Preterm preeclampsia and timing of delivery: a systematic literature review

sem informaçãoIntroduction Preeclampsia, a multifactorial disease with pathophysiology not yet fully understood, is a major cause of maternal and perinatal morbidity and mortality, especially when preterm. The diagnosis is performed when there is an association between3911499499sem informaçãosem informaçãosem informaçã

Obstetrician's risk perception on the prescription of magnesium sulfate in severe preeclampsia and eclampsia: a qualitative study in Brazil

Magnesium sulfate (MgSO4) is the drug of choice for the prevention and control of seizures in the management of severe preeclampsia/eclampsia. Several barriers have been iden-tified in the use of MgSO4, especially in low and middle-income settings. Objective To describe the obstetrician's perception on possible reasons for underutilizing magnesium sulfate to treat preeclampsia/eclampsia. Method A qualitative clinical study, based on phenomenological reference by semi-structured inter-views and open-ended discussions with obstetricians of the public healthcare system in pri-mary care units (PCU) and referral maternity hospitals (RMH), in a southeastern Brazilian city. Results Fear of drug toxicity was the major cause for not prescribing the medication in PCU. Fear was justified by insufficient technical, structural and organizational resources of healthcare facilities and by a shortage of physicians properly trained for adequate drug use. Conclusion Fear of toxicity of magnesium sulfate was the main barrier towards timely and proper drug use. Periodic skill development and training of obstetricians, along with integration of the medical team in the work environment may contribute to decrease fear, ensuring safety of drug prescription and thus possibly reducing adverse outcomes related to PE.Introduction Magnesium sulfate (MgSO4) is the drug of choice for the prevention and control of seizures in the management of severe preeclampsia/eclampsia. Several barriers have been iden-tified in the use of MgSO4, especially in low and middle-income set123sem informaçãosem informaçã

Pregnancy In Women Undergoing Hemodialysis: Case Series In A Southeast Brazilian Reference Center [gestação Em Mulheres Em Tratamento Hemodialítico: Série De Casos Em Um Centro De Referência Do Sudeste Do Brasil]

PURPOSE: To describe maternal and neonatal outcomes in pregnant women undergoing hemodialysis in a referral center in Brazilian Southeast side. METHODS: Retrospective and descriptive study, with chart review of all pregnancies undergoing hemodialysis that were followed-up at an outpatient clinic of high- risk prenatal care in Southeast Brazil. RESULTS: Among the 16 women identified, 2 were excluded due to follow-up loss. In 14 women described, hypertension was the most frequent cause of chronic renal failure (half of cases). The majority (71.4%) had performed hemodialysis treatment for more than one year and all of them underwent 5 to 6 hemodialysis sessions per week. Eleven participants had chronic hypertension, 1 of which was also diabetic, and 6 of them were smokers. Regarding pregnancy complications, 1 of the hypertensive women developed malignant hypertension (with fetal growth restriction and preterm delivery at 29 weeks), 2 had acute pulmonary edema and 2 had abruption placenta. The mode of delivery was cesarean section in 9 women (64.3%). All neonates had Apgar score at five minutes above 7. CONCLUSIONS: To improve perinatal and maternal outcomes of women undergoing hemodialysis, it is important to ensure multidisciplinary approach in referral center, strict control of serum urea, hemoglobin and maternal blood pressure, as well as close monitoring of fetal well-being and maternal morbidities. Another important strategy is suitable guidance for contraception in these women.37159Bramham, K., Lightstone, L., Pre-pregnancy counseling for women with chronic kidney disease (2012) J Nephrol, 25 (4), pp. 450-459Hou, S., Pregnancy in chronic renal insufficiency and end-stage renal disease (1999) Am J Kidney Dis, 33 (2), pp. 235-252Shemin, D., Dialysis in pregnant women with chronic kidney disease (2003) Semin Dial, 16 (5), pp. 379-383Pipili, C., Grapsa, E., Koutsobasili, A., Sorvinou, P., Poirazlar, E., Kiosses, D., Pregnancy in dialysis-dependent women--the importance of frequent dialysis and collaborative care: A case report (2011) Hemodial Int, 15 (3), pp. 306-311Podymow, T., August, P., Akbari, A., Management of renal disease in pregnancy (2010) Obstet Gynecol Clin North Am, 37 (2), pp. 195-210Siviero, P., Machado, C.J., Cherchiglia, M.L., Chronic kidney failure by means of multiple causes of death in Brazil (2014) Cad Saúde Coletiva, 22 (1), pp. 75-85Furaz-Czerpak, K.R., Fernández-Juárez, G., Moreno-De La Higuera, M.A., Corchete-Prats, E., Puente-García, A., Martín-Hernández, R., Pregnancy in women on chronic dialysis: A review (2012) Nefrologia, 32 (3), pp. 287-294Hou, S.H., Pregnancy in women on haemodialysis and peritoneal dialysis (1994) Baillieres Clin Obstet Gynaecol, 8 (2), pp. 481-500Chao, A.S., Huang, J.Y., Lien, R., Kung, F.T., Chen, P.J., Hsieh, P.C., Pregnancy in women who undergo long-term hemodialysis (2002) Am J Obstet Gynecol, 187 (1), pp. 152-156Reddy, S.S., Holley, J.L., Management of the pregnant chronic dialysis patient (2007) Adv Chronic Kidney Dis, 14 (2), pp. 146-155Piccoli, G.B., Cabiddu, G., Daidone, G., Guzzo, G., Maxia, S., Ciniglio, I., The children of dialysis: Live-born babies from on-dialysis mothers in Italy--an epidemiological perspective comparing dialysis, kidney transplantation and the overall population (2014) Nephrol Dial Transplant, 29 (8), pp. 1578-1586Shahir, A.K., Briggs, N., Katsoulis, J., Levidiotis, V., An observational outcomes study from 1966-2008, examining pregnancy and neonatal outcomes from dialysed women using data from the ANZDATA Registry (2013) Nephrology (Carlton), 18 (4), pp. 276-284Silva, G.B., Jr., Monteiro, F.A., Mota, R.M., Paiva, J.G., Correia, J.W., Bezerra Filho, J.G., Acute kidney injury requiring dialysis in obstetric patients: A series of 55 cases in Brazil (2009) Arch Gynecol Obstet, 279 (2), pp. 131-137Castellano, G., Losappio, V., Gesualdo, L., Update on pregnancy in chronic kidney disease (2011) Kidney Blood Press Res, 34 (4), pp. 253-260Hladunewich, M., Hercz, A.E., Keunen, J., Chan, C., Pierratos, A., Pregnancy in end stage renal disease (2011) Semin Dial, 24 (6), pp. 634-639Espinoza, F., Romeo, R., Ursu, M., Tapia, A., Vukusich, A., Pregnancy during dialysis: Experience in six patients (2013) Rev Med Chil, 141 (8), pp. 1003-1009Hladunewich, M.A., Hou, S., Odutayo, A., Cornelis, T., Pierratos, A., Goldstein, M., Intensive hemodialysis associates with improved pregnancy outcomes: A Canadian and United States cohort comparison (2014) J am Soc Nephrol, 25 (5), pp. 1103-110

Computer-assisted Telephone Interviewing (cati): Using The Telephone For Obtaining Information On Reproductive Health [computer-assisted Telephone Interviewing (cati): Usando Telefone Para A Obtenção De Informações Sobre Saúde Reprodutiva]

The objective of this study was to evaluate the feasibility of using computer assisted telephone interviewing (CATI) as a method for obtaining information on reproductive health in Brazil. A total of 998 eligible women for the study were selected to answer a questionnaire through computer-assisted telephone interviewing undertaken by trained interviewers. The outcomes of each telephone contact attempt were described. Differences between groups were assessed using the χ2 test. Phone contact was made in 60.3% of the attempts and 57.5% of the interviews were completed. The success rate improved with the decrease in time from hospitalization to interview and with the higher numbers of telephones available. A total of 2,170 calls were made, comprising of one to sixteen attempts per woman. The majority of situations where extra calls were necessary were due to the number being busy or to the fact that the woman was not available at the time of the call. CATI can prove be a valuable procedure for obtaining information on reproductive health among Brazilian women, particularly for relatively recent events and when more than one alternative telephone number is available.27918011808Marcus, A.C., Crane, A.L., Telephone surveys in public health research (1986) Med Care, 24, pp. 97-112Corey, C.R., Freeman, H.E., Use of telephone interviewing in health care research (1990) Health Serv Res, 25, pp. 129-144Chittleborough, C.R., Taylor, A.W., Baum, F.E., Hiller, J.E., Non-response to a life course socioeconomic position indicator in surveillance: Comparison of telephone and face-to-face modes (2008) BMC Med Res Methodol, 8, p. 54Lee, S., Tsang, A., Lau, L., Mak, A., Ng, K.L., Chan, D.M., Concordance between telephone survey classification and face-to-face structured clinical interview in the diagnosis of generalized anxiety disorder in Hong Kong (2008) J Anxiety Disord, 22, pp. 1403-1411Lee, S., Tsang, A., Mak, A., Lee, A., Lau, L., Ng, K.L., Concordance between telephone survey classification and face-to-face interview diagnosis of one-year major depressive episode in Hong Kong (2010) J Affect Disord, 126, pp. 155-160Sykes, W., Collins, M., Effects of mode of interview: Experiments in the UK (2001) Telephone Survey Methodology, pp. 301-320. , In: Groves RM, Biemer PP, Lyberg LE, editors, New York: John Wiley and SonsSmith, J.M., Sullivan, S.J., Baxter, G.D., Telephone focus groups in physiotherapy research: Potential uses and recommendations (2009) Physiother Theory Pract, 25, pp. 241-256Thomas, R., Purdon, S., Telephone methods for social surveys (1994) Social Research Update, (8). , http://sru.soc.surrey.ac.uk/SRU8.htmlSmith, M., Chey, T., Jalaludin, B., Salkeld, G., Capon, T., Increasing response rates in telephone survey: A randomized trial (1995) J Public Health Med, 17, pp. 33-38Banjanovic, A., Towards universal global mobile phone coverage (2010) Special Report, , http://www.euromonitor.com/Articles.aspx?folder=Special_Report_Towards_universal_global_mobile_phone_coverage&print=true, accessed on 10/Jul(2003) Pesquisa Nacional Por Amostra De Domicílios: Síntese De Indicadores, , http://www.ibge.gov.br/english/presidencia/noticias/noticia_visualiza.php?id_noticia=226&id_pagina=1, Instituto Brasileiro de Geografia e Estatística, accessed on 10/Jul/2010Barbosa, A.F., (2009) Survey On the Use of Information and Communication Technologies In Brazil: ICT Households and ICT Enterprises 2008, , São Paulo: Comitê Gestor da Internet no BrasilMonteiro, C.A., Moura, E.C., Jaime, P.C., Lucca, A., Florindo, A.A., Figueiredo, I.C.R., Monitoramento de fatores de risco para doenças crônicas por entrevistas telefônicas (2005) Rev Saúde Pública, 39, pp. 47-57Souza, J.P., Cecatti, J.G., Pacagnella, R.C., Giavarotti, T.M., Parpinelli, M.A., Camargo, R.S., Development and validation of a questionnaire to identify severe maternal morbidity in epidemiological surveys (2010) Reprod Health, 7, p. 16Cooper, C.P., Jorgensen, C.M., Merritt, T.L., Report from the CDC. Telephone focus groups: An emerging method in public health research (2003) J Womens Health (Larchmt), 12, pp. 945-951Iredell, H., Shaw, T., Howat, P., James, R., Granich, J., Introductory postcards: Do they increase response rate in a telephone survey of older persons? (2004) Health Educ Res, 19, pp. 159-164Smyth, B.P., Darker, C.D., Donnelly-Swift, E., Barry, J.M., Allwright, S.P., A telephone survey of parental attitudes and behaviours regarding teenage drinking (2010) BMC Public Health, 10, p. 297França, E., Souza, J.M., Guimarães, M.D.C., Goulart, E.M.A., Colosimo, E., Antunes, C.M.F., Associação entre fatores sócio-econômicos e mortalidade infantil por diarréia, pneumonia e desnutrição em região metropolitana do Sudeste do Brasil: Um estudo caso-controle (2001) Cad Saúde Pública, 17, pp. 1437-1447Elias, M.C., Alves, A., Medicina não-convencional: Prevalência em pacientes oncológicos (2002) Rev Bras Cancerol, 48, pp. 523-532Hayakawa, L.M., Schmidt, K.T., Rossetto, E.G., Souza, S.N.D.H., Bengozi, T.M., Incidência de reinternação de prematuros com muito baixo peso nascidos em um hospital universitário (2010) Esc Anna Nery Rev Enferm, 14, pp. 324-329Brenner, H., Schmidtmann, I., Stegmaier, C., Effects of record linkage errors on registry-based follow-up studies (1997) Stat Med, 16, pp. 2633-2643Perriera, L.K., Reeves, M.F., Chen, B.A., Hohmann, H.L., Hayes, J., Creinin, M.D., Feasibility of telephone follow-up after medical abortion (2010) Contraception, 81, pp. 143-149Kempf, A.M., Remington, P.L., New challenges for telephone survey research in the twenty-first century (2007) Annu Rev Public Health, 28, pp. 113-12

Validação Da Versão De 36 Itens Do Who Disability Assessment Schedule 2.0 (whodas 2.0) Para A Avaliação De Incapacidade E Funcionalidade Da Mulher Associada à Morbidade Materna

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)To validate the translation and adaptation to Brazilian Portuguese of 36 items from the World Health Organizaton Disability Assessment Schedule 2.0 (WHODAS 2.0), regarding their content and structure (construct), in a female population after pregnancy. Methods This is a validation of an instrument for the evaluation of disability and functioning and an assessment of its psychometric properties, performed in a tertiary maternity and a referral center specialized in high-risk pregnancies in Brazil. A sample of 638 women in different postpartum periods who had either a normal or a complicated pregnancy was included. The structure was evaluated by exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), while the content and relationships among the domains were assessed through Pearson’s correlation coefficient. The sociodemographic characteristics were identified, and the mean scores with their standard deviations for the 36 questions of the WHODAS 2.0 were calculated. The internal consistency was evaluated byCronbach’s α. Results Cronbach’s α was higher than 0.79 for both sets of questons of the questionnaire. The EFA and CFA for the main 32 questions exhibited a total variance of 54.7% (Kaiser-Meyer-Olkin [KMO] measure of sampling adequacy = 0.934; p < 0.001) and 53.47% (KMO = 0.934; p < 0.001) respectively. There was a significant correlation among the 6 domains (r = 0.571–0.876), and a moderate correlation among all domains (r = 0.476–0.694). Conclusion The version of the WHODAS 2.0 instrument adapted to Brazilian Portuguese showed good psychometric properties in this sample, and therefore could be applied to populations of women regarding their reproductive history. © 2017 by Thieme-Revinter Publicações Ltda, Rio de Janeiro, Brazil.3924452471142/2011-5, CNPq, Conselho Nacional de Desenvolvimento Científico e TecnológicoConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Calcified Abdominal Pregnancy With Eighteen Years Of Evolution: Case Report.

CONTEXT: The lithopedion (calcified abdominal pregnancy) is a rare phenomenon and there are less than 300 cases reported in the medical literature. CASE REPORT: In this case, a 40 year-old patient had had her only pregnancy 18 years earlier, without medical assistance since then. She came to our hospital with pain and tumoral mass of approximately 20 centimeters in diameter. Complementary examinations (abdominal X-ray, ultrasonography and computerized tomography) demonstrated an extra-uterine abdominal 31-week pregnancy with calcification areas. Exploratory laparotomy was performed, with extirpation of a well-conserved fetus with partially calcified ovular membranes.118619219

Support During Childbirth: Perception Of Health Care Providers And Companions Chosen By Women [apoio No Nascimento: Percepções De Profissionais E Acompanhantes Escolhidos Pela Mulher]

Objective: To understand health cue providers' perception on managing laboring women in the presence of a labor companion of their choice, and the labor companion's perception of this experience. Methods: A qualitative study was conducted based on a controlled randomized clinical trial. Sampling was intentional and determined through information saturation. Semi-structured interviews were carried out with 11 health care providers and 16 laboring companions in the obstetric unit of a maternity facility at the hospital complex, in Campinas, Southern Brazil, between October 2004 and March 2005. The thematic analysis of discourse was applied using the following methodological figures: central idea, key expressions and discourse of the collective subject. Results: The most remarkable central ideas of health care providers were: no difference was observed in managing laboring women with a labor companion; positive changes were noted in labor management when a labor companion was present; the companion provided emotional support to laboring women who were more pleased, and felt safer and peaceful; many positive aspects were seen in the behavior and involvement of laboring women with a labor companion; the companion caused no problems and encouraged health providers to engage in a more humane and less routine attitude. The main central ideas of labor companions were: positive feelings, emotions, a sense of satisfaction with the experience; being with the laboring woman was a great opportunity to provide her emotional support; and they felt welcome by health care providers. Conclusions: Health providers considered positive the support provided by a labor companion and had no problems in managing laboring women in the presence of their companions. Labor companions were pleased and happy with this experience. There was no conflicting opinions. © 2007 Faculdade de Saúde Pública da Universidade de Sao Paulo.41119Alves, M.T.S.S.B., O parto na maternidade: Qualidade da assistência, o dia-a-dia do trabalho e o olhar das mulheres (2002) Interfaces: Gênero, Sexualidade E Saúde Reprodutiva, pp. 279-307. , In: Barbosa RM, Aquino EML, Heilborn ML, Berquó E. Campinas: UnicampCarvalho, M.L.M., Participação dos pais no nascimento em maternidade pública: Dificuldades institucionais e motivarções dos casais (2003) Cad Saúde Pública, 19 (SUPPL. 2), pp. S389-S398Hodnett, E.D., Gates, S., Hofmeyr, G.J., Sakala, C., Continuous support for women during childbirth (2003) Cochrane Database Syst Rev, (3). , http://cochrane.bireme.br/cochrane, Disponível em [acesso em 05 jun de 2005]Lefrève, F., Lefrève, A.M.C., Discurso do sujeito coletivo: Um novo enfoque em pesquisa qualitativa (Desdobramentos) (2003), Caxias do Sul: EducsLeão, M.R.C., Bastos, M.A.R.B., Doulas apoiando mulheres durante o trabalho de parto: Experiência do Hospital Sofia Feldman (2001) Rev Latinoam Enferm, 9, pp. 90-94Pinto, C.M.S.P., Basile, A.L.O., Silva, S.F., Hoga, L.A.K., O acompanhante no parto: Atividades e avaliação da experiência (2003) REME Rev Min Enferm, 7, pp. 41-47Ratto, K.M.N., É possível humanizar a assistência ao parto?: Avaliação de dois anos de Maternidade Leila Diniz (2001) Saúde Foco, 21, pp. 115-135Santos, O.M.B., Siebert, E.R.C., The humanization of birth experience at the University of Santa Catarina maternity hospital (2001) Int J Gynecol Obstet, 75, pp. S73-S79Seidel, J., The ethnograph v5.0: A users guide (1998), London: ScolariSomers-Smith, M.J., A palce of the partner?: Expectations and experiences of support during childbirth (1999) Midwifery, 15, pp. 101-108Tornquist, C.S., Paradoxos da humanização em uma maternidade no Brasil (2003) Cad Saúde Pública, 19 (SUPPL. 2), pp. 419-427Turato, E.R., Tratado de pesquisa clínico-qualitativa: Construção teórico-epistemológica, discussão comparada e aplicação nas áreas da saúde e humanas (2003), Petrópolis: VozesApropriate techonology for birth (1985) Lancet, 24, pp. 436-437. , World Health OrganizationCare in normal birth: A practical guide (1996), World Health Organization. Genev

Factors Associated With Mode Of Delivery Among Primipara Women With One Previous Cesarean Section And Undergoing A Trial Of Labor [1] [a Prova De Trabalho E A Via De Parto Em Primíparas Com Uma Cesárea Anterior]

OBJECTIVE. To identify factors associated with cesarean section in women with only one previous delivery by cesarean section and undergoing a trial of labor. METHODS. A retrospective cross sectional study was performed from 1986 to 1998 including a total of 1746 women with one prior cesarean section and delivering after a trial of labor. Cases with a current twin pregnancy or with malformation incompatible with life were excluded. Women were divided in two groups according to the mode of the second delivery: Cesarean (n=731) or Vaginal Birth After Cesarean (VBAC, n=1015). To identify factors associated to the mode of delivery, the prevalence ratios (PR) and the 95%CI for each isolated factor, adjusted according to age, were assessed. In each analysis, cases with missing information were excluded. RESULTS. The total rate of Vaginal Birth After Cesarean was 58.1%. The factors significantly associated with cesarean section were: higher maternal age, greater fundal height (PR 1.5; 95%CI 1.19-1.88), premature rupture of membranes (1.3; 1.08-1.54), amniotic fluid with an altered aspect (1.22; 1.04-1.43) or volume (1.32; 1.01-1.73), altered fetal heart rate (1.96; 1.68-2.28), non cephalic presentation (2.03; 1.54-2.66), induction of labor (1.74; 1.42-2.11) and no labor analgesia (2.57; 2.11-3.11). CONCLUSION. The factors associated with cesarean section were older age, non-cephalic presentation, premature rupture of membranes, signs of large fetus, the need of induction of labor and signs of compromised fetal wellbeing.532109115Villar, J., Valladares, E., Wojdyla, D., Zavaleta, N., Carroli, G., Velazco, A., Caesarean delivery rates and pregnancy outcomes: The 2005 WHO global survey on maternal and perinatal health in Latin América (2006) Lancet, 367 (9525), pp. 1819-1829O'Driscoll, K., Foley, M., Correlation of decrease in perinatal mortality and increase in cesarean section rates (1983) Obstet Gynecol, 61, pp. 1-5Belizan, J.M., Althabe, F., Barros, F.C., Alexander, S., Rates and implications of cesarean sections in Latin America: Ecological study (1999) BMJ, 319, pp. 1397-1400Murray, S.F., Relation between private health insurance and high rates of caesarean section in Chile: Qualitative and quantitative study (2000) BMJ, 321, pp. 1501-1505Kim, C., Ko, S.K., Kim, K.Y., Are league tables controlling epidemic of caesarean sections in South Korea? (2005) Br J Obstet Gynecol, 112, pp. 607-611Grobman, W.A., Peaceman, A.M., Socol, M.L., Cost-effectiveness of elective cesarean delivery after one prior low transverse cesarean (2000) Obstet Gynecol, 95, pp. 745-751Flamm, B.L., Once a cesarean, always a controversy (1997) Obstet Gynecol, 90, pp. 312-315Cragin, E., Conservatism in obstetrics (1916) N Y Med J, 104, pp. 1-3Dauphinee, J.V., Safety for the patient and the nurse (2004) J Obstet Gynecol Neonatal Nurs, 33, pp. 105-115Socol, M.L., (2003) VBAC: Is it worth the risk? Semin Perinatol, 27, pp. 105-111Brill, Y., Windrim, R., Vaginal birth after Caesarean section: Review of antenatal predictors of success (2003) J Obstet Gynecol Can, 25, pp. 275-286Committee opinion. Induction of labor for vaginal birth after cesarean delivery (2002) Obstet Gynecol, 99, pp. 679-680. , ACOG Committee on Obstetric PracticePotter, J.E., Berquó, E., Perpétuo, I.H.O., Leal, O.F., Hopkins, K., Souza, M.R., Unwanted cesarean sections among public and private patients in Brazil: Prospective study (2001) Br Med J, 323, pp. 1155-1158Cecatti JG, Andreucci CB, Cacheira PS, Besteti Pires HM, Pinto e Silva JLC, Aquino MMA. Fatores associados à realização de cesárea em primíparas com uma cesárea anterior. Rev Bras Ginecol Obstet. 2000;22:175-9Matias, J.P., Parpinelli, M.A., Cecatti, J.G., Passini Jr, R., A prova de trabalho de parto aumenta a morbidade materna e neonatal em primíparas com uma cesárea anterior? (2003) Rev Bras Ginecol Obstet, 25, pp. 255-260Brill, Y., Kingdom, J., Thomas, J., Fraser, W., Milne, J.K., Thomas, M., The management of VBAC at term: A survey of Canadian obstetricians (2003) J Obstet Gynaecol Can, 25, pp. 300-310Cecatti, J.G., Pires, H.M., Faundes, A., Duarte Osis, M.J., Factors associated with vaginal birth after previous cesarean section in Brazilian women (2005) Rev Panam Salud Publica, 18, pp. 107-113Dodd, J.M., Crowther, C.A., Huertas, E., Guise, J.M., Horey, D., Planned elective repeat Caesarean section versus planned vaginal birth for women with a previous Caesarean birth (2006) Cochrane Review, (1). , The Cochrane Library, Oxford: Update SoftwareSantos, L.C., Amorim, M.M.R., Porto, A.M.F., Azevedo, E.B., Mesquita, C.C., Fatores prognósticos para o parto transvaginal em pacientes com cesárea anterior (1998) Rev Bras Ginecol Obstet, 20, pp. 342-349Reddy, U.M., DiVito, M.M., Armstrong, J.C., Hyslop, T., Wapner, R.J., Population adjustment of the definition of the vaginal birth after cesarean rate (2000) Am J Obstet Gynecol, 183, pp. 1166-1169Pires, H.M., Cecatti, J.G., Faundes, A., Factors associated with the trial of labor in primíparas women with one previous cesarean section (1999) Rev Saúde Pública, 33, pp. 342-348Socol, M.L., Peaceman, A.M., Vaginal birth after cesarean: An appraisal of fetal risk (1999) Obstet Gynecol, 93, pp. 674-679O'Brien-Abel, N., Uterine rupture during VBAC trial of labor: Risk factors and fetal response (2003) J Midwifery Womens Health, 48, pp. 249-257Shipp, T.D., Zelop, C.M., Repke, J.T., Cohen, A., Caughey, A.B., Lieberman, E., Labor after previous cesarean: Influence of prior indication and parity (2000) Obstet Gynecol, 95, pp. 913-916Linton, A., Peterson, M.R., Williams, T.V., Effects of maternal characteristics on cesarean delivery rates among US Department of Defense healthcare beneficiaries, 1996-2002 (2004) Birth, 31, pp. 3-11Lydon-Rochelle, M., Holt, V.L., Easterling, T.R., Martin, D., Risk of uterine rupture during labor among women with a prior cesarean delivery (2001) N Engl J Med, 345, pp. 3-8Lieberman, E., Risk factors for uterine rupture during a trial of labor after cesarean (2001) Clin Obstet Gynecol, 44, pp. 609-621Fisler, R.E., Cohen, A., Ringer, S.A., Lieberman, E., Neonatal outcome after trial of labor compared with elective repeat cesarean section (2003) Birth, 30, pp. 83-88Mozurkewich, E.L., Hutton, E.K., Elective repeat cesarean delivery versus trial of labor: A meta-analysis of the literature from 1989 to 1999 (2000) Am J Obstet Gynecol, 183, pp. 1187-119

Perceptions And Actions Of Healthcare Professionals Regarding The Mother-child Relationship With Premature Babies In An Intermediate Neonatal Intensive Care Unit: A Qualitative Study

Background: The mother-child interaction after delivery may be hampered when the newborn baby is hospitalized. The objective of the study was to understand perceptions and actions of healthcare professionals (HCPs), working in an intermediate neonatal intensive care unit (NICU), regarding mother-child relationship of hospitalized premature babies in the first weeks after delivery and the professionals' support for the development of this relationship within an NICU environment. The psychoanalytic concept of holding defined by Winnicott was used as the theoretical framework.Methods: A qualitative study was conducted with 20 HCPs (physicians, medical residents, nurses, and nurse technicians) working at an intermediate NICU of a referral hospital in Brazil. Semi-structured interviews were conducted, recorded and transcribed verbatim; and thematic analysis was performed.Results: The HCPs referred to the difficulty that these mothers had to develop the mother-child relationship within this environment. If they observed that the mother had initial inhibitions to interact with her baby, they tried to facilitate this process, since they were aware of the importance of early bonding for the child's well-being. They attributed the mothers' difficulty to the fragile appearance of the premature baby, the limited contact often imposed by the routine of the unit and the lack of participation in the decisions regarding the care given to her baby. HCPs tried to help women bond with her child by giving support and encouragement. Most of the physicians reported that the nurses represented a link between physicians and the mothers of the hospitalized babies.Conclusion: The HCPs reported attitudes and actions indicative of holding. A more in-depth understanding of the relationship between HCPs and mothers of premature babies at an NICU during the first days after delivery, and the needs of the mothers and her baby to be close to facilitate bonding should be part of the routine discussions of the NICU health team.141Hoffenkamp, H.N., Tooten, A., Hall, R.A., Croon, M.A., Braeken, J., Winkel, F.W., Vingerhoets, A.J., van Bakel, H.J., The impact of premature childbirth on parental bonding (2012) Evol Psychol, 10, pp. 542-561Flacking, R., Ewald, U., Wallin, L., Positive effect of kangaroo mother care on long-term breastfeeding in very preterm infants (2011) J Obstet Gynecol Neonatal Nurs, 40, pp. 190-197. , 21410756Nicolaou, M., Rosewell, R., Marlow, N., Nicolaou, C.G., Mothers' experiences of interacting with their premature infants (2009) J Reprod Infant Psychol, 27, pp. 182-194Lasiuk, G.C., Comeau, T., Newburn-Cook, C., Unexpected: an interpretive description of parental traumas' associated with preterm birth (2013) BMC Pregnancy Childbirth, 13, p. 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The impact of proteinuria on maternal and perinatal outcomes among women with pre-eclampsia

sem informaçãoTo assess the impact of proteinuria on pregnancy outcomes among women with pre-eclampsia. Methods: The present retrospective cohort study included patients with pre-eclampsia who delivered at a referral maternity hospital in Brazil between January 1, 20091431101107sem informaçãosem informaçãosem informaçã