Prevalencia del inicio precoz de la lactancia materna / Prevalence of the early onset of maternal breastfeeding

Introducción: el momento en que el recién nacido recibe la primera toma no ha sido estudiado de modo explícito y se necesitan investigaciones para evaluar las medidas de apoyo a la lactancia. Nuestro objetivo fue determinar la prevalencia del inicio precoz de la lactancia materna (IPLM) y analizar su relación con distintos factores maternos y del recién nacido. Métodos: estudio descriptivo transversal realizado durante tres años en un hospital público. La base de datos utilizada para el estudio procedió de un registro clínico electrónico. Se realizó un análisis univariado descriptivo de todas las variables y se analizó la relación existente entre el IPLM con distintos parámetros maternos y del recién nacido mediante el test de Fisher. Resultados: nuestros resultados mostraron que la prevalencia de un IPLM fue de un 88,4%, de un total de 2.683 nacimientos incluidos en el estudio. Además, se encontró asociación significativa entre este IPLM y distintos factores maternos, como la paridad (p = 0,05) y las semanas de gestación (p = 0,047), excepto con la edad (p = 0,522). Igualmente, se encontró una asociación fuerte con todos los factores del niño (p = 0,000), como el peso, el color del líquido amniótico, el test de Apgar al minuto y a los cinco minutos, el tipo de reanimación que precisaba o la necesidad de ingreso en la unidad neonatal. Conclusiones: la tasa de IPLM en nuestro ámbito de estudio es alta y está influenciada por distintos factores maternos y del recién nacido

Introduction: the situation with maternal breastfeeding is difficult to describe with any certainty, given the absence of any data gathered in maternity hospitals, and the timing of its onset has not been explicitly evaluated. Further research is needed to evaluate breastfeeding support measures. The objective of the present study was to determine the prevalence of early onset of maternal breastfeeding (EOMB) and to analyze the relationship with different maternal and newborn factors. Methods: a descriptive study was performed of births in a public hospital over a three-year period. The database used for the study derived from an electronic clinical record system designed by professionals. Descriptive and univariate analyses were performed. The association of early onset of maternal breastfeeding with other parameters from mother and newborn was analyzed by the Fisher's test. Results: the prevalence of EOMB was 88.4%. A total of 2,683 births were included in the study. Significant associations were found between this EOMB and different maternal factors, such as parity (p = 0.05) and weeks of gestation (p = 0.047), but not with age (p = 0.522). A strong association was also found with all the factors of the child (p = 0.000), such as weight, color of the amniotic fluid, the Apgar test at one and five minutes, the type of resuscitation required or the need for admission in the neonatal unit. Conclusions: There has been a high rate of (EOMB) in our setting

[Prevalence of the early onset of maternal breastfeeding]. / Prevalencia del inicio precoz de la lactancia materna.

INTRODUCTION: Introduction: the situation with maternal breastfeeding is difficult to describe with any certainty, given the absence of any data gathered in maternity hospitals, and the timing of its onset has not been explicitly evaluated. Further research is needed to evaluate breastfeeding support measures. The objective of the present study was to determine the prevalence of early onset of maternal breastfeeding (EOMB) and to analyze the relationship with different maternal and newborn factors. Methods: a descriptive study was performed of births in a public hospital over a three-year period. The database used for the study derived from an electronic clinical record system designed by professionals. Descriptive and univariate analyses were performed. The association of early onset of maternal breastfeeding with other parameters from mother and newborn was analyzed by the Fisher's test. Results: the prevalence of EOMB was 88.4%. A total of 2,683 births were included in the study. Significant associations were found between this EOMB and different maternal factors, such as parity (p = 0.05) and weeks of gestation (p = 0.047), but not with age (p = 0.522). A strong association was also found with all the factors of the child (p = 0.000), such as weight, color of the amniotic fluid, the Apgar test at one and five minutes, the type of resuscitation required or the need for admission in the neonatal unit. Conclusions: There has been a high rate of (EOMB) in our setting.

INTRODUCCIÓN: Introducción: el momento en que el recién nacido recibe la primera toma no ha sido estudiado de modo explícito y se necesitan investigaciones para evaluar las medidas de apoyo a la lactancia. Nuestro objetivo fue determinar la prevalencia del inicio precoz de la lactancia materna (IPLM) y analizar su relación con distintos factores maternos y del recién nacido. Métodos: estudio descriptivo transversal realizado durante tres años en un hospital público. La base de datos utilizada para el estudio procedió de un registro clínico electrónico. Se realizó un análisis univariado descriptivo de todas las variables y se analizó la relación existente entre el IPLM con distintos parámetros maternos y del recién nacido mediante el test de Fisher. Resultados: nuestros resultados mostraron que la prevalencia de un IPLM fue de un 88,4%, de un total de 2.683 nacimientos incluidos en el estudio. Además, se encontró asociación significativa entre este IPLM y distintos factores maternos, como la paridad (p = 0,05) y las semanas de gestación (p = 0,047), excepto con la edad (p = 0,522). Igualmente, se encontró una asociación fuerte con todos los factores del niño (p = 0,000), como el peso, el color del líquido amniótico, el test de Apgar al minuto y a los cinco minutos, el tipo de reanimación que precisaba o la necesidad de ingreso en la unidad neonatal. Conclusiones: la tasa de IPLM en nuestro ámbito de estudio es alta y está influenciada por distintos factores maternos y del recién nacido.

Risk Assessments of Epidural Analgesia During Labor and Delivery.

Epidural analgesia (EA) is one of the methods of choice for labor pain relief, but its adverse effects on the mother and child remain controversial. The objective of this study was to determine whether there is an association between the use of EA and different aspects of labor. The author(s) analyzed the effect of EA on different aspects of labor in a retrospective cohort observational study of deliveries in a public Spanish hospital during a 3-year period. Women with EA administration were found to increase the risk of stimulated labor, reduce the percentage of spontaneous deliveries, increase the risk of instrumental labor due to stalled labor or loss of fetal well-being, and increase the percentage of episiotomies. However, women with EA were not and increased risk for perineal laceration or the condition of the membranes at the delivery or with the type of placental expulsion. Thus, the administration of EA should be assessed in each case by the health care professional.

The Effect of Epidural Analgesia Alone and in Association With Other Variables on the Risk of Cesarean Section.

INTRODUCTION: Epidural analgesia (EA) is the most widespread pharmacologic method of labor pain relief. There remains disagreement, however, regarding its adverse effects. The objective of this study was to determine the effect of EA administration on the risk of cesarean delivery and its causes (e.g., stalled labor, risk of loss of fetal well-being, among others) and the degree to which this effect may be modulated by mother-, newborn-, and labor-related variables. METHOD: A retrospective cohort observational study was conducted including all deliveries in a Spanish public hospital between March 2010 and March 2013 ( N = 2,450; EA = 562, non-EA = 1,888). RESULTS: Risk of a cesarean section was significantly increased by EA administration (odds ratio [ OR] = 2.673; p < .0001). The percentage of cesarean deliveries due to the risk of loss of fetal well-being was significantly higher in the EA (47.8%) versus non-EA group (27.5%; OR = 1.739; p = 0.0012,). The EA-associated risk of cesarean section was not significantly modified as a function of maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration alone. However, these variables in combination may increase the risk. We present multivariate models for each group that account for these variables, allowing for estimation of the risk of a cesarean delivery if EA is administered. CONCLUSION: EA is associated with an increased risk of cesarean delivery. Other variables in combination (maternal age or parity, fetal position, newborn weight, weeks of gestation, or sedation administration) may increase this risk.

Detección precoz de la violencia de género: hacia el diagnóstico biológico / Early detection of gender violence: towards biological diagnosis

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[SAFETY AND EFFICACY OF INFLUENZA VACCINE IN PREGNANCY]. / Seguridad y eficacia de la vacuna antigripal en el embarazo.

UNLABELLED: Only 22.7% of pregnant women are immunized against the flu virus, by the popular belief that the vaccine can cause the onset of the disease or other complications. OBJECTIVE: To review the scientific evidence regarding the safety and efficacy of influenza vaccines in pregnant women. METHODOLOGY: Literature review of the scientific literature. RESULTS: Pregnant women and the fetus can have complications if they contract the flu. The influenza vaccine in pregnant women is effective in reducing flu boxes during pregnancy, and it is not observed any increase in adverse effects of the vaccine in mothers or children, compared with non pregnant women. CONCLUSIONS: Vaccination is safe for pregnant women and fetus and is well tolerated. Therefore, vaccination is the safest and most effective method to prevent infection in any trimester.

Seguridad y eficacia de la vacuna antigripal en el embarazo / Safety and efficacy of Influenza vaccine in pregnancy

Solo el 22.7 % de las gestantes se inmunizan contra el virus de la gripe, por la creencia popular de que la vacuna puede causar la aparición de la enfermedad u otras complicaciones. Objetivo. Revisar la evidencia científica existente con respecto a la seguridad y eficacia de las vacunas antigripales en las embarazadas. Metodología. Revisión bibliográfica de la literatura científica. Resultados. Las embarazadas y el feto pueden tener complicaciones si contraen la gripe. La vacuna antigripal en la mujer embarazada es efectiva en la reducción de los cuadros de gripe durante el embarazo y no se observa ningún aumento de efectos adversos de la vacuna en madres ni en niños, comparados con las no embarazadas. Conclusiones. La vacunación es segura para la embarazada y para el feto y se tolera bien. Por lo tanto, la vacunación es el método más seguro y efectivo para prevenir la infección en cualquier trimestre de la gestación (AU)

Only 22.7 % of pregnant women are immunized against the flu virus, by the popular belief that the vaccine can cause the onset of the disease or other complications. Objective. To review the scientific evidence regarding the safety and efficacy of influenza vaccines in pregnant women. Methodology. Literature review of the scientific literature. Results. Pregnant women and the fetus can have complications if they contract the flu. The influenza vaccine in pregnant women is effective in reducing flu boxes during pregnancy, and it is not observed any increase in adverse effects of the vaccine in mothers or children, compared with non pregnant women. Conclusions. Vaccination is safe for pregnant women and fetus and is well tolerated. Therefore, vaccination is the safest and most effective method to prevent infection in any trimester (AU)

El contacto piel con piel de la madre con el recién nacido durante el parto / The skin to skin contact between mother and the newborn during delivery

El contacto piel con piel de la madre con el recién nacido en el parto tiene diversos beneficios para la madre y el recién nacido. Objetivo: Realización de un protocolo de actuación de enfermería acerca del contacto piel con piel del recién nacido con su madre o padre. Metodología: Se realizó una revisión bibliográfica de los protocolos de actuación y procedimientos enfermeros acerca del tema, en Cuiden y diversas bases de datos y publicaciones de diferentes instituciones y sociedades científicas de ámbito nacional e internacional. Resultados: Procedimiento actualizado del contacto piel con piel en el parto, realizado por la madre, y también realizado por el padre. Conclusiones: Se fomentará el contacto piel a piel de la madre y el recién nacido, y si no se pudiera, se ofrecerá al padre la posibilidad de mantener el contacto piel a piel con su hijo, tal y como la evidencia científica lo expone (AU)

The skin to skin contact between mother and the newborn at birth, has several benefits for the mother and the newborn. Objective: Conduct a nursing intervention protocol on the skin contact of the newborn with her mother or father. Methods: A literature review of protocols for nursing intervention and about the subject, Take care and various databases and publications of various institutions and scientific societies nationally and internationally. Results: Procedure updated skin contact at birth, by the mother, and also by the father. Conclusions: It will encourage skin to skin contact of mother and baby, and if it can not be offered to father the possibility of maintaining skin contact with your child, as it exposes the scientific evidence (AU)

Influencia de la obesidad en la salud sexual y reproductiva / Influence of obesity in sexual and reproductive health

Introducción. La epidemia mundial del sobrepeso y la obesidad se está convirtiendo, dado su crecimiento, en un importante problema de salud pública en muchas partes del mundo; afecta aproximadamente a la mitad de la población y por lo tanto resulta un problema común entre la franja de edad fértil. Exposición. La obesidad y el sobrepeso son condiciones comunes que tienen consecuencias no sólo en la salud en general, sino también en gran medida sobre la salud reproductiva. Existe una alta prevalencia de mujeres obesas en la población estéril y numerosos estudios han puesto de relieve el vínculo entre la obesidad y la infertilidad. También aumenta los riesgos de atención obstétrica y complicaciones neonatales, disminuye la fecundidad, incluso en mujeres que ovulan, y está asociada a trastornos menstruales y mayor riesgo de abortos espontáneos de repetición. Conclusiones. Cambios en el estilo de vida, la realización de una dieta y un programa de ejercicio, constituyen la primera línea de tratamiento para la obesidad(AU)

Introduction. The global epidemic of overweight and obesity is becoming, as its growth into a major public health problem in many parts of the world affects about half the general population and is therefore a problem common among fertile. Exposure. Obesity and overweight are common conditions that have implications not only for overall health, but also largely on reproductive health. A high prevalence of obese women in the sterile population and numerous studies have highlighted the link between obesity and infertility. Obesity increases the risks of obstetric and neonatal complications, including decreased fertility in women who ovulate and is also associated with menstrual disorders and increased risk of recurrent spontaneous abortions. Conclusions. Changes in lifestyle, the realization of a diet and exercise program, are the first line of treatment for obesity(AU)

Hemorragia tras un parto eutócico / Postpartum hemorrhage after eutocic delivery

La hemorragia posparto aparece en el 5-15% de todos los partos. Entrelas opciones de tratamiento se incluyen fármacos para aumentarlas contracciones uterinas, técnicas quirúrgicas, intervenciones radiológicas,fármacos hemostáticos y otros medios, como el taponamientocon gasa estéril y la utilización de balones intrauterinos. Se presentael caso de una mujer con un parto eutócico y alumbramiento espontáneo,con placenta y membranas íntegras, en la que persiste una hemorragiamoderada/intensa a pesar de la administración de uterotónicos.Tras la revisión de la cavidad uterina, se detectó un cotiledónaccesorio insertado en el segmento uterino, que se extrajo manualmentesin conseguir que cediera la hemorragia, por lo que se decidióinsertar un balón intrauterino de Bakri, que permitió controlarla (AU)

Postpartum hemorrhage occurs in 5-15% of all the deliveries, in the optionsof treatment we include drugs to increase the muscle uterine contractions,surgical procedures, radiological interventions, and otherhemostatic agents such as tamponade with sterile gauze and the use ofintrauterine balls. We report the case of a woman with normal humandelivery, placenta and intact membranes, in which bleeding persistsmoderate to severe, despite the administration of uterotonic. After reviewof the uterine cavity, is detected accessory cotyledon segment insertedinto the uterus, which is extracted manually without getting toyield the bleeding, it was decided to insert intrauterine Bakri balloongetting control of it (AU)

[Influence of obesity in sexual and reproductive health]. / Influencia de la obesidad en la salud sexual y reproductiva.

INTRODUCTION: The global epidemic of overweight and obesity is becoming, as its growth into a major public health problem in many parts of the world affects about half the general population and is therefore a problem common among fertile. EXPOSURE: Obesity and overweight are common conditions that have implications not only for overall health, but also largely on reproductive health. A high prevalence of obese women in the sterile population and numerous studies have highlighted the link between obesity and infertility. Obesity increases the risks of obstetric and neonatal complications, including decreased fertility in women who ovulate and is also associated with menstrual disorders and increased risk of recurrent spontaneous abortions. CONCLUSIONS: Changes in lifestyle, the realization of a diet and exercise program, are the first line of treatment for obesity.

[Childbirth via the vagina birth canal. Breech presentation through the cervix uteri]. / Parto por vía vaginal en presentación de nalgas.

At the present time in our country, when faced with a breech presentation through the cervix uteri, the majority of hospitals carry out an elective Cesarean section. The Spanish Association of Gynecology and Obstetrics does not indicate a strict operating protocol for these cases. The authors carry out a transversal study to test a mother's and her child's state of health after having undergone birth through the vagina birth canal when a breech presentation through the cervix uteri occurred, using various parameters for their analysis. Our results indicate that with the mother's consent and in the situations indicated, to have birth via the vagina birth canal when there is a breech presentation through the cervix uteri can be tried.

Parto por vía vaginal en presentación de nalgas / Childbirth via the vagina birth canal. Breech presentation through the cervix uteri

Actualmente, en nuestro país, ante una presentación de nalgas la mayoría de los hospitales realiza una cesárea electiva. La SEGO (Sociedad Española de Ginecología y Obstetricia) no indica un protocolo de actuación estricto de cesárea en estos casos. Se realiza un estudio transversal para comprobar el estado de salud de la madre y el recién nacido en partos vaginales con presentación de nalgas, midiendo diferentes parámetros. Nuestros resultados indican que, en consenso con la madre y en los casos que se indiquen, se podría intentar parto vía vaginal de presentación de nalgas(AU)

At the present time in our country, when faced with a breech presentation through the cervix uteri, the majority of hospitals carry out an elective Cesarean section. The Spanish Association of Gynecology and Obstetrics does not indicate a strict operating protocol for these cases. The authors carry out a transversal study to test a mother’s and her child’s state of health after having undergone birth through the vagina birth canal when a breech presentation through the cervix uteri occurred, using various parameters for their analysis. Our results indicate that with the mother’s consent and in the situations indicated, to have birth via the vagina birth canal when there is a breech presentation through the cervix uteri can be traed(AU)

[Prescriptions by nurses and the law on medications]. / La prescripción enfermera y la ley del medicamento.

To prescribe means to issue a professional health criteria directed towards a patient in order to select materials, products and/or medication administered as part of nursing care. To prescribe consists in fulfilling medication or a medical formula. At present times, the countries which authorize prescriptions by nurses are Australia, France, the USA, Canada, Botswana, Zambia, New Zealand, South Africa, the United Kingdom, Ireland and Brazil. In Spain, studies show that nurses prescribe more than 200 pharmaceutical medications and other sanitary products every day; moreover, health professionals and management are aware of and approve this activity carried out by nurses.

La prescripción enfermera y la ley del medicamento / Prescriptions by nurses and the law on medications

Prescribir es emitir un criterio profesional sanitario dirigido al paciente para seleccionar materiales, productos y medicación, administrados en forma de cuidados de enfermería. Recetar consiste en cumplimentar un formulario de medicación. Actualmente, los países con prescripción enfermera autorizada son Australia, Francia, EEUU, Canadá, Bostwana, Zambia, Nueva Zelanda, Sudáfrica, Reino Unido, Irlanda y Brasil. En España, hay estudios que demuestran que las enfermeras prescriben más de 200 fármacos y productos sanitarios diariamente, con el conocimiento y beneplácito de los profesionales y gestores sanitarios(AU)

To prescribe means to issue a professional health criteria directed towards a patient in order to select materials, products and/or medication administered as part of nursing care. To prescribe consists in fulfilling medication or a medical formula. At present times, the countries which authorize prescriptions by nurses are Australia, France, the USA, Canada, Botswana, Zambia, New Zealand, South Africa, the United Kingdom, Ireland and Brazil. In Spain, studies show that nurses prescribe more than 200 pharmaceutical medications and other sanitary products every day; moreover, health professionals and management are aware of and approve this activity carried out by nurses(AU)