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La ruptura prematura de membranas se define como la pérdida de la integridad de las membranas corioamnióticas que se producen desde las 20 semanas de gestación hasta antes del inicio del trabajo de parto, se produce en el 10 % de las gestaciones y se asocia a la morbi-mortalidad materna neonatal. Se requiere que los profesionales de enfermería implementen cuidados individualizados e integrales para cubrir las necesidades reales y potenciales. El proceso de atención de enfermería sirve como instrumento para dar un abordaje biopsicosocial mediante la aplicación del método científico. El objetivo de este estudio de caso fue elaborar el proceso de atención de enfermería mediante la valoración en base a los dominios NANDA y el uso de las taxonomías estandarizadas NANDA-NIC-NOC, para que sirva como base de construcción de guías y protocolos de atención a usuarias gestantes con esta patología. Los diagnósticos enfermeros planteados son: privación del sueño, conocimientos deficientes, riesgo de alteración de la diada materno-fetal, ansiedad, riesgo de infección y dolor de parto. A su vez las intervenciones son: mejorar el sueño, preparación al parto, monitorización de los signos vitales, monitorización fetal, disminución de la ansiedad, protección contra las infecciones, administración de medicación y manejo del dolor.

Objetivo: comprobar la tasa de evaluación correcta mediante la comparación visual directa de las medidas de dilatación cervical en modelos de cuello uterino de consistencia dura. Método: estudio aleatorizado abierto con 63 estudiantes de obstetricia a los que se les asignó usar o no la comparación visual directa con una guía de dilatación. Los estudiantes estimaron de forma ciega la dilatación cervical en simuladores con diferentes dilataciones. El resultado primario fue la tasa de evaluación correcta. Resultados: los estudiantes realizaron 441 pruebas. Se observó una mayor tasa de evaluación correcta en el grupo experimental que en el grupo control (47,3% versus 27,2%; p < 0,001; Odds Ratio = 2,41; intervalo de confianza del 95% = 1,62-3, 58). Conclusión: la comparación visual directa aumentó la precisión de la evaluación de la dilatación cervical en modelos de simulación de cuello, lo que podría ser beneficioso en el entrenamiento de laboratorio. Registro Brasileño de Ensayos Clínicos n.º U1111-1210-2389.

Introduction: The COVID-19 pandemic has had effects on the health of health workers, including obstetricians, but the consequences in this occupational group are unknown. Objective: Determine the consequences of COVID-19 on the physical, psychological and social health of obstetricians in Peru. Methods: Observational, descriptive, cross-sectional study, carried out on 511 attending obstetricians, in the first line of care. An online questionnaire, previously validated and reliable, was applied to measure the variables: general characteristics and exposure to COVID-19, physical health, psychological health, and social health. Data were analyzed using descriptive statistics. Results: 468 (91.6%) obstetricians are women, 287 (56.2%) aged 40-59 years, 213 (41.7%) married, 292 (57.1%) working at the first level of care; 216 (42.3%) were infected with COVID-19, 165 (32.3%) had headache, 127 (24.9%) sore throat and 121 (23.7%) fatigue; 167 (77.3%) required outpatient treatment and 3 (1.3%) intensive care. Obesity reported by 102 (20.0%) obstetricians was the main comorbidity, followed by hypertension with 38 (7.4%) and diabetes with 14 (2.7%); 263 (51.5%) reported depressive symptoms and 464 (90.8%) stress; 238 (46.6%) felt discrimination and 118 (23.1%) carried the workload of the home alone. Conclusions: The physical, psychological and social health of obstetricians is affected by the pandemic; generates disorders of overweight/obesity, depression, stress; as well as discrimination and work overload at home.

Objective: To describe the quality of clinical records of deliveries and births by quantitative assessing the unfilled variables in birth data collection forms and their implications at Maternity Hospital, in the municipality of Lubango, Angola. Method: The study was conducted from January to August 2018. It adopted a quantitative research design, analysed variables not filled in a total of 202 birth record forms collected for 3 months (secondary data). Results: The findings revealed that 80% of the sections of the entire set of information about obstetrical history were not filled in. This occurred with a relatively high frequency resulting in some of the relevant variables being left blank, such as antenatal diagnosis (94%) and the number of last menstruation (91%). Conclusions: The rate of missing fundamental information from the clinical birth record are high. This result has important implications in evaluating the quality of data and may, consequently, jeopardize: 1) the evaluation of the prenatal assistance, 2) the clinical assistance at delivery, and 3) decision-making for preventive and intervening procedures. Resumen: Objetivo: Describir la calidad de los registros clínicos de partos y nacimientos mediante la evaluación cuantitativa de las variables no cumplimentadas en los formularios de recolección de datos de nacimiento y sus implicaciones en el Hospital de Maternidad de Lubango, Angola. Método: El estudio se realizó de enero a agosto de 2018. Adoptó un diseño de investigación cuantitativa y analizó variables no cumplimentadas en un total de 202 registros de nacimiento recolectados durante 3 meses (datos secundarios). Resultados: Los hallazgos revelaron que el 80% de las secciones de todo el conjunto de información sobre la historia obstétrica no se completaron. Esto ocurrió con una frecuencia relativamente alta, lo que provocó que algunas de las variables relevantes se dejaran en blanco, como el diagnóstico prenatal (94%) y el número de la última menstruación (91%). Conclusiones: La tasa de falta de información fundamental en el registro clínico de nacimientos es alta. Estos resultados tienen implicaciones importantes en la evaluación de la calidad de los datos y, en consecuencia, pueden poner en peligro: 1) la evaluación de la asistencia prenatal, 2) la asistencia clínica al parto y 3) la toma de decisiones para los procedimientos preventivos e intervinientes.

Undoubtedly, great advances have been made in terms of maternal and infant morbidity and mortality. However, in Mexican Social Security System, the quality of maternal care is questionable, as reflected in proportions of cesarean births three times higher than those recommended by WHO, abandonment of exclusive breastfeeding and the fact that up to one in three women is a victim of abuse during delivery. Given this, the IMSS decides to implement the model called Integral Maternal Care AMIIMSS, focused on users experience and based on friendly obstetric care, along different stages of the reproductive process. Four pillars underpin the model, women's empowerment, infrastructure adaptation, training and adaptation of processes and standards. Although there are advances, with 73 pre-labor rooms enabled and 14,103 friendly attentions granted, there are pending tasks and challenges. In terms of empowerment, the birth plan needs to be included as an institutional practice. In terms of infrastructure adequacy, a budget is required to build and adapt friendly spaces. In addition, it is necessary to update the staffing tables and include new categories, for an adequate operation of the program. On training, the adaptation of academic plans for doctors and nurses is pending. In terms of processes and regulations, there is a lack of qualitative evaluation of the impact of the program on people's experience and satisfaction and elimination of obstetric violence. [ABSTRACT FROM AUTHOR]

The worldwide incidence of acute kidney injury (AKI) in pregnancy is 1.6 to 6.3 per 10,000 pregnancies. In developing countries, maternal mortality due to secondary complications of acute kidney injury is 4 to 5.8%. As it is well known, most cases of acute kidney injury in obstetrics occur during the puerperium, its presentation has been associated with an increase in fetal morbidity and mortality, compared to normoevolutive pregnancies. [ABSTRACT FROM AUTHOR]

Introduction: The Medicine career at the Pontificia Universidad Católica de Chile has undergone subsequent adjustments in its study plan. In this context, the theoretical-practical course of Obstetrics and Gynecology changed according to current paradigms in Medical Education. This research aims to describe the implementation and evaluation (student satisfaction and learning) of a blended learning (B-Learning modality) course in Obstetrics and Gynecology for medical students. Methods: A retrospective and descriptive design was used. Student satisfaction and learning was analized comparing the B-Learning to the face-to-face teaching previously used. Results: Students with the B-Learning modality reported dedicating more time to the course, better achievement of learning outcomes, and better perception of assessment and feedback. The average achievement of students with the B-Learning modality was slightly lower than that of other students; however, they demonstrated better performance on more complex assessment questions. Student satisfaction with the learning process was higher for B-Learning than face-to-face classes. Conclusions: B-Learning students had a similar level of learning attainment compared with the face-to-face modality but showed better performance on assessment questions that required a higher level of integration. This information is vitally important in the context of the SARS-CoV-2 pandemic, as much medical education has had to be carried out remotely during this time.

Introduction: Scientific publication is fundamental for the development of knowledge. In the health field, evidence-based practice is promoted; therefore, it is necessary for higher education teachers to carry out research as part of their training. Objective: To describe the profile of obstetrics university teachers at a public university according to their scientific production. Methods: A descriptive and cross-sectional study was carried out on Obstetrics teachers of the Universidad Nacional Mayor de San Marcos to whom a questionnaire was applied to identify their characteristics; and a data sheet was used to identify the characteristics of their publications. Descriptive and inferential statistics were performed at a 95% confidence level. Results: 36.1% of obstetrics teachers published a scientific article between 2011 and 2020; 110 articles were identified, of which 68.2% were original articles, 54.4% had a teacher as the main author, 26.4% were indexed in Scopus. Differences were found between teachers who did or did not publish a scientific article with respect to training in thesis advising (p= 0.007), in scientific writing (p= 0.001), with participation in research workshops (p< 0.001), those responsible for courses (p< 0.001) and with experience in thesis advising (p< 0.001). Conclusions: There is a low proportion of obstetrics teachers who publish scientific articles; in addition; various academic, work and especially research characteristics are associated with this knowledge production.

Objetivo: Compreender a percepção da mulher surda acerca do atendimento no sistema de saúde durante o processo de pré-natal, parto e puerpério. Metodologia: Estudo de campo descritivo de abordagem qualitativa, realizado com nove mulheres surdas que foram acompanhadas nos serviços de saúde durante os períodos citados. A coleta de dados aconteceu por meio de plataforma online, gravada em áudio e vídeo. Para organização das informações, utilizou-se análise temática. Resultados: Os resultados apontam que em todo o ciclo gravídico-puerperal há presença da barreira de comunicação, resultando na falha da promoção do cuidado, onde estas mulheres necessitam de uma terceira pessoa como interlocutor devido a falta de profissionais intérpretes nas instituições de saúde. Conclusão: A falha na acessibilidade para as mulheres surdas durante o atendimento nos serviços de saúde as coloca numa posição de fragilidade, na qual estas tornam-se ainda mais vulneráveis por não receberem o cuidado integral pelos profissionais de saúde.

Objectives: To determine agreement in assessing the need for postpartum pharmacological prophylaxis between the scale of the Royal College of Obstetricians and Gynaecologists and the Colombian guideline scale in a Level IV institution in Bogota, Colombia. Material and methods: Diagnostic agreement study assembled on a cross-sectional study. The included population consisted of pregnant women with 24 or more weeks of pregnancy admitted between March 1 and April 30 of 2021 to a high complexity private institution in Bogotá, Colombia, for labor induction, in active labor, for elective cesarean section, or who required urgent cesarean section. Convenience sampling was used. Measured variables included demographics, risk factors, risk classification and pharmacological prophylaxis according to the two scales. The prevalence of risk factors for each scale was estimated and agreement regarding prophylaxis indication between the two scales was measured using the weighted kappa value. Results: Overall, 320 patients were included. According to the scale of the Royal College Obstetricians and Gynaecologists, 54.7 % patients were classified as low risk, 42.5 % as intermediate risk and 2.8 % as high risk. The Colombian scale classified 80 % of patients as low risk, 17.2 % as intermediate risk, 2.2 % as high risk, and 0.6 % as very high risk. The weighted kappa value for agreement regarding the indication was 0.47 (95 % CI: 0.38-0.56). Conclusions: Agreement between the two scales to determine the need for postpartum pharmacological prophylaxis is moderate. Risk classification criteria for the Colombian scale should be validated in a second cohort. Moreover, the predictive ability of the Colombian guideline tool should be assessed at different cut-off points in terms of the consequences of false positive and false negative results. [ABSTRACT FROM AUTHOR]

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Objetivo: analisar a prática de realização de métodos não farmacológicos para alívio da dor durante o trabalho de parto. Método: estudo quantitativo, descritivo de corte transversal desenvolvido de dezembro de 2019 a setembro de 2020 em um Serviço de Enfermagem Materno Infantil do sul do Brasil. Foram realizados analises de 560 prontuários e coletas em banco de dados institucional. Utilizou-se o teste de Kolmogorov-Smirnov para a normalidade das variáveis e, para associações, os testes t para amostras independentes, Qui-quadrado ou exato de Fischer. Resultados: Constatou-se que 164 (29,3%) das parturientes realizaram pelo menos um tipo de método, sendo os mais utilizados a hidroterapia 137(24,5%), mudança de posição 124(22,1%) e exercícios de respiração 121(21,6%). Houve associação significativa p(

Objetivo: analizar la práctica de implementar métodos no farmacológicos para aliviar el dolor durante el trabajo de parto. Método: estudio cuantitativo y descriptivo de corte transversal desarrollado entre diciembre de 2019 y septiembre de 2020 en un Servicio de Enfermería Materno Infantil del sur de Brasil. Se analizaron 560 historias clínicas y los datos se recolectaron en una base de datos institucional. Se utilizó la prueba de Kolmogorov- Smirnov para la normalidad de las variables y, para las asociaciones, la prueba t para muestras independientes, la de chi-cuadrado o la prueba exacta de Fisher. Resultados: Se descubrió que 164 (29,3%) de las parturientas realizaron al menos un tipo de método, siendo los más utilizados hidroterapia con 137 (24,5%), cambio de posición con 124 (22,1%) y ejercicios respiratorios con 121 (21,6%). Se registró una asociación significativa (p

Introdução: A violência obstétrica é um fenômeno multifatorial mundial. É caracterizada pelo tratamento desrespeitoso no contexto das instituições de saúde, que ocorre durante o ciclo gravídico-puerperal. Identificar o conhecimento dos futuros profissionais de saúde sobre esse tema é uma forma de contribuir para o desenho de estratégias de ensino que favoreçam uma formação profissional consciente e comprometida com a prevenção e enfrentamento da violência obstétrica. Objetivo: Avaliar o conhecimento de estudantes de enfermagem sobre o tema Violência Obstétrica. Métodos: Trata-se de uma pesquisa descritiva e exploratória, com abordagem quantitativa, realizada com 115 acadêmicos de uma universidade pública. Os dados foram coletados através de um questionário semiestruturado. As questões foram analisadas utilizando testes estatísticos e modelos de regressão de Poisson com variância robusta. Resultados: Cerca de 99,1% dos estudantes tiveram contato com o tema e 56,3% conhecem alguém que sofreu violência obstétrica. A faculdade e as redes sociais foram citadas como as principais fontes de informação. Apenas 10,5% foram capazes de estimar quantas mulheres atualmente sofrem violência obstétrica; 13% conhecem a legislação disponível e 33,04% disseram saber fazer uma reclamação. Conclusão: Os achados indicam que os acadêmicos possuem um conhecimento superficial sobre o tema investigado, ignorando os aspectos epidemiológicos, a legislação vigente no país e os equipamentos disponíveis para a denúncia. Esses resultados justificam a qualificação do ensino sobre violência obstétrica no processo de formação desses futuros profissionais, como estratégia de prevenção e combate à violência obstétrica.

Resumo: A atenção à saúde materno-infantil no período neonatal exige dos profissionais uma compreensão integral do binômio mãe-filho. Os conhecimentos estudados pela Obstetrícia e pela Neonatologia são intimamente relacionados e devem ser abordados de forma integrada, sobretudo durante a graduação médica, quando o futuro médico constrói a base de seus raciocínio clínico. Os alunos do 6o período do curso médico da UFPE realizam as atividades práticas de Obstetrícia e Neonatologia integradas em maternidades-escola, acompanhadas de monitores. A concepção teórica e a concretização prática deste ensino integrado contaram com algumas dificuldades no início de seu funcionamento. A dificuldade de compreensão da importância da prática integrada e a falta de motivação de alguns professores foram relatadas como dificuldades menores. O maior problema desde o início tem sido a infra-estrutura e demanda de pacientes atendidos nas maternidades. O trabalho democrático e participativo de construção coletiva do projeto de ensino realizado por alunos, monitores e a coordenação do estágio tem-se mostrado uma estratégia eficiente para a superação das dificuldades.

Introducción: La tasa de fecundidad adolescente (15-19 años) de América Latina y el Caribe (ALC), con un valor de 73,2 por mil, se destaca por ser muy elevada, comparada con 48,9 a nivel mundial y 52,7 en los países en desarrollo. Metodología: Es un estudio observacional, descriptivo y temporalmente retrospectivo. El muestreo es no probabilístico de casos consecutivos. La población accesible son mujeres entre 12 y 19 años que aceptaron la aplicación del implante subdérmico como método anticonceptivo que acuden en el espacio Ñangareko del Servicio de Ginecología y Obstetricia, en el periodo de 1 año (2019 - 2020). Resultados: Sobre los efectos adversos del implante subdérmico, el 79,4 % no nota cambios en el patrón menstrual, sin embargo, el 17,9 % tiene spotting y el 2,7 % amenorrea. El 5,4 % reporta cefalea, el 1,3 % informa alteración del humor o ansiedad. En cuanto a la tensión mamaria estuvo presente en el 0,4 % de los casos. El 4 % reportó dolor o irritación en la zona. Discusión: El uso del implante subdérmico ha demostrado ser un método seguro, de bajo coste, que no genera molestias ni efectos secundarios que hagan desistir a las mujeres de su uso, la seguridad de este método anticonceptivo está avalada por varias investigaciones sobre sus beneficios y seguridad.

O artigo tem o objetivo de despertar reflexões em defesa do uso do termo “violência obstétrica” frente à postura do Ministério da Saúde e do Conselho Federal de Medicina em evitá-lo e aboli-lo. Entende-se que essa postura anula a constituição social, histórica e cultural da expressão e banaliza a agressão sofrida por mulheres no momento, durante e após o parto. Dessa forma, buscou-se demonstrar a importância do uso do vocábulo por meio de conceituações e caracterizações, bem como pela abordagem de breve histórico sobre a sua gradual notoriedade como questão de violação dos direitos humanos fundamentais. Ademais, o trabalho sugere a manutenção da expressão e espera colaborar para a sensibilização do leitor sobre esse tipo de violência.

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Scire Salutis is the property of CBPC - Companhia Brasileira de Producao Cientifica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The study aimed to describe and analyze everyday aspects of childbirth care in a university hospital in southern Brazil. The expression “taking off the coat” serves as a metaphor to illuminate the process of converting the obstetrician nurse into a researcher in a hospital environment. This is a qualitative research work that made use of the perspective socio-anthropology as a theoretical and methodological framework. The results showed a recurrent lack of information about medical conduct and decisions given to women, disregarding them as subjects of rights, despite what the policy of humanization of childbirth, revealing nuances of childbirth and birth based on the model assistance technocracy. This current care model in teaching hospitals requires important changes through the incorporation of practices with scientific foundations, the inclusion of obstetric nurses and respect for women as the protagonists of this event. [ABSTRACT FROM AUTHOR]

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: En Colombia las cifras de mortalidad materna siguen siendo alarmantes, es por esto que es necesario conocer causas, estadísticas, determinantes sociales en salud asociados a este fenómeno. Objetivo: Enumerar las causas e identificar la razón de mortalidad materna en gestantes entre las edades de 15 y 49 años comparando los departamentos de La Guajira y en la ciudad de Bogotá en el 2019. Metodología: Estudio observacional descriptivo de tipo ecológico. Incluyendo población gestante entre los 15 y 49 años con cualquier edad gestacional, de los departamentos estudiados; Se analizó información de fuentes estadísticas nacionales como el Departamento Nacional de Estadística (DANE) tabuladas en Excel 2.0, y bases de datos nacionales con publicaciones médicas y científicas. Se realizó una revisión bibliográfica sistematizada de la capacidad asistencial ginecobstetrica de los departamentos estudiados. Resultados: En el 2019 se evidencio que Bogotá presentó una RMM de 48,19 defunciones y La Guajira 189,74 por cada 100.000 NV, con tendencia a la disminución. Identificando 514 muertes maternas en donde prevaleció la hemorragia obstétrica con 18,5% y los trastornos hipertensivos asociados al embarazo con 18,1%. Respecto a la capacidad asistencial ginecoobstetrica, los datos de afiliación al Sistema de Seguridad Social en Salud fueron determinantes causales. El 82.9% de los afiliados en La Guajira corresponden al régimen subsidiado, mientras que en Bogotá el 82.8% son contribuyentes. Dentro de los determinantes sociales en salud de La Guajira se identificaron como causales la pobreza, etnicidad, condiciones socioeconómicas, entre otras; comparadas con Bogotá que presenta un menor índice de riesgo. Conclusión: La RMM en Bogotá es menor que en el departamento de La Guajira. Ambos comparten las principales causas como hemorragias obstétricas y trastornos hipertensivos asociados al embarazo. Se presenta un mayor índice de afiliación en La Guajira al SISBEN 1; comparado a Bogotá con mayor cantidad de personas afiliadas al régimen contributivo. Respecto a los determinantes sociales en salud hay mayor riesgo de mortalidad materna en las gestantes de La Guajira.

Objetivo: Relatar a vivência do estresse no trabalho da Enfermagem no fluxo de atendimento em uma emergência obstétrica na pandemia de COVID-19. Método: Relato de experiência sobre o estresse no trabalho da Enfermagem, durante a pandemia de COVID-19, no fluxo de atendimento na emergência obstétrica de uma maternidade terciária de Fortaleza, Ceará. Resultados: Os profissionais de saúde alocados para atendimento de emergência às gestantes suspeitas e/ou confirmadas de COVID-19 enfrentaram maior estresse no trabalho devido à exposição direta e prolongada durante o monitoramento do trabalho de parto e parto, à exaustão física e emocional e ao trabalho em ambiente não ajustado. Conclusão: O estresse relacionado ao trabalho em emergência obstétrica constitui fator de risco para o desenvolvimento de morbidade psicológica nos profissionais de saúde da linha de frente, especialmente os trabalhadores de Enfermagem.

Introdução: Apresentam-se as caraterísticas demográficas e profissionais dos especialistas de Ginecologia-Obstetrícia registados em Portugal e avaliam-se necessidades atuais e futuras. Material e Métodos: Analisaram-se dados do Instituto Nacional de Estatística, da Ordem dos Médicos e de resposta a questionário enviado a diretores de serviços hospitalares portugueses de Ginecologia-Obstetrícia. Calcularam-se as necessidades de especialistas com base em indicadores estabelecidos de atividade médica da especialidade. Resultados: Em 2018, registaram-se, em Portugal, 1 437 441 consultas da especialidade, 89 110 grandes cirurgias e 85 604 partos. Para essa atividade calcula-se serem necessários 1065 médicos da especialidade, em regime de 40 horas semanais, dos quais não mais do que 40% com idade igual ou superior a 55 anos; para manter este número são necessários 30 internos por ano. Segundo o Instituto Nacional de Estatística, nesse ano existiam 1143 especialistas nos hospitais portugueses, 234 dos quais em hospitais privados. Por outro lado, estavam inscritos 1772 especialistas na Ordem dos Médicos, dos quais 1163 (66%) apresentavam uma idade igual ou superior a 55 anos, sendo 84% dos especialistas com menos de 40 anos do sexo feminino. Em 2020, nos 39 dos 41 serviços públicos e público-privados que responderam ao questionário, existiam 864 especialistas, dos quais 395 (46%) com idade igual ou superior a 55 anos. Para 2035 prevê-se um aumento de 7% nas necessidades de especialistas desta área. Conclusão: Em Portugal não há falta de especialistas de Ginecologia-Obstetrícia em número absoluto, mas a existência de um elevado número de especialistas com idade igual ou superior a 55 anos, que tem direito a deixar de prestar atividade nos Serviços de Urgência, e de assimetrias regionais, contribuem para que continuem a existir algumas carências destes profissionais em vários serviços, nomeadamente em hospitais públicos.

No hay ramo de las ciencias médicas que no haya experimentado los inmensos beneficios de la antisepsia, y si esto es cierto en modo general, podemos decir que la obstetricia en particular, es una de las que más provecho han sacado de los inmortales descubrimientos del ilustre Pasteur.

Objetivo: interpretar el significado de acompañamiento del padre durante la atención perinatal. Metodología: investigación cualitativa, descriptiva, sustentada por la teoría de representaciones sociales; participaron 34 parejas, seleccionadas por haber sido atendidas durante toda la etapa perinatal; colecta de datos mediante entrevista, se efectúa el análisis de datos bajo un marco interpretativo, mediante técnica cromática, los resultados se discuten con base en representaciones sociales de Moscovici, conceptualizando la categoría; se confronta el dato empírico con la teoría, así plasmar el razonamiento lógico. Resultados: percepción de participación del padre y significado del acompañamiento de este en la atención, tipo de experiencia obtenida, concientización del esposo en la atención del neonato, destacar el rol del padre en la atención perinatal integral, patentizar su intervención como parte del trinomio. Conclusión: el significado que la madre manifiesta de la participación del padre durante el periodo del parto es la relevancia de su presencia.

Background: Body Stalk Syndrome (BSS) is a rare condition with a reported frequency of one case in every 31,000 pregnancies, and is characterized by severe congenital malformations, mainly thoracoschisis, abdominoschisis, limb defects and exencephaly. Its exact etiology is unknown and no teratogenic factor has been described so far. Furthermore, reports of familial recurrence suggest the possibility of a genetic origin for the condition. Aim: To report a case of SBS seen in our Service. Case report: This was a 23-year-old patient, with no comorbidities and a primigravida, who was referred to high-risk prenatal care due to a 2.5 mm nuchal translucency, observed by a morphological ultrasound (USG) performed with a gestational age (GA) of 11 weeks and 4 days. Two subsequent USGs showed signs suggestive of increasing SBS. The patient spontaneously went into labor with a GA of 33 weeks and 6 days. The fetus didn't have any cardiac activity since it's cefalicus disattachtment. After birth, multiple malformations were found confirming SBS. The mother received puerperal care and was discharged the following day. Conclusion: SBS is a rare and lethal malformation, justifying case reports that contribute to continuing medical education in Gynecology and Obstetrics. As seen in the case reported here, USG is important in the hypothesis of early diagnosis of SBS, allowing the pregnant woman to choose whether or not to terminate her pregnancy. There is also evidence that fetal magnetic resonance imaging could provide bases for a prenatal diagnosis of the syndrome during the beginning of the second gestational semester, as well as the diagnostic capacity of USGs for fetuses with GA at 11 and 12 weeks. [ABSTRACT FROM AUTHOR]

Background: Dandy-Walker Syndrome (DSW) is a complex malformation that involves the posterior fossa and the cerebellum, being considered a rare condition with an estimated incidence of 1 in 30,000 births. Hydrocephalus is its most common finding, identified in approximately 80% of cases, and SDW is present in between 4% and 12% of cases of hydrocephalus in infants. The "classical triad" of SDW is defined by complete or partial agenesis of the vermis, enlargement of the posterior fossa with upward displacement of the tentorium, transverse and torcular sinuses, and cystic dilatation of the fourth ventricle. Objective: To report a case of SDW attended in our Service. Method: This is a single case report treated at the Gynecology and Obstetrics Service of the São Francisco University Hospital in Providência de Deus - HUSF, located in the city of Bragança Paulista, SP, Brazil. The patient authorized the use of information about the case by signing an informed consent form. Conclusion: This report demonstrated the importance of imaging techniques, such as magnetic resonance imaging, ultrasound, for the identification, even during the prenatal period, of fetuses with the syndrome, allowing the medical team to design the treatment suitable for the future newborn. The findings provided by the imaging analyzes allowed us to investigate in great detail all the changes indicative of SDW after the 18th week of gestation, as well as after delivery. [ABSTRACT FROM AUTHOR]

Background: Neuroblastoma is a tumor of poorly differentiated embryonic nerve cells. Although most commonly found in the adrenal gland (90%), it can also be found in the posterior mediastinum or along the sympathetic neural chain. Furthermore, congenital neuroblastoma is the second most common tumor in the neonatal period, corresponding to 20% of all congenital tumors. Aim: To report a case of fetal neuroblastoma diagnosed in our Service. Case report: It was a pregnancy where the patient had gestational diabetes mellitus and gestational age of 38 weeks and 3 days. The fetus, according to morphological ultrasonography (USG), presented a tumor lesion in its right adrenal gland, in addition to macrosomia. Due to the observed results, a cesarean delivery was performed, without intercurrences. At postpartum USG, the tumor lesion remained, however, no clinical repercussions were observed. The newborn was discharged from the Service with outpatient referral to the pediatric surgery team, and a third USG showed a solid-cystic lesion in his right adrenal gland measuring 2.8 x 2.7 x 2.0 cm, still without clinical repercussions. Conclusion: Fetal neuroblastoma has an excellent prognosis, and reports of spontaneous tumor remission are common. However, caution is required when dealing with this type of tumor, as it is possible that in utero metastases or compression of the fetal/newborn spinal cord may occur. The importance of prenatal imaging tests, mainly USG and magnetic resonance imaging, is highlighted for the prior identification of neuroblastoma, and postpartum for the identification of tumor staging. Furthermore, tumors classified as 4S have a better prognosis, with the possibility of spontaneous remission. [ABSTRACT FROM AUTHOR]

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Objetivo: Describir las características de la producción científica de los obstetras docentes de universidades en el Perú. Material y métodos: Estudio descriptivo y transversal, que incluyó a 115 obstetras docentes de universidades peruanas públicas y privadas. Se estudiaron sus características y la de sus publicaciones científicas realizadas entre el 2010 y 2019, e indexadas en Scopus y Scielo. La búsqueda sistemática se realizó en estas bases de datos, en Google Académico y en el perfil de usuario del Directorio de Recursos Humanos afines a la Ciencia y Tecnología. Resultados: El 10,4% de docentes realizó alguna publicación científica, de ellos, la mayoría sólo publicó un artículo (58,4%) y era autor de al menos un artículo original (91,7%). Se identificaron 32 artículos, el 53,1% de estos se publicaron en revistas peruanas, además, la mayoría estaba en español (87,5%), fue publicada entre el 2010 y 2014 (62,5%) y eran originales y originales breves (71,9%). Entre estos artículos, 65,1% eran del área de salud materna y perinatal. La proporción de docentes con alguna publicación fue mayor en la universidades públicas (11,2%) que en las privadas (7,7%). Conclusiones: Una mínima proporción de obstetras docentes de universidades del Perú realizó la publicación de algún artículo, y la producción científica de estos en los últimos diez años, fue insuficiente.

Resumen El objetivo es comprender la aparición y propagación de locuras puerperales en Argentina y Colombia, a finales del siglo XIX y principios del XX, así como su decadencia o desvanecimiento hacia la década de 1940-1950. Investigación histórico-hermenéutica, según los conceptos de “campo de visibilidad” y “nicho ecológico” de una enfermedad transitoria. No existió correlación entre embarazo, parto y puerperio con el estado delirante que motivaba la internación, atribuido a factores predisponentes y, asimismo, tuvieron una autonomía nosográfica en virtud de etiopatogenias singulares. Al tiempo que empezó a emerger el tipo clínico locura puerperal, se entrecruzaron el campo disciplinar de la obstetricia con el alienismo, con una mayor preponderancia del primero.

Fundamento: la diversidad de actividades que realiza el médico de familia, la heterogeneidad de los profesores que los evalúan y las diferentes fases en que se puede encontrar este médico, entre otras circunstancias, hacen que su evaluación en el contexto asistencial esté plegada de innumerables criterios subjetivos y que no exista uniformidad.Objetivo: elaborar una guía para evaluar, bajo observación directa, el desarrollo de las habilidades clínicas del residente de Medicina General Integral en la atención ginecobstétrica.Métodos: se realizó la investigación con el uso de métodos teóricos y empíricos. Para el desarrollo de la priorización de las habilidades clínicas se partió de los problemas identificados. Se practicó la observación directa del comportamiento del residente en sus encuentros reales con pacientes ambulatorios. Los profesores de Medicina General Integral realizaron la observación del desempeño mientras ocurría la atención de una paciente. Sobre la base de los principales problemas identificados en el desempeño del residente se elaboró la guía y se sometió a criterio de expertos para su aprobación.Resultados: la guía incluye la evaluación de las siguientes habilidades clínicas: examen físico obstétrico, auscultación de la frecuencia cardiaca fetal, examen físico de la puérpera, examen físico de las mamas, colocación y extracción de dispositivo intrauterino, prueba citológica, cepillado de canal y realización de test de Schiller.Conclusiones: la guía es de fácil aplicación y permite identificar las dificultades que presenta el residente durante la ejecución del procedimiento. Su implementación sistemática contribuye al diagnóstico de las necesidades de aprendizaje.

RESUMO O artigo trata de uma revisão integrativa sobre os determinantes que envolvem a escolha da via de parto no Brasil. Foram selecionados e analisados 15 documentos evidenciando a escolha da via de parto sob a perspectiva da autonomia das mulheres e a prevalência da cirurgia cesariana. O estudo revelou três categorias para análise: perfil socioeconômico das mulheres inseridas no atendimento público e privado, relação assimétrica entre os profissionais de saúde e a paciente e aspectos socioculturais que envolvem a escolha da cesárea comumente conhecidos como a ‘cultura da cesárea’. Os achados revelaram que aspectos como acesso aos serviços, violência obstétrica e informação às mulheres sobre as vias de parto são preponderantes. Quanto à autonomia das mulheres, elas não se sentem participativas ou respeitadas na decisão. Ademais, espera-se contribuir para a discussão sobre a elaboração de medidas que garantam o direito da mulher quanto à sua participação na escolha da via de parto, possibilitando a escolha informada e resgatando a autonomia das mulheres em seu processo gravídico-puerperal.

La violencia obstétrica es una forma de control extremo del cuerpo y la autodeterminación de la mujer durante su trabajo de parto. La praxis médica utiliza protocolos establecidos para garantizar el saber hacer profesional mecanizando la intervención y toma de decisiones, e incluso aplicando criterios profesionales sobre preferencias personales para asegurar el bienestar clínico de la paciente, dejando al margen subjetividades complejas de tipificar desde el enfoque médico y que, sin embargo, darían lugar a un parto humanizado con trato digno y la participación activa de la madre. En este artículo, el objetivo es identificar los principales elementos teóricos sobre la violencia obstetra: proceso de parto, respeto, trato, poder y bienestar reproductivo, mediante el enfoque hermenéutico de un caso real actual.

Resumen Este estudio pretende profundizar en la experiencia vivida por mujeres mexicanas en la emergencia obstétrica. Para ello, se realizó un estudio cualitativo-fenomenológico por medio de entrevistas en profundidad a 15 mujeres sobrevivientes de esta experiencia que se realizaron en el periodo de enero a septiembre de 2017. La información se procesó mediante análisis fenomenológico del discurso, y para su interpretación se organizó en las cuatro dimensiones de la fenomenología de la percepción: cuerpo, tiempo, espacio y relacionabilidad. Las informantes percibieron la complicación de forma temprana, sin embargo, postergaron la atención institucional hasta que se hicieron presentes signos objetivos de complicación; la llegada puntual a los servicios de salud no implicó, desde su percepción, la certeza de manejo oportuno y adecuado, además se reportó un insuficiente apoyo de las redes formales e informales para el traslado y la atención especializada. Es necesario que sociedad y gobierno articulen estrategias que empoderen a las mujeres para la atención a las situaciones de emergencia obstétrica, acciones que promuevan su autocuidado pero garanticen también el apoyo pronto y expedito de sus redes y una atención profesional de calidad.

Critical pregnancy at high altitudes increases morbidity and mortality from 2500 m above sea level. In addition to altitude, there are other influential factors such as social inequalities, cultural, prehospital barriers, and lack the appropriate development of healthcare infrastructure. The most frequent causes of critical pregnancy leading to admission to Intensive Care Units are pregnancy hypertensive disorders (native residents seem to be more protected), hemorrhages and infection/sepsis. In Latin America, there are 32 Intensive Care Units above 2500 m above sea level. Arterial blood gases at altitude are affected by changes in barometric pressure. The analysis of their values provides very useful information for the management of obstetric emergencies at very high altitude, especially respiratory and metabolic pathologies., (Copyright © 2024 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.)

The article reports the results of a study conducted to examine midwifery and nursing students' perceptions of body intimacy and the factors affecting their perceptions. This was a cross-sectional study, with 389 midwifery and nursing students at a public university volunteering to participate in the study. Data were collected using a "Personal Information Form", the "Body Confidentiality Scale for Obstetrics and Gynecology" and the "Rosenberg Self-Esteem Scale". The participants had a mean age of 20.89 ± 1.86 years. The mean score they gave to the question whether they paid attention to privacy was 8.21 ±1.88. The mean Rosenberg self-esteem score was 29.44 ± 4.83 (minimum = 10, maximum = 40). The mean overall privacy score was 36.10 ± 6.84 (min = 9, max = 45), rights and privacy was 20.80 ± 3.71 (min = 5, max = 25), ethics and privacy was 20.45 ± 3.67 (min = 5, max = 25), and clinical privacy was 75.22 ± 12.33 (min = 18, max = 90). According to the results, obstetrics and nursing students, who would later intervene in women's health, had higher than average self-esteem and perception of privacy. Nevertheless, the establishment of the concept of "privacy" is an issue that should be addressed and reinforced in the training of obstetrics and nursing students who will provide services in such a sensitive field as gynecology and obstetrics. [ABSTRACT FROM AUTHOR]