Preparação para o parto: as capacidades como superpoder que a mulher leva para o seu trabalho de parto / Preparation for childbirth: The capacities as a superpower that a woman brings to her labor

O presente documento trata-se de um relatório de estágio de natureza profissional desenvolvido no âmbito do Mestrado em Enfermagem de Saúde Materna e Obstétrica, no período compreendido entre 17 de novembro de 2020 e 30 de junho de 2021, num hospital do grande Porto. Este reflete a aquisição e o desenvolvimento de competências enquanto Enfermeira Especialista em Enfermagem de Saúde Materna e Obstétrica e consiste na minha reflexão relativamente às experiências vividas nos diferentes âmbitos de atuação: gravidez, trabalho de parto, parto e puerpério. Este processo de desenvolvimento de competências tem por base o Regulamento de Competências Específicas do Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica definidos pela Ordem dos Enfermeiros. Um dos objetivos do presente relatório prendeu-se na realização de uma Revisão Integrativa da Literatura, sendo que me suscitou interesse a procura de evidência científica relativamente às possíveis capacidades que a mulher poderia adquirir na preparação para o parto e que seriam facilitadoras, como um superpoder, do processo de trabalho de parto, ou seja, de que forma é que o Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica poderia contribuir, ainda durante a gravidez, para o empoderamento da mulher enquanto parturiente. Através da pesquisa de evidência sobre o tema concluí que o superpoder que a mulher pode levar para o seu trabalho de parto é a perceção da autoeficácia. Existem fatores, internos e externos à grávida, que predizem maiores níveis de perceção da autoeficácia, nesse sentido, e uma vez que maiores níveis de autoeficácia se traduzem numa maior satisfação durante o trabalho de parto e parto, compete ao(à) EEESMO trabalhar com a grávida a sua perceção de autoeficácia durante a gravidez, empoderando-a. Esta pesquisa permitiu-me também perceber que não existe ainda muita evidência sobre o tema, principalmente em Portugal, e seria interessante investir-se na realização de mais estudos.

This document is a professional internship report developed within the scope of the Master's Degree in Maternal and Obstetric Health Nursing, between November 17, 2020 and June 30, 2021, at an hospital in Porto. It reflects the acquisition and development of skills as a Midwife and consists on my reflection on the experiences lived in the different areas of action: pregnancy, labor, childbirth and puerperium. This process of skills development is based on the Regulation of Specific Skills for Specialist Nurses in Maternal and Obstetric Health Nursing defined by the Ordem dos Enfermeiros. One of the objectives of this report was to carry out an Integrative Literature Review, and I was interested in the search for scientific evidence regarding the possible skills that women could acquire in preparation for childbirth and that would be facilitators, like a superpower, of the labor process, that is, how Midwives could contribute, even during pregnancy, to the empowerment of women as parturients. Through researching evidence on the subject, I concluded that the superpower that a woman can bring to her labor is the perception of self-efficacy. There are factors, internal and external to women, that predict higher levels of perception of self-efficacy, in that regard, and since higher levels of self-efficacy translate into greater satisfaction during labor and delivery, it is up to the Midwives to work with women their perception of self-efficacy during pregnancy, empowering them. This research also allowed me to realize that there is still not much evidence on the subject, especially in Portugal, and it would be interesting to invest in further studies.

Proximal-type epithelioid sarcoma-unusual presentation: unilateral vulvar mass.

Epithelioid sarcoma of the vulva is a very rare malignant soft tissue tumour, usually initially asymptomatic, which simulates a variety of benign lesions, leading to diagnosis only at later stages. Prognosis is generally poor. We report a case of a 55-year-old postmenopausal woman, who presented with rapid growth of an asymptomatic mass located in the left labia majora. Biopsy of the lesion revealed features characteristic of proximal-type epithelioid sarcoma. Ganglionar, adrenal, pulmonary and hepatic metastases were found at thoracoabdominopelvic CT scan. During hospitalisation, the patient's clinical condition suffered rapid deterioration and she died on the 16th day of admission.

Pregnancy after uterine artery embolization: a case report in a woman with leiomyomata.

Background. Several pregnancies have been reported after embolization of uterine artery. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids but its safety in women desiring future childbearing is not well established. Case Report. We present a 40-year-old woman with leiomyomata who became pregnant after previously undergone uterine artery embolization for three times. The placenta was previa and the fetus was in transverse position. She had a cesarean delivery of an appropriately grown fetus at 37 weeks, which was followed by uterine atony requiring hysterectomy. Conclusion. Although pregnancy-related outcomes remain understudied, the available reports evidence that pregnancies after uterine artery embolization may be at significantly increased risk for postpartum hemorrhage, cesarean delivery, abnormal placentation, and malpresentation. In patients who are undergoing this type of treatment and contemplating pregnancy, the possibility of adverse complications should be taken in consideration and women should be appropriately advised.