Factores obstétricos asociados con el nacimiento de bebés prematuros moderados y tardíos / Fatores obstétricos associados ao nascimento de bebês prematuros moderados e tardíos / Obstetric factors associated with birth of moderate and late premature babies

OBJETIVO: Analizar las variables obstétricas asociadas con el nacimiento de bebés prematuros moderados y tardíos en una ciudad de la región sur de Brasil. MÉTODO: Estudio transversal que analizó las variables obstétricas de 151 recién nacidos prematuros moderados y tardíos desde mayo de 2016 hasta mayo de 2017 que residen en Santa Maria/RS. Los datos fueron recolectados, por medio de un instrumento específico, diariamente, y posteriormente analizados de manera descriptiva y por comparación de frecuencia y correlación. RESULTADOS: La gemelaridad (14,6%) fue la característica más frecuente entre los tardíos, en comparación con el grupo de moderados (p = 0,019). Los otros factores no mostraron diferencias significativas. El mayor número de partos prematuros anteriores tiene una correlación significativa con la menor edad gestacional al nacer (IC = -0.522, p = 0.008). CONCLUSIÓN: Para los dos grupos de recién nacidos prematuros estudiados, los motivos no mostraron ninguna diferencia significativa, lo que sugiere homogeneidad con respecto a los motivos obstétricos para el parto prematuro

OBJETIVO: Analisar variáveis obstétricas associadas ao nascimento de bebês prematuros moderados e tardios em um município da região sul do Brasil. MÉTODO: Estudo transversal que analisou as variáveis obstétricas de 151 neonatos prematuros moderados e tardios no período de maio de 2016 a maio de 2017 residentes em Santa Maria/RS. Os dados foram coletados, por meio de instrumento próprio, diariamente, e posteriormente analisados de forma descritiva e por comparação de frequência e correlação. RESULTADOS: A gemelaridade (14,6%) foi a característica mais frequente entre os tardios, quando comparados ao grupo de moderados (p = 0,019). Os demais fatores não apresentaram diferença significativa. O maior número de partos prematuros anteriores possui correlação significativa com a menor idade gestacional ao nascer (IC= -0,522, p = 0,008). CONCLUSÃO: Para os dois grupos de prematuros estudados, os motivos não apresentaram diferença significativa, o que sugere homogeneidade quanto aos motivos obstétricos de nascimento precoce

OBJECTIVE: To analyze obstetric variables associated with the birth of moderate and late premature babies in a city in the southern region of Brazil. METHOD: Cross-sectional study that analyzed the obstetric variables of 151 moderate and late preterm infants from May 2016 to May 2017 resident in Santa Maria/RS. Data were collected by means of their own instrument daily, and subsequently analyzed descriptively and by comparison of frequency and correlation. RESULTS: Twinning (14.6%) was the most frequent feature among late twins when compared to the moderate group (p = 0.019). The other factors showed no significant difference. The higher number of previous premature births has a significant correlation with the lower gestational age at birth (CI = -0.522, p = 0.008). CONCLUSION: For the two groups of premature infants studied, the reasons did not present significant difference, which suggests homogeneity regarding the obstetric reasons for early birth

Effects of Relaxation-Focused Nursing Care in Women in Preterm Labor.

BACKGROUND: Threatened preterm labor is a common problem that causes women to be hospitalized. During this period, physical problems such as a decrease in muscle functions, edema and pain, and psychological problems such as anxiety and stress may develop. OBJECTIVE: This study aimed to investigate the effect of relaxation-focused nursing care state anxiety, cortisol, contraction severity, nursing care satisfaction, knowledge, and birth weeks on threatened preterm labor. METHOD: This study was a pre-post single-blind randomized controlled trial. The study was conducted with 66 women in the threatened preterm labor process, 33 in the intervention group and 33 in the control group. The intervention group received relaxation-focused nursing care, which comprises a 2-day program in four stages. The data were collected before and after the relaxation-focused nursing care, and after the birth. RESULTS: In the intervention group, state anxiety, cortisol level, and contraction severity were lower than those in the control group (p < .05). The knowledge level about threatened preterm labor, satisfaction from nursing care, and birth weeks were higher in the intervention group (p < .05). CONCLUSION: Relaxation-focused nursing care was found to reduce the state anxiety in women, improve the knowledge level about threatened preterm labor and birth weeks, and decrease the level of cortisol. Therefore, it is recommended to use relaxation-focused nursing care in threatened preterm labor.

Implementing Patient-Centered Trauma-Informed Care for the Perinatal Nurse.

Adverse childhood experiences and trauma significantly impact physical and mental health. Increased maternal perinatal depression/anxiety, preterm labor, and low birth weight, as well as infant morbidity and mortality, are some examples of the impact of trauma on perinatal health. Trauma-informed care begins with knowledge about trauma, the ability to recognize signs of a trauma response, responding to patients effectively, and resisting retraumatization. As holistic providers, perinatal nurses can create safe care environments, establish collaborative patient relationships based on trust, demonstrate compassion, offer patients options when possible to support patient autonomy, and provide resources for trauma survivors. This can prevent or reduce the negative impact of trauma and improve the health and well-being of infants, mothers, and future generations. This clinical article outlines key strategies for implementation of patient-centered trauma-informed perinatal nursing care.

Perfil de gestantes acometidas de parto prematuro em uma maternidade pública / Profile of the pregnant women affected by preterm birthing a public maternity hospital / Perfil de la mujer embarazada de trabajo afectada prematura en una maternidad pública

Objetivo: Caracterizar o perfil das gestantes acometidas de parto prematuro; descrever as complicações do parto prematuro; identificar o número de óbitos por parto prematuro. Método: Pesquisa retrospectiva; transversal com abordagem quantitativa; realizada em uma maternidade pública, a amostra que representou a população constituiu-se de 300 prontuários de gestantes com parto prematuro. Pesquisa aprovada pelo Comitê de Ética; sob CAAE nº 47429315.1.0000.5210. Resultados: Faixa etária predominante foi 14 a 19 anos 26,38%; escolaridade ensino médio (56,68%); situação conjugal casada (38,11%); ocupação do lar (48,21%); raça não registrada (99,67%); local de moradia zona rural (57,00%). Maior incidência de complicações dentro das variáveis; foram pré-eclâmpsia (28,66%); amniorrexe prematura (17,26%). Causa maior de óbito: Pré-eclâmpsia. Conclusão: Destaca-se que pré-eclâmpsia foi o agravo que causou o maior número de óbitos nas mulheres investigadas; esse dado evidencia as estatísticas alarmantes; confirmando que as doenças hipertensivas ocupam o primeiro lugar como causa de morte materna no Brasil

Objetivo: Caracterizar el perfil de parto prematuro afectaba a lãs mujeres embarazadas; describir lãs complicaciones Del nacimiento prematuro; identificar el número de muertes debidas al parto prematuro. Método: Estudio retrospectivo; cruzar com un enfoque cuantitativo; realizado em un hospital público, La muestra que representa la población constaba de 300 historias clínicas de mujeres embarazadas com trabajo de parto prematuro. De investigacióna probado por el Comité de Ética, La opinión Nº 1.175.971. Resultados: Rango de edad predominante fue de 14 a 19 años 26,38%; educación secundaria (56,68%); estado civil casada (38,11%); ocupación de la casa (48,21%); No raza registrado (99,67%); lugar de residencia, rural (57.00%). Mayor incidencia de complicaciones en las variables y preeclampsia (28,66%); ruptura prematura de membranas (17,26%). Principal causa de muerte: La pre-eclampsia. Conclusión: Es de destacar que La preeclampsia fue La lesión que causo el mayor número de muertes investigadas em lãs mujeres; estos datos pone de manifiesto las estadísticas alarmantes; lo que confirma que lãs enfermedades hipertensivas ocupan el primer lugar como causa de muerte materna en Brasil

Objective: Herein, our goal has been to characterize the pregnant women profile that experienced preterm birth. Moreover, describe the complications of preterm birth, and also to identify the number of deaths due to preterm birth. Methods: It is a retrospective cohort study with a quantitative approach, whichwas carried out in a public maternity hospital. The sample that represented the population consisted of 300 medical records of pregnant women with preterm birth. The research was approved by the Ethics Committee under the Legal Opinion No. 1,175,971. Results: The predominant age group was from 14 to 19 years old (26.38%); high school education (56.68%); married (38.11%); housekeeper (48.21%); unregistered race (99.67%); rural area as residence place (57.00%). The following were the higher incidence of complications within the variables: pre-eclampsia(28.66%) and premature amniorrexis (17.27%). The major cause of death was pre-eclampsia. Conclusion: It should be noted that pre-eclampsia caused the highest number of deaths in the women investigated and this fact shows the alarming statistics, confirming that hypertensive diseases occupy the first place as cause of maternal death in Brazil

Atrial fibrillation case study.

This article discusses the irregular heart rhythm caused by atrial fibrillation (AF). A brief overview of the pathophysiology will be provided. A case study is discussed to highlight the treatment and management of AF. The care provision describes common signs and symptoms and also the treatment and management of AF within the maternity care setting. The importance of maintaining the mother-baby dyad is highlighted. For the purpose of maintaining confidentiality the woman will be referred to as Shama.

Parto prematuro: enfoques presentes en la producción científica nacional e internacional / Parto prematuro: abordagens presentes na produção científica nacional e internacional / Premature birth: approaches presents in national and international scientific production

Objetivo del estudio fue conocer la producción científica sobre el parto prematuro. Se trata de un estudio bibliográfico, realizado con 24 trabajos completos que abordan la prematuridad, derivado de la Biblioteca Virtual en Salud, publicados entre los años 2008 y 2013. El análisis de la literatura se llevó a cabo temáticamente, emergiendo cuatro categorías: factores de riesgo asociados al parto prematuro, nacimiento prematuro: Aspectos positivos y negativos; conducta profesional relacionada con el parto prematuro y el papel de la atención de enfermería en el trabajo de parto prematuro. Este estudio indica que muchos investigadores están preocupados por los factores de riesgo asociados con la prematuridad, lo que contribuye a la identificación temprana y a la reducción de las tasas de esta complicación. Aún así, son pocos los estudios que brindan contribuciones a la enfermería, dejando de contribuir al conocimiento y proceso de trabajo de estos profesionales, también responsables de producir salud en este momento de la vida de mujeres y familias que viven la prematuridad (AU)

Estudo com o objetivo de conhecer a produção científica acerca do parto prematuro. Trata-se de um estudo bibliográfico, realizado com 24 artigos científicos completos abordando a prematuridade, oriundos da Biblioteca Virtual em Saúde, publicados entre os anos de 2008 e 2013. A análise dos artigos foi realizada tematicamente, emergindo quatro categorias: Fatores de risco associados ao parto prematuro; Prematuridade: aspectos negativos e positivos; Conduta profissional relacionada ao trabalho de parto prematuro e O papel da enfermagem na assistência ao trabalho de parto prematuro. Este estudo aponta que muitas pesquisas estão preocupadas com os fatores de risco relacionados à prematuridade, contribuindo para a identificação precoce e redução nos índices desta complicação. Ainda, percebe-se que poucos estudos trazem contribuições para enfermagem, deixando de contribuir para o conhecimento e processo de trabalho desses profissionais, também responsáveis por produzir saúde neste momento da vida de mulheres e famílias que vivenciam a prematuridade (AU)

The study aimed to gather the scientific production about preterm birth. This is a bibliographic study, conducted across 24 full papers addressing prematurity, derived from the Virtual Health Library, published between the years 2008 and 2013. The analysis of the literature was carried out thematically, emerging four categories: Risk factors associated with preterm labor; Prematurity: negative and positive aspects; Professional Conduct related to preterm labor and the role of nursing care in preterm labor. This study indicates that many works are concerned about the risk factors associated with prematurity, contributing to early identification and reduction in rates of this complication. Still, few studies benefit nursing regarding to the knowledge and work process of such professionals, responsible for producing health at this moment in the lives of women and families are experiencing prematurity (AU)

Preterm Births: A Global Health Problem.

Globally, in 2012, there were 15 million babies born preterm. The majority of preterm births occur in resource-poor countries including India, Nigeria, Pakistan, and the Democratic Republic of Congo where many die due to lack of basic skilled nursing care. In September 2000, the United Nations signed the Millennium Development Declaration establishing eight Millennium Development Goals (MDGs). These MDGs provide specific, measurable targets that are designed to provide equitable health to all, particularly the most vulnerable including preterm babies. On May 2, 2014, the World Health Organization specifically targeted the nursing workforce as a key stakeholder in strategies to reduce global prematurity and end preventable preterm newborn deaths. Specific strategies include primary care, screening for risk factors, kangaroo mother care, and early initiation of breastfeeding with exclusive breastfeeding for the first 6 months of life. By sharing our knowledge and skills, nurses can contribute to global actions being taken to end preventable preterm newborn deaths.

Preterm labor: role of the nurse practitioner.

The nurse practitioner may play a pivotal role in diagnosing preterm labor through risk assessment and physical exam. While treatment and management of preterm labor are usually beyond the nurse practitioner's scope of practice, they can play an important role in preventing preterm birth through assessment, action, or advocacy.

Screening for symptoms of postpartum traumatic stress in a sample of mothers with preterm infants.

There are no established screening criteria to help identify mothers of premature infants who are at risk for symptoms of emotional distress. The current study, using data obtained from recruitment and screening in preparation for a randomized controlled trial, aimed to identify potential risk factors associated with symptoms of depression, anxiety and posttraumatic stress in a sample of mothers with premature infants hospitalized in a neonatal intensive care unit. One hundred, thirty-five mothers of preterm infants born at 26-34 weeks of gestation completed three self-report measures: the Stanford Acute Stress Reaction Questionnaire, the Beck Depression Inventory (2nd ed.), and the Beck Anxiety Inventory to determine their eligibility for inclusion in a treatment intervention study based on clinical cut-off scores for each measure. Maternal sociodemographic measures, including race, ethnicity, age, maternal pregnancy history, and measures of infant medical severity were not helpful in differentiating mothers who screened positive on one or more of the measures from those who screened negative. Programs to screen parents of premature infants for the presence of symptoms of posttraumatic stress, anxiety, and depression will need to adopt universal screening rather than profiling of potential high risk parents based on their sociodemographic characteristics or measures of their infant's medical severity.

Prevention of postpartum traumatic stress in mothers with preterm infants: manual development and evaluation.

Premature birth has been associated with multiple adverse maternal psychological outcomes that include depression, anxiety, and trauma as well as adverse effects on maternal coping ability and parenting style. Infants who are premature are more likely to have poorer cognitive and developmental functioning and, thus, may be harder to parent, both as infants and as they get older. In response to these findings, a number of educational and behavioral interventions have been developed that target maternal psychological functioning, parenting, and aspects of the parent-infant relationship. The current study aimed to both develop and evaluate a treatment that integrates, for the first time, effective interventions for reducing symptoms of posttraumatic stress disorder (PTSD) and enhancing maternal-infant interactions. Conclusions from the study indicate that the intervention is feasible, able to be implemented with a high level of fidelity, and is rated as highly satisfactory by participants. Though encouraging, these findings are preliminary, and future studies should strive to reproduce these findings with a larger sample size and a comparison group.

Magnesium sulfate during anticipated preterm birth for infant neuroprotection.

Advances in medical care of preterm infants, including the widespread use of surfactant and antenatal steroids, and improvements in ventilation management, have increased the survival rates of some of the most vulnerable infants. Yet, the risk of neurologic impairment and long-term medical complications remains a concern. Recently, the use of magnesium sulfate during anticipated preterm birth has been identified as a potential treatment to reduce adverse neurologic outcomes among preterm infants. This article discusses the use of magnesium sulfate for anticipated preterm birth to reduce neurologic impairment in preterm infants, including current clinical practice guidelines and implications for nurses.

Obstetric cholestasis (OC).

Obstetric cholestasis (OC) is the most common liver condition specific to pregnancy and affects around 5,000 women in the UK every year. It's generally benign for the mother although the main presenting symptom of pruritus can sometimes be so severe that the woman scratches herself until she bleeds. However, the main concerns are for the fetus, as the condition is associated with an increased risk of fetal distress, spontaneous premature labour and stillbirth. This article aims to provide information about the condition so that as a practising midwife you can offer women sufficient support should OC be suspected or diagnosed.