Perfil de puérperas submetidas a métodos de reprodução assistida / Profile of postpartum women submitted to assisted reproduction methods / Perfil de puérperas sometidas a métodos de reproducción asistida

Estudo cujo objetivo foi discutir o perfil de mulheres submetidas a métodos de reprodução assistida em hospital privado do Município de São Paulo, em 2009. Pesquisa quantitativa, descritiva, exploratória, transversal, de nível I. A amostra constituiu-se de 38 puérperas no segundo dia de internação, submetidas a método de reprodução assistida. Para a coleta de dados utilizou-se a entrevista estruturada baseada em formulário específico. As mulheres tinham entre 30 e 39 anos (77%), eram casadas (89%) e 68% eram profissionais da área das ciências humanas. Os métodos mais utilizados foram indução da ovulação (47%) e fecundação in vitro clássica (39%). Engravidaram na primeira tentativa 63% e o tempo entre as tentativas de fertilização e o sucesso variou de um mês e meio a dois anos. O grupo estudado corresponde a uma nova geração de mulheres que, independente da idade e da técnica utilizada, tiveram possibilidade de escolher e planejar uma gestação.

The study discussed the profile of women submitted to assisted reproduction methods in a private hospital in São Paulo, Brazil, in 2009. It was a Level I, exploratory, descriptive, quantitative, cross-sectional study. The sample was 38 mothers on the second day of hospitalization who had undergone assisted reproduction. Data collection was performed by structured interview based on a specific script. The women were from 30 to 39 years old (77%), married (89%), and professionals in the human sciences (68%). The methods used were ovulation induction (47%) and classical in vitro fertilization (39%); 63% becoming pregnant on the first try, and the interval between attempted and successful fertilization ranging from a month and a half to two years. The group studied represents a new generation of women who, regardless of age and the technique used, had the opportunity to choose and plan a pregnancy.

Estudio cuyo objetivo fue discutir el perfil de mujeres sometidas a métodos de reproducción asistida en hospital privado de São Paulo-Brasil, en 2009. Se trata de investigación cuantitativa, descriptiva, exploratoria, de corte transversal, de nivel I. La muestra estuvo conformada por 38 madres en el segundo día de hospitalización, sometidas a método de reproducción asistida. Para recopilar los datos se utilizó la entrevista estructurada basada en formulario específico. Las mujeres tenían edades entre 30 y 39 años (77%), eran casadas (89%) y 68% eran profesionales de las ciencias humanas. Los métodos utilizados fueron: inducción de la ovulación (47%) y la clásica fertilización in vitro (39%). 63% quedaran embarazadas en el primer intento y el tiempo entre los intentos y el éxito de la fertilización varió de un mes a dos años y medio. El grupo representa una nueva generación de mujeres que, independientemente de la técnica utilizada, pudieron escoger y planear un embarazo.

Indagación desde los conocimientos, actitudes y prácticas en salud reproductiva femenina: algunos aportes desde la investigación / Inquiry based on knowledge, attitudes & practices in women's reproductive health: some insights from research

La morbilidad materna es una de las primeras causas de alteración del bienestar de la mujer en el mundo en vías de desarrollo, por lo cual la salud reproductiva de la mujer sigue siendo una prioridad investigativa en la mayoría de estas sociedades. Sin embargo, es notable la hegemonía de la investigación clínica biomédica en esta área que ha dejado ver la ausencia y la necesidad de estudios que den cuenta del fenómeno desde una perspectiva integral. Los estudios de "conocimientos, actitudes y prácticas" (CAP) son una alternativa conceptual para acercase a la complejidad del fenómeno en el área de la salud reproductiva. La propuesta de los estudios tipo CAP plantea un acercamiento integral para entender los comportamientos con respecto a la salud de las personas a través de sus tres elementos; y sus resultados han sido base fundamental de los diagnósticos para la creación, ejecución y evaluación de programas sanitarios. Por lo anterior, este artículo se propone mostrar y discutir algunas evidencias relacionadas con la utilidad de este tipo de trabajos en el área de la salud reproductiva de las mujeres (AU)

Maternal morbidity is one of the first causes of women`s welfare alteration in the less-developed countries; therefore, their reproductive health has been a research priority in most of these societies. However, the dominance of the clinical/biomedical research on this topic has been notable, and shown the gap and need for studies reporting this phenomenon from an integral perspective. The Knowledge, Attitude and Practices (KAP) studies are an alternative design to approaching this complex situation. The KAP proposal offers a comprehensive approach to understanding the behaviors related to people`s health through its three main components, and its results have been cornerstone for the situation diagnoses, leading to the creation, execution and evaluation of sanitary programs. Hence, the objective of this paper is to show and to discuss some evidences related to the utility of this approach in women`s reproductive health (AU)

Influencia de la obesidad en la salud sexual y reproductiva / Influence of obesity in sexual and reproductive health

Introducción. La epidemia mundial del sobrepeso y la obesidad se está convirtiendo, dado su crecimiento, en un importante problema de salud pública en muchas partes del mundo; afecta aproximadamente a la mitad de la población y por lo tanto resulta un problema común entre la franja de edad fértil. Exposición. La obesidad y el sobrepeso son condiciones comunes que tienen consecuencias no sólo en la salud en general, sino también en gran medida sobre la salud reproductiva. Existe una alta prevalencia de mujeres obesas en la población estéril y numerosos estudios han puesto de relieve el vínculo entre la obesidad y la infertilidad. También aumenta los riesgos de atención obstétrica y complicaciones neonatales, disminuye la fecundidad, incluso en mujeres que ovulan, y está asociada a trastornos menstruales y mayor riesgo de abortos espontáneos de repetición. Conclusiones. Cambios en el estilo de vida, la realización de una dieta y un programa de ejercicio, constituyen la primera línea de tratamiento para la obesidad(AU)

Introduction. The global epidemic of overweight and obesity is becoming, as its growth into a major public health problem in many parts of the world affects about half the general population and is therefore a problem common among fertile. Exposure. Obesity and overweight are common conditions that have implications not only for overall health, but also largely on reproductive health. A high prevalence of obese women in the sterile population and numerous studies have highlighted the link between obesity and infertility. Obesity increases the risks of obstetric and neonatal complications, including decreased fertility in women who ovulate and is also associated with menstrual disorders and increased risk of recurrent spontaneous abortions. Conclusions. Changes in lifestyle, the realization of a diet and exercise program, are the first line of treatment for obesity(AU)

Hard to conceive. Interview by Mary-Claire Mason.

For fertility nurses, helping couples is a rewarding and sometimes emotionally taxing job.

Conscientious objection and the nurse: a right or a privilege?

This article examines to what extent nurses can at present opt out of clinical procedures on the basis of conscience in English law. It considers the current rights to opt out on the basis of conscience contained in section 4 of the Abortion Act 1967 and section 38 of the Human Fertilisation and Embryology Act 1990. It examines how through codes of practice and guidance, there is recognition of the ability to opt out beyond theses statutes. It suggests that rather than let practice evolve to enable persons to opt out, the fundamental issues as to whether it should be a right or a privilege needs careful consideration across healthcare professions as a whole and a broader public debate.

Culture, conceptive technology, and nursing.

Technology is a form of cultural expression, formed of and forming culture. A paradox about technological innovation is that, in addition to creating new human arrangements and possibilities, it often serves only to reinforce existing sociocultural practices, norms, and values. The technologically radical is often the culturally conservative. Conceptive technology has contributed toward the redefinition of patienthood, the multiplication of models of infertility, and the reinforcement of existing cultural norms. Nurses are well-positioned to conduct a kind of technology assessment that places culture and ethics at the center of inquiry. They are also well-positioned to assist women and their partners seeking technological assistance to reproduce to understand the controversies concerning conceptive technology that may account for their own ambivalence toward continuing or terminating medical treatment, societal ambivalence toward supporting expensive fertility treatments, and cultural ambivalence toward technological development.

Informed consent issues in assisted reproduction.

Given the enormous ethicolegal controversies surrounding the use of assisted reproductive technologies (ART) in the United States, the most important role for nurses may be helping couples and third party participants obtain fully informed consent. The high compensation fees for egg donors may place them at special risk of exploitation. New government and professional guidelines, broader representation on ethics committees, and expanded counseling about risks and benefits can help reduce the potential for litigation and enhance patient autonomy.

Comfort care interventions in a preimplantation genetic testing program.

The fields of human genetics and assisted reproductive technology (ART) have experienced many scientific advances over the past 50 years. The integration of these two clinical specialties has resulted in the ability to perform preimplantation genetic testing (PGT) on an embryo created through ART. This is a technology that can be used by individuals at risk for the transmission of a genetic disorder to prevent occurrence of the disorder in their child. Both the process of PGT and the life experiences that lead to the decision to use PGT stimulate many levels and types of discomfort. Holistic comfort care interventions performed by the nurse are uniquely designed to eliminate or reduce discomfort and to enable those at risk to utilize the available technologies to create healthy families.

The nurse's role in treating fertility problems.

This article is the fifth part of our series on aspects of fertility. The role of nursing in this specialty is described alongside the training and education needed to develop this role.

The perioperative nurse's role in assisted-fertility procedures.

Infertility is the inability to achieve pregnancy within a stipulated period of time (ie, one year) or the repeated failure to carry a pregnancy to term. Advances in assistive reproductive technology have enabled many couples to overcome infertility, but health care providers need to remember that these couples require much support. This article addresses the perioperative nurse's responsibilities during assisted-fertility procedures that are performed in the OR (eg, transvaginal oocyte retrieval, gamete intrafallopian transfer, zygote intrafallopian transfer.