Development of the Hiesho (sensitivity of hands or feet to cold) Care Practice Scale for pregnant women.

AIM: Evidence-based indicators are needed to increase the frequency of practicing care for hiesho, which can be a risk factor during childbirth. Such practice will lead to hiesho prevention. This study aimed to develop a Hiesho Care Practice Scale (HCPS) for pregnant women and examine its reliability and validity. METHODS: To develop a HCPS and examine its reliability and validity, we conducted a questionnaire-based survey among nurses who provide hiesho care for pregnant women in Japan. RESULTS: The analysis included 100 participants (recovery rate: 96%). Exploratory factor analysis produced four factors and 20 items. The model's fit indices obtained from the confirmatory factor analysis include goodness of fit of .80, adjusted goodness of fit of .75, comparative fit index of .88, and root mean squared error of approximation of .08. The correlation coefficients for the patient coaching skill evaluation scale for criterion-related validity test ranged from .23 to .51 (p < .01). Cronbach's α was .88, and intraclass correlation coefficient (ICC) was .81. CONCLUSIONS: The HCPS developed in this study consisted of four factors and 20 items, and its reliability and validity were verified. This scale enables the subjective and objective evaluation of hiesho care practice in the nursing profession. It may contribute to standardizing and developing improvement measures for hiesho care among pregnant women by nurses and midwives.

The Relations Among Childhood Maltreatment and Later Intimate Partner Violence Victimization With and Without a Weapon in a Sample of Pregnant Black Individuals.

Black pregnant and postpartum individuals are at risk for intimate partner violence (IPV), and those with a history of childhood maltreatment and IPV are even more likely to be re-victimized during pregnancy. However, it is unknown if specific types of child maltreatment predict later IPV with and without a weapon better than others. The current study sought to (i) document the prevalence of childhood maltreatment and IPV and (ii) examine the relations among types of childhood maltreatment and later IPV with and without a weapon within a sample of Black individuals seeking prenatal care at a large public hospital in the southeastern United States. Participants (n = 186; mean age = 27.2 years, SD = 5.3) completed measures assessing childhood maltreatment and IPV with and without a weapon. Approximately 68.5% of participants (n = 124) endorsed experiencing childhood maltreatment, while 42.6% (n = 78) endorsed experiencing IPV. The bivariate relations among five childhood maltreatment types (i.e., sexual, physical, and emotional abuse, physical and emotional neglect) and IPV with and without a weapon were assessed. All childhood maltreatment subtype scores-except childhood physical neglect-were significantly higher among participants who reported a history of IPV with or without a weapon compared to participants who denied a history of IPV with or without a weapon. Logistic regression models revealed childhood sexual abuse emerged as the only significant predictor of experiencing IPV with a weapon (B = 0.10, p = .003) and IPV without a weapon (B = 0.11, p = .001). For every point increase in childhood sexual abuse subtype score, the odds of experiencing IPV with and without a weapon increased by 10% (OR = 1.10, 95%CI [1.04, 1.18]) and 12% (OR = 1.12, [1.05, 1.20]), respectively. Findings suggest that screening for childhood sexual abuse may provide a critical opportunity for maternity care providers to identify individuals at increased risk for IPV victimization with and without a weapon.

Reproductive and developmental safety evaluation of Thymelaea hirsuta (L.) leaves aqueous extract in Wistar albino rats.

ETHNOPHARMACOLOGICAL RELEVANCE: The popularity of herbal medicine is expanding globally due to the common belief that herbal products are natural and nontoxic. Thymelaea hirsuta leaves are traditionally used for the treatment of recurrent abortion in humans and animals. However, a lack of safety evaluation of the plant, particularly in pregnant women, raises serious concerns regarding its potential embryotoxic effects. AIM OF THE STUDY: Therefore, the present study investigated the safety of Thymelaea hirsuta leaves aqueous extract (THLE) during pregnancy and lactation following maternal rat treatment. MATERIALS AND METHODS: THLE phytochemical compounds were identified using high-performance liquid chromatography (HPLC). THLE was orally administered to pregnant rats and lactating dams at dosages of 0, 250, 500, and 1000 mg/kg/day. At the end of the study, dam s' and pups' body weights, serum biochemical and hematological indices, and histopathological changes were investigated. For the fetal observation and histopathological changes were also evaluated. RESULTS: Our findings revealed that THLE is rich in different phenolic and flavonoid compounds. However, biochemical and hormonal parameters such as ALT, AST, and prolactin were significantly increased in dams treated with a higher dosage of THLE when compared to the control dams (P ≤ 0.05). Additionally, external, visceral and skeletal examinations of fetuses revealed a marked increase of malformation rates in treated fetuses. CONCLUSIONS: The results revealed that higher oral dosing of THLE during pregnancy could affect embryonic development in rats, while lower doses are safe and can be used during pregnancy and lactation to attain its beneficial effects.

Effects of Carrier's sex on the outcome of embryos and pregnancies in 412 couples undergoing preimplantation genetic testing for structural rearrangements.

STUDY DESIGN: To ascertain whether the carrier's sex affects the outcome of embryos and pregnancies in couples undergoing preimplantation genetic testing for structural rearrangements (PGT-SR). METHODS: This retrospective study comprised 412 couples with reciprocal translocations (RecT), Robertsonian translocations (RobT), or inversions (INV) between January 2017 and October 2022. We applied next-generation sequencing (NGS) on 2588 embryos after trophectoderm (TE) biopsy. RESULTS: Genetically transferable blastocyst rate was higher in the male carrier group (34.0 % vs 31.7 %, P = 0.013) relative to the female carrier group whereas other embryo and pregnancy outcomes remained similar. Further analysis revealed that this result was primarily due to the alteration of segregation patterns in the RobT subgroup, in which the proportion of alternate segregation was higher (84.3 % vs 66.4 %, P < 0.001) in male carriers compared with female carriers. In the RecT subgroup, the genetically transferable blastocyst rate between male and female carriers was similar although the segregation models also changed, such that the frequency of the adjacent-1 segregation pattern was higher in male carriers than in female carriers (42.5 % vs 34.7 %, P = 0.002). In addition, interchromosomal effect (ICE) did not differ between male and female carriers although ICE was lower in male carriers of the RobT subgroup (pure ICE: 35.50 % vs 44.30 %, P = 0.14; total ICE: 35.50 % vs 40.30 %, P = 0.32) and higher in male carriers of the INV subgroup (pure ICE: 42.3 % vs 37.20 %, P = 0.33; total ICE: 40.90 % vs 36.00 %, P = 0.36). CONCLUSIONS: The carrier's sex was closely associated with the genetically transferable embryo rate in couples undergoing PGT-SR, principally resulted from the change in segregation pattern in the RobT subgroup but not in the RecT and INV subgroups.

Exposición a temperaturas extremas y su efecto en la gestación en un departamento de Colombia / Exposure to extreme temperatures and its effect on pregnancy in a department of Colombia

Introducción: Diversas investigaciones han establecido la relación entre temperatura y duración del embarazo, la exposición a temperaturas altas durante el embarazo plantea interrogantes en especial el papel que esta juega frente a los partos prematuros y partos de bajo peso, es indispensable determinar si las temperaturas altas o bajas tienen un comportamiento protector o de riesgo sobre el feto durante la gestación en regiones tropicales. Objetivo: describir la relación entre la exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos del departamento del Guaviare-Colombia. Metodología: Estudio tipo observacional, analítico, retrospectivo de corte transversal que busco determinar la relación entre exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos, el universo estuvo conformado por 10.137 nacidos vivos, de los cuales 9.932 cumplieron los criterios de inclusión. Se determinó Odds Ratio para estimar la asociación entre las variables. Resultados: Dentro de la semana de retraso 3 el estar expuesto a temperaturas máximas percentil 90 es un factor protector para la ganancia ponderal de peso OR < 1, la exposición a temperaturas mínimas percentil 10 se asoció como factor protector para el parto prematuro en la semana de retraso 1 y 2 OR < 1.Conclusión: A pesar del beneficio de las altas y bajas temperaturas durante el embarazo en la ganancia ponderal de peso y disminución del parto prematuro, es recomendable prevenir la exposición a temperaturas extremas durante el periodo de gestación[AU]

Introduction: Various investigations have established the relationship between temperature and duration of pregnancy. Exposure to high temperatures during pregnancy raises questions, especially the role it plays in premature births and low-weight births. It is essential to determine whether high temperatures or low have a protective or risky behavior on the fetus during pregnancy in tropical regions.Objective: to describe the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns in the department of Guaviare-Colombia.Methodology:Observational, analytical, retrospective cross-sectional study that sought to determine the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns. The universe was made up of 10,137 births. alive, of which 9,932 met the inclusion criteria. Odds Ratio was determined to estimate the association between the variables.Results:Within the 3rd week of delay, being exposed to maximum temperatures at the 90th percentile is a protective factor for weight gain OR < 1, exposure to minimum temperatures at the 10th percentile was associated as a protective factor for premature birth in the week. of delay 1 and 2 OR < 1. Conclusion: Despite the benefit of high and low temperatures during pregnancy in weight gain and reduction in premature birth, it is advisable to prevent exposure to extreme temperatures during the gestation period[AU]

Introdução: Várias investigações estabeleceram a relação entre temperatura e duração da gravidez. A exposição a altas temperaturas durante a gravidez levanta questões, especialmente o papel que desempenha nos partos prematuros e nos nascimentos de baixo peso. É essencial determinar se as temperaturas altas ou baixas têm um comportamento protetor ou de risco para o feto durante a gravidez em regiões tropicais. Objetivo:descrever a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos no departamento de Guaviare-Colômbia. Metodologia: Estudo observacional, analítico, retrospectivo e transversal que buscou determinar a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos. O universo foi composto por 10.137 nascimentos. vivos, dos quais 9.932 preencheram os critérios de inclusão. O Odds Ratio foi determinado para estimar a associação entre as variáveis. Resultados:Na 3ª semana de atraso, a exposição a temperaturas máximas no percentil 90 é fator de proteção para ganho de peso OR < 1, a exposição a temperaturas mínimas no percentil 10 foi associada como fator de proteção para parto prematuro na semana. de atraso 1 e 2 OR < 1.Conclusão:Apesar do benefício das altas e baixas temperaturas durante a gravidez no ganho de peso e redução do parto prematuro, é aconselhável evitar a exposição a temperaturas extremas durante o período de gestação[AU]

Escala de Preocupação com a Imagem Corporal Durante a Gravidez: Tradução e validação para a população portuguesa / Body Image Concerns During Pregnancy Scale: Translation and validation for the Portuguese population / Escala de Preocupação com a Imagem Corporal Durante a Gravidez: traducción y validación para la población portuguesa

Resumo Enquadramento: As preocupações com a imagem corporal durante a gravidez podem ter diversos problemas. A compreensão destas preocupações podem ajudar os profissionais de saúde a melhorarem os cuidados com a saúde das grávidas. Objetivo: Adaptar e validar para a população portuguesa a Body Image Concern Scale During Pregnancy, que foi traduzida Escala de Preocupação com a Imagem Corporal Durante a Gravidez (EPICDG). Metodologia: Estudo quantitativo e transversal, participaram 231 grávidas. A avaliação das propriedades métricas da EPICDG foi realizada com base na análise fatorial exploratória e confirmatória. Resultados: A versão portuguesa com 21 itens, apresentou índices de ajuste idênticos à escala original. O modelo com melhor qualidade, foi o modelo com as quatro subdimensões da escala original (X 2 (176) = 446,320; p < 0,001, X 2 df = 2,536; CFI = 0,91; TLI = 0,89; GFI = 0,86; RMSEA = 0,077, p < 0,001). Conclusão: Os resultados demonstram que a validação da escala para a língua portuguesa, tem propriedades psicométricas adequadas para a avaliação das preocupações com a imagem corporal durante a gravidez.

Abstract Background: Body image concerns during pregnancy can lead to a number of problems. Understanding these concerns can help health professionals improve health care for pregnant women. Objective: Translate, adapt, and validate the Body Image Concerns During Pregnancy Scale for the Portuguese population (Escala de Preocupação com a Imagem Corporal Durante a Gravidez - EPICDG). Methodology: A quantitative cross-sectional study was conducted with 231 pregnant women. The psychometric properties of the EPICDG were assessed using exploratory and confirmatory factor analysis. Results: The fit indices of the Portuguese 21-item version were identical to those of the original scale. The four-dimension model had the best fit (X 2 (176) = 446.320; p < 0.001, X 2 df = 2.536; CFI = 0.91; TLI = 0.89; GFI = 0.86; RMSEA = 0.077, p < 0.001). Conclusion: The results show that the EPICDG has adequate psychometric properties for assessing body image concerns during pregnancy in the Portuguese population.

Resumen Marco contextual: La preocupación por la imagen corporal durante el embarazo puede causar diversos problemas. Comprender estas preocupaciones puede ayudar a los profesionales sanitarios a mejorar los cuidados a las mujeres embarazadas. Objetivo: Adaptar y validar para la población portuguesa la Body Image Concerns During Pregnancy Scale, que fue traducida en la Escala de Preocupação com a Imagem Corporal Durante a Gravidez (EPICDG). Metodología: Estudio cuantitativo transversal en el que participaron 231 mujeres embarazadas. Las propiedades métricas de la EPICDG se evaluaron mediante análisis factorial exploratorio y confirmatorio. Resultados: La versión portuguesa con 21 ítems mostró índices de ajuste idénticos a los de la escala original. El modelo con mejor calidad fue el que tenía las cuatro subdimensiones de la escala original (X 2 (176) = 446,320; p < 0,001, X 2 df = 2,536; CFI = 0,91; TLI = 0,89; GFI = 0,86; RMSEA = 0,077, p < 0,001). Conclusión: Los resultados muestran que la validación de la escala para el idioma portugués tiene propiedades psicométricas adecuadas para evaluar las preocupaciones sobre la imagen corporal durante el embarazo.

Percepção do vínculo parental e variáveis associadas ao apego materno-fetal na gestação de alto risco

Este estudo investigou os efeitos da percepção do vínculo parental, variáveis sociodemográficas e gestacionais na intensidade do apego materno-fetal (AMF) no contexto de gestação de alto risco. Trata-se de um estudo quantitativo e transversal com 119 participantes. Foi aplicado um questionário sociodemográfico, a Escala de Apego Materno-Fetal - Versão Breve e o Parental Bonding Instrument. Os resultados da análise de regressão linear múltipla foram estatisticamente significativos (p < 0,05). O modelo final explicou 28,7 % da variância do AMF e foi composto pelas variáveis de superproteção paterna, cuidado paterno, idade da mulher, idade gestacional e suporte do pai do bebê. Reitera-se que a intensidade do AMF é multideterminada, envolvendo aspectos da história de vida, sociais e situacionais. A percepção da mulher acerca do vínculo paterno durante sua infância e adolescência e o apoio do pai do bebê no período gestacional destacam-se como fatores influentes para a vinculação materno-fetal, indicando a importância do envolvimento paterno ao longo do ciclo vital. São pontuadas implicações para a prática profissional, bem como limitações e recomendações de estudos futuros.

Este estudio investigó los efectos de la percepción del vínculo parental, las variables sociodemográficas y gestacionales en la intensidad del apego materno-fetal (AMF) en el contexto de embarazos de alto riesgo. Se trata de un estudio cuantitativo y transversal con 119 participantes. Se aplicó un cuestionario sociodemográfico, la Escala de Apego Materno-Fetal-Versión Breve y el Instrumento de Vínculo Parental. Los resultados del análisis de regresión lineal múltiple fueron estadísticamente significativos (p < .05). El modelo final explicó el 28.7 % de la varianza del AMF y estuvo compuesto por las variables de sobreprotección paterna, cuidado paterno, edad de la mujer, edad gestacional y apoyo del padre del bebé. Se reitera que la intensidad del AMF es multideterminada, lo que involucra aspectos de la historia de vida, sociales y situacionales. La percepción de la mujer sobre el vínculo paternal durante su infancia y adolescencia, así como el apoyo del padre del bebé durante el período gestacional, destacan como factores influyentes en el apego materno-fetal, lo que indica la importancia de la participación paterna a lo largo del ciclo vital. Se puntualizan implicaciones para la práctica profesional, así como limitaciones y recomendaciones para estudios futuros.

This study investigated the effects of perceived parental bonding, sociodemographic and gestational variables on the intensity of maternal-fetal attachment (MFA) in the context of high-risk pregnancies. This is a quantitative, cross-sectional study involving 119 participants. A sociodemographic questionnaire, the Maternal-Fetal Attachment Scale-Brief Version, and the Parental Bonding Instrument were administered. The results of the multiple linear regression analysis were statistically significant (p < .05). The final model explained 28.7 % of the variance in MFA and included the variables of paternal overprotection, paternal care, maternal age, gestational age, and the support from the baby's father. We emphasize that MFA intensity is multidetermined, involving aspects of life history, social, and situational factors. The woman's perception of paternal bonding during her childhood and adolescence, as well as the support from the baby's father during the gestational period, are highlighted as influential factors for maternal-fetal attachment, indicating the importance of paternal involvement throughout the life cycle. Implications for professional practice, as well as limitations and recommendations for future studies are discussed.

Histerectomía con embrión en útero en paciente con tromboembolismo pulmonar: reporte de un caso / Hysterectomy with embryo in utero in a patient with pulmonary thromboembolism: report of a case

Resumen Antecedentes: la histerectomía en bloque es un procedimiento controvertido y con poca literatura actualizada. Se define como la extirpación del útero grávido con su contenido gestacional in situ, las indicaciones para la realización de esta cirugía son los procesos neoplásicos (como la causa más frecuente( procesos sépticos, enfermedad trofoblástica y hemorragia secundaria a inserción placentaria anómala. Caso clínico: paciente de 45 años con embarazo de 8 semanas y 5 días, según la fecha de última regla, con miomatosis uterina gigante asociada con tromboembolismo pulmonar, quien decide la interrupción voluntaria del embarazo y realizarse la histerectomía en bloque. Conclusiones: la histerectomía en bloque es una cirugía poco realizada en la actualidad, sin embargo, este abordaje quirúrgico es una opción segura y efectiva para la interrupción voluntaria del embarazo, y no se debe descartar entre las alternativas de tratamiento quirúrgico, siempre individualizando cada paciente.

ABSTRACT BACKGROUND: En bloc hysterectomy is defined as the removal of the pregnant uterus with its gestational content in situ. The indications for performing this en bloc surgery are neoplastic processes, as the most frequent cause; septic processes, trophoblastic disease and hemorrhage secondary to abnormal placental insertion, however, it is a controversial procedure, and with little updated literature. CLINICAL CASE: 45-year-old patient with a pregnancy of 8 weeks and 5 days, with giant uterine myomatosis associated with pulmonary thromboembolism who decided to voluntarily terminate the pregnancy, and it was decided to perform en bloc hysterectomy. CONCLUSIONS: En bloc hysterectomy is a surgery rarely performed at present, however, this surgical approach is a safe and effective option for the voluntary termination of pregnancy, and it should not be ruled out among the surgical treatment alternatives, always individualizing each patient.

Assistência pré-natal às usuárias de substâncias psicoativas: dificuldades elencadas pelos profissionais da saúde / Prenatal care for users of psychoactive substances: difficulties listed by health professionals / Atención prenatal a consumidoras de sustancias psicoactivas: dificultades mencionadas por los profesionales de la salud

Objetivo: conhecer as dificuldades elencadas pelos profissionais de saúde na assistência pré-natal às usuárias de substâncias psicoativas. Método: estudo qualitativo, exploratório-descritivo, realizado nas mídias sociais, com profissionais da área da saúde que realizam atendimento pré-natal. A coleta de dados ocorreu de novembro de 2022 a janeiro de 2023 por meio de questionário eletrônico. Os dados foram analisados por meio da análise temática. Protocolo aprovado pelo Comitê de Ética em Pesquisa. Resultados: os profissionais destacam o déficit de conhecimento para abordar este público em específico. A abordagem superficial e condenatória do uso de substâncias pelas políticas públicas corrobora para que os profissionais se sintam preparados em parte para atender essas gestantes. Considerações finais: a capacitação dos profissionais é necessária para superar práticas condenatórias e retrógradas de cuidado que focam unicamente a abstinência; como também, o investimento na capacitação acerca da rede de atenção à saúde, buscando ampliar sua visibilidade e utilização.

Objective: understanding the difficulties listed by health professionals in prenatal care for users of psychoactive substances. Method: this is a qualitative, exploratory-descriptive study carried out on social media with health professionals who provide prenatal care. Data was collected from November 2022 to January 2023 using an electronic questionnaire. The data was analyzed using thematic analysis. Protocol approved by the Research Ethics Committee. Results: the professionals highlight the lack of knowledge to deal with this specific public. The superficial and condemnatory approach to substance use by public policies contributes to making professionals feel partly prepared to deal with these pregnant women. Final considerations: the training of professionals is necessary to overcome condemnatory and retrograde care practices that focus solely on abstinence; and investment in training about the health care network, seeking to increase its visibility and use.

Objetivo: conocer las dificultades mencionadas por los profesionales de la salud en la atención prenatal de las consumidoras de sustancias psicoactivas. Método: estudio cualitativo, exploratorio-descriptivo, realizado en redes sociales, con profesionales de la salud que brindan atención prenatal. La recolección de datos se llevó a cabo de noviembre de 2022 a enero de 2023 a través de un cuestionario electrónico. Los datos se analizaron mediante análisis temático. El protocolo fue aprobado por el Comité de Ética en Investigación. Resultados: los profesionales destacan que les falta el conocimiento para atender a este público específico. El abordaje superficial y condenatorio del consumo de sustancias por parte de las políticas públicas contribuye a que los profesionales se sientan parcialmente preparados para atender a esas gestantes. Consideraciones finales: es necesario capacitar a los profesionales para superar las prácticas asistenciales condenatorias y retrógradas que se centran únicamente en evitar el consumo; e invertir en capacitación sobre la red de atención de salud, para ampliar su visibilidad y uso.

Prevalência de nascimentos prematuros como desfechos de infecções pela COVID-19 na gestação / Prevalence of Preterm Birth as an Outcome of COVID-19 Infections during Pregnancy / Prevalencia de nacimientos prematuros producto de la infección por COVID-19 durante el embarazo

Objetivo: estimar a prevalência de nascimento prematuro em gestantes infectadas pela Covid-19, comparar índices de prematuridade entre infectadas e não infectadas e elucidar fatores associados à prematuridade. Métodos: coorte retrospectiva, com coleta de dados por inquérito online, de abril a dezembro de 2022, com mulheres que estiveram gestantes durante a pandemia, com acesso à internet, idade superior a 18 anos e que preencheram o primeiro inquérito online. Protocolo de pesquisa aprovado pelo Comitê de Ética. Resultados: primeiro inquérito respondido por 304 gestantes/puérperas, e o segundo por 82 (27%), compondo a amostra final. O índice de prematuridade no primeiro inquérito foi de 7,2% (n=14), já no segundo, 8,5% (n=7). A infecção pela Covid-19 não foi associada à prematuridade. A prematuridade associou-se a baixo peso, à necessidade de internação em centros de terapia intensiva neonatal e internações após o nascimento. Conclusão: a infecção pela Covid-19 não influenciou no aumento de nascimentos prematuros.

Objective: to estimate the prevalence of preterm birth in pregnant women infected with Covid-19, compare prematurity rates between infected and non-infected, and elucidate factors associated with prematurity. Methods: a retrospective cohort study was conducted using online survey data collected from April to December 2022, involving women who were pregnant during the pandemic, had internet access, were over 18 years old, and completed the initial online survey. The research protocol was approved by the Ethics Committee. Results: the initial survey was completed by 304 pregnant/postpartum women, and the follow-up survey by 82 (27%), comprising the final sample. The preterm birth rate in the initial survey was 7.2% (n=14), and in the follow-up survey, it was 8.5% (n=7). Covid-19 infection was not associated with prematurity. Prematurity was associated with low birth weight, the need for neonatal intensive care unit admission, and postnatal hospitalizations. Conclusion: Covid-19 infection did not influence an increase in preterm births.

Objetivo: estimar la prevalencia de partos prematuros en gestantes infectadas por Covid-19, comparar las tasas de prematuridad entre gestantes infectadas y no infectadas y determinar los factores asociados a la prematuridad. Métodos: estudio de cohorte retrospectivo, con recolección de datos mediante encuesta online, de abril a diciembre de 2022, con mujeres que estuvieron embarazadas durante la pandemia, con acceso a internet, mayores de 18 años y que completaron la primera encuesta online. El protocolo de investigación fue aprobado por el Comité de Ética. Resultados: la primera encuesta fue respondida por 304 gestantes/puérperas, y la segunda por 82 (27%), que conformaron la muestra final. La tasa de prematuridad en la primera encuesta fue del 7,2% (n=14), en la segunda, del 8,5% (n=7). La infección por Covid-19 no se asoció con la prematuridad. La prematuridad se asoció con bajo peso, necesidad de internación en centros de cuidados intensivos neonatales e internaciones después del nacimiento. Conclusión: La infección por Covid-19 no influyó en el aumento de nacimientos prematuros.

Desfechos obstétricos adversos durante a COVID-19: uma série de casos retrospectiva / Adverse obstetric outcomes during COVID-19: a retrospective case series / Resultados obstétricos adversos durante el COVID-19: serie de casos retrospectiva

Objetivo: analisar as características e os desfechos obstétricos adversos em gestantes/puérperas infectadas pelo SARS-CoV-2 em serviço de referência. Método: série de casos retrospectiva entre gestantes com Covid-19 em um hospital universitário em Minas Gerais, Brasil, atendidas no serviço de 2020 a 2021, coletados em abril de 2022, empregando-se estatística descritiva para análise dos dados através do Statistical Package for the Social Science. Resultados: incluídas 26 gestantes, em sua maioria brancas, que tiveram como principais desfechos obstétricos adversos a internação em UTI (43,5%), parto prematuro (34,6%), dado reestratificado de semanas para dias para investigar o encurtamento da gestação, onde constatou-se média de 38,6 dias potenciais de gravidez perdidos dos 280 dias ideais, e ainda 15,4% evoluíram para óbito materno. Conclusão: o estudo proporcionou evidenciar a necessidade de vigilância e atenção às gestantes com foco nos principais desfechos adversos, podendo-se intervir em tempo oportuno para diminuir adversidades.

Objective: to analyze the characteristics and adverse obstetric outcomes in pregnant/puerperal women infected by SARS-CoV-2 at a reference service. Method: a retrospective case series conducted among pregnant women with Covid-19 in a university hospital from Minas Gerais, Brazil, treated at the service from 2020 to 2021. The cases were collected in April 2022 employing descriptive statistics for data analysis in the Statistical Package for the Social Science. Results: a total of 26 pregnant women were included, mostly white-skinned, whose main adverse obstetric outcomes were admission to the ICU (43.5%), premature birth (34.6%) and data restratified from weeks to days to investigate shortening of pregnancy, where a mean of 38.6 potential days of pregnancy were lost out of the ideal 280 days, and 15.4% resulted in maternal death. Conclusion: the study provided evidence of the need for surveillance and care for pregnant women with a focus on the main adverse outcomes, enabling timely intervention to reduce adversities.

Objetivo: analizar las características y resultados obstétricos adversos en gestantes/puérperas infectadas por SARS-CoV-2 en un servicio de referencia. Método: serie de casos retrospectiva entre gestantes con Covid-19 en un hospital universitario de Minas Gerais, Brasil, atendidas en el servicio de 2020 a 2021. Los datos se recolectaron en abril de 2022, se utilizó estadística descriptiva para analizar los datos mediante el Statistical Package for the Social Science. Resultados: se incluyeron 26 gestantes, la mayoría de raza blanca, cuyos principales resultados obstétricos adversos fueron ingreso a UCI (43,5%), parto prematuro (34,6%), dato reestratificado de semanas a días para investigar el acortamiento de la gestación, que arrojó como resultado un promedio de 38,6. Se comprobó que se perdieron en promedio 38,6 días potenciales de embarazo de los 280 días ideales, y muerte materna (15,4%). Conclusión: la evidencia que proporcionó el estudio indica que es necesario vigilar y atender a las gestantes enfocándose en los principales resultados adversos, lo que permite intervenir de forma oportuna para reducir adversidades.

Representações sociais sobre o planejamento reprodutivo entre mulheres em gravidez não planejada / Social representations of reproductive planning among women with unplanned pregnancies / Representaciones sociales sobre la planificación reproductiva de las mujeres con embarazo no planificado

Objetivo: conhecer as representações sociais sobre o planejamento reprodutivo entre mulheres em gravidez não planejada na Estratégia Saúde da Família. Método: estudo qualitativo, orientado pela Teoria das Representações Sociais, realizado com 15 gestantes, entre abril e maio de 2019. Utilizou-se a entrevista semiestruturada. Os dados foram organizados por meio do Discurso do Sujeito Coletivo, com auxílio do software DSCsoft©. Protocolo de pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: as representações sociais das mulheres em gravidez não planejada evidenciadas pelo Discurso do Sujeito Coletivo foram representadas por oito ideias centrais, a saber: "eu não me preveni, nem ele", "nós nos prevenimos", "eu comprava", "pegava no posto", "construir uma família", "ter esse acesso", "estou por fora" e "eu sei que é disponível". Conclusão: as representações sociais nos discursos das mulheres em gravidez não planejada estavam pautadas no desconhecimento acerca do planejamento reprodutivo, dos anticoncepcionais disponíveis e seu uso correto.

Objective: to understand the social representations of reproductive planning among women with unplanned pregnancies in the Family Health Strategy. Method: qualitative study, guided by the Theory of Social Representations, carried out with 15 pregnant women between April and May 2019. Semi-structured interviews were used. The data was organized using the Discourse of the Collective Subject, with the aid of DSCsoft© software. Research protocol approved by the Research Ethics Committee. Results: the social representations of women with unplanned pregnancies as evidenced by the Collective Subject Discourse were represented by eight central ideas, namely: "I didn't prevent myself, nor did he", "we prevented ourselves", "I would buy it", "I would get it at the health center", "build a family", "have this access", "I am not aware" and "I know it is available". Conclusion: the social representations in the women's speeches about unplanned pregnancies were based on a lack of knowledge about reproductive planning, the contraceptives available and their correct use.

Objetivo: conocer las representaciones sociales sobre la planificación reproductiva de las mujeres con embarazo no planificado en la Estrategia Salud de la Familia. Método: estudio cualitativo, basado en la Teoría de las Representaciones Sociales, realizado con 15 mujeres embarazadas, entre abril y mayo de 2019. Se utilizaron entrevistas semiestructuradas. Los datos fueron organizados mediante el Discurso del Sujeto Colectivo, con ayuda del software DSCsoft©. El protocolo de investigación fue aprobado por el Comité de Ética en Investigación. Resultados: las representaciones sociales de las mujeres con embarazo no planificado reveladas por el Discurso del Sujeto Colectivo fueron representadas por ocho ideas centrales, a saber: "yo no me cuidé y él tampoco", "nos cuidamos", "yo los compraba", "los buscaba en el centro de salud", "construir una familia", "tener acceso", "no participo" y "sé que está disponible". Conclusión: las representaciones sociales en los discursos de las mujeres con embarazo no planificado se basaron en la falta de conocimiento sobre la planificación reproductiva, en los anticonceptivos disponibles y su uso correcto.

The Association and diagnostic value between Maternal Serum Placental Markers and Placenta Previa.

Objective: This study aims to evaluate the correlation and diagnostic value of maternal serum placental markers: pregnancy-associated plasma protein-A (PAPP-A), free beta human chorionic gonadotropin (free ß-hCG), and alpha fetoprotein (AFP) in relation to placenta previa. Methods: A retrospective case-control study was conducted to gather data on 137 pregnant women who were hospitalized for delivery at Hangzhou Women's Hospital. These women participated in the late stage of early and mid-term maternal serum prenatal screening between January 2018 and December 2020. Of the 137 women, 45 were diagnosed with placenta previa, while 92 were selected at random as the control group, in a ratio of 1: 2. Independent samples t-test or Mann-Whitney U test were utilized to compare the quantitative data of the two groups, and the Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of maternal serum placental marker levels for placenta previa. Results: The levels of first trimester and second trimester free beta subunit of human chorionic gonadotropin (FT-Free ß-hCG; ST-Free ß-hCG) in the placenta previa group were higher than those in the normal group [1.38 (0.55-6.03) MoM vs.1.08 (0.32-4.00) MoM, 1.38 (0.39-4.10) MoM vs.1.01 (0.29-4.12) MoM], and the differences between the groups were statistically significant (Z = 2.830, Z = 2.846, both P < 0.05). The AFP level was higher than the normal group [1.13 (0.65-2.15) MoM vs. 0.94 (0.51-2.02) MoM], and the difference was statistically significant (Z = 2.551, P < 0.05). There was no significant difference in PAPP-A between the placenta previa group and the normal group (Z = 1.396, P > 0.05). The ROC curve analysis results showed that the AUCs of FT-Free ß-hCG and ST-Free ß-hCG for placenta previa were 0.649 (95 % CI: 0.551-0.747, P = 0.005), 0.634 (95 % CI: 0.539-0.730, P = 0.011), and 0.650 (95 % CI: 0.554-0.746, P = 0.004). Using PPV, NPV, FPR, FNR, +LR, and -LR as evaluation indicators for the 5 models, the results showed that FT-Free ß-hCG was the best performer in terms of PPV, FPR, and +LR, with values of 0.725, 0.600, and 2.632, respectively. The three-indicator combined detection model (AFP + ST-Free ß-hCG + FT-Free ß-hCG) had the best performance in terms of NPV and -LR, with values of 0.770 and 0.298, respectively. Conclusion: The elevated maternal serum levels of Free ß-hCG and AFP may be associated with placenta previa. The combined detection of maternal serum markers in the early and mid-trimesters has better diagnostic value for predicting placenta previa than individual detection.

Anti-N-Methyl-D-Aspartate Receptor (Anti-NMDAR) Encephalitis in a Young Pregnant Woman With a 10-Year Follow-Up: A Case Report.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease of the central nervous system with unknown etiology and multiple triggers. It is clinically characterized by the onset of psychiatric symptoms, seizures, memory disturbance, and cognitive decline. We present a young, newly married woman in the first trimester of pregnancy who presented with purely psychiatric manifestations, fever, and two instances of generalized tonic-clonic seizures. She eventually progressed to develop a decreased level of consciousness and hemodynamic instability. A diagnosis was made of anti-NMDA encephalitis. Her symptoms progressed even after the administration of two intravenous immunoglobulin (IVIG) trials, steroids, and three anti-seizure medications until she experienced a spontaneous abortion. She then gradually returned to her normal baseline condition. This case underscores the importance of suspecting anti-NMDAR encephalitis in pregnant patients with acute onset of psychiatric manifestations. Anti-NMDAR encephalitis can be a difficult, challenging, and exhausting diagnosis for both the patient and treating physicians, particularly in pregnant patients where diagnostic and therapeutic options may be limited due to concerns for fetal safety. However, this case provides evidence that anti-NMDAR encephalitis during pregnancy can have a good prognosis.

Successful treatment of osteosarcoma in a pregnant woman with survival of the gestational product: A case report and literature review.

Osteosarcoma (OS) is the most prevalent bone neoplasm of mesenchymal origin, accounting for 20% of all bone tumors worldwide. It mainly affects the marrow of long bones, and its diagnosis is more common among adolescents and the geriatric population. Histologically, it is characterized by high cellular variability, abundant osteoid and fibrotic material. In the early stages, it presents with only local symptoms such as pain, edema and limited joint mobility. This neoplasm, when detected promptly, is associated with a favorable prognosis and can be effectively treated through surgical removal and adjuvant therapy. The development of tumors in pregnant women is rare, and the occurrence of osteosarcoma is even more exceptional, with only 10 cases documented in the literature. Given its rarity, the present study describes the case of a female patient with OS diagnosed in the first trimester of pregnancy, where the patient responded well to treatment, resulting in no adverse effects on the pregnancy outcome.

Association of Gestational Iron-deficiency Anemia with Antenatal Depression among Pregnant Women: A Case-control Study from Tertiary Care Hospitals, Lahore.

Objective: The goal of this study is to investigate the potential association between gestational anemia and antenatal depression in pregnant women. Methods: It is a case-control study consisting of 684 pregnant women under 18 years recruited in different tertiary care hospitals, in Lahore, between June 2023 and December 2023. Utilizing an online questionnaire, data collection encompassed demographics, dietary habits, and the Edinburgh Postnatal Depression Scale (EPDS). Pregnant women with antenatal hemoglobin (Hb) levels above and below 11.0 g/dL were categorized as a nonanemic and anemic group. Statistical analysis involved Chi-square tests to explore the relationships between gestational parameters and maternal factors. Findings: The depression scores of anemic and nonanemic pregnant women compare two groups of pregnant women based on their Hb levels: those with Hb <110 g/l during pregnancy (anemic) and those with Hb ≥110 g/l (nonanemic). The anemic group had higher depression scores than the nonanemic group, both for those with EPDS <12 points and those with EPDS ≥12 points. However, P = 0.077 indicates that this difference was not statistically significant at a typical alpha level of 0.05. Conclusion: No significant association was found between gestational anemia and antenatal depression in pregnant women. These findings prompt further research to unravel the intricacies of the association between gestational anemia and depression. The outcomes thus urge the researchers and health-care professionals to consider the diverse factors that may contribute to mental health outcomes during pregnancy and refine strategies for maternal care.

Psychological Distress in Patients With Recurrent Ectopic Pregnancies: A Cross-Sectional Study.

AIM: Most patients with ectopic pregnancies experience a high level of psychological distress for various reasons. The psychological state and needs of patients with recurrent ectopic pregnancies need to be seriously addressed. However, psychological distress in patients with recurrent ectopic pregnancy has not been widely studied. The purpose of this study is to investigate and understand the prevalence and factors influencing psychological distress in patients with recurrent ectopic pregnancies. DESIGN: A cross-sectional study. METHODS: This study follows the STROBE guidelines. The Kessler Psychological Distress Scale (K10) was utilised to assess the level of psychological stress in patients. The Kruskal-Wallis test or Mann-Whitney U test was used to compare the factors influencing psychological stress in patients with different conditions. RESULTS: A total of 134 patients with recurrent ectopic pregnancies completed the survey, and most patients experienced moderate-to-severe psychological distress. The psychological distress experienced by patients with recurrent ectopic pregnancies is complex and dynamic, influenced by various factors. Among them, the main factors affecting the psychological distress of patients were age, education level, number of children, number of abortions, medical insurance and economic pressure (p < 0.05). CONCLUSION: This study suggests that the psychological distress experienced by patients with recurrent ectopic pregnancies is universal and cannot be ignored. It is necessary to pay attention to the psychological needs of patients with recurrent ectopic pregnancies and carry out scientific and effective psychological care management.

Caesarean scar endometriosis: how to make an accurate diagnosis.

Caesarean scar endometriosis is a rare condition characterised by the presence of endometrial tissue within a surgical scar following a caesarean section. A woman in her late 30s presented with a painful lump beneath her caesarean section skin scar, worsening during menstruation. Despite a previous incision and drainage procedure for a 'scar abscess', the symptoms persisted. Ultrasound imaging revealed a cystic lesion beneath the scar. A diagnosis of scar endometriosis was made, and surgical excision was performed. The patient remained symptom-free at 2-year follow-up postsurgery. Histopathology confirmed the presence of endometrial glands and stroma within the scar tissue. This case demonstrates that a reliable diagnosis of caesarean section endometriosis could be made with a triad of symptoms of a cyclic painful mass at the site of a caesarean section scar. Imaging is helpful in excluding other differential diagnoses. Diagnosis can be confirmed with histopathology and treated with complete surgical excision.

Nutritional Requirements in Pregnancy and Lactation.

Optimal nutrition during pregnancy and lactation is vital for the health of the mother and fetus. Nutritional needs should begin in the preconception period, as the fetus depends on the placenta for essential nutrients required for growth and development. A balanced diet rich in nutrient-dense foods-such as whole grains, vegetables, fruits, dairy, legumes, fish, and lean meats-is essential to meet caloric needs during pregnancy. Assessment of maternal health, including dietary history and micronutrient status, is critical to identify potential risks and ensure adequate nutrition. The increased need for micronutrients must be met to prevent complications and fetal growth. Exclusive breastfeeding is recommended for the first six months, and continued breastfeeding is recommended throughout the first year and beyond. During pregnancy and lactation, calorie intake should be increased by focusing on protein and healthy fats. The composition of breast milk is adapted during the breastfeeding period, so that it can provide the necessary nutrients for the growth of the infant. Personalized nutrition plans, developed in consultation with health care professionals, are critical to optimizing maternal and infant health outcomes. This manuscript supports the importance of comprehensive nutritional strategies during pregnancy and lactation to reduce risks and support healthy growth and development of mother and child.