, never had an oral examination, and used special oral care products for pregnant women, respectively. The frequency of brushing teeth and oral examination was positively associated with age and annual household income. Compared to unemployed pregnant women with rural registered residences and low education levels, highly educated and employed pregnant women with city registered residences had a higher frequency of brushing teeth and undergoing oral examination. Pregnant women with depressive symptoms had a lower frequency of brushing teeth (OR=0.73, 95% CI: 0.65-0.81), while those with medical insurance underwent more frequent oral examination (OR=1.19, 95% CI: 1.02-1.39). Compared to pregnant women who were unaware of the risk of gingivitis, those who believed gingivitis to be harmful to both themselves and their fetus had a higher frequency of brushing teeth and oral examination and were more likely to use special oral care products.@*Conclusion@#Most pregnant women did not pay attention to the need for oral examinations and special oral care products. Their oral health behavior was associated with socioeconomic status, depressive symptoms, and awareness of the importance of oral health. Therefore, oral health care before and during pregnancy was required to help them improve their self-care behavior.

O papel do exame ultrassonográfico na representação do bebê imaginário em primigestas / The role of ultrasound examination in the representation of the imaginary baby in first time mothers / El papel del examen ultrasonográfico en la representación del bebé en primerizas / Le rôle de l'examen ultrasonographique dans la représentation du bébé imaginaire en primigestes

Este estudo objetivou analisar a influência do exame ultrassonográfico na representação psí-quica do bebê imaginado em mulheres que engravidaram pela primeira vez. O mundo repre-sentacional desempenha um importante papel na determinação da natureza do relacionamento dos pais com o bebê. Para este autor convém pensar em dois mundos paralelos: o mundo externo real e o mundo das representações, imaginário e subjetivo, onde existem o bebê real no ventre ou nos braços da mãe e o bebê imaginado em sua mente. O confronto do bebê imaginário com o bebê real, via de regra, acontece após o nascimento, porém atualmente com o advento da ultrassonografia obstétrica, alguns aspectos concretos do bebê podem ser reconhecidos durante a gestação. Os dados apresentados neste estudo de cunho qualitativo consistem no relato de três primigestas que não haviam se submetido à ultrassonografia antes do contato para a participação nesta pesquisa....

The aim of this is study is to analyze the influence of ultrasound test in the mental representation of the imagined baby in women who became pregnant for the first time. The representational world plays an important role in determining the nature of the parents' relationship with the baby. For the author is important to think of two parallel worlds: the external real world and the representational subjective world of ideas and imagery, where there is the real baby in the womb or in the mother's arms and the baby pictured in her mind. The comparison of the imaginary baby with the real baby, usually happens after birth, but now with the advent of obstetric ultrasound, some specific aspects of the baby may be recognized during pregnancy...

Este estudio tiene como objetivo analizar la influencia del examen ultrasonográfico en la repre-sentación psíquica del bebé imaginado para casos de madres primerizas. El mundo represen-tacional desempeña un importante papel en la determinación de la naturaleza de la relación de los padres con el bebé. Para este autor, conviene pensar en dos mundos paralelos: el mundo externo real y el mundo de las representaciones, imaginario y subjetivo, en los que existen el bebé real en el vientre o los brazos de la madre, y el bebé imaginado en su mente. La confron-tación del bebé imaginario con el real ocurre generalmente después de su nacimiento, pero actualmente con el avance de la ultrasonografía obstrética, algunos aspectos concretos del bebé se pueden reconocer durante la gestación...

Cette étude a pour but analyser l'influence de l'échographie dans la représentation psychique du bébé imaginé par les femmes qui tombent enceintes pour la première fois. La représentation du monde joue un rôle important dans la détermination de la nature de la relation des parents avec le bébé. Pour cet auteur il existe deux mondes parallèles : le monde extérieur et le monde réel des instances, imaginaire est subjective, où il y a le vrai bébé dans l'utérus ou dans les bras de la mère et le bébé imaginé dans son esprit. La confrontation des bébés imaginaires avec le bébé réel, se fait toute fois après la naissance, mais aujourd'hui, avec l'avènement de l'échographie obstétricale, certains aspects spécifiques de l'enfant peuvent être reconnu au cours de la grossesse. Les données présentées dans cette étude sont de nature qualitative se composent des rapports des trois primigestes qui n'ont pas participé à l'examen ultrasonographique avant le contacte pour la participation à la recherche...