A comprehensive investigation of biopsychosocial determinants influencing primary dysmenorrhea among university students.

Dysmenorrhea, characterized by pain and related symptoms, significantly impacts women's quality of life in work and education, prompting a comprehensive evaluation of associated factors. The objective of this study was to utilize structural equation modeling (SEM) to analyze and assess the biopsychosocial factors influencing dysmenorrhea among university students. Three hundred and thirty-nine university students were included in this cross-sectional descriptive study. Data were collected using the Participant Information Form, the Beck Anxiety Scale (BAS), the Beck Depression Scale (BDS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Adverse Childhood Experiences Scale (ACES), the Pain Catastrophizing Scale (PCS) and the Visual Analogue Scale (VAS). It was determined that the variables of pain onset (t = 3.24, p < .05) and age at menarche (t = -2.16, p < .05) showed a significant relationship with the model. The variables of the PCS (t = 16.87, p < .001), BDS (t = 3.06, p < .05), and BAS (t = 5.13, p < .001) showed a significant relationship with the model. Social factors in the model were examined, and a family history of dysmenorrhea and the ACES variables did not contribute significantly to the model (p > .05). The study indicates primary dysmenorrhea influenced by biological and psychological factors. Nurses should conduct holistic assessments and provide comprehensive care for affected women.

Fatores associados a lesões perineais em partos vaginais: análise multinível / Factors associated with perineal injuries in vaginal deliveries: multilevel analysis / Factores asociados con lesiones perineales en parto vaginal: análisis multinivel

Objetivo: Estimar a prevalência de lesão perineal e seus fatores associados em casa de parto, controlando-se o contexto de cidade de origem da parturiente. Métodos: Estudo transversal retrospectivo realizado com parturientes no Centro de Parto Normal de São Sebastião, Distrito Federal. Os dados de práticas obstétricas foram obtidos por meio de registros em prontuários físicos (n=400) coletados entre junho e setembro de 2016. Considerou-se como variável dependente 'lesão perineal', e independentes os registros de lacerações de primeiro, segundo e terceiro graus. Para o processo de análise de regressão logística multinível considerou-se dois níveis, I ­ variáveis individuais e II ­ contextual 'cidade de origem'. Resultados: A prevalência de lesão perineal foi 72,8% (IC 96% 6,85-77,2) nas mulheres assistidas. Permaneceram associadas positivamente à lesão perineal as variáveis independentes, anos de estudo <8 anos, primiparidade e uso de ocitocina intraparto. Conclusão: A alta prevalência de lesão perineal e seus fatores associados encontrados na população estudada reforçam a importância da atuação de enfermeiras obstétricas nestes dispositivos de atenção à saúde da mulher, visando a redução destes agravos. (AU)

Objective: To estimate the prevalence of perineal injury and its associated factors in the delivery home, controlling the mother's city of origin. Methods: Retrospective cross-sectional study carried out with parturients at the Normal Childbirth Center of São Sebastião, Distrito Federal. Data on obstetric practices were obtained through records in physical records (n=400) collected between June and September 2016. The dependent variable was 'perineal injury', and records of first, second and third lacerations were considered independent. degree. For the multilevel logistic regression analysis process, two levels were considered, I ­ individual variables and II ­ contextual 'city of origin'. Results: The prevalence of perineal injury was 72.8% (CI 96% 6.85-77.2) in women assisted. The independent variables, years of education <8 years, primiparity and use of intrapartum oxytocin remained positively associated with perineal injury. Conclusion: The high prevalence of perineal injury and its associated factors found in the studied population reinforce the importance of the role of obstetric nurses in these women's health care devices, aiming at reducing these injuries. (AU)

Objetivo: Estimar la prevalencia de lesión perineal y sus factores asociados en el hogar de parto, controlando la ciudad de origen de la madre. Métodos: Estudio transversal retrospectivo realizado con parturientas en el Centro de Parto Normal de São Sebastião, Distrito Federal. Los datos sobre prácticas obstétricas se obtuvieron a través de registros en registros físicos (n=400) recolectados entre junio y septiembre de 2016. La variable dependiente fue 'lesión perineal', y los registros de primer, segundo y tercer grado se consideraron independientes. Para el proceso de análisis de regresión logística multinivel, se consideraron dos niveles, I - variables individuales y II - contextual 'ciudad de origen'. Resultados: La prevalencia de lesión perineal fue 72,8% (IC 96% 6,85-77,2) en mujeres asistidas. Las variables independientes, años de educación <8 años, primiparidad y uso de oxitocina intraparto permanecieron asociadas positivamente con la lesión perineal. Conclusión: La alta prevalencia de lesión perineal y sus factores asociados encontrados en la población estudiada refuerzan la importancia del papel de las enfermeras obstétricas en los dispositivos de atención de salud de estas mujeres, con el objetivo de reducir estas lesiones. (AU)

Understanding the role and impact of electronic health records in labor and delivery nursing practice: A scoping review protocol.

Background: Electronic health records have a significant impact on nursing practice, particularly in specializations such as labor and delivery, or acute care maternity nursing practice. Although primary studies on the use of electronic health records in labor and delivery have been done, no reviews on this topic exist. Moreover, the topic of labor and delivery nurses' organizing work in the electronic health record-enabled context has not been addressed. Objective: To (a) synthesize research on electronic health record use in labor and delivery nursing and (b) map how labor and delivery nursing organizing work is transformed by the electronic health record (as described in the reviewed studies). Methods: The scoping review will be guided by a modified methodology based on selected recommendations from the Joanna Briggs Institute and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews. A comprehensive search will be conducted in the following databases: CINAHL Complete, MEDLINE, Academic Search Complete, Web of Science, Scopus and Dissertations and Theses Abstracts and Indexes. Included sources will be primary research, dissertations, or theses that address the use of electronic health records in labor and delivery nursing practice in countries with high levels of electronic health record adoption. Data extracted from included sources will be analyzed thematically. Further analysis will theorize labor and delivery nurses' organizing work in the context of electronic health record use by utilizing concepts from Davina Allen's Translational Mobilization Theory. Findings will be presented in tabular and descriptive formats. Conclusion: The findings of this review will help understand transformations of nursing practice in the electronic health record-enabled labor and delivery context and identify areas of future research. We will propose an extension of the Translational Mobilization Theory and theorize nurses' organizing work involving the use of the electronic health record.

Avaliação da amamentação com emprego da escala latch em um hospital público do Distrito Federal / Assessment of breastfeeding using the latch scale in a public hospital in the Federal District

Avaliar o processo de amamentação em um hospital da rede pública do Distrito Federal através da aplicação da escala LATCH. Método: Trata-se de um estudo epidemiológico, observacional, descritivo, transversal, de abordagem quantitativa. Resultados: Ao aplicar a escala LATCH para avaliação do aleitamento materno observou-se uma inclinação ascendente dos escores no decorrer do período pós-parto. Foram identificadas evoluções nas variáveis pega, deglutição audível e colo. O tipo de mamilo não apresentou grandes diferenças entre os grupos, sendo o protuso o tipo mais comum. O conforto apresentou uma evolução inversamente proporcional ao longo do tempo. Conclusão: A escala LATCH permite aos profissionais dos setores materno-infantis sistematizar o cuidado em amamentação de forma direcionada e facilitada, sendo um importante instrumento de avaliação no ambiente intra hospitalar.(AU)

To evaluate the breastfeeding process in a public hospital in the Federal District by applying the LATCH scale. Method: This is an epidemiological, observational, descriptive, cross-sectional study with a quantitative approach. Results: When applying the LATCH scale to assess breastfeeding, an upward slope of the scores was observed over the course of the postpartum period. Developments were identified in the latch-on, audible swallowing and lap variables. The type of nipple did not differ greatly between the groups, with protrusion being the most common type. Comfort showed an inversely proportional evolution over time. Conclusion: The LATCH scale allows professionals in the maternal and child sectors to systematize breastfeeding care in a targeted and facilitated way, making it an important assessment tool in the intra-hospital environment.(AU)

Evaluar el proceso de amamantamiento en un hospital público del Distrito Federal mediante la aplicación de la escala LATCH. Método: Se trata de un estudio epidemiológico, observacional, descriptivo, transversal, con abordaje cuantitativo. Resultados: Al aplicar la escala LATCH para evaluar la lactancia materna, se observó una pendiente ascendente de las puntuaciones en el transcurso del puerperio. Se identificaron evoluciones en las variables prensión, deglución audible y regazo. El tipo de pezón no presentó grandes diferencias entre los grupos, siendo el más frecuente el protruido. La comodidad mostró una evolución inversamente proporcional a lo largo del tiempo. Conclusión: La escala LATCH permite a los profesionales del sector materno-infantil sistematizar la atención a la lactancia materna de forma dirigida y facilitada, lo que la convierte en una importante herramienta de evaluación en el ámbito intrahospitalario.(AU)

Partos verticalizados e ocorrência de lacerações perineais em casa de parto do Distrito Federal / Vertical births and occurrence of perineal lacerations in a birth center in the Federal District

Comparar as distintas posições verticalizadas adotadas por parturientes durante o trabalho de parto, associando à ocorrência de possíveis lacerações perineais e seus respectivos graus. Metodologia: Trata-se de um estudo epidemiológico, observacional, descritivo, transversal, retrospectivo, de abordagem quantitativa. O estudo foi realizado na Casa de Parto de São Sebastião, localizada no Distrito Federal, a qual contou com uma amostra aleatória de 499 mulheres, que tiveram seus partos no período de janeiro de 2018 a dezembro de 2021. Resultados: O estudo apontou que 354 mulheres adotaram posições verticalizadas durante o período expulsivo e 249 obtiveram algum grau de laceração; já 145 adotaram posições não verticalizadas e 74 tiveram algum grau de laceração. Entre as posições verticalizadas, a mais adotada foi com o uso da banqueta de parto (37%). Conclusão: As posições verticalizadas estão associadas ao maior número de lacerações, porém o grau da laceração varia entre as posições.(AU)

To compare the different upright positions adopted by parturients during labor, associating them with the occurrence of possible perineal lacerations and their respective degrees. Methodology: This is an epidemiological, observational, descriptive, cross-sectional, retrospective study with a quantitative approach. The study was carried out at the Casa de Parto de São Sebastião, located in the Federal District, which had a random sample of 499 women who gave birth between January 2018 and December 2021. Results: The study found that 354 women adopted upright positions during the expulsive period and 249 had some degree of laceration; 145 adopted non-upright positions and 74 had some degree of laceration. Among the upright positions, the most commonly adopted was the use of the birthing stool (37%). Conclusion: Upright positions are associated with a higher number of lacerations, but the degree of laceration varies between positions.(AU)

Comparar las diferentes posiciones erguidas adoptadas por las parturientas durante el trabajo de parto, asociándolas con la ocurrencia de posibles laceraciones perineales y sus respectivos grados. Metodología: Se trata de un estudio epidemiológico, observacional, descriptivo, transversal, retrospectivo y con abordaje cuantitativo. El estudio se realizó en la Casa de Parto de São Sebastião, ubicada en el Distrito Federal, que contó con una muestra aleatoria de 499 mujeres que dieron a luz entre enero de 2018 y diciembre de 2021. Resultados: El estudio encontró que 354 mujeres adoptaron posiciones erguidas durante el período expulsivo y 249 tuvieron algún grado de laceración; 145 adoptaron posiciones no erguidas y 74 tuvieron algún grado de laceración. Entre las posturas erguidas, la más adoptada fue el uso del taburete de parto (37%). Conclusión: Las posiciones verticales se asocian con el mayor número de laceraciones, pero el grado de laceración varía entre las posiciones.(AU)

Impact of SARS-COV-2 Infection on Maternal, Obstetric and Neonatal Outcomes in a Cohort of Vaccinated Women: A Pilot Study.

We aimed to investigate the impact of COVID-19 infection on maternal characteristics and obstetric and neonatal outcomes in a cohort of women in labor previously vaccinated who tested positive for SARS-CoV-2 infection, compared to aged-matched healthy controls. A retrospective case-control study was conducted among 66 women in labor. Clinical data were obtained from medical records. The attendance rates at childbirth and parenting classes, as well as the implementation of a birth plan, were significantly lower in the COVID-19 infection group (6.1% vs. 48.5%, <0.001; 6.1% vs. 33.3%, p = .005, respectively). Women with COVID-19 had a higher prevalence of prolonged postpartum hospital stay (33.3% vs. 9.1%, p = .016), and significantly higher prevalence of spontaneous preterm birth (27.3% vs. 1.09%, p = .006). Breastfeeding within the first 24 hr was also lower in women with COVID-19 (72.7% vs. 97.0%, p = .006). Maternal characteristics and neonatal outcomes are influenced by COVID-19 infection in vaccinated women. Complications include spontaneous preterm birth, prolonged postpartum hospital stay, and lack of breastfeeding within the first 24 hr. Childbirth education, parenting classes and implementing a birth plan may be associated with a decreased risk of COVID-19 infection.

Support Needs of Labor and Delivery Nurses After Traumatic Experiences.

OBJECTIVE: To examine the effect of psychological distress, overall distress, and institutional support following a traumatic workplace event on absenteeism, turnover intention, and resilience among labor and delivery nurses. DESIGN: A quantitative cross-sectional survey. SETTING: Online distribution from January 13, 2021, to February 2, 2021. PARTICIPANTS: A nationwide convenience sample of labor and delivery nurses recruited from the Association of Women's Health, Obstetric and Neonatal Nurses (N = 171). METHODS: Participants completed a survey that included the Second Victim Experience and Support Tool-Revised and the Second Victim Support Desirability survey. We compared available versus desired support options using descriptive analyses. We examined levels of psychological distress and lack of institutional support in relation to turnover intention, absenteeism, and resilience using multiple regression analyses. RESULTS: Participants identified and described various traumatic experiences in the workplace, including neonatal and maternal death, complicated births, and workplace violence. Participants indicated that the available support services did not meet their needs. Psychological distress, overall distress, and lack of institutional support were associated with absenteeism and turnover, whereas only institutional support was associated with resilience. CONCLUSION: Labor and delivery nurses encounter various traumatic events in the workplace, and the support services provided after an event do not meet their needs. Additional research is needed to understand the scope of the problem and investigate best practices to assist labor and delivery nurses following traumatic events.

Unit-Based Nurses' Development of a Couplet Care Acuity Scoring Tool.

OBJECTIVE: To evaluate content validity (CV) and interrater reliability (IRR) of an acuity scoring tool developed for the couplet care/postpartum/nursery patient population and to determine if there was agreement between supervisor or director scoring and staff scoring. DESIGN: A scoring tool to assess the acuity of the couplet care/postpartum/nursery patients was developed. SETTING: Two hospitals: one Level 2 hospital, one Level 3 hospital. Unit-based patient care councils participated in the development, and all couplet care nurses participated in scoring patients for testing. MEASUREMENTS: The final tool was evaluated for CV and IRR using expert review, universal agreement scores, and discriminant content validation. RESULTS: Regarding CV for the Couplet Care Acuity Scoring Tool, the average of the number of experts in agreement divided by the total number of experts across all items was 1.00. Regarding IRR, the intraclass correlation coefficient was 0.85, indicating that the tool is valid and reliable for the study sample. CONCLUSION: The tool was reliable and valid in this study. Future testing is needed with larger samples and different health care facilities.

Gerenciamento clínico da hemorragia pós-parto pelo enfermeiro obstetra: um protocolo de revisão de escopo / Clinical management of postpartum hemorrhage by obstetric nurses: a scoping review protocol

OBJETIVO: Mapear as evidências científicas sobre as ações dos enfermeiros obstétricos no gerenciamento clínico da hemorragia pós-parto. MÉTODO: Trata-se de uma revisão de escopo elaborada segundo as recomendações do JBI Institute Manual do Revisor para Scoping Review. As buscas serão realizadas nas bases de dados eletrônicas CINAHL, Cochrane Library, EMBASE, Literatura Latino-americana e do Caribe em Ciências da Saúde, MEDLINE/PubMed, SciELO, ScienceDirect, SCOPUS, Web of Science e na literatura cinzenta. Os estudos que serão incluídos precisarão responder ao objetivo desta pesquisa e estar nos idiomas Português, Espanhol ou Inglês. Além disso, é necessário ter disponibilidade dos estudos na íntegra através de acesso remoto pelo acesso da CAFe. Os estudos que não serão incluídos serão os em formato de editorial e carta ao editor. Haverá a seleção por meio da leitura do título e resumo dos materiais encontrados nas buscas, sendo assim avaliados de maneira independente por dois revisores e nos casos de divergências por um terceiro avaliador. Os dados coletados estarão organizados e relacionados segundo a análise descritiva. Os resultados poderão estar dispostos em tabelas ou quadros, e serão discutidos com suporte de literatura acerca da temática, retratando a quinta etapa do método escolhido.

OBJECTIVE: To map the scientific evidence regarding the actions of obstetric nurses in the clinical management of postpartum hemorrhage. METHOD: This scoping review was developed according to the JBI Institute Reviewer's Manual for Scoping Reviews. The electronic databases CINAHL, Cochrane Library, EMBASE, Latin American and Caribbean Health Sciences Literature, MEDLINE/PubMed, SciELO, ScienceDirect, SCOPUS, Web of Science, and gray literature were searched. Included studies must address the research objective in Portuguese, Spanish, or English. In addition, full remote access to the studies via CAFe is required. Studies in editorial or letter format will be excluded. Selection will be based on the title and abstract of the materials found in the searches, independently assessed by two reviewers, with disagreements resolved by a third reviewer. Collected data will be organized and related through descriptive analysis. Results may be presented in tables or figures and discussed with support from literature, reflecting the fifth step of the selected methodology.

Sociodemographic and obstetric factors associated with health-related quality of life of high-risk pregnant women.

OBJECTIVE: To evaluate the association between sociodemographic and obstetric factors and the health-related quality of life of pregnant women in high-risk prenatal care. METHODS: A cross-sectional study of women in high-risk prenatal care in Ceara, Brazil. The investigated outcomes were health-related quality of life, using the Medical Outcomes Study 36-item short-form health survey; the investigated covariates were sociodemographic and obstetric data. Associative analyses were performed using the Jamovi® software version 0.9. RESULTS: Of the 276 women included in the study, women with the following characteristics presented a better quality of life in some domain of the scale: age equal to or greater than 35 years, higher income per dependent, religious, living with three or fewer persons, with their own home, in primigestation, nulliparous, with no history of previous abortion, and with up to two living children. The regression model showed an association between the total scale score, which means a higher quality of life in women with age equal to or greater than 35 years and a higher income per dependent. CONCLUSION: The study identified sociodemographic and obstetric factors that may affect the quality of life of high-risk pregnant women, providing subsidies to health providers so that they can promote better prenatal care.

Experiences of high-risk parturient women with the use of non-invasive care technologies / Experiencias de parturitas de alto riesgo con el uso de tecnologías de atención no invasivas / Experiências das parturientes de alto risco com o uso das tecnologias não invasivas de cuidado

ABSTRACT Objective: to analyze high-risk parturient women's experiences with the use of non-invasive nursing care technologies during labor. Method: this is qualitative and descriptive research, with twenty high-risk postpartum women admitted to a tertiary maternity hospital in the state of Rio de Janeiro, Brazil. Data were collected from April to July 2019 through semi-structured interviews, subjected to thematic content analysis and analyzed in light of Kristen Swanson's Theory of Caring. Results: the experiments revealed that theory processes were associated with the use of non-invasive care technologies by nurses. "Maintaining belief", "knowing" and "being with" were made up of the following technologies: encouraging self-confidence; understanding the lived experience; bond formation; and creating a supportive and helpful relationship with parturient women. The "doing for" and "enabling" processes included other technologies that promoted comfort and facilitated the experience such as: encouraging active participation and conscious breathing; stimulation of vertical positions and pelvic movements; companion involvement in care; using resources, such as warm water, Swiss balls and essential oils; and applying massages. Conclusion: parturient women realize that the use of non-invasive care technologies by nurses shapes experiences of well-being during labor, expressed in feelings of safety, acceptance, respect, appreciation, support and comfort. The importance of investing in nurses' work in assisting high-risk pregnancies is highlighted, as these technologies provide respectful care and women's satisfaction with childbirth.

RESUMEN Objetivo: analizar las experiencias de parturientas de alto riesgo con el uso de tecnologías de atención de enfermería no invasivas durante el parto. Método: investigación cualitativa y descriptiva, con veinte puérperas de alto riesgo ingresadas en una maternidad de tercer nivel del estado de Río de Janeiro, Brasil. Los datos fueron recolectados de abril a julio de 2019 a través de entrevistas semiestructuradas, sometidos a análisis de contenido temático y analizados a la luz de la Teoría del Cuidado de Kristen Swanson. Resultados: los experimentos revelaron que los procesos teóricos estaban asociados con el uso de tecnologías de atención no invasivas por parte de las enfermeras. "Mantener la creencia", "saber" y "estar con" se componían de las siguientes tecnologías: fomentar la confianza en uno mismo; comprender la experiencia vivida; formación de enlaces; y construir una relación de apoyo y ayuda con la parturienta. Los procesos de "hacer por" y "habilitar" incluyeron otras tecnologías que promovieron la comodidad y facilitaron la experiencia, tales como: fomentar la participación activa y la respiración consciente; estimulación de posiciones verticales y movimientos pélvicos; participación del acompañante en el cuidado; aprovechamiento de recursos, como agua tibia, pelotas suizas y aceites esenciales; y aplicando masajes. Conclusión: las parturientas se dan cuenta de que el uso de tecnologías de atención no invasivas por parte de las enfermeras da forma a experiencias de bienestar durante el parto, expresadas en sentimientos de seguridad, aceptación, respeto, aprecio, apoyo y comodidad. Se destaca la importancia de invertir en la labor de enfermería en la asistencia a embarazos de alto riesgo, ya que estas tecnologías brindan un cuidado respetuoso y la satisfacción de las mujeres con el parto.

RESUMO Objetivo: analisar as experiências das parturientes de alto risco com o uso das tecnologias não invasivas de cuidado de enfermagem durante o trabalho de parto. Método: pesquisa qualitativa e descritiva, com vinte puérperas de alto risco internadas em uma maternidade terciária do estado do Rio de Janeiro, Brasil. Os dados foram coletados de abril a julho de 2019, através de entrevistas semiestruturadas, submetidos à análise de conteúdo temática e analisados à luz da Teoria dos Cuidados de Kristen Swanson. Resultados: as experiências revelaram que os processos da teoria se associaram ao uso das tecnologias não invasivas de cuidado pelas enfermeiras. "Manter a crença", "conhecer" e "estar com" se conformaram com as seguintes tecnologias: incentivo à autoconfiança; compreensão da experiência vivida; formação de vínculo; e construção da relação de apoio e ajuda com a parturiente. Os processos "fazer por" e "possibilitar" contemplaram outras tecnologias que promoveram conforto e facilitaram a experiência como: incentivo à participação ativa e respiração consciente; estímulo aos posicionamentos verticalizados e movimentos pélvicos; envolvimento do acompanhante nos cuidados; uso de recursos, como água morna, bola suíça e óleos essenciais; e aplicação de massagens. Conclusão: as parturientes percebem que o uso das tecnologias não invasivas de cuidado pelas enfermeiras conforma experiências de bem-estar no trabalho de parto, expressas em sentimentos de segurança, acolhimento, respeito, valorização, apoio e conforto. Ressalta-se a importância de investimentos na atuação das enfermeiras na assistência às gestações de alto risco, pois essas tecnologias proporcionam cuidados respeitosos e satisfação das mulheres com o parto.

Analgesia neuroaxial no trabalho de parto: efeitos sobre desfechos maternos e neonatais / Anestesia neuroaxial en el trabajo de parto: efectos sobre desenlaces maternos y neonatales / Neuroaxial analgesia in labor: effects on maternal and neonatal outcomes

Resumo Objetivo Comparar os desfechos maternos e neonatais de mulheres que usaram e não usaram analgesia neuroaxial durante o trabalho de parto. Métodos Estudo transversal comparativo, documental, com coleta retrospectiva de dados, realizado em uma maternidade terciária de referência no Ceará. O tamanho da amostra foi calculado pela diferença entre duas proporções: partos vaginais com e sem analgesia, sendo 130 mulheres para cada grupo, totalizando 260 prontuários. A coleta de dados ocorreu entre julho de 2019 e fevereiro de 2020. Foram usados os testes t de Student, U de Mann-Whitney, qui-quadrado de Pearson, exato de Fisher e o programa IBM SPSS. Resultados O grupo com analgesia apresentou maior média de consultas pré-natal (8,24; p<0,001), maior exposição à indução (74; 56,9%; p<0,001), com uso de ocitocina (57; 43,8%; p<0,001), maior duração do trabalho de parto ativo (média: 392 min; p<0,001) e do período expulsivo (média: 85,3 min; p<0,001), maior frequência de episiotomia (7; 7,9%; p=0,03), de parto cesárea (41; 31,5%; p<0,001), e pariram bebês mais pesados (média: 3,28 kg; p=0,007). Conclusão O uso de analgesia está associado à maior frequência de intervenções obstétricas, bem como ao aumento na duração do trabalho de parto. Quanto aos desfechos neonatais, o grupo com analgesia pariu recém-nascidos mais pesados; além disso, não foi observada associação com o escore de Apgar, nem encaminhamentos para unidades de risco.

Resumen Objetivo Comparar los desenlaces maternos y neonatales de mujeres que recibieron anestesia neuroaxial durante el trabajo de parto y las que no recibieron. Métodos Estudio transversal comparativo, documental, con recopilación retrospectiva de datos, realizado en una maternidad de tercer nivel de referencia en el estado de Ceará. El tamaño de la muestra se calculó mediante la diferencia entre dos proporciones: partos vaginales con y sin anestesia, con 130 mujeres en cada grupo, 260 historias clínicas en total. La recopilación de datos se realizó entre julio de 2019 y febrero de 2020. Se utilizaron las pruebas t de Student, U de Mann-Whitney, ji cuadrado de Pearson, exacto de Fisher y el programa IBM SPSS. Resultados El grupo con anestesia presentó un mayor promedio de consultas prenatales (8,24; p<0,001), una mayor exposición a la inducción (74; 56,9 %; p<0,001), con uso de oxitocina (57; 43,8 %; p<0,001), una duración mayor del trabajo de parto activo (promedio: 392 min; p<0,001) y del período expulsivo (promedio: 85,3 min; p<0,001), una mayor frecuencia de episiotomía (7; 7,9 %; p=0,03), de parto por cesárea (41; 31,5 %; p<0,001), y parieron bebés más pesados (promedio: 3,28 kg; p=0,007). Conclusión El uso de anestesia está asociado a una mayor frecuencia de intervenciones obstétricas, así como también al aumento de la duración del trabajo de parto. Respecto a los desenlaces neonatales, el grupo con anestesia parió recién nacidos más pesados. Además, no se observó relación con el puntaje de Apgar, ni derivaciones a unidades de riesgo.

Abstract Objective To compare maternal and neonatal outcomes of women who used and did not use neuraxial analgesia during labor. Methods A cross-sectional, comparative, documentary study, with retrospective data collection, carried out at a tertiary reference maternity hospital in Ceará. Sample size was calculated by the difference between two proportions: vaginal births with and without analgesia, with 130 women for each group, totaling 260 medical records. Data collection took place between July 2019 and February 2020. Student's t test, Mann-Whitney U test, Pearson's chi-square test, Fisher's exact test and the IBM SPSS program were used. Results The group with analgesia had a higher mean number of prenatal consultations (8.24; p<0.001), greater exposure to induction (74; 56.9%; p<0.001), with use of oxytocin (57; 43.8%; p<0.001), longer duration of active labor (mean: 392 min; p<0.001) and expulsive period (mean: 85.3 min; p<0.001), higher frequency of episiotomy (7; 7.9%; p=0.03), by cesarean section (41; 31.5%; p<0.001), and heavier babies were born (mean: 3.28 kg; p=0.007). Conclusion The use of analgesia is associated with a greater frequency of obstetric interventions as well as an increase in the duration of labor. Regarding neonatal outcomes, the group with analgesia gave birth to heavier newborns; Furthermore, no association was observed with the Apgar score, nor referrals to high-risk units.

Plano de pós-parto para gestantes e puérperas: produção de material educativo / Plan de posparto para mujeres embarazadas y puérperas: producción de material educativo / Postpartum plan for pregnant and postpartum women: production of educational material

Resumo Objetivo Desenvolver e validar material educativo para a construção de um plano de pós-parto pela mulher no ciclo gravídico-puerperal, com ou não profissionais da saúde. Métodos Estudo metodológico, organizado em três etapas. 1) Análise e seleção de conteúdo, elaboração teórica do projeto e adaptação na linguagem; 2) Produção do material, com elaboração do design gráfico e projeto ilustrativo; 3) Validação com sete juízes nas áreas de saúde da mulher e educação em saúde. A coleta de dados foi executada com a aplicação de um questionário de caracterização e o Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). A análise se deu por estatística descritiva e Índice de Validade de Conteúdo, sendo considerados aprovados os itens que apresentassem valor igual ou superior a 0,80. Resultados O plano de cuidado intitulado "Meu plano de pós-parto" apresentou ótima aceitação e confiabilidade, evidenciado por um Índice de Validade de Conteúdo global de 0,98. As principais sugestões apresentadas foram a respeito da adaptação da escrita para uma linguagem mais simples e acessível, sendo estas aceitas pelas autoras. Os especialistas apontaram a importância e relevância do plano de pós-parto para o público-alvo. Conclusão O material demonstrou ser um instrumento válido e confiável para a utilização das mulheres durante o ciclo gravídico puerperal, favorecendo uma reflexão sobre os cuidados e preparo precoce para enfrentamento deste período.

Resumen Objetivo Elaborar y validar material educativo para la creación de un plan de posparto por la mujer durante el embarazo y el puerperio, con o sin profesionales de la salud. Métodos Estudio metodológico, organizado en tres etapas: 1) análisis y selección de contenido, elaboración teórica del proyecto y adaptación del lenguaje; 2) producción del material, con elaboración del diseño gráfico y proyecto ilustrativo, y 3) validación por siete jueces de áreas de la salud de la mujer y educación para la salud. La recopilación de datos se llevó a cabo mediante la aplicación de un cuestionario de caracterización y el Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). El análisis se realizó con estadística descriptiva y con el Índice de Validez de Contenido, donde se consideraron aprobados los ítems que presentaron un valor igual o superior a 0,80. Resultados El plan de cuidado llamado "Mi plan de posparto" presentó una excelente aceptación y fiabilidad, demostradas con un Índice de Validez de Contenido global de 0,98. Las principales sugerencias propuestas fueron sobre adaptar la escritura a un lenguaje más simple y accesible, y las autoras las aceptaron. Los especialistas señalaron la importancia y la relevancia del plan de posparto para el público destinatario. Conclusión El material demostró ser un instrumento válido y confiable para que lo utilicen mujeres durante el embarazo y el puerperio, y así favorecer una reflexión sobre los cuidados y la preparación temprana para enfrentar este período.

Abstract Objective To develop and validate an educational material for the construction of a postpartum plan by women in the pregnancy-puerperal cycle, with or without health professionals. Methods Methodological study, organized in three stages. 1) Content analysis and selection, theoretical elaboration of the project and language adaptation; 2) Production of material, with preparation of graphic design and illustrative project; 3) Validation with seven judges in the areas of women's health and health education. Data collection was carried out using a characterization questionnaire and the Suitability Assessment of Materials for evaluation of health-related information for adults (SAM). The analysis was carried out using descriptive statistics and Content Validity Index, with items that presented a value equal to or greater than 0.80 being considered approved. Results The care plan entitled "My postpartum plan" showed excellent acceptance and reliability, evidenced by an overall Content Validity Index of 0.98. The main suggestions presented were about adapting the writing to a simpler and more accessible language, which were accepted by the authors. Experts highlighted the importance and relevance of the postpartum plan for the target audience. Conclusion The material proved to be a valid and reliable instrument for use by women during the pregnancy and puerperal cycle, encouraging reflection on care and early preparation to face this period.

The effect of compression stockings on the complaints well-being and sleep quality of pregnant women with restless legs syndrome: a randomized controlled study

SUMMARY OBJECTIVE: The aim of this study was to determine the effect of compression stockings on complaints, well-being, and sleep quality in pregnant women with restless legs syndrome. METHODS: This randomized placebo-controlled study was conducted on 63 pregnant women (placebo group [PG]=31; experimental group [EG]=32) at the Perinatology Outpatient Clinic of a Health Research and Application Centre in Turkey. Pregnant women in the experimental group wore compression stockings when they got up in the morning for 3 weeks and took them off at bedtime. Placebo group women wore a placebo stocking. Data were collected using the restless legs syndrome Severity Rating Scale, the Pittsburgh Sleep Quality Index, the World Health Organization-5 Well-Being Index, and the Application Satisfaction Form on the 22nd day of the first interview. Statistical significance was accepted as p<0.05. RESULTS: Post-test mean scores of both the experimental group and placebo group in the restless legs syndrome Severity Rating Scale (post-test:;8.87±5.27, 12.19±5.60; pre-test:;21.28±5.63, 21.0±5.61; p<0.05), the Pittsburgh Sleep Quality Index (post-test:;5.34±3.28, 6.12±3.12; pre-test:;10.15±4.23, 9.61±4.59; p<0.05), and Well-Being Index (post-test:;18.06±4.59, 19.00±4.47; pre-test:;12.71±5.85, 15.09±5.62; p<0.05) showed recovery according to the pre-tests. However, the post-test restless legs syndrome Severity Rating Scale of the experimental group was lower than that of the placebo group (p<0.05). The effect of their application started in 3.93±1.74 days on average in the experimental group, while it started in 5.09±1.55 days in the placebo group (p<0.05). CONCLUSION: Both applications reduced the severity of restless legs syndrome in pregnant women and increased sleep quality and well-being. However, compression stockings were more effective in reducing restless legs syndrome severity. Nurses can use compression and placebo stockings in the care of pregnant women with restless legs syndrome. Clinical Trial Registration Number: NCT05795868.

Nursing care for women with HELLP syndrome: a scoping review / Cuidados de enfermagem a mulheres com síndrome HELLP: scoping review Atención de enfermería a mujeres con síndrome HELLP: revisión del alcance / Cuidados de enfermagem a mulheres com síndrome HELLP: scoping review

ABSTRACT Objective: To map evidence on nursing care for women with HELLP syndrome. Method: A scoping review with searches carried out in May 2023, independently, in the PubMed/MEDLINE, LILACS, Scopus, EMBASE, Web of Science, CINAHL, CAPES Theses and Dissertations Catalog and Cochrane Library databases, correlating the descriptors HELLP Syndrome, Nursing Care and Obstetric Nursing and its synonyms, without delimitation of time and language. Selection was carried out by three researchers independently and resolved by consensus. Results: Of the 129 studies, ten were selected, which made up the final sample. The studies date from 2004 to 2022, with a predominance of English language and clinical case studies. A greater occurrence of the syndrome was observed in second-time pregnant women in the second decade of life, with a gestational age from 32 weeks, which resulted in an emergency cesarean section, and all newborns were discharged accompanied by their mothers. Studies that described nursing diagnoses and focused on nursing care were retrieved. From the review, 39 nursing care were identified. Conclusion: This review pointed out the magnitude of the syndrome, however with a lack of studies.

RESUMEN Objetivo: Mapear evidencia sobre los cuidados de enfermería a mujeres con síndrome HELLP. Método: Revisión de alcance, con búsquedas realizadas en mayo de 2023, de forma independiente, en las bases de datos PubMed/MEDLINE, LILACS, Scopus, EMBASE, Web of Science, CINAHL, Catálogo de Tesis y Disertaciones CAPES y Cochrane Library, correlacionando los descriptores HELLP Syndrome, Nursing Care y Obstetric Nursing y sus sinónimos, sin delimitación de tiempo e idioma. La selección fue realizada por tres investigadores de forma independiente y resuelta por consenso. Resultados: De las 129 publicaciones se seleccionaron diez, que conformaron la muestra final. Las publicaciones datan de 2004 a 2022, con predominio del inglés y estudios de casos clínicos. Se observó una mayor ocurrencia del síndrome en mujeres embarazadas por segunda vez en la segunda década de la vida, con edad gestacional a partir de las 32 semanas, lo que resultó en cesárea de emergencia, y todos los recién nacidos fueron dados de alta acompañados de sus madres. Se recuperaron estudios que describían diagnósticos de enfermería y se centraban en los cuidados de enfermería. De la revisión se identificaron 39 medidas de cuidados de enfermería. Conclusión: Esta revisión señaló la magnitud del síndrome, aunque faltan estudios.

RESUMO Objetivo: Mapear evidências sobre assistência de enfermagem às mulheres com síndrome HELLP. Método: Scoping review, com buscas realizadas em maio de 2023, independentemente, nas bases PubMed/MEDLINE, LILACS, Scopus, EMBASE, Web of Science, CINAHL, Catálogo de Teses e Dissertações da CAPES e Cochrane Library, correlacionando os descritores HELLP Syndrome, Nursing Care e Obstetric Nursing e seus sinônimos, sem delimitação de tempo e idioma. A seleção foi realizada por três pesquisadores independentemente e resolvida por consenso. Resultados: Das 129 publicações, foram selecionadas dez, que compuseram a amostra final. As publicações datam de 2004 a 2022, com predomínio do idioma inglês e de estudos de casos clínicos. Observou-se maior ocorrência da síndrome em secundigestas na segunda década de vida, com idade gestacional a partir de 32 semanas, que tiveram como desfecho cesárea de emergência, e todos os recém-nascidos receberam alta acompanhados das mães. Resgataram-se estudos que descreviam diagnósticos de enfermagem e que focavam em cuidados assistenciais de enfermagem. A partir da revisão, identificaram-se 39 cuidados de enfermagem. Conclusão: A presente revisão apontou a magnitude da síndrome, contudo possui escassez de estudos.