Programa educativo Sonrisas desde el vientre, para embarazadas de un hogar materno / Educational program Smiles from the womb, for pregnant women from a maternal home

RESUMEN Introducción: el hogar materno es un lugar esencial para brindar educación para la salud y orientar a las futuras madres acerca de su salud bucal y la repercusión de esta en ella y su futuro bebé. Objetivo: diseñar un programa educativo de salud bucal para las embarazadas del Hogar Materno de Cabaiguán, en la provincia de Sancti Spíritus. Materiales y métodos: investigación cualitativa de intervención educativa realizada entre enero y marzo de 2020. La unidad de estudio estuvo constituida por 20 embarazadas ingresadas en el Hogar Materno de Cabaiguán. Resultados: se estructuró un programa para las futuras madres que aborda, en ocho sesiones educativas, el componente bucal de la salud enfocado en dos variantes: salud bucal de la embarazada y la del futuro bebé. Conclusiones: el programa puede ser aplicado en los hogares maternos, que constituyen espacios idóneos para el cumplimiento de las actividades propuestas, las cuales pueden contribuir a producir cambios significativos en los conocimientos sobre salud bucal en este grupo priorizado.

ABSTRACT Introduction: a maternal home is an essential place where health education should be provided and future mothers should be guided about their oral health and its repercussions on them and on their future baby. Objective: to design an educational oral health program for pregnant women at the Maternal Home of Cabaiguán, in the province of Sancti Spíritus. Materials and methods: qualitative research of educational intervention carried out between January and March 2020. The study unit consisted of 20 pregnant women admitted to the Maternal Home of Cabaiguán. Results: a program for future mothers that approaches the oral component of health focused on two variants: the oral health of the pregnant woman and the oral health of the future baby, was structured in eight educational sessions. Conclusions: the proposed program can be implemented in maternal homes, which are ideal spaces for fulfilling the proposed activities; it can contribute to significant changes in oral health knowledge in this prioritized group.

Effect of an Interactive Training on Choosing Delivery Method among Primiparous Pregnant Women: An Interventional Study.

OBJECTIVES: To evaluate the effect of interactive training conducted during pregnancy on choosing delivery method among primiparous women. METHODS: Quasi-experimental study carried out in 2017 in two hospitals in the city of Bushehr (Iran), with the participation of 108 primiparous pregnant women in an educational program consisting of eight 2-hour sessions every two weeks in which interactive training activities were performed (group discussions, classroom sessions, and delivery of printed educational material) on themes related with physiological delivery, painless vaginal delivery methods, and complications of cesarean delivery without indication, among others. Before and after the intervention, the Knowledge and Preferred Method of Delivery Questionnaire by Moradabadi et al., was used to obtain information. RESULTS: The results indicated that the level of knowledge in the group of mothers increased significantly between the pre-intervention and post-intervention assessment (13.2 versus 19.4, of 20 possible maximum points; p < 0.001). Additionally, significant difference was observed in the selection of the vaginal delivery method before and after the intervention (74.1% versus 98.1%; p < 0.001). CONCLUSIONS: Implementation of interactive training increased knowledge of pregnant women on the delivery and induced a positive effect to encourage the primiparous mothers to have a vaginal delivery.

Impacto de la educación para la salud en la lactancia materna. Beneficios para el recién nacido / Impact of health education on breastfeeding. Benefits for the newborn

OBJETIVOS El objetivo general del trabajo es conocer la efectividad entre la educación sanitaria sobre la lactancia materna en mujeres embarazadas en últimas semanas de fecha de parto en relación a su decisión de amamantar a sus hijos/as. MATERIALES Y MÉTODOS En primer lugar, se realiza una revisión bibliográfica del estado actual de la producción científica enfermera sobre la efectividad de la educación en la población relacionado con la lactancia materna. A continuación, se realiza un estudio de enfoque cuantitativo, medición de la variable y diseño con intervención siendo este cuasi experimental con una muestra de 102 mujeres embarazadas. RESULTADOS Tras la aplicación de los test preeducacional y posteducacional en las sesiones de educación maternal sobre la lactancia materna la comparativa es positiva respecto a la adquisición de nivel de conocimientos de las mujeres embarazadas de la lactancia materna con el objetivo de aumentar la tasa de lactancia materna exclusiva en la población. CONCLUSIONES En la actualidad existe evidencia científica de un notable descenso de madres que amamantan a sus hijos debido a una carencia de información adecuada sobre el tema. Para ello, se hace necesaria la realización de educación sanitaria, los programas de educación tienen un afán promotor en el uso de la lactancia natural.

OBJECTIVES The general objective of the work is to know the effectiveness among health education on breastfeeding in pregnant women in the last weeks of the date of delivery in relation to their decision to breastfeed their children. MATERIALS AND METHODS First, a bibliographic review of the current state of nursing scientific production on the effectiveness of education in the population related to breastfeeding is carried out. A quantitative approach, measurement of the variable and design with intervention study is carried out, this quasi-experimental being with a sample of 102 pregnant women. RESULTS After the application of the preeducational and posteducational tests in the maternal education sessions on breastfeeding, the comparison is positive regarding the acquisition of the level of knowledge of pregnant women of breastfeeding in order to increase the rate of exclusive breastfeeding in the population. CONCLUSIONS Currently there is scientific evidence of a notable decline in mothers who breastfeed their children due to a lack of adequate information on the subject. For this, it is necessary to carry out health education, education programs have a promoting desire in the use of breastfeeding.

Recommendations of physical activity and rest in a Colombian prenatal control program.

OBJECTIVE: To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia. METHODS: An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10. RESULTS: There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers. CONCLUSIONS: The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.

Recommendations of physical activity and rest in a Colombian prenatal control program / Recomendaciones de actividad física y reposo en un programa de control prenatal colombiano

ABSTRACT OBJECTIVE To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia. METHODS An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10. RESULTS There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers. CONCLUSIONS The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.

RESUMEN OBJETIVO Determinar la frecuencia del registro de recomendaciones de actividad física y reposo realizadas a las gestantes y explorar sus factores asociados, en un programa de atención de control prenatal de instituciones públicas de primer nivel de atención en Bucaramanga, Colombia. MÉTODOS Se realizó un estudio observacional. El marco muestral estuvo conformado por los registros médicos de las gestantes que asistieron al menos a un programa de atención de control prenatal entre el 1º de enero y 31 de diciembre de 2012 (n = 2,932), en 21 centros de salud de primer nivel de atención. Se analizaron variables sociodemográficas, antecedentes prenatales, antecedentes clínicos, e información relacionada con el personal de salud y la organización de los centros de salud como posibles factores asociados con las recomendaciones de actividad física y reposo registrados en la historia clínica. Se aplicaron modelos de regresión logística para explorar las asociaciones con un α = 0.10. RESULTADOS Se observó una frecuencia de 26.1% de registro de recomendaciones de AF y 3.6% de reposo, emitidas por parte de profesionales de nutrición (97.3%) y medicina (86.7%), respectivamente. Los factores asociados al registro de las recomendaciones de actividad física fueron: ser gestante nulípara (OR = 1.7), asistir a más de cuatro Programas de Atención de Control Prenatal (OR = 2.2), tener riesgo obstétrico alto o medio en el primer programa de atención de control prenatal (OR = 0.6) y ser atendidas en los centros de salud de las zonas administrativas de occidente (OR = 0.5) y oriente (OR = 0.2). CONCLUSIONES La baja frecuencia del registro de recomendaciones de actividad física encontrada, genera la necesidad de reforzar las estrategias de gestión de los centros de salud y fortalecer el monitoreo y acompañamiento en el cumplimiento de los protocolos de atención. Adicionalmente, es necesario capacitar a los equipos de salud sobre los beneficios de la actividad física y su prescripción adecuada, atendiendo a los múltiples beneficios derivados de su práctica sobre la salud materno-fetal.

A arte de nascer (The art of being born).

In 2008, this project began with a small group of volunteers in a poor rural community in northeastern Brazil using art therapy to increase the knowledge of pregnant women about gestation, birth, and care of their babies. After positive results were seen within that community, the methodology was published as a book to be replicated in other states of Brazil. In 2010/2011, after being selected as a "Young Champions of Maternal Health" winner by Ashoka and Maternal Task Force competition, the project was adapted for the local culture in Mali and replicated in villages in West Africa with workshops using songs, poems, stories, crafts, and cinema. It continues to be implemented throughout Brazil, and since 2012, at the Institute Santos Dumont, a health, teaching, and research center in a rural area in Northeast Brazil. It is also used as a teaching strategy for students of medicine, physiotherapy, psychology, resident doctors, and multiprofessionals. It contributes to the development of attitudes, health education skills, and interprofessional education experience. It also provides information and educates groups to empower women about their health and rights to make informed choices regarding pregnancy and childbirth.

Evaluation of Ready, Set, BABY: A prenatal breastfeeding education and counseling approach.

BACKGROUND: Comprehensive prenatal education on infant feeding is recommended by many United States health organizations because of the need to maximize maternal preparedness for managing lactation physiology. Ready, Set, BABY (RSB) is a curriculum developed for counseling women about breastfeeding benefits and management including education on optimal maternity care practices. We hypothesized that RSB would be acceptable to mothers and that mothers' strength of breastfeeding intentions would increase, and their comfort with the idea of formula feeding would decrease after educational counseling using the materials. We also hypothesized that mothers' knowledge of optimal maternity care practices would increase after participation. METHODS: Materials were sent to a total of seven sites in the United States and Puerto Rico. Local health care practitioners completed training before counseling mothers with the curriculum. A pre- and postintervention questionnaire was administered to participants. Statistical analysis of results included paired t tests, Wilcoxon signed-rank tests, and McNemar's tests. RESULTS: Four hundred and sixteen expectant women participated. In the pre- and postintervention comparison, maternal participation in RSB significantly improved Infant Feeding Intentions Scale scores (P < 0.001) and knowledge of Baby-Friendly recommended maternity care practices (P < 0.001), while significantly decreasing comfort with the idea of formula feeding (P < 0.001). The education materials were positively rated by participants. CONCLUSIONS: The findings indicate that the approach of using RSB in prenatal counseling group classes or individual sessions improves breastfeeding intentions. Future testing is needed to determine the effectiveness of the materials for impacting breastfeeding outcomes.

Perspective of pregnant women regarding antenatal preparation: A qualitative study.

BACKGROUND: Antenatal Education programs have been recommended for pregnant women to help them during gestation, childbirth and development of parenthood. Evidence on the perspectives and expectations of pregnant women regarding antenatal education in hospital settings, specifically in developing countries is still scarce. In-depth understanding is a key issue to organize interventions. AIM: Identify experiences, needs and expectations of a group of pregnant women regarding antenatal education. METHODS: A qualitative study was conducted. Data were collected through semi-structured interviews at the antenatal clinic of a public maternity teaching hospital in the southeastern region of Brazil. The interviews were recorded, transcribed verbatim and thematic analysis was performed. Twenty-two pregnant women were recruited following the logic of purposive sampling. FINDINGS: All the participants reported they would like to receive guidance on non-pharmacological techniques for pain management during labor. The participants reported barriers to performed physical exercise; however, they also said that if they were encouraged by healthcare professionals they would exercise. According to the majority, the exercises should be of low intensity, and the improvement of general wellbeing was the most commented benefit. Also participants said that antenatal education meetings should be linked to antenatal consultations to facilitate participation. According to some participants, knowledge about antenatal education was acquired in conversations with other women, from lay media, and some reported a lack of guidance during antenatal consultation. CONCLUSION: The participants of our study reported they would like to participate in antenatal education groups to receive guidance on non-pharmacological techniques to use during labor and childbirth.

Ações educativas com gestantes: relato de experiência em uma Unidade Básica de Saúde em São Francisco do Conde / Educational actions with pregnant women: experience report in a Health Unit of São Francisco do Conde

A assistência ao pré-natal é caracterizada como um conjunto de procedimentos clínicos e educativos, visando o acompanhamento e à evolução da gravidez. Contudo, os profissionais de saúde devem assumir papéis de educadores, compartilhando saberes e experiências no grupo de gestantes. O objetivo deste trabalho foi relatar a experiência das oficinas de educação em saúde realizadas com as gestantes acompanhadas na Estratégia Saúde da Família (ESF) Eliene Oliveira dos Santos, no período de agosto a setembro de 2016, em São Francisco do Conde (BA). Os periódicos para o embasamento do trabalho foram pesquisados na fonte de dados Literatura Latino-americana e do Caribe em Ciências da Saúde (Lilacs). A atividade contou com a participação crescente de gestantes bem como de um companheiro, durante três encontros, em que houve um diálogo e troca de experiências entre os participantes e uma equipe de residentes multiprofissional em saúde da família. Conclui-se que a realização desse trabalho serviu como um espaço de aproximação com os participantes e como um fluxo de ganho e troca de informações pertinentes àquele momento, sendo capaz de desmistificar alguns conceitos já enraizados

Beta talasemia y embarazo / Beta thalassemia and pregnancy

La talasemia es un desorden congénito hemolítico causado por una deficiencia parcial o completa de la síntesis de las cadenas alfa o beta de las globinas de la hemoglobina. Se manifiesta en una amplia gama de cuadros clínicos que van desde la muerte intrauterina hasta la microcitosis asintomática sin anemia. El depósito de hierro constituye la complicación más importante de la talasemia y su mayor preocupación en el manejo. El embarazo en mujeres con talasemias deviene un grave problema de salud que exige una atención diferenciada y multidisciplinaria. Para esta afección no existe tratamiento específico definitivo. El arsenal médico existente solo puede manejar los efectos y no la causa. El objetivo del trabajo es mostrar algunos aspectos relacionados con las complicaciones que pueden aparecer en esta entidad cuando se asocia al embarazo, la discusión del problema clínico, el diagnóstico y la importancia de la prevención y del consejo genético oportuno en este grupo de pacientes. Presentamos una gestante de 26 años de edad con edad gestacional de 13,5 semanas de piel negra, con antecedentes patológicos personales de S-b Talasemia. Desde muy pequeña presenta dolor en extremidades a predominio en miembros superior derecho e inferior izquierdo, fijo, de intensidad moderada a severa, que no responde a los analgésicos, acompañado de dolor en hipogastrio que se intensifica en los días siguientes. Requiere realizar dos exanguíneo transfusiones. Se reafirma la importancia de la visita preconcepcional para educar preventivamente a la población antes del embarazo para evitar complicaciones(AU)

Thalassemia is a congenital hemolytic disorder caused by a partial or complete deficiency of the synthesis of the alpha or beta chains of hemoglobin globins. It manifests itself in a wide range of clinical conditions ranging from intrauterine death to asymptomatic microcytosis without anemia. Iron deposition is the most important complication of thalassemia and its major management concern. Pregnancy in women with thalassemias becomes a serious health problem requiring differentiated and multidisciplinary attention. There is no definitive specific treatment for this condition. The existing medical arsenal can only handle the effects and not the cause. The objective of this study is to show some aspects related to the complications that may appear in this entity when it is associated with pregnancy, the discussion of the clinical problem, the diagnosis and the importance of prevention and timely genetic counseling in this group of patients. We present a black 26 year-old pregnant woman with gestational age of 13.5 weeks, with a personal pathological history of S-? Thalassemia. From a very young age, she presented pain in her limbs, with predominance in the upper right and lower left, fixed, moderate to severe intensity, which does not respond to analgesics, accompanied by pain in hypogastrium that intensifies in the following days. The patient required two blood transfusions. The importance of the preconception visit is reaffirmed to preemptively educate the population before pregnancy to avoid complications(AU)

[Educational practices in accordance with the "Ten steps to successful breastfeeding" in a Human Milk Bank]. / Práticas educativas segundo os "Dez passos para o sucesso do aleitamento materno" em um Banco de Leite Humano.

This article sought to evaluate educational practices in line with the "Ten Steps to Successful Breastfeeding" in a Human Milk Bank. It involved a retrospective study using sociodemographic data about the pregnancy and the baby, obtained from a nursing mothers care protocol (2009-2012). These data were associated to steps related to educational practices from the "Ten Steps." Descriptive analysis, chi-square test and Poisson regression were performed. 12,283 mothers, with a median of 29 (12-54) years old, were evaluated. The guidelines about breastfeeding received during prenatal care (step 3) prevailed among mothers aged 30-39 years and the skin to skin contact (step 4) prevailed among oriented mothers. Breastfeeding training (step 5) predominated among those who breastfed exclusively. Higher prevalence of exclusive breastfeeding (step 6), breastfeeding on demand (step 8) and use of artificial nipples (step 9) were noted among infants whose mothers were oriented. These findings indicate the important role of health professionals on mother/child training about breastfeeding, on encouragement of the skin/skin contact, exclusive breastfeeding and breastfeeding on demand. The guidelines indicated the need to improve in order to reduce the use of artificial nipples and enhance exclusive breastfeeding.

Práticas educativas segundo os "Dez passos para o sucesso do aleitamento materno" em um Banco de Leite Humano / Educational practices in accordance with the "Ten steps to successful breastfeeding" in a Human Milk Bank

Resumo Este artigo objetivou avaliar práticas educativas segundo os “Dez Passos para o Sucesso do Aleitamento Materno” em Banco de Leite Humano. Estudo retrospectivo com informações sociodemográficas e gestacionais maternas e referentes ao bebê, obtidas de protocolo de atendimento de nutrizes (2009-2012). Tais dados foram associados aos passos relacionados a práticas educativas dentre os “Dez Passos”. Realizou-se análise descritiva, teste qui-quadrado e regressão de Poisson. Foram avaliadas 12.283 mães, com mediana de 29 (12-54) anos de idade. As orientações recebidas sobre amamentação no pré-natal (passo 3) prevaleceram entre mães de 30-39 anos e o contato pele/pele (passo 4) entre as orientadas. O treinamento sobre amamentação (passo 5) predominou entre aquelas que amamentaram exclusivamente. Notou-se maior prevalência de amamentação exclusiva (passo 6) e sob livre demanda (passo 8) e uso de bicos artificiais (passo 9) entre os lactentes de mães orientadas. Os achados apontam importante papel do profissional da saúde no treinamento mãe/filho sobre aleitamento materno e incentivo ao contato pele/pele, amamentação exclusiva e sob livre demanda. As orientações ofertadas necessitam aprimoramento a fim de reduzir o uso de bicos artificiais e potencializar a amamentação exclusiva.

Abstract This article sought to evaluate educational practices in line with the “Ten Steps to Successful Breastfeeding” in a Human Milk Bank. It involved a retrospective study using sociodemographic data about the pregnancy and the baby, obtained from a nursing mothers care protocol (2009-2012). These data were associated to steps related to educational practices from the “Ten Steps.” Descriptive analysis, chi-square test and Poisson regression were performed. 12,283 mothers, with a median of 29 (12-54) years old, were evaluated. The guidelines about breastfeeding received during prenatal care (step 3) prevailed among mothers aged 30-39 years and the skin to skin contact (step 4) prevailed among oriented mothers. Breastfeeding training (step 5) predominated among those who breastfed exclusively. Higher prevalence of exclusive breastfeeding (step 6), breastfeeding on demand (step 8) and use of artificial nipples (step 9) were noted among infants whose mothers were oriented. These findings indicate the important role of health professionals on mother/child training about breastfeeding, on encouragement of the skin/skin contact, exclusive breastfeeding and breastfeeding on demand. The guidelines indicated the need to improve in order to reduce the use of artificial nipples and enhance exclusive breastfeeding.

Características y creencias maternas asociadas al abandono de la lactancia materna exclusiva / Characteristics and maternal beliefs associated to the cessation of exclusive breastfeeding

Objetivo: determinar las características y creencias maternas relacionadas con el abandono de la lactancia materna exclusiva. Métodos: estudio observacional, descriptivo y transversal en 239 madres que culminaron el parto y acudieron al Servicio de Crecimiento y Desarrollo del Niño del Hospital Regional del Departamento de Ica (Perú). Para el análisis bivariado se dicotomizaron las variables de estudio. Se empleó la prueba chi cuadrado cuando las variables fueron categóricas y la prueba t de student para comparar la diferencia de promedios cuando las variables eran numéricas. Resultados: el abandono de la lactancia materna exclusiva se observó en 69 (28,87 por ciento) madres que tenían 23,54 años de edad en promedio (IC 95 por ciento: 22,24-22,84), mientras que aquellas que no abandonaron la lactancia materna exclusiva tenían un promedio de edad de 24,85 años (IC95 por ciento: 23,94-25,76) (p= 0,121). Las creencias inadecuadas: Dar de lactar es doloroso, El biberón es la mejor forma de controlar la alimentación de mi bebé y Dar pecho daña mi imagen corporal, así como la discrepancia de las madres con las afirmaciones La lactancia materna exclusiva es suficiente para satisfacer el hambre de mi bebé y La lactancia materna exclusiva es suficiente para engordar a mi bebé, se asoció con mayor proporción de abandono de la lactancia materna exclusiva (p< 0,05). Conclusión: las creencias maternas inadecuadas sobre la lactancia materna están ligadas al abandono de la lactancia materna exclusiva(AU)

Objectives: to determine the characteristics and maternal beliefs about the cessation of exclusive breastfeeding. Methods: observational, descriptive and cross-sectional study of 239 women who had given birth and had gone to the Service for child growth and development located in the Regional Hospital of Ica department in Peru. The bivariate study required dichotomizing the study variables. The Chi-square test was used for categorical variables whereas the Student´s t test served to compare the differences among averages when variables were numerical. Results: sixty nine mothers (28.87 percent), aged 23.54 years as average (CI 95 percent 22.24-22.84), ceased to breastfeed their children whereas those mothers continue breastfeeding were 24.85 years-old as average (CI 95 percent: 23.94-25.76) (p= 0.121). Incorrect beliefs such as breastfeeding is painful, Breastfeeding is the best way of managing my baby´s feeding and breastfeeding damages my body image as well as the disagreement of mothers with the statements Exclusive breastfeeding is enough to satisfy the baby´s hunger and Exclusive breastfeeding is enough for my baby to gain weight were associated to a higher number of mothers who ceased exclusive breastfeeding (p< 0.05). Conclusions: Incorrect maternal beliefs are related to the cessation of exclusive breastfeeding(AU)

Determinación de sífilis por método serológico en gestantes de la ciudad de Guayaquil / Detection of syphilis by a serological method in pregnant women from Guayaquil City

INTRODUCCIÓN: en Ecuador la sífilis es un problema de salud pública. La sífilis congénita conlleva a la aplicación de medidas para lograr la disminución de la transmisión y la erradicación de la enfermedad. El uso de las técnicas de diagnóstico permite detectarla durante la gestación, garantiza un seguimiento durante el control prenatal de las gestantes, para brindar un tratamiento adecuado en caso necesario. OBJETIVO: determinar la sífilis por método serológico en las gestantes que acuden al Centro de Salud # 3, de la ciudad de Guayaquil. MÉTODOS: se aplicó un estudio de carácter correlacionar y retrospectivo a las 445 gestantes que acudieron al centro, para su control prenatal o por libre demanda, de abril a agosto del 2012. Se identificaron las que resultaron positivas a sífilis, mediante la prueba serológica Venereal Disease Research Labotarory. Se diseñó un cuestionario para evaluar el nivel de conocimiento existente sobre la enfermedad, que se aplicó a 71 mujeres seleccionadas al azar. Además se propuso un programa educativo. RESULTADOS: los resultados se estratificaron según el grupo etario y etapa de gestación. De las 18 gestantes con sífilis (4 %), solo 3 recibieron tratamiento. El mayor porcentaje de casos positivos correspondió al rango entre los 21 y 28 años de edad (61 %) y el 50 % correspondió a mujeres en etapa de gestación entre 21 y 28 semanas. La aplicación del cuestionario demostró un gran desconocimiento sobre el tema, por lo que el programa educativo incluyó 9 tareas vinculadas, directo a la capacitación y divulgación del tema.

INTRODUCTION: syphilis is a public health problem in Ecuador. Congenital syphilis leads to the implementation of actions to achieve the reduction of transmission and finally eradication of disease. The use of diagnostic techniques allows detecting the disease during gestation, thus guaranteeing a follow-up in prenatal management stage and an adequate treatment if necessary. OBJECTIVE: to determine syphilis by a serological method in pregnant women who went to the Health Center #3 in the city of Guayaquil. METHODS: aretrospective correlational study of 445 pregnant women who went to the center for prenatal management or at will in the period of April to August 2012. The syphilis positivity was determined by the serological test Venereal Disease Research Laboratory. A questionnaire was designed to evaluate the level of knowledge on the disease and given to 71 randomly selected women. Additionally, an educational program was suggested. RESULTS: the results were stratified by aged group and pregnancy stage. Of 18 pregnant women with syphilis (4%), just 3 were treated. The highest percentage of positive cases was found in 21-28 age group (61%) and 50% of women were in gestational stage between 21 and 28 weeks. the application of the questionnaire showed a lack of knowledge on the topic, so the educational program included 9 tasks directly related to training in and dissemination of information on this topic.

Developing strategies to be added to the protocol for antenatal care: an exercise and birth preparation program.

OBJECTIVES: To describe the implementation process of a birth preparation program, the activities in the protocol for physical and birth preparation exercises, and the educational activities that have been evaluated regarding effectiveness and women's satisfaction. The birth preparation program described was developed with the following objectives: to prevent lumbopelvic pain, urinary incontinence and anxiety; to encourage the practice of physical activity during pregnancy and of positions and exercises for non-pharmacological pain relief during labor; and to discuss information that would help women to have autonomy during labor. METHODS: The program comprised the following activities: supervised physical exercise, relaxation exercises, and educational activities (explanations of lumbopelvic pain prevention, pelvic floor function, labor and delivery, and which non-pharmacological pain relief to use during labor) provided regularly after prenatal consultations. These activities were held monthly, starting when the women joined the program at 18-24 weeks of pregnancy and continuing until 30 weeks of pregnancy, fortnightly thereafter from 31 to 36 weeks of pregnancy, and then weekly from the 37th week until delivery. Information and printed materials regarding the physical exercises to be performed at home were provided. Clinicaltrials.gov: NCT01155804. RESULTS: The program was an innovative type of intervention that systematized birth preparation activities that were organized to encompass aspects related both to pregnancy and to labor and that included physical, educational and home-based activities. CONCLUSIONS: The detailed description of the protocol used may serve as a basis for further studies and also for the implementation of birth preparation programs within the healthcare system in different settings.

Atividades educativas no pré-natal sob o olhar de mulheres grávidas / Educación durante el pre-natal, bajo la mirada de las mujeres embarazadas / Educational activities in pre-natal under the gaze of pregnant women

Introdução: as atividades educativas, sejam elas individuais ou em grupo, constituem-se em um espaço de discussão informal sobre questões relevantes para a assistência à mulher/família no ciclo gravídico-puerperal e ao recém-nascido. No entanto, parece que há uma falha nas atividades educativas, pois, mesmo frequentando o pré-natal, algumas mulheres chegam despreparadas para vivenciar o parto. Objetivou-se: se conhecer a experiência de mulheres grávidas na participação de atividades educativas desenvolvidas no pré-natal. Pesquisa qualitativa descritiva, exploratória realizada com 17 gestantes matriculadas no programa de pré-natal de uma maternidade pública de Salvador, Bahia, Brasil. A obtenção dos dados ocorreu por meio de entrevistas, respeitando a Resolução 196/96 do Conselho Nacional de Saúde. Resultados: demonstraram que as gestantes reconhecem a importância das atividades educativas no pré-natal e destacaram o esclarecimento de dúvidas, os temas abordados e a linguagem clara dos profissionais como alguns dos fatores que estimulam a participação nessas atividades. Entretanto, apontaram entraves para participação ativa das mesmas devido a pouca divulgação das atividades por parte de profissionais de saúde, a priorização das primigestas e o desestímulo à participação por parte de familiares que dão pouca importância a essas práticas. Conclusão: as (os) profissionais, principalmente enfermeiras, devem estimular a participação de gestantes nessas atividades, sejam elas primigestas ou não. Esse espaço de discussão em prol de um pré-natal qualificado tem impacto direto na promoção do empoderamento das mulheres assistidas(AU)

Introducción: las actividades educativas, ya sea individual o de grupo, se constituyen en un espacio para la discusión informal de temas pertinentes a la atención de salud para las mujeres / familias en el embarazo y el parto, y al recién nacido. Sin embargo, parece que hay un defecto en las actividades educativas, porque incluso asistiendo al control prenatal, algunas mujeres no llegan preparadas para experimentar el parto. Objetivo: conocer la participación y experiencia de las mujeres embarazadas en las actividades educativas de atención prenatal. Métodos: cualitativo descriptivo, exploratorio, realizado con 17 mujeres embarazadas inscritas en el programa de pre-natal en una maternidad pública de Salvador, Bahía, Brasil. Los datos fueron recolectados a través de entrevistas, respetando la 196/96 Resolución del Consejo Nacional de Salud. Resultados: las mujeres embarazadas reconocieron la importancia de la educación durante el pre-natal, además, los temas abordados y el lenguaje claro de los profesionales como algunos de los factores que estimulan la participación en estas actividades. Sin embargo, fueron notables las barreras a la participación activa de ellas debido a la pobreza en las actividades de promoción por parte de profesionales de la salud, la priorización de las primigestas y el desaliento a la participación de los miembros de la familia que se preocupan poco por estas prácticas. Conclusiones: los (as) profesionales, sobre todo enfermeras, deben fomentar la participación de mujeres embarazadas en estas actividades, ya sea primíparas o no. Este espacio de discusión hacia un prenatal calificado tiene un impacto directo en la promoción del empoderamiento de las mujeres atendidas(AU)

Introduction: Educational activities, whether individual or group them, constitute themselves into a space for informal discussion of issues relevant to health care for women / families in pregnancy and childbirth and the newborn. However, it seems that there is a flaw in the educational activities, because even attending antenatal, some women arrive unprepared to experience childbirth. Therefore, it was aimed to know the experience of pregnant women participation in educational activities in prenatal care. Methods: Qualitative descriptive, exploratory conducted with 17 pregnant women enrolled in pre-natal program in a public maternity hospital in Salvador, Bahia, Brazil. Data collection occurred through interviews, respecting the Resolution 196/96 of the National Health Council. Results: showed that pregnant women recognize the importance of education during pre-natal and highlighted clarify questions, the topics addressed and the clear language of the professionals as some of the factors that stimulate participation in these activities. However, pointed barriers to active participation by them due to little promotion activities by health professionals, the prioritization of primigravidae and discouraging the participation by family members who care little for these practices. Conclutions: professionals, especially nurses, should encourage the participation of pregnant women in these activities, either primiparous or not. This discussion space towards a qualified prenatal has a direct impact in promoting the empowerment of women assisted(AU)