Estudo comparativo entre inserção do DIU TCU 380A no pós-parto imediato vs. tardio / Comparative study between TCU 380A IUD insertion in immediate vs. late postpartum

Racional: O dispositivo intrauterino de cobre (DIU TCu380A) é método contraceptivo eficaz e de longa duração, sendo um aliado no planejamento familiar. Objetivo: Analisar e comparar as taxas de complicações, expulsão, seguimento e reinserção do método no período pós-parto (PP) imediato e tardio. Método: Estudo transversal retrospectivo em que foram analisadas todas as mulheres que inseriram o DIU. Os dados coletados foram computados em planilha Excel e avaliados de forma descritiva e analítica. Resultados: Foram avaliados 210 prontuários, onde 182 foram incluídos. Destes, 46.2% inseriram o DIU no PP imediato e 53,8% no PP tardio; ao todo 2,7% tiveram complicações durante a inserção do método. A taxa de expulsão foi de 5,5%, sendo 10,7% no PP imediato e 1,02% no PP tardio. Conclusão: O PP tardio mostrou ser superior nos parâmetros avaliados. No entanto, o PP imediato não deve ser desconsiderado. O imediato possui maiores taxas de expulsão, enquanto que o tardio, apresenta taxas mais elevadas de mau posicionamento.

Background: The copper intrauterine device (TCu380A IUD) is an effective and long-lasting contraceptive method, being an ally in family planning. Objective: To analyze and compare the rates of complications, expulsion, follow-up and reinsertion of the method in the immediate and late postpartum period. Method: Retrospective cross-sectional study in which all women who had the IUD inserted were analyzed. The collected data were computed in an Excel and make spreadsheet in a descriptive and analytical way. Results: 210 medical records were taken, of which 182 were included. Of these, 46.2% inserted the IUD in the immediate postpartum and 53.8% in the late postpartum; a total of 2.7% had complications during insertion of the method. The expulsion rate was 5.5%, being 10.7% in the immediate postpartum and 1.02% in the late postpartum. Conclusion: The late postpartum proved to be superior in the adopted parameters. However, the immediate postpartum should not be disregarded. The immediate period has higher expulsion rates, while the late one has higher rates of bad positioning.

Depressão pós-parto: quais os fatores de risco? / Post-partum depression: which are risk factors?

Esta revisão sistemática visa identificar os fatores de risco psicossociais para depressão pós-parto (DPP). Foram selecionados 11 artigos por meio das bases: Embase, Medline e SciELO. Os critérios de inclusão foram: data de publicação nos últimos cinco anos, língua inglesa ou portuguesa, delineamento observacional longitudinal e ser referente a fatores de risco psicossociais para DPP. Foram encontrados 25 fatores de risco psicossociais. Entre eles, os fatores mais citados foram: falta de apoio social/familiar, gravidez não planejada, história pessoal de doença psiquiátrica, relacionamento ruim com o parceiro, idade menor que 20 anos e baixa escolaridade. A prevalência de DPP alcançou valores de 4,5% até 50,3% nos estudos avaliados. Isso demonstra a importância da detecção precoce desses fatores de risco e de mais investimentos na área de prevenção dessa doença. Para uma visão integral da doença, uma análise envolvendo uma amostra maior de artigos de bases de dados alternativas se faz necessária.(AU)

This systematic review has the purpose of identifying psychosocial risk factors on post-partum depression (PPD). Eleven articles were selected utilizing three databases: Embase, Medline and SciELO. The inclusion criteria were: publication data in the last five years, English or Portuguese, longitudinal observational design and reference to psychosocial risk factors for Postpartum Depression.Twenty-five factors were identified. Some of them were identified more than others, such as social and/or family support, unplanned pregnancy, personal history of psychiatric diseases, bad relationship with the partner, age under 20 years old, and low levels of schooling. PPD's prevalence was between 4,5% and 50,3%. These numbers confirm the importance of both early detection of risk factors as well as more investments in the prevention of this disease. For an integral view of the disease, an analysis involving a larger sample of alternative database articles is required.(AU)

Women infected with HIV and the impact of associated sexually transmitted infections.

OBJECTIVE: To review the relationship between concomitant sexually transmitted infections in women infected with HIV. METHODS: PubMed and Scopus were searched for articles published in English and Portuguese between January 1, 1994, and December 31, 2015, using relevant keywords, including AIDS, HIV, female genital diseases, and sexually transmitted infections. Articles that associated sexually transmitted infections with HIV-infected women were selected for inclusion. Those that only investigated prevalence in pregnant women or focused on social or behavioral aspects were excluded. RESULTS: Of 108 identified articles, 24 were included. When correlated with HIV, genital herpes demonstrated an increased recurrence rate and increased replication rate for HIV in the mucosa. In HIV-positive women, syphilis can cause more genital ulcers. Bacterial vaginosis provides a pool of microorganisms that can increase the viral copy levels of genital HIV. Chlamydia, gonorrhea, and candidiasis may be more severe and complicated in women infected with HIV. CONCLUSIONS: Screening of HIV-positive patients who could have other sexually transmitted infections is important to protect women and decrease the risk of transmission.