RESUMEN
Uterine rupture is a rare, but potentially catastrophic complication of a trial of vaginal birth after cesarean (VBAC). In part because of concerns about this complication, the rate of cesarean deliveries continue to raise in developed countries. However, multiple repeat cesarean deliveries are associated with a greater risk of complications during surgery and of abnormal placentation in a subsequent pregnancy. VBAC should be proposed to women with good prognosis of VBAC success and low risk of uterine rupture. We aimed to review antepartum and intrapartum factors that are required for a safe VBAC.
Asunto(s)
Parto Vaginal Después de Cesárea , Toma de Decisiones , Femenino , Humanos , Selección de Paciente , Embarazo , Rotura Uterina/etiología , Rotura Uterina/prevención & control , Parto Vaginal Después de Cesárea/efectos adversosRESUMEN
OBJECTIVES: To examine the relationship between acculturation and five health practices, including cigarette smoking, alcohol consumption, exercise, obesity, and sleeping habits. METHODS: The study sample consisted of 573 Latinas, aged 46 to 92 years. Participants were recruited from 17 publicly subsidized housing projects in Los Angeles, Calif. Health practices information was obtained through an interview. RESULTS: Regression analyses showed an interaction between age and acculturation: the effects of acculturation on health practices were stronger among Latinas aged 64 years and under than among their 65 to 74 year-old counterparts. Level of acculturation did not affect the likelihood of engaging in healthy practices for elderly women (aged 75 and over). CONCLUSIONS: The data indicate that acculturation negatively affects the health practices of middle-aged Latinas, who are at a particularly critical age during which chronic diseases emerge. Intervention programs are needed to encourage adoption of healthy practices, particularly exercise and weight control, at an earlier stage in life.
Asunto(s)
Aculturación , Conductas Relacionadas con la Salud/etnología , Estado de Salud , Hispánicos o Latinos , Anciano , Consumo de Bebidas Alcohólicas/etnología , Distribución de Chi-Cuadrado , Ejercicio Físico , Femenino , Humanos , Entrevistas como Asunto , Lenguaje , Modelos Lineales , Los Angeles/epidemiología , Persona de Mediana Edad , Obesidad/etnología , Análisis de Regresión , Sueño , Fumar/etnología , Factores SocioeconómicosRESUMEN
This cross-sectional study of 226 HIV-positive Latino men and women sampled and assessed at an outpatient HIV clinic in Los Angeles examined the associations among acculturation, use of a substance before sex, and unsafe sexual behaviour. As acculturation increased, men and women were increasingly likely to have engaged in unsafe sex in the most recent sexual encounter since testing seropositive. In men, the association was partially mediated by use of a substance (primarily alcohol) in the three hours before the sexual encounter; in women, the association was not mediated by drug use. The findings underscore the need for culturally sensitive, secondary prevention programmes for HIV-positive persons.