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2.
Rev. enferm. UERJ ; 28: e44488, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1096023

RESUMO

Objetivo: identificar dúvidas de puérperas e familiares sobre cuidados domiciliares com o recém-nascido de baixo risco e analisar a roda de conversa, mediada por simulador realístico de baixa fidelidade, como uma tecnologia educativa para o preparo de famílias no processo de alta da maternidade. Método: pesquisa qualitativa, incluindo dezenove familiares de recém-nascidos de baixo risco em um hospital municipal de Rio das Ostras, Rio de Janeiro, de maio a outubro de 2018, por entrevista semiestruturada. Dados submetidos à Análise Temática. Resultados: as dúvidas dos familiares versaram sobre cuidados com higiene, alimentação, ambiente, afeto, saúde, sono e doenças. A roda de conversa com simulador de baixa fidelidade foi considerada uma estratégia positiva para mediar o aprendizado. Conclusão: a tecnologia educativa revelou-se útil na instrumentalização de famílias no processo de alta da maternidade, visto que o cuidador fortalece suas potencialidades, retira dúvidas e troca informações e experiências no grupo.


Objective: to identify puerperal and family members' questions about home care with low-risk newborns and to analyze the conversation circle, mediated by a realistic low fidelity simulator, as an educational technology for the preparation of families in the maternity discharge process. Method: qualitative research conducted with nineteen relatives of low-risk newborns in the municipal hospital in Rio das Ostras, Rio de Janeiro, Brazil, from May to October 2018, through semi-structured interview. Data submitted to thematic analysis. Results: the family members' doubts were about care with hygiene, food, environment, affection, health, sleep and diseases. The conversation wheel with low fidelity simulator was considered a positive strategy to mediate learning. Conclusion: the educational technology proved to be useful in the instrumentalization of families in the maternity discharge process, as the caregiver strengthens their potential, removes doubts and exchanges information and experiences in the group.


Objetivo: identificar dudas puerperales y familiares sobre atención domiciliaria con recién nacidos de bajo riesgo y analizar el círculo de conversación, mediado por simulador realista de baja fidelidad, como una tecnología educativa de preparación de familias en el proceso de alta de la maternidad. Método: investigación cualitativa, con diecinueve familiares de recién nacidos de bajo riesgo en un hospital municipal en Río das Ostras, Río de Janeiro, de mayo a octubre de 2018, a través de entrevistas semiestructuradas. Se utilizó a Análisis temático. Resultados: las dudas fueron sobre higiene, alimentación, medio ambiente, afecto, salud, sueño y enfermedades. El círculo de conversación con simulador se consideró una estrategia positiva para mediar en el aprendizaje. Conclusión: la tecnología educativa demostró ser útil en la instrumentalización de familias en el proceso de alta de la maternidad, porque el cuidador fortalece su potencial, elimina dudas e intercambia información y experiencias en el grupo.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Alta do Paciente , Recém-Nascido , Família , Cuidadores/educação , Tecnologia Educacional , Assistência Domiciliar/educação , Brasil , Tecnologia Educacional/métodos , Pesquisa Qualitativa , Treinamento por Simulação , Maternidades , Hospitais Municipais
3.
BMC Infect Dis ; 20(1): 601, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32799811

RESUMO

BACKGROUND: Listeriosis is a rare but severe foodborne infectious disease. Perinatal listeriosis is often associated with septicemia, central nervous system (CNS) infection, and serious adverse pregnancy outcomes (miscarriage and neonate death). Here we report the characteristics and outcomes of perinatal listeriosis cases treated over 6 years at Beijing Obstetrics and Gynecology Hospital (BOGH), the largest maternity hospital in China. METHODS: We retrospectively reviewed the records of laboratory-confirmed, pregnancy-associated listeriosis cases treated from January 1, 2013 to December 31, 2018. The clinical manifestations, laboratory results, perinatal complications and outcomes (post-natal follow-up of 6 months) were investigated. RESULTS: In BOGH, 12 perinatal listeriosis cases were diagnosed based on Listeria monocytogenes positive culture, including 10 single pregnancies and 2 twin pregnancies. The corresponding incidence of pregnancy-associated listeriosis was 13.7/100,000 deliveries. Among those cases, four pregnant women and four newborns had septicemia, and two of the neonates with septicemia also suffered CNS infection. All the maternal patients recovered. Two inevitable miscarriages and four fetal stillbirths occurred. Of the eight delivered newborns, six survived, and two died within 2 days from birth. None of the survivors had neurological sequelae during a 6-month follow-up. The overall feto-neonatal fatality rate was 57.1%; notably, this rate was 100% for infections occurring during the second trimester of pregnancy and only 14.3% for those occurring in the third trimester. CONCLUSIONS: Perinatal listeriosis is associated with high feto-neonatal mortality, and thus, a public health concern. Additional large-scale studies are needed to strengthen the epidemiological understanding of listeriosis in China.


Assuntos
Listeriose/tratamento farmacológico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Aborto Espontâneo/epidemiologia , Adulto , Pequim/epidemiologia , Infecções do Sistema Nervoso Central/microbiologia , Feminino , Maternidades/estatística & dados numéricos , Humanos , Incidência , Recém-Nascido , Listeria monocytogenes/isolamento & purificação , Listeriose/diagnóstico , Listeriose/epidemiologia , Morte Perinatal , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez , Estudos Retrospectivos , Sepse/etiologia , Natimorto
4.
Womens Health (Lond) ; 16: 1745506520949727, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32842920

RESUMO

OBJECTIVES: maternal and neonatal mortality in Ethiopia is a major reproductive health problem. Obstructed labor is one of the leading causes of maternal, fetal, and neonatal morbidity in developing countries. The evidence regarding its determinants at the tertiary level of care is sparse. Therefore, this study aimed to study the determinants of obstructed labor among women attending intrapartum care in Amhara region referral hospitals. METHODS: A Hospital-based unmatched case-control study was conducted from March 1stto August 30, 2017. Cases were women whose labor was obstructed (n = 270), and controls were women whose labor was not obstructed (n = 540). Both cases and controls were selected randomly, and a proportional to size allocation was made to the referral hospitals selected for the study. A binary and a multivariable logistic regression model was computed to identify the determinant factors at 95% CI. RESULTS: The mean age of the study participants was 27.66 years (27.4 ± 5.44 for cases and 28.15 ± 6.16 for controls), ranging between 16 and 45 years. Relatively, higher proportions of cases than controls were unable to read and write (58.5%) and were urban residents (53.7%). Distance from hospital, distance from health center, mothers inability to read and write, mothers primary level of education, more than 28 weeks of gestation at the first visit of antenatal care, 37 to 42 weeks at admission, above 42 weeks at admission, women of a merchant spouse, and history of pregnancy-related complications were the positive determinants of obstructed labor. However, mothers whose gestational age was 16 to 28 weeks at the first antenatal care visit were 62% less likely to be exposed to obstructed labor. CONCLUSIONS: Obstetric, service-related, and system factors were predictors of obstructed labor. Improving women's literacy status, health service access, and utilization will help reduce obstructed labor.


Assuntos
Parto Obstétrico/estatística & dados numéricos , Complicações do Trabalho de Parto/epidemiologia , História Reprodutiva , Determinantes Sociais da Saúde/estatística & dados numéricos , Adolescente , Adulto , Estudos de Casos e Controles , Etiópia/epidemiologia , Feminino , Maternidades , Hospitais Estaduais , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Assistência Perinatal , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
5.
BMJ Open ; 10(7): e038004, 2020 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-32699166

RESUMO

INTRODUCTION: An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurred in Wuhan, China starting in December 2019. Yet the clinical features and long-term outcomes of neonates with SARS-CoV-2 exposure are lacking. The purpose of this study is to describe the clinical course and prognosis of the neonates exposed to SARS-CoV-2. METHODS AND ANALYSIS: This is a multicentre observational study conducted at the designated children and maternal and child hospitals in the mainland of China. Neonates exposed to SARS-CoV-2 infection will be recruited. The data to be collected via case report forms include demographic details, clinical features, laboratory and imaging results, as well as outcomes. Primary outcomes are the mortality of neonates with COVID-19 and SARS-CoV-2 infection of neonates born to mothers with COVID-19. Secondary outcomes are the birth weight, premature delivery and neurological development of neonates exposed to SARS-CoV-2. The neurological development is assessed by the Chinese standardised Denver Developmental Screening Test at the corrected age of 6 months. ETHICS AND DISSEMINATION: This study has been approved by the Children's Hospital of Fudan University ethics committee (No. (2020)31). The study findings will be disseminated in peer-reviewed journals and presented at national and international conferences in order to improve the understanding of the clinical course among neonates exposed to SARS-CoV-2 and to provide evidence-based treatment and prevention strategies for this group. TRIAL REGISTRATION NUMBER: NCT04279899.


Assuntos
Desenvolvimento Infantil , Infecções por Coronavirus/epidemiologia , Transtornos do Neurodesenvolvimento/epidemiologia , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/fisiopatologia , Feminino , Maternidades , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/fisiopatologia , Gravidez , Estudos Prospectivos , Índice de Gravidade de Doença
6.
PLoS Med ; 17(7): e1003089, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32649668

RESUMO

INTRODUCTION: Inequalities in maternal and newborn health persist in many high-income countries, including for women of refugee background. The Bridging the Gap partnership programme in Victoria, Australia, was designed to find new ways to improve the responsiveness of universal maternity and early child health services for women and families of refugee background with the codesign and implementation of iterative quality improvement and demonstration initiatives. One goal of this 'whole-of-system' approach was to improve access to antenatal care. The objective of this paper is to report refugee women's access to hospital-based antenatal care over the period of health system reforms. METHODS AND FINDINGS: The study was designed using an interrupted time series analysis using routinely collected data from two hospital networks (four maternity hospitals) at 6-month intervals during reform activity (January 2014 to December 2016). The sample included women of refugee background and a comparison group of Australian-born women giving birth over the 3 years. We describe the proportions of women of refugee background (1) attending seven or more antenatal visits and (2) attending their first hospital visit at less than 16 weeks' gestation compared over time and to Australian-born women using logistic regression analyses. In total, 10% of births at participating hospitals were to women of refugee background. Refugee women were born in over 35 countries, and at one participating hospital, 40% required an interpreter. Compared with Australian-born women, women of refugee background were of similar age at the time of birth and were more likely to be having their second or subsequent baby and have four or more children. At baseline, 60% of refugee-background women and Australian-born women attended seven or more antenatal visits. Similar trends of improvement over the 6-month time intervals were observed for both populations, increasing to 80% of women at one hospital network having seven or more visits at the final data collection period and 73% at the other network. In contrast, there was a steady decrease in the proportion of women having their first hospital visit at less than 16 weeks' gestation, which was most marked for women of refugee background. Using an interrupted time series of observational data over the period of improvement is limited compared with using a randomisation design, which was not feasible in this setting. CONCLUSIONS: Accurate ascertainment of 'harder-to-reach' populations and ongoing monitoring of quality improvement initiatives are essential to understand the impact of system reforms. Our findings suggest that improvement in total antenatal visits may have been at the expense of recommended access to public hospital antenatal care within 16 weeks of gestation.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Hospitais Públicos/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , Adulto , Feminino , Maternidades/estatística & dados numéricos , Humanos , Recém-Nascido , Análise de Séries Temporais Interrompida , Idade Materna , Gravidez , Segundo Trimestre da Gravidez , Melhoria de Qualidade , Fatores Socioeconômicos , Vitória/epidemiologia , Adulto Jovem
7.
PLoS One ; 15(6): e0233845, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32479522

RESUMO

INTRODUCTION: As facility-based deliveries increase globally, maternity registers offer a promising way of documenting pregnancy outcomes and understanding opportunities for perinatal mortality prevention. This study aims to contribute to global quality improvement efforts by characterizing facility-based pregnancy outcomes in Kenya and Uganda including maternal, neonatal, and fetal outcomes at the time of delivery and neonatal discharge outcomes using strengthened maternity registers. METHODS: Cross sectional data were collected from strengthened maternity registers at 23 facilities over 18 months. Data strengthening efforts included provision of supplies, training on standard indicator definitions, and monthly feedback on completeness. Pregnancy outcomes were classified as live births, early stillbirths, late stillbirths, or spontaneous abortions according to birth weight or gestational age. Discharge outcomes were assessed for all live births. Outcomes were assessed by country and by infant, maternal, and facility characteristics. Maternal mortality was also examined. RESULTS: Among 50,981 deliveries, 91.3% were live born and, of those, 1.6% died before discharge. An additional 0.5% of deliveries were early stillbirths, 3.6% late stillbirths, and 4.7% spontaneous abortions. There were 64 documented maternal deaths (0.1%). Preterm and low birthweight infants represented a disproportionate number of stillbirths and pre-discharge deaths, yet very few were born at ≤1500g or <28w. More pre-discharge deaths and stillbirths occurred after maternal referral and with cesarean section. Half of maternal deaths occurred in women who had undergone cesarean section. CONCLUSION: Maternity registers are a valuable data source for understanding pregnancy outcomes including those mothers and infants at highest risk of perinatal mortality. Strengthened register data in Kenya and Uganda highlight the need for renewed focus on improving care of preterm and low birthweight infants and expanding access to emergency obstetric care. Registers also permit enumeration of pregnancy loss <28 weeks. Documenting these earlier losses is an important step towards further mortality reduction for the most vulnerable infants.


Assuntos
Maternidades/estatística & dados numéricos , Resultado da Gravidez/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adulto , Parto Obstétrico/estatística & dados numéricos , Feminino , Maternidades/normas , Humanos , Lactente , Recém-Nascido , Quênia , Masculino , Mortalidade Materna , Gravidez , Melhoria de Qualidade , Uganda
9.
Rev Lat Am Enfermagem ; 28: e3292, 2020.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-32520244

RESUMO

OBJECTIVE: to analyze the time of access to care during labor and delivery and the safety of maternal health. METHOD: cross-sectional analytical study, carried out in five maternity hospitals, four of which are of habitual and intermediate risk and one of high risk. For data collection, data from the maternal medical record and interviews with the puerperal woman were used. In the data analysis, the Chi-square test (p≤0.05) was performed to search for possible associations between the independent variables - model three delays and dependents [Adverse maternal outcomes], [Knowledge about labor/delivery] and [Service satisfaction]. RESULTS: statistical significance was observed between the adverse maternal outcome and the delay in looking for a health service (p = 0.005) and the delay in transport to the maternity hospital (p = 0.050), while the outcome knowledge about labor/delivery showed statistical association with delay in looking for a health service (p = 0.048). There was no statistically significant difference between the three delays model and satisfaction with the care. CONCLUSION: the women's knowledge about labor and delivery and the time of access to obstetric care negatively interferes with the maternal outcome at delivery, which directly impacts maternal health safety.


Assuntos
Acesso aos Serviços de Saúde , Trabalho de Parto , Saúde Materna , Estudos Transversais , Parto Obstétrico , Feminino , Maternidades , Humanos , Gravidez
10.
Int Nurs Rev ; 67(3): 323-325, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32578218

RESUMO

The COVID-19 pandemic has disrupted clinical nursing and midwifery education. This disruption has long-term implications for the nursing and midwifery workforce and for future healthcare responses to pandemics. Solutions may include enhanced partnerships between schools of nursing and midwifery and health service providers and including schools of nursing and midwifery in preparedness planning. These suggestions notwithstanding, we call upon national and international nursing and midwifery bodies to study how to further the clinical education of nurses and midwives during pandemics and other times of crisis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Bacharelado em Enfermagem/normas , Tocologia/educação , Pneumonia Viral/epidemiologia , Escolas de Enfermagem/organização & administração , Currículo/normas , Educação em Enfermagem/normas , Feminino , Maternidades/organização & administração , Humanos , Serviços de Saúde Materna/organização & administração , Tocologia/organização & administração , Pandemias
11.
Obstet Gynecol ; 136(2): 252-258, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32433453

RESUMO

OBJECTIVE: To investigate the clinical evolution of coronavirus disease 2019 (COVID-19) in hospitalized pregnant women and potential factors associated with severe maternal outcomes. METHODS: We designed a prospective multicenter cohort study of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who were admitted to 12 Italian maternity hospitals between February 23 and March 28, 2020. Clinical records, laboratory and radiologic examinations, and pregnancy outcomes were collected. A subgroup of patients with severe disease was identified based on intensive care unit (ICU) admission, delivery for respiratory compromise, or both. RESULTS: Seventy-seven patients were included, 14 of whom had severe disease (18%). Two thirds of the patients in the cohort were admitted during the third trimester, and 84% were symptomatic on admission. Eleven patients underwent urgent delivery for respiratory compromise (16%), and six were admitted to the ICU (8%). One woman received extracorporeal membrane oxygenation; no deaths occurred. Preterm delivery occurred in 12% of patients, and nine newborns were admitted to the neonatal intensive care unit. Patients in the severe subgroup had significantly higher pregestational body mass indexes (BMIs) and heart and respiratory rates and a greater frequency of fever or dyspnea on admission compared with women with a nonsevere disease evolution. CONCLUSION: In our cohort, one in five women hospitalized with COVID-19 infection delivered urgently for respiratory compromise or were admitted to the ICU. None, however, died. Increased pregestational BMI and abnormal heart and respiratory rates on admission were associated with severe disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Hospitalização/estatística & dados numéricos , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Índice de Massa Corporal , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/transmissão , Dispneia/etiologia , Feminino , Febre/etiologia , Maternidades , Humanos , Recém-Nascido , Itália/epidemiologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/transmissão , Gravidez , Complicações Infecciosas na Gravidez/fisiopatologia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Terceiro Trimestre da Gravidez , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/virologia , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
12.
PLoS One ; 15(5): e0232760, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32374772

RESUMO

OBJECTIVES: The Korean government has been providing financial support to open and operate the maternal hospital in Obstetrically Underserved Areas (OUAs) since 2011. Our study aims to assess the effectiveness of the government-support program for OUAs and to suggest future directions for it. METHODS: We performed sequential-mixed method approach. Descriptive analyses and multi-level logistic regression were performed based on the 2015 Korean National Health Insurance claim data. Data for the qualitative analysis were obtained from in-depth interviews with health providers and mothers in OUAs. RESULTS: Descriptive analyses indicated that the share of babies born in the hospitals located in the area among total babies ever born from mothers residing in the area (Delivery concentration Index: DCI) was lower in government-supported OUAs than other areas. Qualitative analyses revealed that physical distance is no longer a barrier in current OUAs. Mothers travel to neighboring big cities to seek elective preferences only available at specialized maternal hospitals rather than true medical need. Increasing one-child families changed the mother's perception of pregnancy and childbirth, making them willing to pay for more expensive services. Concern about an emergency for mothers or infants, especially of high-risk mothers was also an important factor to make mothers avoid local government-supported hospitals. Adjusted multi-level logistic regression indicated that DCIs of government-supported OUAs were higher than the ones of their counterpart areas. CONCLUSION: Our results suggest that current OUAs do not reflect reality. Identification of true OUAs where physical distance is a real barrier to the use of obstetric service and focused investment on them is necessary. In addition, more sophisticated performance indicator other than DCI needs to be developed.


Assuntos
Programas Governamentais/métodos , Serviços de Saúde Materna/tendências , Saúde Materna , Área Carente de Assistência Médica , Obstetrícia , Adulto , Feminino , Maternidades , Humanos , Recém-Nascido , Serviços de Saúde Materna/economia , Mães , Parto , Gravidez , Pesquisa Qualitativa , República da Coreia , População Rural , Viagem
13.
Medicine (Baltimore) ; 99(18): e19961, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358367

RESUMO

This study aimed to investigate blood transfusion rates and spectrum of diseases in hospitalized neonates treated with blood transfusion in China to provide supporting data for future studies on neonatal blood transfusion.Data on hospitalized neonates were obtained from more than 100 experts from the Department of Neonatology of 55 hospitals in China between January 1, 2012 and December 31, 2016, using a standardized survey. A statistical analysis was conducted to evaluate the data collected, including the blood transfusion rates, blood component transfused, spectrum of diseases, and spectrum of major diseases.Between 2012 and 2016, 541,128 neonates were hospitalized in the 55 hospitals surveyed. There were 70,433 neonates who received blood transfusion, with an average transfusion rate of 13.02%. The rates of red blood cell transfusion, platelet transfusion, and plasma transfusion were 9.44%, 0.66%, and 4.77%, respectively. The neonatal blood transfusion rate was 17.99% in Northeast China, 9.74% in Northwest China, and between 10.60% and 16.22% in other regions. The neonatal blood transfusion rate was 12.3% in general hospitals and 13.8% in women and children's hospitals. The top 10 diseases identified in hospitalized neonates treated by blood transfusion were, in rank order, as follows:prematurity,pneumonia, hyperbilirubinemia, bacterial sepsis, respiratory distress syndrome, anemia, hemolytic disease, asphyxia, hemorrhage, and necrotizing enterocolitis.The neonatal blood transfusion rate in China is 13.03%.The rank order in the disease spectrum of the hospitalized neonates and that in hospitalized neonates treated with blood transfusion are different.


Assuntos
Transfusão de Sangue/estatística & dados numéricos , Doenças do Recém-Nascido/classificação , Doenças do Recém-Nascido/terapia , Transfusão de Componentes Sanguíneos/estatística & dados numéricos , China/epidemiologia , Hospitais Gerais/estatística & dados numéricos , Maternidades/estatística & dados numéricos , Humanos , Recém-Nascido , Características de Residência
14.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47345

RESUMO

O presente documento visa fornecer informação atualizada sobre as indicações do uso de fórmula infantil na maternidade em crianças saudáveis a termo, visando reduzir o uso desnecessário de suplemento.


Assuntos
Nutrição do Lactente , Fórmulas Infantis , Desmame , Substitutos do Leite Humano , Leite Humano , Maternidades
15.
Int J Gynaecol Obstet ; 149(3): 377-378, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-47393

RESUMO

From February 24, 2020, a COVID-19 obstetric task force was structured to deliver management recommendations for obstetric care. From March 1, 2020, six COVID-19 hubs and their spokes were designated. An interim analysis of cases occurring in or transferred to these hubs was performed on March 20, 2020 and recommendations were released on March 24, 2020. The vision of this strict organization was to centralize patients in high-risk maternity centers in order to concentrate human resources and personal protective equipment (PPE), dedicate protected areas of these major hospitals, and centralize clinical multidisciplinary experience with this disease. All maternity hospitals were informed to provide a protected labor and delivery room for nontransferable patients in advanced labor. A pre-triage based on temperature and 14 other items was developed in order to screen suspected patients in all hospitals to be tested with nasopharyngeal swabs. Obstetric outpatient facilities were instructed to maintain scheduled pregnancy screening as per Italian guidelines, and to provide pre-triage screening and surgical masks for personnel and patients for pre-triage-negative patients. Forty-two cases were recorded in the first 20 days of hub and spoke organization. The clinical presentation was interstitial pneumonia in 20 women. Of these, seven required respiratory support and eventually recovered. Two premature labors occurred.


Assuntos
Instituições de Assistência Ambulatorial/normas , Infecções por Coronavirus , Alocação de Recursos para a Atenção à Saúde , Maternidades/normas , Obstetrícia/normas , Pandemias , Assistência ao Paciente/normas , Pneumonia Viral , Instituições de Assistência Ambulatorial/organização & administração , Feminino , Alocação de Recursos para a Atenção à Saúde/organização & administração , Alocação de Recursos para a Atenção à Saúde/normas , Maternidades/organização & administração , Hospitais Especializados/organização & administração , Hospitais Especializados/normas , Humanos , Itália , Equipamento de Proteção Individual/provisão & distribução , Gravidez
16.
Int J Gynaecol Obstet ; 149(3): 377-378, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32267531

RESUMO

From February 24, 2020, a COVID-19 obstetric task force was structured to deliver management recommendations for obstetric care. From March 1, 2020, six COVID-19 hubs and their spokes were designated. An interim analysis of cases occurring in or transferred to these hubs was performed on March 20, 2020 and recommendations were released on March 24, 2020. The vision of this strict organization was to centralize patients in high-risk maternity centers in order to concentrate human resources and personal protective equipment (PPE), dedicate protected areas of these major hospitals, and centralize clinical multidisciplinary experience with this disease. All maternity hospitals were informed to provide a protected labor and delivery room for nontransferable patients in advanced labor. A pre-triage based on temperature and 14 other items was developed in order to screen suspected patients in all hospitals to be tested with nasopharyngeal swabs. Obstetric outpatient facilities were instructed to maintain scheduled pregnancy screening as per Italian guidelines, and to provide pre-triage screening and surgical masks for personnel and patients for pre-triage-negative patients. Forty-two cases were recorded in the first 20 days of hub and spoke organization. The clinical presentation was interstitial pneumonia in 20 women. Of these, seven required respiratory support and eventually recovered. Two premature labors occurred.


Assuntos
Instituições de Assistência Ambulatorial/normas , Infecções por Coronavirus , Alocação de Recursos para a Atenção à Saúde , Maternidades/normas , Obstetrícia/normas , Pandemias , Assistência ao Paciente/normas , Pneumonia Viral , Instituições de Assistência Ambulatorial/organização & administração , Feminino , Alocação de Recursos para a Atenção à Saúde/organização & administração , Alocação de Recursos para a Atenção à Saúde/normas , Maternidades/organização & administração , Hospitais Especializados/organização & administração , Hospitais Especializados/normas , Humanos , Itália , Equipamento de Proteção Individual/provisão & distribução , Gravidez
17.
Fractal rev. psicol ; 32(1): 57-63, abr. 2020.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1098266

RESUMO

Na atualidade, a demanda por profissionais da psicologia no ambiente hospitalar torna-se crescente. Assim, surge a necessidade de ampliar o conhecimento desse profissional sobre o referido contexto, no intuito de orientar sua conduta, além de contribuir para a concretização do seu espaço de atuação. Considerando esses aspectos e a relevância de pôr em questão o trabalho da psicologia nos serviços de saúde, o presente estudo apresenta um relato de experiência que objetiva refletir sobre a atuação da psicologia no âmbito hospitalar, especificamente na maternidade, através da apresentação de casos atendidos na maternidade e UTINeo do Hospital Universitário de Brasília. Os atendimentos foram conduzidos de modo a contemplar especificamente os aspectos relacionados à maternidade, ao tornar-se mãe, bem como à aderência do tratamento e ao período de hospitalização. Observaram-se diversos aspectos que o psicólogo enfrenta no ambiente hospitalar, como fatores relacionados às limitações do espaço físico e impasses referentes à atuação do psicólogo na equipe multidisciplinar.(AU)


Currently the demand for psychology professionals in a hospital environment is increasing. Thus the need to stimulate these professional's knowledge on that particular context to guide their conduct and to contribute them to achieve a respectable area of professional action. Considering these aspects and the importance of questioning psychology's works in healthcare the present study is an experience report that aims to reflect on psychology's role in a hospital environment, specifically in maternity services, by the analysis of patients from the University of Brasilia's Hospital's maternity sector and neonatal ICU. The sessions were conducted in such a way to specifically contemplate aspects related to maternity, to becoming a mother, as well as to treatment's adherence and the time of hospitalization. Different aspects of what the psychologist faces on hospital's environment were observed, like factors related to space limitation and impasses related to psychologies roles in multidisciplinary teams.(AU)


Assuntos
Humanos , Feminino , Psicologia , Hospitais , Maternidades
18.
Int J Gynaecol Obstet ; 150(1): 83-91, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32285452

RESUMO

OBJECTIVE: To assess general and reproductive health in women after severe maternal morbidity (SMM). METHODS: A retrospective cohort study was performed at a tertiary maternity hospital. Women with SMM criteria who delivered during 2008-2012 were included in the SMM group. The control group included a random sample of women without SMM delivering in the same year of cases. Both groups were compared regarding sociodemographic/obstetric characteristics, general and reproductive health, using χ2 , Yates χ2 , Fisher exact, and Mann-Whitney tests. RESULTS: There were 315 women in the SMM group and 323 women in the control group. The SMM group was older and had a history of more medical conditions (hypertension, diabetes, obesity), cesarean deliveries, preterm births, and perinatal deaths. Breastfeeding was negatively affected in these women, as was fertility. The SMM group had a non-significant trend of fewer children after index pregnancy, had new complications in subsequent pregnancies, and required specialized medical care, besides higher risk of death. CONCLUSION: Women experiencing SMM are at higher risk of general and reproductive health problems after pregnancy, including risk of death. Therefore, their surveillance and follow-up should continue beyond 42 days postpartum, highlighting the importance of more specialized health care.


Assuntos
Complicações na Gravidez/epidemiologia , Saúde Reprodutiva , Adulto , Estudos de Casos e Controles , Criança , Feminino , Maternidades/estatística & dados numéricos , Humanos , Morbidade , Período Pós-Parto , Gravidez , Estudos Retrospectivos
19.
BMC Health Serv Res ; 20(1): 337, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-32316970

RESUMO

BACKGROUND: In the past two decades, the number of maternity hospitals in Finland has been reduced from 42 to 22. Notwithstanding the benefits of centralization for larger units in terms of increased safety, the closures will inevitably impair geographical accessibility of services. METHODS: This study aimed to employ a set of location-allocation methods to assess the potential impact on accessibility, should the number of maternity hospitals be reduced from 22 to 16. Accurate population grid data combined with road network and hospital facilities data is analyzed with three different location-allocation methods: straight, sequential and capacitated p-median. RESULTS: Depending on the method used to assess the impact of further reduction in the number of maternity hospitals, 0.6 to 2.7% of mothers would have more than a two-hour travel time to the nearest maternity hospital, while the corresponding figure is 0.5 in the current situation. The analyses highlight the areas where the number of births is low, but a maternity hospital is still important in terms of accessibility, and the areas where even one unit would be enough to take care of a considerable volume of births. CONCLUSIONS: Even if the reduction in the number of hospitals might not drastically harm accessibility at the level of the entire population, considerable changes in accessibility can occur for clients living close to a maternity hospital facing closure. As different location-allocation analyses can result in different configurations of hospitals, decision-makers should be aware of their differences to ensure adequate accessibility for clients, especially in remote, sparsely populated areas.


Assuntos
Serviços Centralizados no Hospital , Acesso aos Serviços de Saúde , Maternidades , Criança , Pré-Escolar , Feminino , Finlândia , Reforma dos Serviços de Saúde , Fechamento de Instituições de Saúde , Humanos , Lactente , Sistemas de Informação , Gravidez , Viagem
20.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47116

RESUMO

Nota de Alerta da Sociedade Brasileira de Pediatria- SBP, que visa disponibilizar orientações para sistematizar fluxos assistenciais e práticas clínicas durante o período da pandemia pelo novo corona vírus. Foram compiladas informações técnicas baseadas nas melhores evidências disponíveis ou em painéis de especialistas.


Assuntos
Pandemias , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Recém-Nascido , Maternidades , Pneumonia Viral
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