Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 26.263
Filtrar
1.
Rev. enferm. UERJ ; 29: e56037, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1151921

RESUMEN

Objetivo: mapear as evidências disponíveis na literatura acerca dos manejos e desfechos da infecção pelo novo coronavírus no puerpério. Método: revisão de escopo conforme o Institute Joanna Briggs, desenvolvida em quatro fontes de dados eletrônicas. A extração, análise e síntese dos dados foi realizada por quatro pesquisadores independentes. Resultados: Nove publicações foram revisadas de 188 localizadas. Seis foram os países produtores das evidências, todas obtidas e publicadas em 2020. Vinte e um casos de COVID-19 no puerpério estiveram tratados nestas publicações, sendo 15 (71,4%) relativos a evoluções graves/exacerbação da doença e seis (28,6%) diagnosticados após a alta hospitalar. Conclusão: O mapeamento aponta para a ocorrência da infecção ou seu agravamento no período pós-parto, com indicativas ao monitoramento de sinais e sintomas, exploração diagnóstica e tratamento acurado e necessidade de acompanhamento próximo das mulheres diagnosticadas com COVID-19, sintomáticas ou não, no período pós-parto.


Objective: to map the evidence available in the literature about management and outcomes of postpartum infection by the new coronavirus. Method: scoping review conducted in four electronic sources, following Joanna Briggs Institute guidelines. Data were extracted, analyzed and summarized by four researchers independently. Results: nine of the 188 publications located were reviewed. The evidence, all obtained and published in 2020, was produced in six countries. These publications considered 21 cases of postpartum COVID-19, 15 (71.4%) of which related to severe developments / exacerbation of the disease and six (28.6%) diagnosed after hospital discharge. Conclusion: the mapping points to the occurrence of infection or worsening of the disease in the postpartum period, indicating the need for monitoring of signs and symptoms, diagnostic exploration and accurate treatment and the need for close monitoring of postpartum women diagnosed with COVID-19, whether symptomatic or not.


Objetivo: mapear las evidencias disponibles en la literatura sobre el manejo y los resultados de la infección por el nuevo coronavirus en el período posparto. Método: revisión del alcance según el Instituto Joanna Briggs, desarrollada en cuatro fuentes de datos electrónicas. La extracción, el análisis y la síntesis de los datos fueron realizados por cuatro investigadores independientes. Resultados: se revisaron nueve publicaciones de 188 encontradas. Fueron seis los países que produjeron las evidencias, obtenidas y publicadas en 2020. En estas publicaciones se trataron 21 casos de COVID-19 en el período posparto, 15 (71,4%) de los cuales estaban relacionados con evoluciones graves/exacerbación de la enfermedad y seis (28,6%) diagnosticados tras el alta hospitalaria. Conclusión: el mapeo apunta hacia la ocurrencia de la infección o su agravamiento en el posparto, con indicaciones de seguimiento de indicios y síntomas, exploración diagnóstica, tratamiento preciso y la necesidad de un seguimiento cercano a las mujeres diagnosticadas con COVID-19, sintomáticas o no, en el período posparto.


Asunto(s)
Humanos , Femenino , Embarazo , Salud de la Mujer , Periodo Posparto , COVID-19 , COVID-19/terapia , COVID-19/epidemiología , Revisión , Infecciones por Coronavirus , Periodo Posparto/sangre , COVID-19/diagnóstico
2.
Rev. enferm. UERJ ; 29: e53642, jan.-dez. 2021.
Artículo en Inglés, Portugués | LILACS | ID: biblio-1224513

RESUMEN

Objetivo: descrever os cuidados domiciliares prestados por parteiras tradicionais durante a assistência ao parto. Método: estudo qualitativo conduzido por meio do método da História Oral Temática, realizado com 16 parteiras em nove municípios do Cariri cearense. A coleta de dados ocorreu entre julho e dezembro de 2015 por meio de entrevista semiestruturada, os relatos foram transcritos, textualizados e transcriados. Resultados: as parteiras prestavam cuidados familiares, assistência ao parto vaginal, cuidados com o recém-nascido e no puerpério imediato. Usavam chás e orações como adjuvantes do seu ofício. Conclusão: o cuidado das parteiras na assistência ao parto centralizava-se nas necessidades da mulher e da família, sendo, em alguns casos, extensivo à casa. As parteiras conheciam os sinais e sintomas do trabalho de parto e agiam nas possíveis intercorrências.


Objective: to describe home care provided by traditional midwives during childbirth care. Method: this qualitative study, using the Thematic Oral History method, was conducted with 16 midwives from nine municipalities in Cariri, Ceará. Data were collected from July to December 2015 through semi-structured interviews, the reports were transcribed, textualized and transcreated. Results: midwives provided family care, vaginal delivery care, newborn care and immediate postpartum care. They used teas and prayers as an adjuncts to their craft. Conclusion: childbirth care by midwives centered on the women's and families' needs and, in some cases, extended to the home. Midwives knew the signs and symptoms of labor and acted on possible complications.


Objetivo: describir los cuidados domiciliarios brindados por parteras tradicionales durante la atención al parto. Método: estudio cualitativo conducido mediante el método de Historia Oral Temática, realizado con 16 parteras en nueve municipios de Cariri en Ceará. La recolección de datos se realizó entre julio y diciembre de 2015 a través de entrevistas semiestructuradas; los relatos fueron transcritos, textualizados y transcreados. Resultados: las parteras brindaron atención familiar, asistencia en el parto vaginal, cuidados al recién nacido y en el puerperio inmediato. Usaban tés y oraciones como complemento de su oficio. Conclusión: el cuidado de las parteras en la atención al parto se centraba en las necesidades de la mujer y de la familia, extendiéndose, en algunos casos, al hogar. Las parteras conocían los signos y síntomas del trabajo de parto y actuaban sobre las posibles complicaciones.


Asunto(s)
Humanos , Femenino , Anciano , Anciano de 80 o más Años , Atención Perinatal , Parto Domiciliario , Atención Domiciliaria de Salud , Partería , Trabajo de Parto , Investigación Cualitativa , Periodo Posparto
3.
J Med Case Rep ; 15(1): 498, 2021 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-34627357

RESUMEN

BACKGROUND: Autoimmune diseases refers to a class of diseases involving abnormal immune response of human body and tissue damage caused by the dysregulation of autoimmune balance or destruction of immune tolerance. Recent research has revealed that the occurrence of autoimmune diseases is influenced by genetic, hormonal, immunological, and environmental factors. As sex hormone levels change obviously during pregnancy and postpartum, the morbidity and recurrence rate of autoimmune diseases increase during this period. CASE PRESENTATION: A 31-year-old Asian woman was admitted to our hospital for myasthenia gravis and treated with methylprednisolone and pyridostigmine bromide 3 months postpartum. Physical examination and laboratory inspection after admission suggested that the patient had primary biliary cirrhosis. Subsequently, azathioprine was added to the treatment, and the symptoms of both diseases were successfully controlled. CONCLUSIONS: This case exhibits a rare condition of myasthenia gravis combined with primary biliary cirrhosis postpartum. Given the fluctuation of the immune status during the postpartum period, combined autoimmune diseases need to be taken into account when patients develop clinical symptoms of an autoimmune disease. Therefore, detailed physical and laboratory examination can help to prevent the missed diagnosis of these diseases.


Asunto(s)
Cirrosis Hepática Biliar , Miastenia Gravis , Adulto , Femenino , Humanos , Cirrosis Hepática Biliar/complicaciones , Cirrosis Hepática Biliar/diagnóstico , Cirrosis Hepática Biliar/tratamiento farmacológico , Miastenia Gravis/complicaciones , Miastenia Gravis/diagnóstico , Miastenia Gravis/tratamiento farmacológico , Recurrencia Local de Neoplasia , Periodo Posparto , Embarazo , Bromuro de Piridostigmina
4.
Rev Bras Enferm ; 75(2): e20210084, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34614101

RESUMEN

OBJECTIVES: To implement strategies for managing perineal pain in puerperal women admitted to a public maternity hospital in São Paulo state and to evaluate their compliance with evidence-based practices. METHODS: Implementation study using the JBI model conducted with nursing professionals and puerperal women between September and December 2019. Interviews with puerperal women and medical record data were used to audit seven evidence-based criteria. The interventions adopted included a care protocol, professional training, and folder elaboration for puerperal women. RESULTS: Prior to the intervention, deficits in audited practices and obstacles to pain management were identified, which were overcome by the strategies employed. The follow-up audit demonstrated improvements in compliance with best care practices. CONCLUSION: There was an increase in the criteria compliance evaluated after the implemented strategies, contributing to improving the nursing care results in the perineal pain management based on the best scientific evidence.


Asunto(s)
Manejo del Dolor , Periodo Posparto , Brasil , Práctica Clínica Basada en la Evidencia , Femenino , Humanos , Embarazo
5.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48425

RESUMEN

Parecer da Associação de Obstetrícia e Ginecologia de São Paulo – SOGESP sobre a vacinação contra covid-19 para gestantes e puérperas que tomaram a primeira dose de vacina Astrazeneca/Oxford.


Asunto(s)
Vacunas contra la COVID-19 , Vacunación , Periodo Posparto , Mujeres Embarazadas
6.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-48426

RESUMEN

O Canal Saúde Mulher mantido pela Associação de Obstetrícia e Ginecologia de São Paulo – SOGESP, fornece informações para a saúde da mulher. Principais seções disponibilizadas pelo website: Blog da Mulher; Revista Mulher SOGESP; vídeos; lives e podcasts da Associação.


Asunto(s)
Salud Materna , Salud de la Mujer , Mujeres Embarazadas , Periodo Posparto
7.
Trials ; 22(1): 599, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488847

RESUMEN

BACKGROUND: Up to 33% of women develop symptoms of posttraumatic stress disorder (PTSD) after a traumatic birth experience. Negative and traumatic childbirth experiences can also lead to fear of childbirth, avoiding or negatively influencing a subsequent pregnancy, mother-infant bonding problems, problems with breastfeeding, depression and reduced quality of life. For PTSD in general, eye movement desensitization and reprocessing (EMDR) therapy has proven to be effective. However, little is known about the preventive effects of early intervention EMDR therapy in women after a traumatic birth experience. The purpose of this study is to determine the effectiveness of early intervention EMDR therapy in preventing PTSD and reducing PTSD symptoms in women with a traumatic birth experience. METHODS: The PERCEIVE study is a randomized controlled trial. Women suffering from the consequences of a traumatic birth experience will be randomly allocated at maximum 14 days postpartum to either EMDR therapy or 'care-as-usual'. Patients in the EMDR group receive two sessions of therapy between 14 (T0) and 35 days postpartum. All participants will be assessed at T0 and at 9 weeks postpartum (T1). At T1, all participants will undergo a CAPS-5 interview about the presence and severity of PTSD symptoms. The primary outcome measure is the severity of PTSD symptoms, whereas the secondary outcomes pertain to fear of childbirth, mother-infant bonding, breastfeeding, depression and quality of life. The study will be conducted at a large city hospital and at multiple midwifery practices in Amsterdam, the Netherlands. DISCUSSION: It is to be expected that the results of this study will provide more insight about the safety and effectiveness of early intervention EMDR therapy in the prevention and reduction of PTSD (symptoms) in women with a traumatic birth experience. TRIAL REGISTRATION: Netherlands Trial Register NL73231.000.20 . Registered on 21 August 2020.


Asunto(s)
Desensibilización y Reprocesamiento del Movimiento Ocular , Trastornos por Estrés Postraumático , Ansiedad , Femenino , Humanos , Periodo Posparto , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/terapia , Resultado del Tratamiento
8.
Rev Med Chil ; 149(4): 543-553, 2021 Apr.
Artículo en Español | MEDLINE | ID: mdl-34479342

RESUMEN

BACKGROUND: Violence against women (VAW) is a violation of women's fundamental rights and special attention must be paid during the gestational and postpartum period. AIM: To determine the prevalence of violence against women attending antenatal and postpartum controls in Primary Health Centers. MATERIAL AND METHOD: The Woman Abuse Screening Tool (WAST) for early detection of VAW was applied to 279 pregnant and 102 puerperal women attending five public primary health centers in metropolitan Santiago. RESULTS: The prevalence ofviolence against pregnant and puerperal women was 5.7 and 5.9%, respectively. In both groups, the factors associated with a greater risk of violence were being immigrants, a history of domestic violence, not having a supportive partner and alcohol consumption by the partner. CONCLUSIONS: Violence against these women is a multifactorial, complex and structural phenomenon, which involves the victim, the abuser and the entire social system. Primary health care level and health professionals can be key elements applying early detection strategies, timely referral mechanisms and bringing emotional support for victims.


Asunto(s)
Violencia Doméstica , Chile/epidemiología , Estudios Transversales , Femenino , Humanos , Periodo Posparto , Embarazo , Prevalencia
9.
Womens Health (Lond) ; 17: 17455065211042190, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34465268

RESUMEN

OBJECTIVES: The COVID-19 pandemic has caused considerable stress throughout the world. Little is known about how postpartum women who gave birth during the early months of the pandemic were impacted. The purpose of this study was to explore and describe the associations between potential risk, protective factors, and psychological distress among postpartum women who gave birth during the early months of the COVID-19 pandemic. METHODS: Postpartum women over the age of 18 years who gave birth in the US hospitals between March and July of 2020 and spoke English completed a survey about their experiences. Demographic and health variables were measured via self-report. Stress was measured using the Perceived Stress Scale-10. Mastery was measured with the Pearlin Mastery Scale. Resilience was measured with the Connor-Davidson Resilience Scale-2. RESULTS: This study included 885 women. Participants had higher stress and lower resilience relative to pre-pandemic norms. Participants had high levels of depression, anxiety, and stress. Women who had an infant admitted to the neonatal intensive care unit had more stress. Income, full-time employment, and partnered relationships were associated with lower stress. Resilience and mastery were related to lower stress, depression, and anxiety. Black, Indigenous, or People of Color women showed higher stress and lower resiliency. Single women were likely to report lower levels of mastery than partnered women. CONCLUSION: Stress, depression, and anxiety were high in postpartum women in this study. Income, partnered relationships, and employment security, along with protective traits such as mastery and resilience, may reduce the impact of stress on postpartum women in a pandemic. Care models should be modified to support women during a pandemic. Health disparities exist in postpartum stress. Future interventions should focus on building resiliency and mastery and ensuring appropriate resources are available to postpartum women in a pandemic.


Asunto(s)
COVID-19/epidemiología , Pandemias , Periodo Posparto/psicología , Estrés Psicológico/epidemiología , Adulto , Ansiedad/epidemiología , COVID-19/psicología , Estudios Transversales , Depresión Posparto/epidemiología , Femenino , Humanos , Embarazo , Factores Protectores , Distrés Psicológico , Resiliencia Psicológica , Factores de Riesgo , SARS-CoV-2 , Factores Socioeconómicos , Encuestas y Cuestionarios , Estados Unidos/epidemiología
10.
JNMA J Nepal Med Assoc ; 59(239): 640-644, 2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-34508514

RESUMEN

INTRODUCTION: Contraception plays a key role in preventing unwanted births. It also decreases pregnancy and childbirth-related morbidities and mortalities, but many women don't use contraception particularly in the postpartum period. The main objective of this study was to find out the prevalence of contraception use among postpartum women in a municipality. METHODS: A descriptive cross-sectional study was conducted among married women of reproductive age in Dhulikhel municipality of Kavrepalanchok from January to September 2019. Ethical approval was obtained from Institutional Review Committee and permission was taken from Dhulikhel Municipality before the study. The sample size was 332. A convenience sampling method was used. A semi-structured questionnaire pre-tested in Panauti municipality was used. Data entry and analysis were done using Statistical Package for Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated for descriptive analysis. RESULTS: Out of total 332 women, 146 (40%) (34.73-45.26 at 95% Confidence Interval) used postpartum contraception. Injectable/Depot was used by 61 (42%) women. Total 97 (52%) of the non-users intended to use contraception in the future. The most common reason for contraception use was women not wanting the next child soon 91 (62%) and reason for non-use was feeling contraception as unnecessary 73 (39%). CONCLUSIONS: The use of postpartum contraception was poor, and only half of the non-users intended to use contraception in the future. Thus, contraception use should be encouraged during all possible contact times, and counselling should be made universal to improve postpartum contraception services' uptake.


Asunto(s)
Anticoncepción , Anticonceptivos , Niño , Conducta Anticonceptiva , Estudios Transversales , Atención a la Salud , Servicios de Planificación Familiar , Femenino , Humanos , Periodo Posparto , Embarazo
11.
Ludovica pediátr ; 24(1): 15-24, Ene-Jun 2021.
Artículo en Español | LILACS, Redbvs, BINACIS | ID: biblio-1293219

RESUMEN

Introducción: El puerperio es una etapa determinante para la mujer, sin embargo la atención está focalizada en el recién nacido. Objetivo: Describir las características gineco-obstétricas, nutricionales y clínico-metabólicas de mujeres durante el posparto que asisten al consultorio materno del Instituto de Desarrollo e Investigaciones Pediátricas. Población y Métodos: Se realizó un análisis retrospectivo de las historias clínicas de mujeres que realizaron su primer control entre los 3 y 6 meses posparto en un consultorio materno de un hospital público entre junio 2018 y diciembre 2019. Se analizaron variables sociodemográficas, gineco-obstétricas, nutricionales y clínico-metabólicas. Resultados: Participaron 211 mujeres, edad 26 (21; 31) años, 41,7 % oriundas de países limítrofes. 38,8 % tuvo un embarazo durante la adolescencia, 38,7 % de los partos fue por cesárea y 21,3 % refirió antecedentes de aborto Más de la mitad presentaron sobrepeso-obesidad y alteraciones del perfil lipídico Conclusiones: Las mujeres asistidas durante el postparto en un hospital público presentan alta frecuencia de exceso de peso y alteraciones metabólicas así como historial de cesáreas y embarazo adolescente. El conocimiento de las problemáticas más prevalentes es clave para el diseño de estrategias de prevención e intervenciones oportunas


Introduction: The puerperium is a determining stage for women, however, attention is focused on the newborn. Objective: To describe the gyneco-obstetric, nutritional and clinical-metabolic characteristics of postpartum women who attend the IDIP maternal clinic. Population and methods: A retrospective analysis was carried out of the medical records of women who underwent their first check-up between 3 and 6 months postpartum in a maternal clinic of a public hospital between June 2018 and December 2019 Sociodemographic, gynecological, nutritional, and clinical-metabolic variables were analysed. Results: 211 women participated, age 26 (21; 31) years old, 41.7% from neighbouring countries, 38.8% had a pregnancy during adolescence, 38.7% of deliveries were by caesarean section, and 21.3% reported a history of abortion. More than half presented overweight-obesity and lipid profile alterations. Conclusions: The women assisted during the postpartum in a public hospital present a high frequency of excess weight and metabolic alterations as well as a history of caesarean sections and adolescent pregnancy. Knowledge of the most prevalent problems is key for the design of prevention strategies and timely interventions


Asunto(s)
Humanos , Femenino , Periodo Posparto , Nutrición Materna , Salud Materna , Obesidad
12.
J Pak Med Assoc ; 71(9): 2124-2129, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34580499

RESUMEN

Objectives: To determine the effect of kangaroo mother care applied to the healthy newborns in the early postpartum period on breastfeeding. METHODS: The randomised controlled experimental study was conducted from June 1 to August 25, 2016, at a training and research hospital in Istanbul, Turkey, and comprised healthy newborns and their mothers equally divided into study group A and control group B. The newborns in group A were administered kangaroo mother care for 3 hours after birth, while group B newborns were cared for using the unit's standard postpartum procedure. The time the newborns in both the groups first started to breastfeed, the frequency of breastfeeding within the first 24 hours, the duration of their breastfeeding and suckling skills were evaluated. Data was analysed using the Number Cruncher Statistical System 2007. RESULTS: There were 112 sets of newborns and their mothers; 56(50%) in each of the two groups. Group A newborns started suckling at the breast sooner, for longer duration, and more frequently compared to the newborns in group B (p<0.05). There was no difference between the groups in terms of initial suckling skills (p= 0.862), but those in group A were better at suckling 24 hours later (p=0.001). CONCLUSIONS: Kangaroo mother care administered to healthy newborns immediately after birth encouraged the newborns to take to the breast sooner, more frequently, and for longer periods. It also increased their suckling skills. Trial registration: ClinicalTrials.gov Identifier: NCT04619459.


Asunto(s)
Método Madre-Canguro , Lactancia Materna , Femenino , Humanos , Recién Nacido , Madres , Parto , Periodo Posparto
13.
Braz J Med Biol Res ; 54(11): e10192, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34586325

RESUMEN

Maternal anxiety symptoms in the perinatal period might have long-term health effects on both the mother and the developing child. Valerian is a phytotherapeutic agent that is widely used for the treatment of anxiety. This study investigated the effects of valerian treatment in postpartum rats on maternal care, toxicity, and milk composition. Postnatal development, memory, and anxiety behavior in the offspring were also assessed. Postpartum Wistar rats received the valerian (500, 1000, or 2000 mg·kg-1·day-1) by oral gavage. Clinical and biochemical toxicity was evaluated with commercial kits. Maternal behavior was observed daily. Milk composition was analyzed by colorimetric methods. Physical and neuromotor tests were used to analyze postnatal development. Anxiolytic activity was assessed by the elevated plus maze, and memory was evaluated by the step-down inhibitory avoidance task. Maternal toxicity and care behavior were not altered by the treatment, while only the highest dose promoted a significant increase of lactose, and the doses 1000 and 2000 mg·kg-1·day-1 promoted a reduction of protein contents in milk. Postnatal development was similar in all offspring. Adult offspring did not display altered anxiety behavior, while long-term memory was impaired in the female adult offspring by maternal treatment with 1000 mg·kg-1·day-1. These results suggested that high doses of valerian had significant effects on important maternal milk components and can cause long-term alterations of offspring memory; thus, treatment with high doses of valerian is not safe for breastfeeding Wistar rat mothers.


Asunto(s)
Efectos Tardíos de la Exposición Prenatal , Valeriana , Animales , Humanos , Memoria a Largo Plazo , Leche Humana , Periodo Posparto , Embarazo , Ratas , Ratas Wistar
14.
BMC Cancer ; 21(1): 1017, 2021 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-34511060

RESUMEN

BACKGROUND: Neutrophils are important for immune surveillance of tumour cells. Neutrophils may also be epigenetically programmed in the tumour microenvironment to promote tumour progression. In addition to the commonly known high-density neutrophils (HDN) based on their separation on density gradient, recent studies have reported the presence of high levels of low-density neutrophils (LDN) in tumour-bearing mice and cancer patients. We reported previously that estrogen promotes the growth of estrogen receptor α-negative mammary tumours in mice undergoing mammary involution through stimulating pro-tumoral activities of neutrophils in the mammary tissue. METHODS: Female BALB/cAnNTac mice at 7-8 weeks old were mated and bilateral ovariectomy was performed 2 days post-partum. At 24 h after forced-weaning of pups to induce mammary involution, post-partum female mice were injected with either E2V, or vehicle control on alternative days for 2-weeks. On 48 h post-weaning, treated female mice were inoculated subcutaneously with 4 T1-Luc2 cells into the 9th abdominal mammary gland. Age-matched nulliparous female was treated similarly. Animals were euthanized on day 14 post-tumour inoculation for analysis. To evaluate the short-term effect of estrogen, post-partum females were treated with only one dose of E2V on day 12 post-tumour inoculation. RESULTS: Estrogen treatment for 2-weeks reduces the number of blood LDN by more than 10-fold in tumour-bearing nulliparous and involuting mice, whilst it had no significant effect on blood HDN. The effect on tumour-bearing mice is associated with reduced number of mitotic neutrophils in the bone marrow and increased apoptosis in blood neutrophils. Since estrogen enhanced tumour growth in involuting mice, but not in nulliparous mice, we assessed the effect of estrogen on the gene expression associated with pro-tumoral activities of neutrophils. Whilst 48 h treatment with estrogen had no effect, 2-weeks treatment significantly increased the expression of Arg1, Il1b and Tgfb1 in both HDN and LDN of involuting mice. In contrast, estrogen increased the expression of Arg1 and Ccl5 in HDN and LDN of nulliparous mice. CONCLUSIONS: Prolonged estrogenic stimulation in tumour-bearing mice markedly hampered tumour-associated increase of LDN plausibly by inhibiting their output from the bone marrow and by shortening their life span. Estrogen also alters the gene expression in neutrophils that is not seen in tumour-free mice. The results imply that estrogen may significantly influence the tumour-modulating activity of blood neutrophils.


Asunto(s)
Estrógenos/farmacología , Neoplasias Mamarias Animales/sangre , Neutrófilos/efectos de los fármacos , Animales , Apoptosis/efectos de los fármacos , Arginasa/genética , Arginasa/metabolismo , Biomarcadores de Tumor/metabolismo , Células de la Médula Ósea/citología , Centrifugación por Gradiente de Densidad , Estrógenos/administración & dosificación , Femenino , Citometría de Flujo , Expresión Génica/efectos de los fármacos , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Glándulas Mamarias Animales , Ratones , Ratones Endogámicos BALB C , Trasplante de Neoplasias , Neutrófilos/citología , Neutrófilos/metabolismo , Ovariectomía/métodos , Paridad , Periodo Posparto , Factores de Tiempo , Factor de Crecimiento Transformador beta1/genética , Factor de Crecimiento Transformador beta1/metabolismo
15.
BMC Infect Dis ; 21(1): 922, 2021 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-34488681

RESUMEN

BACKGROUND: Postpartum alanine transaminase (ALT) flares occur frequently in chronic hepatitis B virus (HBV)-infected mothers with antepartum antiviral therapy (AVT). We aimed to characterize the T cell immunity in HBV-infected mothers experiencing postpartum ALT flares. METHODS: Twenty HBV-infected pregnant women who received AVT at 26-28 weeks of gestation were enrolled and followed up until 15-18 weeks postpartum. Among the 20 HBV-infected pregnant women, 6 experienced postpartum ALT flare (AF mothers), while 14 did not (NAF mothers). T lymphocyte phenotypes and functions were analyzed using flow cytometry. RESULTS: Compared to NAF mothers, the quantitative HBsAg levels in AF mothers decreased significantly at 6-8 or 15-18 weeks postpartum. Significant differences in HBeAg levels between these groups were only found at delivery. Regulatory T cell (Treg) numbers in AF mothers were lower than those of NAF mothers before AVT; however, there were no significant differences in Treg numbers at other follow-up points. Expression of other T cell phenotypes were similar between the two groups. T cells in AF mothers produced more pro-inflammatory cytokines (IFN-γ, IL-21, TNF-α, IL-2) or less anti-inflammatory cytokine (IL-10) than those in NAF mothers before, during, or after antiviral treatment. The ratio of IFN-γ to IL-10 producing by CD4+ T cells or CD8+ T cells was higher in AF mothers than that in NAF mothers during pregnancy or after delivery. CONCLUSIONS: The characteristics of T cell immunity was distinct between mothers with postpartum ALT flare and those without ALT flare from pregnancy to postpartum, which indicated that T cell immunity might get involved in postpartum ALT flare.


Asunto(s)
Hepatitis B Crónica , Alanina Transaminasa , Antivirales/uso terapéutico , Linfocitos T CD8-positivos , ADN Viral , Femenino , Antígenos e de la Hepatitis B , Virus de la Hepatitis B/genética , Hepatitis B Crónica/tratamiento farmacológico , Humanos , Madres , Periodo Posparto , Embarazo
16.
BMC Pregnancy Childbirth ; 21(1): 625, 2021 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-34530772

RESUMEN

BACKGROUND: COVID-19 has placed additional stressors on mothers during an already vulnerable lifecourse transition. Initial social distancing restrictions (Timepoint 1; T1) and initial changes to those social distancing restrictions (Timepoint 2; T2) have disrupted postpartum access to practical and emotional support. This qualitative study explores the postpartum psychological experiences of UK women during different phases of the COVID-19 pandemic and associated 'lockdowns'. METHODS: Semi-structured interviews were conducted with 12 women, approximately 30 days after initial social distancing guidelines were imposed in the UK (22 April 2020). A separate 12 women were interviewed approximately 30 days after the initial easing of social distancing restrictions (10 June 2020). Data were transcribed verbatim, uploaded into NVivo for management and analysis, which followed a recurrent cross-sectional approach to thematic analysis. RESULTS: Two main themes were identified for T1: 'Motherhood is Much Like Lockdown' and 'A Self-Contained Family Unit'. Each main T1 theme contained two sub-themes. Two main themes were also identified for T2: 'Incongruously Held Views of COVID-19' and 'Mothering Amidst the Pandemic'. Each main T2 theme contained three sub-themes. Comparisons between data gathered at each timepoint identified increased emotional distress over time. Current findings call for the improvement of postpartum care by improving accessibility to social support, and prioritising the re-opening of schools, and face-to-face healthcare appointments and visitation. CONCLUSION: Social distancing restrictions associated with COVID-19 have had a cumulative, negative effect on postpartum mental health. Recommendations such as: Allowing mothers to 'bubble' with a primary support provider even at their healthcare appointments; allowing one support partner to attend all necessary healthcare appointments; and providing tailored informational resources, may help to support postpartum emotional wellbeing during this, and similar health crises in the future.


Asunto(s)
Agotamiento Psicológico , COVID-19/psicología , Madres/psicología , Distrés Psicológico , Apoyo Social , Adulto , Control de Enfermedades Transmisibles/métodos , Estudios Transversales , Femenino , Humanos , Entrevistas como Asunto , Servicios de Salud Mental , Atención Posnatal/métodos , Periodo Posparto/psicología , Investigación Cualitativa
17.
Rev Esc Enferm USP ; 55: e20200520, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34528994

RESUMEN

OBJECTIVE: To analyze the effects of an educational intervention via telephone on maternal breastfeeding self-efficacy. METHOD: Randomized controlled clinical trial including 240 puerperae from a secondary care hospital randomized into two groups: control and intervention. The educational intervention took place at seven, 30, 90, and 150 days postpartum and centered on self-efficacy and motivational interviewing principles. Self-efficacy was measured by the Breastfeeding Self-Efficacy Scale - Short Form. The data followed the abnormal distribution, so non-parametric tests were used. RESULTS: The intervention group obtained higher median breastfeeding self-efficacy scores across the three outcome measures when compared to the control group (p < 0,001). Furthermore, the intervention group showed increased self-efficacy scores at all monitoring moments, which shows that the educational intervention was able to raise and maintain women's confidence in breastfeeding their child over time. CONCLUSION: The use of a telephone-based intervention focused on self-efficacy principles and delivered by trained nurses effectively promoted maternal confidence in breastfeeding. Brazilian Clinical Trial Registry: RBR-7m7vc8.


Asunto(s)
Lactancia Materna , Periodo Posparto , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Madres , Autoeficacia , Teléfono
18.
Tijdschr Psychiatr ; 63(7): 557-564, 2021.
Artículo en Holandés | MEDLINE | ID: mdl-34523708

RESUMEN

BACKGROUND: Lithium use during peripartum requires careful consideration due to a risk of teratogenic effects, adverse side effects and risk of neonatal complications. However, given the effectiveness of lithium, use during the peripartum period may be indicated. AIM: To provide an overview of the current evidence regarding the clinical use of lithium during peripartum, including risk of relapse in case of (dis)continuation and evolution of lithium levels. METHOD: A review was performed in the Medline and ScienceDirect database. RESULTS: Ten studies were included. Six studies concerned the risk of relapse in case of (dis)continuation of lithium during the peripartum. Four studies concerned the evolution of lithium levels throughout the peripartum. Lithium discontinuation during pregnancy leads to an increased risk of relapse during pregnancy and postpartum. At the same dose, lithium levels are lower than preconceptual in all trimesters. CONCLUSION: Risk and benefits of lithium use during the peripartum should be carefully considered, if possible prior to conception. Close monitoring of maternal lithium levels and renal function is necessary due to significant fluctuations during peripartum.


Asunto(s)
Trastorno Bipolar , Complicaciones del Embarazo , Trastorno Bipolar/tratamiento farmacológico , Femenino , Humanos , Recién Nacido , Litio/uso terapéutico , Periodo Periparto , Periodo Posparto , Embarazo , Complicaciones del Embarazo/tratamiento farmacológico
19.
Nurs Womens Health ; 25(5): 384-394, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34534496

RESUMEN

In recent years, the incidence of bariatric surgery has increased among women of reproductive age. Health care providers should be knowledgeable about the impact bariatric surgery has on women and developing fetuses to effectively provide care from preconception through postpartum. Although pregnancy in women with normal weight or with excess weight after bariatric surgery has better outcomes when compared to pregnancy complicated by obesity, it is associated with complications such as nutritional deficiencies, low birth weight, and fetal growth restriction. Consequently, a multidisciplinary approach is recommended to ensure adequate nutrition, counseling, and screening before and during pregnancy. This article summarizes evidence regarding pregnancy complications that may occur in women with a history of bariatric surgery and presents a nursing, advanced practice nursing, and midwifery plan of care for these women before, during, and after pregnancy.


Asunto(s)
Cirugía Bariátrica/efectos adversos , Obesidad/cirugía , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo , Adulto , Cesárea , Femenino , Humanos , Partería , Obesidad/complicaciones , Periodo Posparto , Atención Preconceptiva , Embarazo , Mujeres Embarazadas , Nacimiento Prematuro
20.
Arch Womens Ment Health ; 24(5): 817-822, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34494144

RESUMEN

Postpartum psychosis (PPP) is a serious disorder that is associated with maternal and infant morbidity and mortality, yet it is denied a diagnostic classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM). PPP was included in the DSMI (1952) and the DSMII (1968). It was removed from DSMIII (1980). The purpose of this article is to review the history of postpartum psychosis in the DSM and provide the mechanism and research that argues for the inclusion of postpartum psychosis as a separate diagnostic entity in the DSM. This work describes a proposal to the DSMV committee in 2020 for inclusion of PPP as a unique diagnosis based on the cognitive disorganization that accompanies psychotic symptoms. The proposal for inclusion provides the required criteria such as a rationale for the proposed change and evidence that PPP is distinct from other disorders. Validators are described. Reliability studies and benefits of inclusion are provided. We were unable to gain consensus on the presence of cognitive impairment for all postpartum psychotic episodes. The committee opined that we did not demonstrate proof that PPP is a distinct diagnosis. However, the committee acknowledged that the current "specifier" may be insufficient, and thus the option favored by the committee is that it could be added to Sect. 3 of the DSM, "Conditions for Further Study." In the next proposal, we suggest that the unique temporal relationship of symptom onset to childbirth deserves consideration as unique criteria for diagnostic distinction of PPP.


Asunto(s)
Trastornos Psicóticos , Trastornos Puerperales , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Humanos , Periodo Posparto , Trastornos Psicóticos/diagnóstico , Trastornos Puerperales/diagnóstico , Reproducibilidad de los Resultados
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...