Obstetrics and Gynecology

  • Effects of Sublingual Misoprostol as Adjunct to Oxytocin for Active Management of Third Stage of Labour in Paturients at Risk of Post-partum Haemorrhage in Abakaliki : a Comparison of 200 Versus 400 Micrograms

    Background: Postpartum Haemorrhage (PPH) still remains a major cause of maternal mortality despite adequate knowledge of its causes and treatment. Oxytocin administration is one of the major components of active management of third stage of labour (AMTSL). Evidence suggest benefit of misoprostol as an adjunct however optimal dose is yet to be determine considering the dose depended side effect profile of misoprostol. . Objective: This study evaluated the efficacy and side effect profile of 200µg versus 400µg of prophylactic sublingual misoprostol as adjunct to AMTSL among parturient at risk for PPH. Methods: This was a double blinded, single centre, randomized controlled trial involving two hundred and forty parturient with 2.1% drop out rate , thus 235 of them were analyzed; 117 (48.8%) and 118(49.2%) for 200 and 400 microgram group respectively. Data was analyzed using Statistical Package for Social Science (IBM SPSS) software (version 24, Chicago II, USA). Continuous variables were presented as mean and standard deviation (Mean ± 2SD), while categorical variables were presented as numbers and percentages. Chi-square test (X2) was used for comparison between groups for qualitative variables while t-test was used for comparison between groups for quantitative variables. A difference with a P value

  • Premature rupture of membrane and its associated factors among pregnant women admitted to public hospitals

    Background: Premature rupture of membrane is the common complication of pregnancy which is an important cause for perinatal and maternal morbidity and mortality. However most of the studies done on its prevalence had showed a variation with the global prevalence of premature rupture of membrane. The study was aimed to assess prevalence and associated factors of premature rupture of membrane among pregnant women admitted to public hospitals in Nekemte town, Western Ethiopia. Method: An institution based cross-sectional study was carried out from June 1 to July 30, 2019. A systematic random sampling technique was used to select 284 study participants. Interviewer administered structured questionnaires and standardized checklists were used to collect data. Data was entered into Epi.data 3.1 and exported to SPSS version 25.0. Results: About, 121(42.6%) of respondents were found in between the age group of 25-29 years, with the mean of 26.41 and standard deviation of 4.64 (26.41+4.64). The prevalence of premature rupture of membrane was 13.4%with 95% CI (9.9, 17.3). Women who had history of abortion (AOR=3.47, 95% CI: 1.44, 8.37), history of previous premature rupture of membrane (AOR=2.95, 95% CI: 1.15, 7.54), history of cesarean section (AOR=3.56, 95% CI: 1.23, 10.31) and sexually transmitted infection (AOR=7.26, 95% CI: 1.99, 26.46) and ANC follow up (AOR= 0.07, 95% CI: 0.01, 0.63) were significantly associated with premature rupture of membrane. Conclusion: The prevalence of premature rupture of membrane among the participants was considered to be high compared to the global prevalence. An intervention that focuses on strengthening the integration of messages on health promotion and disease prevention to maintain normal pregnancies for pregnant women is recommended.

  • Review of Maternal Mortality Cases at Loandjili General Hospital in Pointe-Noire

    Objectives: A major global public health problem, maternal mortality remains high, especially in the sub-Saharan countries, despite the efforts of the various health systems. Thus, this work was intended to describe the epidemiological profile of deceased patients, to identify the causes of maternal mortality, and to report dysfunctions in relation to management facilities. Methods: Descriptive cross-sectional study, conducted from 1 January 2012 to 31 December 2014 at Loandjili General Hospital, including cases of maternal deaths occurring in the Obstetrics Gynecology Department. Maternal mortality has been defined in accordance with the World Health Organization, as “the death of a woman occurring during pregnancy or within 42 days after delivery, regardless of the cause or aggravated by the pregnancy or the care she has motivated, but neither accidental nor fortuitous “. The review of each file allowed us to analyse the epidemiological, clinical and therapeutic variables, and to deduce dysfunctions related to the commodities (human, material and financial) of management. Results: Eighty-three maternal deaths were recorded out of 8,115 live births, representing a maternal mortality ratio of 1022 / 100,000 live births. Patients who died had a median age of 28.8 years [23.5; 34], secondary school (54%), pauciparous (2.9 ± 1.4 years), unemployed (75%), and referred (64%) in poor condition (76%). Caesarean section was performed in 29% of cases. The causes of death were haemorrhage (46%), complications of arterial hypertension (25%) and abortion (17%). In 60% of the cases, the deceased patients would have benefited from a surgical intervention, but only 37% of them were operated on. The deaths occurred during pregnancy (48%), childbirth (16%) and in the postpartum (36%). The unavailability of blood products and inputs was reported in 60% and 23% of cases, respectively. The third delay was noted in 90% of cases. Conclusion: The maternal mortality in our maternity…

  • Application of Tactical Models in Embryology Teaching for Visually Disabled

    Objective: Apply the idea of tactile models as a tool for embryology teaching for the visually impaired, facilitating learning by encouraging student, sharpening his curiosity and facilitating the teaching-learning process. Method: It was proposed to make tactile models based on the schemes and photos used by normovisual students found in the base books of the study of Embryology, using cheap and easy-to-handle materials. Results: The models were used by the visually impaired student during classes following the discipline schedule and were also used as objects of assessment. Conclusion: The applicability of the tactile models met expectations, since the student can obtain full knowledge of the subject in an inclusive manner and can have the same type of learning as the normovisual students.

  • Nursing Care for Women With Postpartum Blues: A Literature Review

    Introduction: During the puerperal period the woman becomes more sensitive, requiring more emotional support, attention and affection, as it becomes more susceptible to hormonal, psychological and social changes due to the need to adjust to the new role, that of being a mother, which can lead to internal and external conflicts that can directly influence your mental health. Thus, nursing care for puerperal women is of fundamental importance so that they can understand the emotions and changes experienced in this phase, as well as for the identification and monitoring of these cases. Objective: To analyze what the current literature evidences about nursing care for women with puerperal Blues. Methodology: Literature review in MEDLINE, BDENF, LILACS and PubMed databases. A total of 96 articles were found, of which 23 were pre – selected and after the inclusion criteria were applied, 16 remained. A reading of these in full with peer review was performed, and they were subsequently crossed to discuss the divergences found in order to reduce interpretation errors. Results: According to the literature, about 50% of women present puerperal Blues in up to two weeks postpartum, that if there is no necessary therapy, more than 20% of these women tend to develop postpartum depression (PPD). Conclusion: Therefore, an appropriate approach and performed by trained professionals is paramount to identify the factors associated with puerperal blues during puerperium consultations, so that there is the ideal management to promote a better Quality of life, avoiding mental distress.

  • NURSING PERFORMANCE IN PREVENTING POST-DELIVERY DEPRESSION

    Introduction: Becoming a mother entails significant physical and emotional changes that intensify throughout pregnancy and the puerperal period período. The pregnancy-puerperal period may favor or intensify the occurrence of psychological distress in women and even more severe conditions, such as postpartum depression (PPD). In developed countries, PPD affects 10 % to 15 % of women; In Brazil, the prevalence of postpartum depression ranged from 5 % to 9 % in 2016. Objective: To identify how nurses act in the prevention of postpartum depression. Methodology: Integrative literature review study with partial data from the study “Nursing care in the prevention and care of women with postpartum depression”. We searched the MEDLINE, LILACS, BDENF databases using the combination of descriptors: “Nursing”, “Nursing Care”, “Women’s Health”, “Prenatal Care”, “Postpartum Depression”, “Period Post childbirth”. From the 845 articles found, ten articles were selected to compose the final study sample, all primary studies published between 2008 and 2018 and answering the guiding question of the research: how the nurse acts in the prevention of postpartum depression. Results: The puerperium is considered a period of risk for physiological and psychological changes, so it is essential to have qualified nursing care based on prevention of complications, physical and emotional comfort and health education, encouraging women in coping and adaptation in the transition to maternity. The initial approach to the mother in psychic distress usually occurs in primary care; Thus, it is essential that nurses have the competence to identify signs of psychological distress and can plan and implement a care plan for the identified needs. In prenatal nursing consultations, it is important to have a closer relationship based on respect and ethics. When conducting health education groups and actions, nurses favor a space for sharing fears, anxieties and experiences, providing the clarification of doubts and the exchange…

  • BURDEN OF CARE AND QUALITY OF LIFE IN MOTHERS OF AUTISTIC CHILDREN

    Introduction: Autism is a developmental disorder that encompasses changes in the area of socialization, communication and cognition, being sometimes associated to some degree of mental retardation. An autistic child in the family tends to alter the whole routine and the mother, who is the most involved figure in the care of the child, tends to live in function of it, experiencing a continuous psychological overload and compromising its quality of life. Objective: To identify the socio-demographic profile, and to investigate the burden and quality of life in mothers of autistic children attended by Espaço Treat, in Arapiraca-Alagoas. Methodology: This is a descriptive, cross-sectional study with a quantitative approach. Data collection instruments were used: socio-demographic profile questionnaire, Burden scale and WHOQOL-bref. The study was approved by the Research Ethics Committee (REC) of the Universidade Federal de Alagoas. Mothers with a history of psychiatric diseases and those with sensory, motor or cognitive impairments that could impair the application of the instruments used were excluded; Mothers who resided outside Arapiraca/AL; And mothers under the age of 18 years old. Results: The subjects were 35 mothers of autistic children attended by Espaço treat in the period from March to June of 2016. Most mothers had a mean age above 35 years and were predominantly white, married, with more than 10 years of schooling and had a profession. Most of them did not have health insurance and also did not receive financial benefit from the state. Most caregivers of children with autism presented moderate burden of care and the quality of life that was considered mostly as neither good nor bad, showing a lower average in the environment domain (54.73) and higher in the Social relations domain (63.80). There was no statistically significant correlation between quality of life and burden on care of these mothers…

  • ANXIETY IN HIGH RISK MANAGERS IN ALAGOAS

    Introduction: Pregnancy needs to be evaluated with special attention because it lists physical, hormonal, psychic and social insertion changes that can reflect directly on your mental health. High-risk pregnant women may be afflicted with mental disorders such as anxiety and depression and this may have consequences for both maternal and fetal health. Objective: To evaluate the presence of anxiety signs and symptoms in high risk pregnant women in Alagoas. Methodology: Cross-sectional, descriptive study with quantitative approach. The research was conducted at the reference outpatient clinic for high risk pregnancy in the State of Alagoas: Professor Alberto Antunes University Hospital – HUPAA. For data collection we used the identification questionnaire containing social data for sample characterization and the anxiety inventory (STAI) that assesses signs and symptoms of anxiety as trait (STAI T) and state (STAI E) and classifies anxiety on high, moderate and low. The sample consisted of 100 pregnant women from a population of 400 high-risk pregnant women attended monthly and the survey was conducted between January and April 2019. Results: Regarding the presence of signs and symptoms of anxiety, we obtained STAI E classified as high (24 – 9.7%), moderate (132 – 43.4%) and low (91 – 36.8%); and STAI T classified as high (19 – 7.6%), moderate (147 – 59.5%) and low (81 – 32.7%). The study indicates that high-risk pregnant women may present signs and symptoms of anxiety, as it is a phase of life in which women experience feelings of fear and insecurity due to possible obstetric complications. Conclusion: High-risk pregnant women present situations that may interfere with the normal evolution of a pregnancy. Health professionals should be prepared to receive this risky pregnant woman and contribute to early identification and improvement of signs and symptoms of anxiety and depression of this pregnant woman. Final considerations:…

  • BREASTFEEDING AND HEALTH EDUCATION

    Breastfeeding is internationally promoted as the ideal method of infant nutrition due to its numerous benefits to mothers, children, and communities. To enlighten the benefits of breastfeeding and to investigate the influence of breastfeeding preparation and techniques on the frequencies of exclusive breastfeeding. This systematic literature review was built from a bibliography research of scientific papers, publications and materials available on the Internet in English and Portuguese. From this research, four essential themes were identified: benefits of breastfeeding, clinical management of breastfeeding, breastfeeding preparation and techniques, pain and discomfort in the practice of breastfeeding and nipple trauma. In the end, it was possible to notice that counseling sections with the mother throughout the pregnancy and after giving birth are fundamental to the effectiveness and exclusivity of breastfeeding.

  • HUMANIZATION IN OBSTETRIC ASSISTANCE FOR PAIN RELIEF IN NORMAL LABOR

    Introduction: Historically, women were given birth in the home by the help of midwives, but they heard changes from the increase in the performance of professionals with interventional practices, especially in the hospital environment. Today, even in the hospital setting, the humanized care in childbirth remit the values of a natural childbirth as something physiological. Objective: To describe the experience lived as a nursing student about the role of the nurse in humanized childbirth care in a Maternity Hospital in the city of Rio Largo. Method: This is a descriptive study of the experience of the Nursing Work Placement in the city of Rio Largo in the period from 11 to September 29, 2017. Results: It was possible to observe how the humanized care at birth changes the behavior and perception of pain in the parturient. During labor, women were encouraged to use non-pharmacological methods among these methods; the use of the Swiss ball, stool, lumbosacral massage and the calm environment. Assistance was provided in a humane way. Conclusion: It is necessary that nurses take care, so that they have a humanized care focused on childbirth care to minimize the perception of painful stimuli in women, using non-pharmacological methods, without interventional practices allowing women to be protagonists of their childbirth.