Effect of the unfavorable maternal-fetal environment cause by mitigation measures of the covid-19 pandemic in the public maternity of reference of Uruguay.

INTRODUCTION: The mitigation measures to face the health emergency due to the COVID 19 pandemic generated a deep economic, social, and psychological crisis at the community level. This effect is greater in the people, who are the most violated in their rights. In relation to the social crisis and gender perspective, women are particularly affected by the pandemic. Given the disadvantaged situation of women socially, economically, and politically, their self-care is diminished. OBJECTIVE: To identify whether there is an association between the classic risk factors for prematurity and fetal growth restriction and the increase in these pathologies in the period March-September 2020, in a maternity hospital that assists women from low resources. MATERIALS AND METHODS: A retrospective study, with a comparative analysis of the periods between 15 March and 30 September 2019 and the same period in 2020. The data were obtained from an electronic clinical database. The prevalence of preterm birth and small-for-gestational age newborn was analyzed. Indicators available in the database that reflect maternal conditions that lead to an unfavorable maternal environment were selected and they were classified into categories. RESULTS: In the period of 2019, 3225 births were registered and in the period of 2020, 3036 births. In the 2019 period, 12.2% of prematurity was evidenced, while in the 2020 period, 14.5% (RR = 1.19, IC 95% = 1.05-1.35, p = .005). In relation to PEG 5.5% in the first period versus 6.9% in the second (RR = 1.26, CI 95% = 1.04-1.53, p = .01). No increases were found in the indicators that are traditionally related to the etiologies proposed to explain the increase in prematurity and small-for-age gestational, there was no evidence of an increase in inflammatory or vascular conditions. CONCLUSION: The economic, psychological and social crises, in the 1st semester of the health emergency, seriously affected the social determinants of the health of pregnant women who use the Public Maternity of reference in Uruguay. This situation is at the base of the poor perinatal results in the period of the maximum mediated mitigation of the pandemic.

Formación de especialistas de medicina familiar y comunitaria en Uruguay / Training of family and community medicine specialists in Uruguay

INTRODUCCIÓN: A instancias de la convocatoria de la Organización Panamericana de la Salud para El diálogo virtual sobre la formación de especialistas en medicina familiar y comunitaria para la Cobertura Universal de la Salud se trabajó en la producción de este video que constituye la primera producción audiovisual en el Uruguay sobre esta temática. OBJETIVOS: Presentar la evolución, situación actual y perspectivas de la formación de especialistas em medicina familiar y comunitaria en el Uruguay. METODOLOGÍA: Se elaboró un guión que recorre la historia de la medicina familiar y comunitaria en El Uruguay en base a documentos e imágenes de archivo e integra entrevistas a actores clave y actuales del proceso. Se editó en formato AVI. RESULTADOS y CONCLUSIONES: El resultado es un corto audiovisual de 20 minutos de duracción que expone cualitativamente las 5 décadas de desarrollo de la medicina familiar y comunitaria en El Uruguay, la estructura actual de la formación académica en el marco de la residencia, El primer nivel de atención y el ámbito comunitario, sus perspectivas de desarrollo y lós desafíos para mejorar la calidad.