RESUMO
Introduction: In the last decade, Venezuela has experienced a complex humanitarian crisis that has limited access to healthcare. We set out to describe Venezuelan women's experiences accessing sexual and reproductive health services, including abortion, which is heavily restricted by law. Methods: We fielded an online survey in July of 2020 among Venezuelan women recruited through social media advertisements. We conducted descriptive statistical analyses using Excel and STATA SE Version 16.0. Results: We received 851 completed survey responses. Almost all respondents experienced significant hardship in the last year, including inflation (99%), worries about personal safety (86%), power outages (76%), and lack of access to clean water (74%) and medications (74%). Two thirds of respondents used contraception in the last two years, and almost half (44%) of respondents had difficulty accessing contraception during that same time period. About one fifth of respondents reported having had an abortion; of these, 63% used abortion pills, and 72% reported difficulties in the process. Half of those who had an abortion did it on their own, while the other half sought help - either from family members or friends (34%), from providers in the private health sector (14%), or from the Internet (12%). Conclusions: Venezuelan women who responded to our survey describe a harsh context with limited access to sexual and reproductive health services. However, they report relatively high rates of contraceptive use, and abortion seems to be common despite the restrictive legal setting.
RESUMO
The presence of echogenic amniotic fluid on sonography is uncommon and its clinical significance is not well appreciated. Very echogenic amniotic fluid has been attributed to meconium, blood, or vernix caseosa. Two cases of patients with echogenic amniotic fluid at term are presented here. In the first case, the patient's management was altered as the finding of echogenic amniotic fluid was interpreted to be thick meconium. The second case was induced for post-datism and the amniotic fluid was found clear during labour. Since the first reported cases of meconium with echogenic amniotic fluid on sonography by Benacerraf et al. (1984), larger studies have consistently shown that echogenicity is not predictive of meconium. As with our cases, meconium was suspected in both patients with dense echogenic amniotic fluid. Labor was induced in the first case to avoid fetal distress and asphyxia with increasing gestation. Meconium was not present in either of our cases and both the babies were healthy.
