RESUMO
Introducción: La sociedad cubana actual requiere de un profesional de enfermería mejor preparado, desde el punto de vista técnico y humano, para desarrollar con éxito su labor de acuerdo con las exigencias del desarrollo científico tecnológico y las demandas sociales. Objetivo: Exponer el proceso de superación profesional de enfermería para la solución de los problemas profesionales en su desempeño en cuidados intensivos obstétricos. Métodos: El estudio histórico-lógico posibilitó determinar las diferentes etapas histórico-contextuales del proceso de superación de los profesionales de enfermería desde la educación de posgrado, así como el análisis documental y la sistematización realizada a investigaciones nacionales e internacionales. Conclusiones: La superación profesional de enfermería debe corresponderse con el contexto real en que se presentan los problemas profesionales para darles solución; así como promover el desarrollo de nuevos conocimientos y habilidades con pertinencia social, científica y humanística, que posibiliten el fortalecimiento de la práctica del cuidado y eleven la calidad del desempeño(AU)
Introduction: The present Cuban society requires better prepared nursing professionals, from the technical and human point of view, who can develop their work successfully in accordance with the demands of scientific-technological development and the society. Objective: To present the process of nursing professional improvement for the solution of professional problems as part of nurses' performance in obstetric intensive care. Methods: The historical-logical study permitted to determine the different historical-contextual stages of the process of nursing professional improvement from postgraduate education, as well as the documental analysis and the systematization of national and international research. Conclusions: Nursing professional improvement should correspond to the real context where professional problems appear, in order to solve them; as well as to promote the development of new knowledge and skills with social, scientific and humanistic relevance, ensuring the care practice be strengthened and quality of performance be raised(AU)
Assuntos
Humanos , Educação de Pós-Graduação em Enfermagem/história , Capacitação Profissional , Assistência ao Paciente , Enfermagem Obstétrica/educação , Cuidados CríticosRESUMO
Background: The objective of present study was to assess the proportion of maternal near miss and maternal death and the causes involved among patients attending obstetrics and gynaecology department of Agartala Govt. Medical College of North Eastern India.Methods: Potentially life-threatening conditions were diagnosed, and those cases which met WHO 2009 criteria for near miss were selected. Maternal mortality during the same period was also analyzed. Patient characteristics including age, parity, gestational age at admission, booked, mode of delivery, ICU admission, duration of ICU stay, total hospital stay and surgical intervention to save the life of mother were considered. Patients were categorized by final diagnosis with respect to hemorrhage, hypertension, sepsis, dystocia (direct causes) anemia, thrombocytopenia, and other medical disorders were considered as indirect causes contributing to maternal near miss and deaths.Results: The total number of live births during the study period (January 2017 to June, 2018) was 9378 and total maternal deaths were 37 with a maternal mortality ratio of 394.5/1 lakh live births. Total near miss cases were 96 with a maternal near miss ratio of 10.24/1000 live births. Maternal near miss to mortality ratio was 2.6. Of the 96 maternal near miss cases - importantly 20.8% were due to haemorrhage, 19.8% were due to hypertension, 13.5% were due to sepsis, and 11.5% were due to ruptured uterus. In maternal death group (n-37), most important causes were hypertensive (40.5%) followed by septicemia (21.6%), haemorrhage (10.8).Conclusions: Haemorrhage, hypertensive disorders and sepsis were the leading causes of near miss events as well as maternal deaths.
RESUMO
Resumen OBJETIVO: Determinar la correlación entre las concentraciones de ácido úrico y creatinina en pacientes con preeclampsia severa para conocer su utilidad clínica. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y analítico al que se incluyeron pacientes con preeclampsia severa. A la admisión al estudio se registraron las concentraciones sanguíneas de ácido úrico y creatinina para calcular la correlación de las medias generales y por categorías. Se utilizó estadística descriptiva, prueba t de Student, IC95% y coeficiente de correlación de Pearson con el programa estadístico SPSS versión 20. RESULTADOS: Se estudiaron 100 pacientes con preeclampsia severa. La media ge-neral de ácido úrico fue de 5.52 ± 1.43 mg/dL; 85% tuvieron hiperuricemia y 17% hiperuricemia extrema. La media general de creatinina fue de 0.77 ± 0.25 mg/dL; 18% resultaron con hiperazoemia y 14% con hiperazoemia extrema. CONCLUSIONES: El ácido úrico y la creatinina tuvieron correlaciones positivas: a mayor hiperuricemia mayor deterioro de la función renal. Ambos pueden ser marcadores complementarios útiles para identificar la lesión renal aguda en la preeclampsia severa.
Abstract OBJECTIVE: To determine the correlation of uric acid and creatinine in pregnant patients with severe preeclampsia to identify its clinical utility. MATERIAL AND METHOD: cross- sectional study that included 100 pregnant patients with severe preeclampsia. Blood levels of uric acid and creatinine were recorded upon admission to calculate the correlation of the general means and by categories. (Normal uric acid ≤ 4 mg/dL, hyperuricemia > 4 mg/dL and extreme hyperuricemia ≥7 mg/dL vs normal creatinine ≤ 0.9 mg/dL, hyperazotemia > 0.9 mg/dL and extreme hiperazoemia ≥ 1.1 mg/dL). Descriptive statistics, Student's T- test, Confidence inter-vals (CI) and Pearson's correlation coefficient were used with the statistical program SPSS version 20. RESULTS: 100 patients with severe preeclampsia were studied. The general average of uric acid was 5.52 ± 1.43 mg / dL; 85% had hyperuricemia and 17% extreme hy-peruricemia. The general average of creatinine was 0.77 ± 0.25 mg / dL; 18% resulted with hyperazotemia and 14% with extreme azotemia. CONCLUSIONS: Uric acid and creatinine showed positive correlations. It was found that the greater the degree of hyperuricemia, the greater the deterioration of renal function. Both markers can be complemented to identify acute kidney injury in severe preeclampsia.