963 resultados para Trabalho de parto prematuro


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

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O parto é um evento natural e fisiológico permeado por aspectos culturais de grande simbolismo nas sociedades humanas. Representa um ritual de chegada ao mundo e reflete nossos valores a respeito de conceitos como vida e natureza. Dentro da discussão sobre o pensamento técnico científico e os novos paradigmas, o tema é atual e importante para as questões da saúde e do desenvolvimento social. Procuro ilustrar os paralelos existentes entre as práticas culturais que envolvem o parto e a relação homem-natureza, tendo na figura das parteiras tradicionais um eixo de conexão. O trabalho aborda também o saber tradicional representando uma forma mais saudável, sistêmica, integrada e ecológica de bem-nascer. As parteiras assumem uma importante função social nas comunidades em que se encontram, são acolhedoras da vida, curandeiras, benzedeiras, detentoras de uma sabedoria tradicional em muitos casos passada por gerações através da oralidade e pela vivência, caracterizando o tradicionalismo nessas comunidades quanto às questões de cura e saúde. Para tanto será utilizada uma revisão bibliográfica somada a reflexões e discussão sobre o tema a partir da literatura

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The genetic selection and the nutritional management to improve milk production make the dairy cattle more susceptible to the development of diseases, such as the abomasal displacement. It is the most frequently detected abomasal problem and it is the main cause of abdominal surgeries in dairy cattle. It is a multifactorial disease that occurs mainly in dairy cattle of high production during the puerperium. The abomasal displacement can occur to the right (DAD) or to the left (DAE), being the former more frequent than the latter. It is related to feeding management and occurs in animals that also have other diseases such as hypocalcaemia, ketosis and retained placenta. The disease causes economical losses in dairy cattle because of the costs with treatment, reduction of production, increase of the interval between the parturition, loss of body weight, early discard of the matrix and mortality. The most usual clinical signs are apathy, dehydration, low to serious ruminal timpanismo (gas accumulation in the abomasum) with reduction or lack of motility, liquid splash sound during the ballottement of the right flank, metallic sound to percussion, presence of a structure similar to distended viscera in the thorax or in the paralombar cavity on the side corresponding to the displacement, and liquefied, dark, scarce and fetid feces. The treatment is surgical, and the most used technique is the omentopexy on the left flank. The hidroelectrolytic correction must be performed and the concomitant diseases must be treated. The prophylaxis consists of adequate nutrition and pre-parturition management, besides reduction of stress and other diseases of the puerperium

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Function of the uterus is often compromised in cattle by bacterial contamination of the uterine lumen after parturition. Pathogenic bacteria often persist, causing uterine disease, a major cause of infertility in cattle. Knowledge of the immunological aspects of the uterus involved in maintaining reproductive healthiness is fundamental to the study of uterine infections that affect the uterus postpartum. Polymorphonuclear leukocytes have an important role because they are the first line of defense against colonization of bacteria in utero (Hammon and Goff, 2006). The establishment of uterine infection depends in parts of endocrine environment, particularly progesterone, which suppresses the immune system (Lewis, 2003). In the puerperium may occur uterine disorders, such as retained placenta, puerperal metritis, clinical and subclinical endometritis and pyometra, this review was proposed a study of the immunology involved in uterine health and a better understanding of uterine disorders, using the model of Sheldon et al. al, (2006) for classification of diseases, and a study of best treatment options and discussion about its functionality, because a lot of controversy among authors about choosing a treatment and another and between treated and untreated

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The humanization of childbirth implies the understanding of this event as an important experience, and requires the redefinition of human relationships from the review of the assistance project, the understanding of pregnant women condition and human rights. To evaluate child birth assistance using a score that was developed by Botucatu Cuesta Regional Management and Jurumirim Valley Collegiates. This is an epidemiological, descriptive study that is inserted in the field of evaluation of services, programs or health projects. The data has been obtained by direct observation of deliveries, emphasizing the humane care. Results: Approximately one third of the women gave birth in a tertiary hospital (34.1%) and it was their first babies (33%).24.8% of the women received prenatal care in high-risk services. 67.1% of the births were normal, and 84.7% had no companions in the delivery room. In 47.1% of the cases the delivery was performed by obstetrician who used anesthesia in 44.7% and episiotomy in 48.2% of the deliveries. More than half of the newborns were attended by the pediatrician in the delivery room and had a delivery graph completed. Although the present study shows that 67.1% of the births were normal, caesarean rate can be considered excessive, as the WHO points out that c-sections above 15% are unlikely to be justifiable. It is important to emphasize that the Ministry of Health has to have a commitment with all women to promote safe motherhood, even in cases when the pregnancy involves a risk for both the mother and the fetus. It is noteworthy that the created score allowed us to assess variables related to the humanization of childbirth and only average and quite similar situations among the three services were evidenced. We hope that with this study, managers and professionals that work in this area can be subsidized in order to offer effective humane assistance and quality service in the delivery

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Ao viver uma gestação, a mulher passa por mudanças biológicas, somáticas, psicológicas e sociais. É de fundamental importância que as gestantes recebam apoio, sejam orientadas sobre tais mudanças e também sobre o parto, momento comumente temido por elas. A assistência pré-natal é oferecida em nível nacional pelo Ministério da Saúde, que propõem a realização de ações educativas e a criação de grupos de apoio, que visam complementar o atendimento realizado nas consultas médicas. Porém, apesar de serem preconizadas, tais ações ainda são insuficientes ou insatisfatórias. O presente estudo visa contribuir com a área de Educação em Saúde buscando, a partir do conhecimento da realidade de gestantes, realizar uma ação de orientação, com a intenção de complementar o pré-natal realizado em Unidades de Saúde da Família (USFs). Para tanto, o objetivo geral da pesquisa foi investigar aspectos do conhecimento e dos sentimentos de gestantes usuárias do SUS de Rio Claro a respeito da gestação e parto, orientando-as sobre tais assuntos. A pesquisa, com abordagem Qualitativa, objetivo Descritivo e que usou como procedimento técnico a Pesquisa-ação, ocorreu no município de Rio Claro e teve como sujeitos 15 gestantes. A coleta de dados se deu através de entrevistas semi-estruturadas, que foram gravadas e de um diário de campo. Foi elaborado um material contendo 16 imagens coloridas, que foram utilizadas nas orientações individuais com o intuito de esclarecer os processos da gestação e parto. Os dados foram analisados através da técnica de Análise de Conteúdo. A maioria das entrevistadas afirmou que não planejava engravidar e, ainda assim, mais da metade delas não fazia uso de nenhum método contraceptivo, mostrando que não houve um planejamento familiar efetivo. As fontes de informação mais citadas foram as pessoas mais velhas e/ou experientes... (Resumo completo, clicar acesso eletrônico abaixo)

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This work aimed to evaluate the influence of postpartum period (precocious - of 28 to 44 days and late - of 45 to 90 days) on the bovine pregnancy rate using fixed-time AI. For that, 678 cows were divided in two groups: precocious group (G-P, n=151) and late group (G-T, n=527). The animals received CIDR® + 2 mL of estradiol benzoate (BE) in the day zero (D0). After eight days (D8) the dispositive was removed and both groups received 2.5mL PGF2α, concurrent with PGF2α injection, they received either 1.5mL of eCG or temporary calf removal (RTB). In the next day (D9), the cows received 1 mL de BE and 24 hours later, the fixed-time AI was performed with Nelore bovine semen. The calves were returned to their mothers. The pregnancy rate was not different between the groups (p>0.05), G-P=40% and G-T=48%. The results indicate that females with less than 45 days of postpartum are able to hormone protocol of fixed-time IA.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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OBJETIVOS: avaliar as modificações na prática de atividade física (AF) e as barreiras para adoção de um estilo de vida saudável em mulheres que receberam orientações nutricionais e de AF durante a gestação e no primeiro ano após o parto. MÉTODOS: estudo de coorte com 57 mulheres (Grupo Controle = 29 e Grupo Intervenção = 28), e idade média igual a 28 (±6) anos. As informações foram obtidas através de entrevistas em visita domiciliar (durante a intervenção) e inquérito telefônico (um ano após o término da intervenção), utilizou-se questionário de AF. Para análise das barreiras foi realizada uma entrevista semiestruturada com questões abertas, as quais foram codificadas e agrupadas para análise dos dados. Foram realizados testes de qui-quadrado, Mann-Whitney U e Friedman. RESULTADOS: aos seis meses, apenas 30% das mulheres do grupo Intervenção realizavam AF no lazer pelo menos 120 minutos por semana, contra 10% do grupo Controle, reduzindo para 18% e 4%, respectivamente, dois anos após o parto. As principais barreiras à prática de AF regular foram: falta de tempo (44%), cuidado com os filhos (37%), trabalho (21%), afazeres domésticos (21%) e comodismo (26%). CONCLUSÕES: futuros programas devem priorizar a aquisição de conhecimento, visando à adoção de um estilo de vida ativo no pós-parto, considerando as barreiras maternas.

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Vitamin A is an essential nutrient for many physiological processes such as growth and development, so that their adequate nutritional state is essential during pregnancy and lactation. Lactating women and children in breastfeeding are considered risk groups for vitamin A deficiency and some factors may increase the risk of vitamin A deficiency, such as prematurity. The aim of this work was to evaluate the vitamin A concentration in preterm and term lactating women and newborns by determination of retinol in maternal serum, umbilical cord serum and breast milk collected until 72 hours postpartum. 182 mothers were recruited and divided into preterm group (GPT; n = 118) and term group (GT, n = 64). In preterm group were also analyzed transition milk (7th-15th day; n = 68) and mature milk (30th-55th day; n = 46) samples. Retinol was analyzed by high-performance liquid chromatography (HPLC). Maternal retinol concentration in serum was 48.6 ± 12.3 µg/dL in GPT and 42.8 ± 16.3 µg/dL in the GT (p <0.01). Cord serum retinol was 20.4 ± 7.4 µg/dL in GPT and 23.2 ± 7.6 µg/dL in GT (p> 0.05). Among newborns, 43% of premature and 36% of term had low levels of serum retinol in umbilical cord (<20 µg/dL). In colostrum, the retinol in preterm and term groups had an average of 100.8 ± 49.0 µg/dL and 127.5 ± 65.1 µg/dL, respectively (p <0.05). The retinol average in preterm milk increased to 112.5 ± 49.7 µg/dL in transition phase and decreased to 57.2 ± 23.4 µg/dL in mature milk, differing significantly in all stages (p <0.05). When comparing with the recommendation of vitamin A intake (400 µg/day) GT colostrum reached the recommendation for infants, but in GPT the recommendation was not achieved at any stage. Mothers of premature infants had higher serum retinol than mothers at term; however, this was not reflected in serum retinol of umbilical cord, since premature had lower concentration of retinol. Such condition can be explained due to lower maternal physiological hemodilution and placental transfer of retinol to the fetus during preterm gestation. Comparison of retinol in colostrum showed lower concentrations in GPT; however the transition phase there was a significant increase of retinol content released by the mammary gland of preterm mothers. This situation highlights a specific physiological adaptation of prematurity, likely to more contribute to formation of hepatic reserves of retinol in premature infants.

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Preterm birth is a public health problem worldwide. It holds growing global incidence rates, high mortality rates and a risk of the long-term sequelae in the newborn. It is also poses burden on the family and society. Mothers of very low birth weight (VLBW) preterm infants may develop psychological disorders, and impaired quality of life (QoL). Factors related to mothers and children in the postpartum period may be negatively associated with the QoL of these mothers. The aim of this study was to assess factors possibly associated with the QoL of mothers of VLBW preterm newborns during the first three years after birth. Mothers of VLBW preterm answered the World Health Organization Quality of Life (WHOQOL)-bref and the Beck Depression Inventory (BDI) in five time points up to 36 months postpartum, totalizing 260 observations. The WHOQOL–bref scores were compared and correlated with sociodemographic and clinical variables of mothers and children at discharge (T0) and at six (T1), twelve (T2), 24 (T3) and 36 (T4) months after the delivery. We used the Kruskal Wallis test to compared scores across different time points and correlated WHOQOL-bref scores with the sociodemographic and clinical variables of mothers and preterm infants. Multiple linear regression models were used to evaluate the contribution of these variables for the QoL of mothers. The WHOQOL–bref scores at T1 and T2 were higher when compared to scores in T0 in the physical health dimension (p = 0.013). BDI scores were also higher at T1 and T2 than those at T0 (p = 0.027). Among the maternal variables that contributed most to the QoL of mothers, there were: at T0, stable marital union (b= 13.60; p= 0.000) on the social relationships dimension, gestational age (b= 2.38; p= 0.010) in the physical health dimension; post-hemorrhagic hydrocephalus (b= -10.05; p= 0.010; b= -12.18; p= 0.013, respectively) in the psychological dimension; at T1 and T2, Bronchopulmonary dysplasia (b= -7.41; p= 0.005) and female sex (b= 8,094; p= 0.011) in the physical health dimension and environment, respectively. At T3, family income (b= -12.75’ p= 0.001) in the environment dimension, the SNAPPE neonatal severity score (b= -0.23; p= 0.027) on the social relationships dimension; at the T4, evangelical religion (b= 8.11; p= 0.019) and post-hemorrhagic hydrocephalus (b: -18.84 p: 0.001) on the social relationships dimension. The BDI scores were negatively associated with WHOQOL scores in all dimensions and at all times points: (-1.42 ≤ b ≤ -0.36; T0, T1, T2, T3 and T4). We conclude that mothers of preterm infants VLBW tend to have a transient improvement in the physical well-being during the first postpartum year. Their quality of life seems to return to levels at discharge between two and three years after delivery. The presence of maternal depressive symptoms and diagnosis of post-hemorrhagic hydrocephalus or BDP are factors negatively associated with the QoL of mothers. Social, religious and economic variables are positively associated with the QoL of mothers of VLBW preterm.