Prevalência de incontinência urinária e disfunção muscular do assoalho pélvico em primíparas dois anos após parto cesárea: Estudo transversal

CONTEXT AND OBJECTIVE: There is uncertainty in the literature regarding the theory that obstetric events and pelvic floor injuries give rise to lower risk of subsequent urinary incontinence among women delivering via cesarean section than among women delivering vaginally. The objective of this study was to assess the two-year postpartum prevalence of urinary incontinence and pelvic floor muscle dysfunction and the factors responsible for them. DESIGN AND SETTING: Cross-sectional study, conducted in a public university. METHODS: 220 women who had undergone elective cesarean section or vaginal childbirth two years earlier were selected. Their urinary incontinence symptoms were investigated, and their pelvic floor muscle dysfunction was assessed using digital palpation and a perineometer. RESULTS: The two-year urinary incontinence prevalences following vaginal childbirth and cesarean section were 17% and 18.9%, respectively. The only risk factor for pelvic floor muscle dysfunction was weight gain during pregnancy. Body mass index less than 25 kg/m2 and normal pelvic floor muscle function protected against urinary incontinence. Gestational urinary incontinence increased the risk of two-year postpartum urinary incontinence. CONCLUSION: Gestational urinary incontinence was a crucial precursor of postpartum urinary incontinence. Weight gain during pregnancy increased the subsequent risk of pelvic floor muscle dysfunction, and elective cesarean section did not prevent urinary incontinence.

Simulação de perdas de solo em função de cenários de adequação ambiental em microbacias agrícolas

In São Paulo state, deforestation and agriculture activities are increasing soil losses processes, especially in areas of susceptible soils where soil conservation practices are not adopted. Environmental adequacy at property level regarding Permanent Protection Areas and Legal Reserves is considered a potential factor for reducing soil losses and it was based on this fact that we assessed soil losses of different scenarios of environmental adequacy. Simulations of erosive processes were carried out in 15 catchments of the Corumbataí river basin, with different forest restoration scenarios, as well as the current situation of land use/ land cover. The scenarios include reforestation of Permanent Preservation Areas (PPA); the reforestation hydrological sensitive areas; and two scenarios, the Legal Reserve installation in 20% of each catchment, being one of them for most critical areas in terms of erosion and the other at random. It was observed that the establishment of PPA and the reforestation of hydrological sensitive areas (HSA), offered a small contribution to the control of the erosive process, resulting in a reduction of 10% and 7.4%, respectively, while the legal reserve in critical areas has the significant reduction of 69.8%. The random scenario, in turn, resulted in a reduction of 21.4% of erosion. Results show that reforestation can reduce soil losses, but previous studies of land prioritization and planning could significantly increase its efficiency.

Resolución 12: Precios agrícolas y otras medidas = Resolution 12: Agricultural prices and crop insurance = Résolution 12: Prix agricoles et assurance des récoltes

El símbolo E/840/Rev.1 corresponde a la edición bilingüe inglés/francés publicada en 1953