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1.
Rev. enferm. UERJ ; 29: e56037, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1151921

RESUMO

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.


Assuntos
Humanos , Feminino , Gravidez , Saúde da Mulher , Período Pós-Parto , COVID-19 , COVID-19/terapia , COVID-19/epidemiologia , Revisão , Infecções por Coronavirus , Período Pós-Parto/sangue , COVID-19/diagnóstico
2.
Rev. enferm. UERJ ; 29: e53642, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224513

RESUMO

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.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Trabalho de Parto , Assistência Perinatal , Parto Domiciliar , Tocologia , Enfermagem Obstétrica , Parto , Período Pós-Parto , Assistência Domiciliar
3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48425

RESUMO

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.


Assuntos
Vacinas contra COVID-19 , Vacinação , Período Pós-Parto , Gestantes
4.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48426

RESUMO

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.


Assuntos
Saúde Materna , Saúde da Mulher , Gestantes , Período Pós-Parto
5.
J Anim Sci ; 99(9)2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34468760

RESUMO

The main objective of this study was to evaluate the effect of peripartal administration of a commercially available nonspecific immune stimulant (mycobacterium cell wall fraction; MCWF [Amplimune, NovaVive Inc., Napanee, ON, Canada]) on the incidence of disease during early lactation and subsequent fertility of dairy cows. A second objective was to characterize the dynamics of circulating white blood cells (WBC) and metabolic markers following treatment administration. Cows in an United States Department of Agriculture (USDA) organic-certified dairy herd were blocked by parity and, based on sequential calving dates, randomly assigned to receive two injections (5 mL s.c.) of either a placebo (saline solution) as a control (CON; n = 71) or MCWF (n = 65) at enrollment (7 d before expected calving) and within 24 h after calving. Blood samples were collected from a subsample of the study population (MCWF = 16; CON = 18) for WBC count at enrollment, at day 2 post enrollment, and at days 1, 3, 7, and 14 after calving. Serum fatty acids, beta-hydroxybutyrate, and Ca concentrations were determined at days 1 and 7 postpartum (MCWF = 21; CON = 21). Main outcome variables included incidence risk of peripartal and early lactation health disorders and pregnancy at first artificial insemination (AI), at 100, and at 150 days in milk (DIM). In addition, the average daily milk yield up to 90 DIM and death and live culling before 305 DIM were compared. Treatment effects were assessed using multivariable logistic regression, time-to-event analyses, and repeated measures analysis of variance (ANOVA). A treatment effect on the incidence risk of some of the health disorders in the study was established. Incidence risk of metritis and clinical mastitis <28 DIM was smaller in MCWF than in CON cows (36.9% vs. 50.7% and 6.3% vs. 19.7%, respectively). On the contrary, the incidence risk of respiratory disease <28 DIM was smaller in CON (0%) than in MCWF (7.7%). Reproductive performance of multiparous cows was affected by MCWF administration: pregnancy at first AI and pregnancy at 100 and 150 DIM were greater in MCWF than in CON (35.6% vs. 19.2%; 51.1% vs. 25.0%; and 64.4% vs. 40.4%, respectively). Overall, median intervals from calving to pregnancy were 90 vs. 121 d in MCWF and CON cows, respectively. No treatment effects on the dynamics of circulating WBC or in postpartum metabolic status were established. No differences for milk yield or for the proportion of cows that survived up to 305 DIM were determined, although cows in MCWF left the herd earlier than cows in CON. In conclusion, incidence risks of metritis and mastitis in early lactation were smaller in cows receiving MCWF, whereas the incidence risk of respiratory disease was smaller in CON. Fertility significantly improved in MCWF compared with CON cows. As this study was performed in an organic-certified dairy, specific health and reproductive management practices may affect the external validity of the current findings.


Assuntos
Doenças dos Bovinos , Mycobacterium , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Parede Celular , Feminino , Fertilidade , Lactação , Leite , Período Pós-Parto , Gravidez , Reprodução
6.
Rev Med Chil ; 149(4): 543-553, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-34479342

RESUMO

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.


Assuntos
Violência Doméstica , Chile/epidemiologia , Estudos Transversais , Feminino , Humanos , Período Pós-Parto , Gravidez , Prevalência
7.
Womens Health (Lond) ; 17: 17455065211042190, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465268

RESUMO

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.


Assuntos
COVID-19/epidemiologia , Pandemias , Período Pós-Parto/psicologia , Estresse Psicológico/epidemiologia , Adulto , Ansiedade/epidemiologia , COVID-19/psicologia , Estudos Transversais , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Gravidez , Fatores de Proteção , Angústia Psicológica , Resiliência Psicológica , Fatores de Risco , SARS-CoV-2 , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologia
8.
Trials ; 22(1): 599, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488847

RESUMO

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.


Assuntos
Dessensibilização e Reprocessamento através dos Movimentos Oculares , Transtornos de Estresse Pós-Traumáticos , Ansiedade , Feminino , Humanos , Período Pós-Parto , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/terapia , Resultado do Tratamento
9.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48307

RESUMO

Sancionada lei que inclui gestantes, puérperas e lactantes, com ou sem comorbidades, como grupo prioritário no Plano Nacional de Operacionalização da Vacinação contra a Covid-19 (PLO). A medida também se estende a crianças e adolescentes com deficiência permanente ou privados de liberdade.


Assuntos
Gestantes , Período Pós-Parto , Vacinas contra COVID-19 , COVID-19 , Jurisprudência , Brasil
11.
J Addict Med ; 15(4): 292-296, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34397780

RESUMO

OBJECTIVES: For women with opioid use disorder (OUD), the postpartum period is an especially vulnerable period. Buprenorphine (BUP) improves OUD outcomes during this timeframe. Once-monthly injectable BUP (XRI-BUP) is a newer formulation for which evidence of use in postpartum women is extremely limited. We present a case series of 9 women who transitioned from sublingual (SL-BUP) to XRI-BUP in their first year postpartum. METHODS: We conducted a retrospective chart review of our institution's medical record for patients who received at least one administration of XRI-BUP in their first year postpartum (January 2017-March 2020). Data were collected from baseline through mean follow-up of 281.4 days (range 235-417) for participant outcomes. RESULTS: The most common indications for initiating XRI-BUP were participant preference (n = 9) followed by challenges taking SL-BUP (n = 6). Four of the 9 participants transitioned back from XRI- to SL-BUP during the study timeframe, for reasons including incarceration and undesired side effects. Preliminary treatment outcomes demonstrated that participants remained on SL- (n = 4) or XRI-BUP (n = 5) through follow-up. The 5 participants who remained on XRI-BUP had consistent negative urine drug tests for nonprescribed opioids during the study period. CONCLUSIONS: To our knowledge, this is the first study that reviews the feasibility of using XRI-BUP in postpartum women. Our results suggest that XRI-BUP is a viable treatment option, which should be further investigated in future studies of postpartum women with OUD.


Assuntos
Buprenorfina , Transtornos Relacionados ao Uso de Opioides , Analgésicos Opioides/uso terapêutico , Buprenorfina/uso terapêutico , Feminino , Humanos , Antagonistas de Entorpecentes/uso terapêutico , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Período Pós-Parto , Estudos Retrospectivos
12.
Artigo em Inglês | MEDLINE | ID: mdl-34444551

RESUMO

This study selected Google and Naver, the most recognizable Internet portals in Korea, as subjects for analysis. "Postpartum obesity" and "postpartum depression" were used as keywords for data collection. This study aimed to provide basic data for solving maternal problems using big data. Keywords related to postpartum obesity were collected from the portal site Google from 1 January 2019 to 31 December 2019. The collected data were analyzed through simple frequency analysis, N-gram analysis, and keyword network. This study can be used as basic data for postpartum obesity-related programs or academic research. It is also expected to be used for research on the development of a mobile-based customized healthcare system focused on maternal health. Previous papers and data are still insufficient at solving the physical and mental problems related to postpartum obesity and depression. It is necessary to find ways to continuously integrate and collect data from mothers across the country.


Assuntos
Big Data , Depressão Pós-Parto , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Mães , Obesidade/epidemiologia , Período Pós-Parto
13.
Pan Afr Med J ; 39: 70, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422193

RESUMO

Introduction: low back pain (LBP) during pregnancy is an important health concern among women globally. The prevalence and risk factors for LBP in pregnancy vary from and within sub-regions and have implications in preventive and treatment strategies. In West African sub-region, there is scanty data on LBP during pregnancy. This study aimed to determine the prevalence and predisposing factors for LBP during pregnancy in this environment. Methods: this was a cross-sectional study carried out among pregnant women admitted into the Labour Ward of Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria over a period of 8 months. They were interviewed within 2 to 7 days postpartum with a questionnaire. Sociodemographic and obstetrics characteristics as well as LBP intensity, features and associated factors were evaluated. Significant factors for LBP that emerged from the univariable analysis were entered into multivariable regression analysis to evaluate the risk of each factor when adjusted to other factors. Results: of the 478 women interviewed, 138 (28.9%) of them (95% CI 25.1-33.1) reported LBP in the index pregnancy. The onset of pain was predominantly in the third trimester and the mean pain intensity was 4.3 ± 1.36. In the univariable analysis, six factors were significantly associated with LBP. Logistic regression analysis identified LBP in previous pregnancy (aOR: 24.76, (95% CI 6.88-89.11); p< 0.001), macrosomia (aOR: 4.15(95% CI 2.05-8.42); p< 0.001) and absence of domestic help (aOR: 0.50(95% CI 0.31-0.82); p=0.006) as independent risk factors for LBP during pregnancy among the women. Conclusion: in this study, LBP during pregnancy is within worldwide range and predominantly mild to moderate in intensity. The independent risk factors identified call for high priorities accorded to women with these factors in measures aimed at addressing LBP during pregnancy.


Assuntos
Dor Lombar/epidemiologia , Complicações na Gravidez/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria , Período Pós-Parto , Gravidez , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
14.
Reprod Health ; 18(1): 170, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372864

RESUMO

BACKGROUND: The use of a decision aid in clinical settings has been beneficial. It informs and educates patients about the available treatment options that can help them reduce decision-making conflicts related to feeling uninformed compared with routine care. There is a scarcity of published data about using a decision aid during family planning counseling with postpartum women focusing on long-acting reversible contraception in Tanzania. Therefore, we developed a "postpartum Green Star family planning decision aid" and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability perceived by pregnant adolescents and nurses/midwives. METHODS: We used an exploratory qualitative in-depth interview involving six nurses/midwives with three or more years of experience in family planning services and 12 pregnant adolescents aged 15-19 years. Purposive sampling was used to select the participants, and selection relied on the saturation principle of data collection. We used a semi-structured interview guide translated into the Kiswahili language. Data were transcribed and analyzed following inductive content analysis. RESULTS: The amount of information presented was just right, with the time of reading the data ranging from 20 min to 1 h. The study participants perceived the flow of information to be good, with small significant changes suggested. Kiswahili language was used and reported to be appropriate and well elaborated. However, a few words were told to be rephrased to reduce ambiguity. The nurses/midwives said that the decision aid included most of the vital information the participants wanted to know during their family planning counseling. Pregnant adolescents stated that the decision aid improved their knowledge and provided new details on the long-acting reversible contraception methods (intrauterine copper devices and implants) offered immediately after childbirth. The participants stated that the decision aid addressed long-acting reversible contraception methods' benefits and side effects and dispelled myths and misconceptions. The study participants considered the decision aid helpful in complementing the family planning counseling offered and improving pregnant adolescents' knowledge. CONCLUSION: The postpartum Green Star family planning decision aid was practical, useful, and acceptable in enhancing the objectivity of counseling about long-acting reversible contraception methods. It improved the knowledge of pregnant adolescents in Tanzania about the available contraception methods (i.e., the use of intrauterine copper devices and implants), which can be immediately used postpartum. Further research is needed to assess the effects of the decision aid on long-acting reversible contraception postpartum uptake among pregnant adolescents in Tanzania.


Assuntos
Serviços de Planejamento Familiar , Período Pós-Parto , Adolescente , Anticoncepção , Técnicas de Apoio para a Decisão , Estudos de Viabilidade , Feminino , Humanos , Gravidez , Tanzânia
15.
Biomolecules ; 11(8)2021 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-34439868

RESUMO

The term 'cytokine storm' (CS) applies to a pathological autoimmune reaction when the interactions that lead to cytokine production are destabilised and may even lead to death. CS may be induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this study, we present our analysis of certain pathological processes that induce a CS in pregnant and postpartum women. We draw our attention to the similarities between the severe course of Coronavirus Disease 2019 (COVID-19) and haemophagocytic lymphohistiocytosis (HLH). It is noteworthy that many of the criteria used to diagnose HLH are described as COVID-19 mortality predictors. Cytokine storms are considered to be an important cause of death in patients with the severe course of SARS-CoV-2 infection. Due to the fact that pregnant women are in an immunosuppressive state, viral pulmonary infections are more perilous for them-possible risks include miscarriage, intrauterine growth restriction or birth before the term; sometimes ventilation support is needed. HLH should be considered in pregnant and puerperal women suffering from moderately severe to severe COVID-19 and presenting with: fever unresponsive to antibiotic therapy, cytopenia, hepatitis and hyperferritinaemia. The HLH disorder is rare and difficult to diagnose; however, its early detection could reduce patient mortality.


Assuntos
COVID-19/patologia , Síndrome da Liberação de Citocina/patologia , Linfo-Histiocitose Hemofagocítica/patologia , Complicações Infecciosas na Gravidez/patologia , COVID-19/complicações , COVID-19/imunologia , Síndrome da Liberação de Citocina/etiologia , Síndrome da Liberação de Citocina/imunologia , Feminino , Humanos , Linfo-Histiocitose Hemofagocítica/etiologia , Linfo-Histiocitose Hemofagocítica/imunologia , Período Pós-Parto , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Complicações Infecciosas na Gravidez/virologia
16.
Afr J Prim Health Care Fam Med ; 13(1): e1-e7, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34342479

RESUMO

BACKGROUND: Malawi is grappling with a high maternal mortality of 439 per 100 000 live births. It is estimated that 80% of maternal deaths can be prevented by actively engaging the community in the country. However, community support on safe motherhood remains unknown. AIM: This study, therefore, explored community support rendered to mothers and babies during antenatal, intrapartum and postpartum periods. SETTING: This study was conducted in the Lilongwe District, Malawi. METHODS: This was a qualitative study that collected data from 30 village health committee members through Focus Group Discussions (FGDs). Data were analysed using thematic analysis. RESULTS: This study found that community support on safe motherhood rendered to women varied. The following five themes emerged from FGDs data on community support on safe motherhood: antenatal support, intrapartum support, postpartum support, bylaws reinforced by chiefs in the community and safe motherhood support groups. Community members encourage pregnant women to attend antenatal care, escorted pregnant women to the hospital for delivery and assisted women to care for a child and go for postpartum checkups. Community bylaws were considered as a necessary tool for encouraging women to attend antenatal care, deliver at the health facility and attend postpartum checkups. CONCLUSION: This study suggests that community members play a crucial role in providing support to women and newborns during antenatal, intrapartum and postpartum periods.


Assuntos
Mortalidade Materna , Período Periparto , Período Pós-Parto , Gestantes/psicologia , Apoio Social , Feminino , Grupos Focais , Humanos , Recém-Nascido , Malaui , Gravidez , Cuidado Pré-Natal , Pesquisa Qualitativa
17.
Nutrients ; 13(7)2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34371833

RESUMO

Among the human milk oligosaccharides (HMOS), the galactosyllactoses (GLs) are only limitedly studied. This study aims to describe the presence and relative levels of HMOS, including GLs, in human milk (HM) according to maternal Secretor and Lewis (SeLe) phenotype and lactation stage. Relative levels of 19 HMOS were measured in 715 HM samples collected in the first 4 months postpartum from 371 donors participating in the PreventCD study. From a subset of 24 Dutch women (171 HM samples), samples were collected monthly up to 12 months postpartum and were additionally analyzed for relative and absolute levels of ß6'-GL, ß3'-GL and α3'-GL. Maternal SeLe phenotype or HM group was assigned based on the presence of specific fucosylated HMOS. Most HMOS, including ß6'- and ß3'-GL, were present in the vast majority (≥75%) of HM samples, whereas others (e.g., LNDFH II, 2'-F-LNH and α3'-GL) only occurred in a low number (<25%) of samples. Clear differences were observed between the presence and relative levels of the HMOS according to the maternal phenotype and lactation stage. Absolute concentrations of ß6'-GL and ß3'-GL were higher in HM group IV samples compared to samples of the other three HM groups. ß3'-GL was also higher in HM group II samples compared to HM group I samples. ß3'-GL and ß6'-GL were stable over lactation stages. In conclusion, presence and levels of HMOS vary according to HM group and lactation stage. Not all HMOS behave similarly: some HMOS depend strongly on maternal phenotype and/or lactation stage, whereas others do not. ß3'-GL and ß6'-GL were present in low concentrations in over 75% of the analyzed HM samples and showed differences between HM groups, but not between the lactation stages.


Assuntos
Lactação/fisiologia , Fenômenos Fisiológicos da Nutrição Materna/genética , Leite Humano/química , Oligossacarídeos/análise , Trissacarídeos/análise , Adulto , Feminino , Humanos , Fenótipo , Período Pós-Parto
18.
BMJ Open ; 11(8): e049903, 2021 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-34429315

RESUMO

OBJECTIVE: We aimed to investigate the association between weight retention at 6 weeks postpartum after the first pregnancy and large-for-gestational age (LGA) risk in a subsequent pregnancy. STUDY DESIGN: A retrospective cohort study. SETTING: A tertiary hospital of China. PARTICIPANTS: 5950 Chinese singleton pregnancies that delivered their second singletons between 28 and 42 weeks of gestation. OUTCOMES MEASURES: We calculated the weight retention at 6 weeks postpartum after the first pregnancy (the body mass index (BMI) at 6 weeks after the first birth minus the prepregnant BMI of the first pregnancy) and the gestational weight gain in the second pregnancy. We used the logistic regression to obtain adjusted OR. We determined the relationship between maternal BMI change at 6 weeks after the first pregnancy and LGA risk in the second pregnancy. RESULTS: Relative to other categories of BMI change at 6 weeks postpartum, women who gained ≥3 kg/m2 compared with the prepregnancy BMI were at increased LGA risk. The stratified analysis showed that LGA risk was increased in the second pregnancy in underweight and normal weight women who gained ≥3 kg/m2 when using remain stable women as the reference group (OR=3.35, 95% CI 1.11 to 10.12 for underweight women; OR=2.23, 95% CI 1.43 to 3.45 for normal weight women) at 6 weeks postpartum. For the women who gained ≥3 kg/m2 at 6 weeks postpartum, LGA risk was increased in normal weight women with an adequate (OR=3.21, 95% CI 1.10 to 9.33) and excessive (OR=2.62, 95% CI 1.02 to 6.76) gestational weight in the second pregnancy when using obese women as the reference. CONCLUSION: Postpartum weight retention at 6 weeks after the first pregnancy provides us a new early window to identify LGA risk in a subsequent pregnancy and allows us to implement primary preventative strategies.


Assuntos
Período Pós-Parto , Ganho de Peso , China/epidemiologia , Feminino , Idade Gestacional , Humanos , Gravidez , Estudos Retrospectivos
19.
Rev Bras Enferm ; 74(5): e20200607, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34346955

RESUMO

OBJECTIVE: To analyze pelvic floor muscular strength (PFMS), urinary (UI) and anal (AI) incontinence and dyspareunia in primiparous women up to 6 months after normal or cesarean delivery. METHODS: this is a prospective cohort with 169 women (128 normal births, 41 cesarean sections), followed between 50-70 and 170-190 days postpartum, when PFMS was measured using perineometry, and UI and AI and dyspareunia, through interview. RESULTS: PFMS, UI and dyspareunia were similar between types of delivery. The difference was significant only for the time elapsed, with improvement in the studied period (2 and 6 months postpartum). Regarding AI, there was a significant difference between 2 and 6 months postpartum, with an interaction between type of delivery and time (p=0.022). CONCLUSION: the type of delivery did not show any influence on pelvic floor dysfunctions, except for AI. For all outcomes, there was an improvement in the period studied.


Assuntos
Diafragma da Pelve , Incontinência Urinária , Estudos de Coortes , Parto Obstétrico , Feminino , Humanos , Período Pós-Parto , Gravidez , Estudos Prospectivos
20.
BMC Health Serv Res ; 21(1): 772, 2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34348719

RESUMO

BACKGROUND: Gestational diabetes mellitus (GDM) is diagnosed during pregnancy, and women with a history of GDM are at a higher risk of developing type 2 diabetes mellitus (T2DM). Prevention strategies focused on lifestyle modification help to reduce long-term complications. Self-management technology-based interventions can support behaviour change and diabetes control. The Baby Steps programme, a randomised controlled trial intervention offering group education and access to a mobile web application, was evaluated to explore user experience of the app and barriers and facilitators to app usability. METHODS: Ten semi-structured interviews and four focus group discussions were conducted with 23 trial participants between 2018 and 2019. Interviews and focus group discussions were audiotaped, transcribed and independently analysed. The analysis was informed by thematic analysis, with the use of the Nvivo 12 software. RESULTS: Themes identified were: (1) GDM and post-pregnancy support from healthcare services; (2) Impact of Baby Steps app on lifestyle changes; (3) Facilitators and barriers to the usability of the Baby Steps app. The Baby Steps app served as a motivator for increasing self-management activities and a tool for monitoring progress. Peer support and increased awareness of GDM and T2DM enhanced engagement with the app, while poor awareness of all the components of the app and low technical skills contributed to low usability. CONCLUSIONS: This study documents experiences from existing GDM support, user experiences from using the Baby Steps app, and the barriers and facilitators to app usability. The app was both a motivational and a monitoring tool for GDM self-management and T2DM prevention. Peer support was a key trait for enhanced engagement, while barriers were low technical skills and poor awareness of the app components. A digital app, such as the Baby Steps app, could strengthen existing face-to-face support for the prevention of T2DM. The results also have wider implications for digital support technologies for all self-management interventions. Further research on the effect of specific components of apps will be required to better understand the long term impact of apps and digital interventions on self-management behaviours and outcomes. TRIAL REGISTRATION: ISRCTN, ISRCTN17299860 . Registered on 5 April 2017.


Assuntos
Diabetes Mellitus Tipo 2 , Diabetes Gestacional , Aplicativos Móveis , Autogestão , Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Gestacional/prevenção & controle , Feminino , Humanos , Período Pós-Parto , Gravidez
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