Dissertations / Theses: 'Medicina perinatale'

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Døllner, Henrik. "Inflammatory mediators in perinatal infections." Doctoral thesis, Norwegian University of Science and Technology, Faculty of Medicine, 2002. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-574.

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Jenmalm, Maria, and Karel Duchén. "Timing of allergy-preventive and immunomodulatory dietary interventions : are prenatal, perinatal or postnatal strategies optimal?" Linköpings universitet, Institutionen för klinisk och experimentell medicin, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-90064.

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The increasing allergy prevalence in affluent countries may be caused by reduced microbial stimulation and a decreased dietary ω-3/ω-6 long-chain polyunsaturated fatty acid (LCPUFA) ratio, resulting in an abnormal postnatal immune maturation. The timing of allergy-preventive probiotic and ω-3 LCPUFA interventions is critical, as early-life events occurring during critical windows of immune vulnerability can have long-term impact on immune development. The maternal dietary and microbial environment during pregnancy may programme the immune development of the child. Prenatal environmental exposures may alter gene expression via epigenetic mechanisms, aiming to induce physiological adaptations to the anticipated postnatal environment, but potentially also increasing disease susceptibility in the offspring if exposures are mismatched. Although the importance of fetal programming mostly has been studied in cardiovascular and metabolic disease, this hypothesis is also very attractive in the context of environmentally influenced immune-mediated diseases. This review focuses on how prenatal, perinatal or postnatal ω-3 LCPUFA interventions regulate childhood immune and allergy development, and if synergistic effects may be obtained by simultaneous probiotic supplementation. We propose that combined pre- and postnatal preventive measures may be most efficacious. Increasing knowledge on the immunomodulatory effects of prenatal, perinatal and postnatal interventions will help to direct future strategies to combat the allergy epidemic.

Funding Agencies|Swedish Research Council||Ekhaga Foundation||Research Council for the South-East Sweden||Swedish Asthma and Allergy Association||Olle Engkvist Foundation||Vardal Foundation - for Health Care Sciences and Allergy Research||

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Silva, Silvia Anadir Medeiros da. "Ventila??o heterog?nea em prematuros e fatores perinatais associados." Pontif?cia Universidade Cat?lica do Rio Grande do Sul, 2011. http://tede2.pucrs.br/tede2/handle/tede/1394.

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Background: Alterations to lung development in preterm infants is characterized by decreased alveolarization and dysmorphic vasculature. Has been considered the possibility that changes associated with perinatal factors decrease lung volume and quality of ventilation distribution. Objective: To measure the functional residual capacity and heterogeneity of ventilation in preterm infants and to study their association with perinatal factors. Methods: This is a cross-sectional study involving preterm infants corrected age of 8 to 13 months. Were measured at functional residual capacity (FRC) and ventilation inhomogeneity using the lung clearance index (LCI) by the technique multiple breath inert gas washout (MBW) with sulfur hexafluoride (SF6) to 4%, with sedation, using a ultrasonic flowmeter. The statistical analysis used the Student t test and linear regression. Results: We studied 28 preterm infants with gestational age (GA) (mean ?SD) of 31? 2.9 weeks, with of 7.88 ?0.6 and equal to 19.7 ?4.3 ml.kg-1. Positive correlation were found between LCI and males and intrauterine growth restriction (p <0.05). Premature rupture of membranes were negative correlation with LCI (p <0.05). Conclusion: The results suggest that this sample, male sex, the IUGR and premature rupture of membranes affect LCI in preterm infants. The FRC was not associated with prematurity or other pre-natal and post-natal factors.
Introdu??o: A altera??o no desenvolvimento pulmonar em prematuros ? caracterizada por redu??o na alveolariza??o e vasculariza??o dism?rfica. Tem sido considerada a possibilidade de que altera??es associadas a fatores perinatais diminuam volumes pulmonares e a qualidade da distribui??o da ventila??o. Objetivo: Medir a heterogeneidade da ventila??o e a capacidade residual funcional em prematuros e estudar suas associa??es com fatores perinatais. M?todos: Este ? um estudo transversal envolvendo prematuros com idade corrigida de 8 a 13 meses. Foram medidas a capacidade residual funcional (CRF) e a ventila??o heterog?nea utilizando o lung clearence ?ndex (LCI) atrav?s da t?cnica multiple breath inert gas washout (MBW) com hexafluoreto de enxofre (SF6) a 4%, com seda??o, usando um medidor de fluxo ultrass?nico. Na an?lise estat?stica foi usado o teste t de Student e a regress?o linear. Resultados: Foram estudados 28 prematuros com idade gestacional (IG) (m?dia?dp) de 31?2,9 semanas, com LCI de 7,88?0,6 e CRF igual a 19,7?4,3 ml.kg-1. Houve correla??o positiva entre LCI e sexo masculino e restri??o do crescimento intrauterino (RCIU) (p<0,05). Houve correla??o negativa entre LCI e ruptura prematura das membranas (ruprema) (p<0,05). Conclus?o: Os resultados encontrados sugerem, que nesta amostra, o sexo masculino, o RCIU e a ruprema influenciaram o LCI em prematuros. A CRF n?o foi associada ? prematuridade ou outros fatores perinatais.

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Carrera, Hueso Mª Luisa. "Papel del obstetra ante la pérdida perinatal." Doctoral thesis, Universitat de València, 1995. http://hdl.handle.net/10803/10136.

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La relación de la madre con su hijo comienza fisiológica y psicológicamente antes del nacimiento.Kennell en 1970 ya refiere que el proceso de duelo por un recién nacido(RN) muerto es similar al que se produce por la muerte de un familiar cercano.El duelo es una reacción dolorosa que necesita un trabajo psicológico. Bowlby(1984), distingue cuatro fases evolutivas del proceso de duelo: primera de " choque "-incredulidad, segunda de nostalgia-búsqueda, tercera de desorganización y cuarta de reorganización.Condon(1987), cita: "La percepción que la mujer tiene de los hechos que suceden minutos ú horas inmediatamente después de percatarse de la posibilidad de la muerte de su hijo tiene máxima importancia, porque estos recuerdos forman el núcleo del proceso de pesar", de ahí la importancia del equipo obstétrico . JustificaciónNuestra finalidad es conocer lo que ocurre para poderlo evitar. Nos parecio adecuado estudiar la ansiedad(A) y la depresión(D) en las mujeres que han sufrido una pérdida perinatal I, a la vez de administrarles un plan de intervención en la crisis. Material y MetodoTrabajamos con 94 mujeres, distribuidas en tres grupos:- Grupo control: 37 mujeres con RN vivo y sano, valorandolas en A y D en el nacimiento, 6 y 12 meses.- Grupo seguimiento: 23 mujeres con perdida perinatal I a las que se les administro un plan de intervención en la crisis y se valoro su A y D en el nacimiento, 6 y 12 meses.- Grupo no seguimiento: 34 mujeres con perdida perinatal I el año anterior y que no se les administro plan de intervención, valorando su A y D a los 12 meses.Para la valoración psicológica se utilizaron : El inventario de depresión de Beck , la escala de depresión del MMPI, El STAI de Spielberger y Test de ansiedad de Cattell.En el grupo control y de seguimiento el estudio fue prospectivo, mientras que en el grupo de no seguimiento fue transversal.Para comparar las variables obstétricas se utilizó un análisis de varianza , un test de "Chi" Cuadrado o un test exacto de Fisher. Los resultados de las pruebas psicológicas se muestran utilizando las graficas de cajas y bigotes. Se calculan los intervalos de confianza de la media al 95%. ResultadosEn el nacimiento, las madres con perdida puntuaban más en A y D que las madres con RN vivo.A los 6 meses, las madres con perdida igualan sus puntuaciones de A con las del grupo control, pero no las de depresión.A los 12 meses, mientras las mujeres con perdida y plan igualan sus puntuaciones con las de hijo vivo, las mujeres con perdida y sin plan están más deprimidas y ansiosas que las de hijo vivo, siendo estas diferencias significativas, demostrando así la utilidad del plan de intervención. CONCLUSIONES1.- Las mujeres con pérdida perinatal tienen mayor nivel de ansiedad y depresión en el postparto inmediato que las mujeres con hijo vivo. 2.- Las mujeres con pérdida a las que se les ha administrado plan de intervención, mantienen a los 6 meses niveles de depresión superiores a las mujeres con hijo vivo, no habiendo diferencias en ansiedad.Al año estas mujeres han igualado sus índices de ansiedad y depresión con los de las mujeres que habían tenido un hijo vivo.3.- Las mujeres con pérdida que no recibieron plan se encuentran más deprimidas y ansiosas, al año del nacimiento, que las de hijo vivo.4.- Las mujeres con pérdida que recibieron plan de intervención presentan al año, índices de ansiedad y depresión más bajos que las que no recibieron dicho plan
Since Kenell in 1970 has been admited that the mourning process for a newbornbaby dead is similar to the one produced by the death of a relative.Bowlby(1984), distinguishes four evolutives stages at the mourning process:· The first one is shock-unvelieving· The second: nostalgia-seartching· The third: disorganization· The four: reorganizationFor the resolution process has a big importance what happens inmediately is received the notice of the death of a newbornbaby. JustificationWe try to know what happens to be able to avoid it. We considered appropiate study the anxiety and the depression in women who have suffered a perinatal loss I, combining it with a crisis treatment plan.Material and MethodWe worked with 95 women distributed in three groups:· Control group: 37 women with newbornbaby alive and health valuating in A ( Stai of Spielberger and Cattell) and D ( Beck's inventory and scale of MMPI) in the birthmoment, 6 and 12 months.· Following group: 23 women with perinatal loss and the women who have been treated with the crisis treatment plan, being valuated their A and D in birthmoment, 6 and 12 months.· Not Following group: 34 women with perinatal loss I last year whom was not treated with treatment plan, valuating their A and D at twelve months.In control and following groups, the study was prospective whereas in the not following group it was transverse.Results and ConclusionIn the birthmoment, the mothers with perinatal loss have score more in A and D that mothers with newbornbaby alive.At the sixth month, the mothers with perinatal loss level their A score with the following goup ones, but not the depression ones.At twelveth month, whereas the women with perinatal loss and plan, level their score with the alive newbornbaby ones. The women with loss and without plan feel more deppresive and anxious than the women with alive baby, being the differences more significative, showing in that way the profit of the intervention plan.

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Vyas-Lee, J. "Perinatal psychosocial interventions." Thesis, Canterbury Christ Church University, 2017. http://create.canterbury.ac.uk/17719/.

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Background: Joint working between adult and child services has historically been difficult; the Think Family Toolkit was produced by the government in order to aid collaborative working. Aim: The aim of this evaluation was to explore joint working between services using the Think Family Toolkit. Method: An adult team, child team and service users were given questionnaires to explore joint working. Results: Joint working was described as something that would be useful but there were many barriers to achieving it. The child team did not respond to the questionnaire perhaps due to time constraints and potential burnout. Conclusions: Recommendations are provided to increase the effectiveness of joint working between services.

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Ågren, Johan. "Water transport through perinatal skin : Barrier function and aquaporin water channels." Doctoral thesis, Uppsala University, Department of Women's and Children's Health, 2003. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3369.

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While constituting a well functioning interface with the aqueous environment in utero, the skin offers a poor barrier after very preterm birth. As a result, transepidermal water loss (TEWL) is high, a fact which has important clinical consequences in these infants. To investigate the transport of water through perinatal skin and the potential role of aquaporin (AQP), a water channel protein, in this process, we determined TEWL in a group of extremely preterm infants, and in an experimental rat model we analyzed the expression and distribution of AQP in perinatal skin in relation to TEWL, skin surface hydration and water content. The effects of antenatal corticosteroids (ANS) and of restricted intake of fluids and nutrients on barrier characteristics of the perinatal skin and its AQP expression were also studied.

In infants born at 24 and 25 weeks of gestation TEWL was very high in the first days after birth and decreased with increasing postnatal age. At a postnatal age of 4 weeks, TEWL was still twice as high as previously reported in infants born at a gestational age of 25-27 weeks and four times higher than in infants born at term. In the rat model, immunohistochemical analysis revealed that AQP1 and AQP3 are abundantly expressed in the skin. AQP1 was expressed exclusively in dermal capillaries and AQP3 in basal layers of the epidermis. AQP1 and AQP3 mRNA as assessed by semiquantitative RT-PCR was higher in fetal than in adult skin. As in infants, TEWL and skin surface hydration were inversely related to gestational age in the rat. In preterm rat pups exposed to ANS, TEWL and skin surface hydration were lower than in unexposed controls, and AQP3 expression was selectively induced by ANS. In term newborn rat pups, restriction of fluid and nutrient intake resulted in a higher skin water content and higher TEWL early after birth, while at an age of 7 days TEWL was lower in fasting rat pups than in controls, although skin water content was still higher.

To conclude, TEWL is very high in extremely preterm infants early after birth and then decreases at a slower rate than previously reported for a group of slightly more mature infants.

This is the first time that the distribution and gene expression of AQP1 and AQP3 have been demonstrated in perinatal skin. The localization and expression of AQP in the skin might indicate that these water channels are involved in the regulation of skin hydration and transepidermal water transport in the fetus and newborn infant.

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Sedgfield, Amber. "Mindfulness during the perinatal period." Thesis, University of Warwick, 2015. http://wrap.warwick.ac.uk/76034/.

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It is well documented that the perinatal period (the time from pregnancy until the first year of a child’s life) is a crucial window of opportunity for foetal and infant development. Evidence suggests that parental psychopathology can have harmful consequences for the parent-infant relationship, parents’ relationship, infant’s development and later mental-health into adulthood. The focus of this thesis will be on exploring mindfulness as one possible non-pharmacological intervention that could benefit parents’ emotional well-being during the perinatal period. Chapter one contains a mixed methods systematic review of 14 published studies of Mindfulness and Acceptance Based Interventions (MABIs) during the perinatal period, for mothers experiencing anxiety and stress. The synthesis of quantitative and qualitative results were integrated and demonstrated tentative findings that MABIs can reduce anxiety, pregnancy anxiety and stress for mothers, whilst increasing self-efficacy and mindfulness. Qualitative themes discussed propose possible explanations for these findings. Methodological limitations are discussed in line with implications for clinical practice and recommendations for future research. Chapter two explores mothers’ and fathers’ experiences of mindfulness during parenting, one year following their attendance on the Mindfulness-Based Childbirth and Parenting programme (MBCP). Ten semi-structured interviews gathered rich, in-depth, idiosyncratic accounts which were subject to Interpretative Phenomenological Analysis (IPA). Two superordinate themes emerged from the data, ‘Getting closer to really living’ and ‘Greater connectedness and attunement’. Finally, Chapter 3 provides a reflective account of the author’s lived experience of the parallels between her own research journey and personal experience of becoming a mother. It addresses the author’s epistemological position and the researcher’s influence on the research process.

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Fleming, Karen Isobel. "Prenatal, perinatal and postnatal factors in developmental dyslexia." Thesis, University of Hull, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.272002.

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Silva, Silvia Anadir Medeiros da. "Ventilação heterogênea em prematuros e fatores perinatais associados." Pontifícia Universidade Católica do Rio Grande do Sul, 2011. http://hdl.handle.net/10923/4686.

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Background: Alterations to lung development in preterm infants is characterized by decreased alveolarization and dysmorphic vasculature. Has been considered the possibility that changes associated with perinatal factors decrease lung volume and quality of ventilation distribution. Objective: To measure the functional residual capacity and heterogeneity of ventilation in preterm infants and to study their association with perinatal factors. Methods: This is a cross-sectional study involving preterm infants corrected age of 8 to 13 months. Were measured at functional residual capacity (FRC) and ventilation inhomogeneity using the lung clearance index (LCI) by the technique multiple breath inert gas washout (MBW) with sulfur hexafluoride (SF6) to 4%, with sedation, using a ultrasonic flowmeter. The statistical analysis used the Student t test and linear regression. Results: We studied 28 preterm infants with gestational age (GA) (mean ±SD) of 31± 2. 9 weeks, with of 7. 88 ±0. 6 and equal to 19. 7 ±4. 3 ml. kg-1. Positive correlation were found between LCI and males and intrauterine growth restriction (p <0. 05). Premature rupture of membranes were negative correlation with LCI (p <0. 05).Conclusion: The results suggest that this sample, male sex, the IUGR and premature rupture of membranes affect LCI in preterm infants. The FRC was not associated with prematurity or other pre-natal and post-natal factors.
Introdução: A alteração no desenvolvimento pulmonar em prematuros é caracterizada por redução na alveolarização e vascularização dismórfica. Tem sido considerada a possibilidade de que alterações associadas a fatores perinatais diminuam volumes pulmonares e a qualidade da distribuição da ventilação. Objetivo: Medir a heterogeneidade da ventilação e a capacidade residual funcional em prematuros e estudar suas associações com fatores perinatais.Métodos: Este é um estudo transversal envolvendo prematuros com idade corrigida de 8 a 13 meses. Foram medidas a capacidade residual funcional (CRF) e a ventilação heterogênea utilizando o lung clearence índex (LCI) através da técnica multiple breath inert gas washout (MBW) com hexafluoreto de enxofre (SF6) a 4%, com sedação, usando um medidor de fluxo ultrassônico. Na análise estatística foi usado o teste t de Student e a regressão linear. Resultados: Foram estudados 28 prematuros com idade gestacional (IG) (média±dp) de 31±2,9 semanas, com LCI de 7,88±0,6 e CRF igual a 19,7±4,3 ml. kg-1. Houve correlação positiva entre LCI e sexo masculino e restrição do crescimento intrauterino (RCIU) (p<0,05). Houve correlação negativa entre LCI e ruptura prematura das membranas (ruprema) (p<0,05).Conclusão: Os resultados encontrados sugerem, que nesta amostra, o sexo masculino, o RCIU e a ruprema influenciaram o LCI em prematuros. A CRF não foi associada à prematuridade ou outros fatores perinatais.

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Traverzim, Maria Aparecida Dos Santos. "Aplicação de check list ampliado para detecção de incidentes de segurança do paciente em medicina perinatal." Universidade Nove de Julho, 2015. http://bibliotecadigital.uninove.br/handle/tede/1201.

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Patient safety is one of the dimensions of quality that has received increasing attention in recent years. The incident detection in patient safety aims to improve the quality of patient care. Incidents and adverse events (AEs) of patient safety should be reported spontaneously contributing for the apprenticeship and to create barriers so that they would not be repeated, but the fear of prosecution and punishment cause its underreporting. The objective of this study was to evaluate the incidence of patient safety incidents in the perinatal period with the use of an extended check list. This research used the inductive method, empirical approach with exploratory, descriptive, cross and as a strategy action research. Population sample was composed by admitted patients in the perinatal unit from June 25th to July 25th, 2015.We evaluated in maternal registry for proper completion of partogram, the patient chart and newborn data. We looked for: uterine rupture, changing the delivery type, returning to the operating room during hospitalization or after discharge, instrumental delivery, complications in the postpartum period, maternal death. In the newborn chart we collected information on neonatal trauma due to childbirth; research proper fetal vitality; Apgar score less than 7, and death of newborns weighing more than 2,500 g, and mother / newborn (NB). For both we looked for the detection of failure to follow the clinical protocol and blood components transfusion. We also evaluated whether these components of the check list were related to incidents or EAs in health care assistance. The total number of patients studied in the period was 249 patients, and we detected 97 AEs (38.9%). Of EAs, 27 (27.8%) were detected by traditional trigger points and 70 (72.8%) extended check list. The Apgar score less than 7 at the fifth minute was detected in 11 (11.3%) of all EAs and seven newborns (7.2% of events) had some type of trauma due to childbirth, 4 NB (4, 1%) were admitted to the ICU with less than 24 hours of birth. It was noted that two patients (2%) had to undergo to further surgery and one of them is still in outpatient treatment in the unit. Two patients (2%) had lacerations third / fourth degree and one patient (1%) uterine rupture diagnosed at the time of cesarean section. In the extended check list we detected failure in medicines in 20.6% of all AEs. In this study we observed a high incidence of clinical protocols violation (39.2%). Nine patients (9.3%) had complications in the postpartum period, two (2.1%) required liaison and one patient (1%) anesthetic complications.
A segurança do paciente é uma dimensão de qualidade que tem recebido atenção crescente nos últimos anos. A detecção de incidentes na área tem como objetivo melhorar a qualidade da assistência. Os incidentes e eventos adversos (EAs) deveriam ser relatados espontaneamente para que haja aprendizado e criação de barreiras para que não se repetam; porém, o receio de processos judiciais e punições leva a subnotificação. O objetivo deste estudo é avaliar sua incidência no período perinatal com o uso de um check list ampliado. A pesquisa utilizou o método indutivo, abordagem empírica com caráter exploratório, descritivo e transversal, e como estratégia a pesquisa-ação. Foram averiguados os atendimentos prestados a pacientes internadas na unidade de medicina perinatal, no período de 25 de junho a 25 de julho de 2015, quanto ao preenchimento adequado do partograma, dados do prontuário materno e do recém-nascido (RN). Também foi averiguado se a mãe apresentou, durante a internação na unidade: rotura uterina, alteração da via de parto durante o procedimento, retorno à sala cirúrgica durante a internação ou pós-alta hospitalar, parto instrumental, intercorrências no período puerperal ou morte materna. Entre os RNs, verificou-se a ocorrência de trauma neonatal devido ao parto, Apgar menor que 7 e morte com peso superior a 2.500g, além de investigação da vitalidade fetal adequada. Para mãe e recem-nascido, verificou-se se foi seguido o protocolo clínico da instituição e transfusão de heomcomponentes. Também avaliamos se esses componentes do check list, quando presentes, estavam relacionados a incidentes ou EAs no atendimento. O total de pacientes estudadas no período foi de 249, sendo detectados 97 EAs (38,9%). Destes, 27 (27,8%) foram detectados pelos trigger points tradicionais e 70 (72,8%) pelo check list ampliado. O índice de Apgar menor que 7 no quinto minuto foi detectado em 11 (11,3%) do total de EAs e 7 RNs (7,2% dos eventos) apresentaram algum tipo de trauma devido ao parto. 4 RNs (4,1%) foram admitidos na UTI com menos de 24h de nascimento. Observou-se que duas pacientes (2%) tiveram que ser submetidas a nova intervenção cirúrgica e que uma delas ainda continua em tratamento ambulatorial na unidade. Duas (2%) apresentaram lacerações de terceiro/quarto grau e uma (1%), rotura uterina diagnosticada no momento da cesárea. No check list ampliado detectamos falhas de medicamentos como causa de 20,6% de todos os EAs. O número de inobservância de protocolos clínicos da instituição também se mostrou com elevada incidência (39,2%). Nove pacientes (9,3%) apresentaram intercorrências no puerpério, duas (2,1%) necessitaram de interconsulta e uma (1%) de intercorrência anestésica.

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CELESTINO, SANABRIA CINDY. "DIABETES GESTACIONAL, COMPOSICIÓN CORPORAL Y ANTECEDENTES HEREDO-FAMILIARES EN PACIENTES DEL HOSPITAL MATERNO PERINATAL “MÓNICA PRETELINI SÁENZ." Tesis de Licenciatura, Universidad Autónoma del Estado de México, 2019. http://hdl.handle.net/20.500.11799/106019.

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El diagnóstico de diabetes gestacional es más frecuente cuando se tiene presencia de antecedentes de padre y/o madre de diabetes mellitus tipo 2.
La Diabetes Gestacional (DG) es un padecimiento caracterizado por la intolerancia a los carbohidratos que se inicia y diagnóstica durante el embarazo. El diagnóstico de la enfermedad debe realizarse con estudios específicos a las pacientes de alto riesgo entre la semana 24 y 28 de gestación. Existen varios métodos, pero en años recientes los organismos internacionales han aceptado como diagnóstico la prueba de la Curva de Tolerancia Oral a la Glucosa (CTOG) con una carga de 75g.

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Punwani, Shonit. "The use of quantitative magnetic resonance imaging in perinatal brain injury." Thesis, University College London (University of London), 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266160.

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Marques, Ana Teresa de Simões Graça e. Almeida. "Clínica e sanidade em espécies pecuárias." Master's thesis, Universidade de Évora, 2014. http://hdl.handle.net/10174/13541.

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Este trabalho reúne as atividades realizadas durante o estágio curricular do Mestrado Integrado em Medicina Veterinária, apresentando-se a casuística observada nas diferentes espécies e áreas, fazendo-se referência a temas de maior relevância. Como tema de desenvolvimento, optou-se pela realização de um estudo relativo à distócia e mortalidade perinatal em bovinos de carne. Foi realizada uma revisão bibliográfica do tema e seguidamente tratados os dados recolhidos durante o período de estágio. Observou-se a principal influência de fatores como o tempo de intervenção, causa da distócia, resolução da distócia, raça, número de partos da vaca e a coloração dos fluidos e membranas fetais ao parto, apresentando diferenças estatisticamente significativas (P<0.05). Observaram-se também correlações significativas (P<0.05) entre os vários fatores. A distócia e a mortalidade perinatal representam uma grande parte das perdas económicas e na produção das explorações, sendo essencial a sua prevenção; Abstract: Farm animal health and clinics in livestock species This report brings together the activities carried out during the internship for the Master in Veterinary Medicine, presenting the number of cases attended in different species and areas, making reference to the most relevant issues. As a development subject was conducted a study on the perinatal mortality and dystocia in beef cattle. A literature review on the subject was held and the data collected during the training period were analyzed. The main factors observed as influent in dystocia and perinatal mortality were the time of intervention, the cause of dystocia, the resolution of dystocia, the breed of the dam, the parity of the cow and the coloration of the fluid and fetal membranes at birth, showing statistically significant differences (P <0.05). There was also observed significant correlations (P <0.05) among the factors. The dystocia and perinatal mortality represent a large part of production losses and economic holdings, requiring prevention measures.

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Moore, D. "Online resources for perinatal mental illness and stigma." Thesis, City, University of London, 2017. http://openaccess.city.ac.uk/20395/.

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Perinatal mental illness is a global health issue with detrimental outcomes for women and their families if left untreated. Unfortunately, many women do not get the treatment they need for many reasons, one often acknowledged reason is that the stigma some women experience inhibits disclosure of their needs to healthcare providers. This thesis looked at Internet resources for women with perinatal mental illness, in particular online forums. It examined how forums might affect stigma and thus disclosure behaviour. This thesis is by prospective publication. Article 1 aimed to describe and interpret qualitative studies regarding forum use and perinatal mental illness stigma. A metasynthesis of five studies identified four key themes: a safe place to talk; virtual support; stigma and identity; and repair of the mother identity (Moore, Ayers & Drey, under review). Article 2 aimed to identify what websites about postnatal mental illness were available and assess them for content and quality. A systematic review of 114 websites evaluated accuracy of information, resources and website quality. Results showed information was largely incomplete and difficult to read; resources were limited and website quality was variable (Moore & Ayers, 2011). Article 3 aimed to determine how women with perinatal mental illness use web based resources. A qualitative interview study (n= 15) found that the anonymity and non-judgemental social support on forums may have made it an acceptable way to challenge internal stigma and that most women described forums as providing a space to discuss stigma and test out disclosing about their illness to others (Moore & Ayers, 2016). Article 4 therefore aimed to identify whether forums for perinatal mental illness reduce stigma and facilitate disclosure. Thematic analysis of 1546 posts over six months on a forum for postnatal mental illness suggested that forum discourse reconstructed ideology of motherhood as compatible with perinatal mental illness. Many women overcame stigma and posted that they had taken advice and disclosed to a healthcare provider (Moore, Ayers, & Drey, 2016). The final article developed and tested a hypothesised model of the relationship between stigma and disclosure about perinatal mental illness. Study 5 developed a questionnaire measure of stigma for perinatal mental illness in order to test the model. Questionnaire items were completed online by women with perinatal mental illness (n=279). Psychometric testing suggested it was a valid scale with three subscales: external, internal and disclosure stigma (Moore, Ayers, & Drey, 2017). Study 6 tested a hypothesised model that stigma would mediate the relationship between forum use and disclosure to healthcare providers. An online survey of women with perinatal mental illness (n=200) who had used forums provided partial support for this hypothesis, with internal stigma mediating the relationship between length of forum use and disclosure (Moore, Drey, & Ayers, 2017). This research highlights the importance of considering the stigma associated with perinatal mental illness and its role in online forum use and disclosure. Overall, findings suggest that forums may facilitate recognition of stigma, which may in turn lead to greater disclosure of symptoms to healthcare providers. However, the relationship between forum use, stigma and disclosure may be more complex than our initial model proposed. Similarly, most participants in these studies were white, well-educated and actively participated in the forums. Future studies would benefit from testing these relationships using longitudinal designs with more representative samples.

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Buriak, Oleksandr Grygorovych, Dmytro Yuriiovych Nechytailo, and Halyna Grygorivna Mararash. "Experience in teaching of foreign students in the department of pediatrics, neonatology and perinatal medicine." Thesis, European Conference on Education and Applied Psychology, 2015. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/12112.

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Peters, T. J. "A statistical investigation of risk indicators for perinatal outcome and early child development." Thesis, University of Exeter, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.233830.

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Chakr, Valentina Coutinho Baldoto Gava. "Influ?ncia de infec??es da via a?rea inferior e de fatores perinatais na fun??o e no crescimento pulmonares em lactentes prematuros." Pontif?cia Universidade Cat?lica do Rio Grande do Sul, 2014. http://tede2.pucrs.br/tede2/handle/tede/1433.

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Made available in DSpace on 2015-04-14T13:33:08Z (GMT). No. of bitstreams: 1 457124.pdf: 593064 bytes, checksum: 3d608aeef8635bc4754492396d116824 (MD5) Previous issue date: 2014-03-31
Objectives : To assess if lung function could be used to predict risk of viral lower respiratory tract infections in prematurely born infants. In addition, we want to assess the impact of number and severity of LRTI episodes on lung growth. Methods : Longitudinal measurements of lung function by raised volume rapid thoracic compression technique were obtained in the first 6 months of life and after one year of follow-up in preterm infants. Number and severity of LRTI were recorded prospectively. The main outcome is an association between lung function measurements and number and severity of LRTI episodes. Results : Lung function tests were obtained in 71 preterm infants. There was a negative association between lung function and LRTI. Compared with infants with one or no LRTI episode (n=41), those with two or more episodes of LRTI (n=30) had significantly lower expiratory flows at first test (p<0.05 for zVEF0.5 zFEF50, zFEF75, zFEF25-75 and zFEFV0.5/FVC). No significant differences in gender distribution, gestational age, birth weight, school age siblings and smoke exposure were detected in relation to number or severity of LRTI. In the multivariate analysis, lung function and respiratory support in the neonatal intensive care unit was associated with higher number of LRTI. Severe LRTI was predicted by passive smoking and reduced zFEV0.5. In the longitudinal analysis, the change in lung function, adjusted for length, sex and smoke exposure during pregnancy was not affected by the number and severity of LRTI. Lung growth in this preterm birth cohort was not significantly different from a reference control group composed of full term babies. Conclusion : Our data suggest that lung function is a direct factor that mediates respiratory morbidity in premature infants. Lung function was a better predictor of number of LRTI than gestational age, sex and social demographics factors. The findings suggest that prenatal factors, particularly those that promote premature birth, determine lung development early in life. Postnatal events, like viral LRTI, do not have a detectable effect on lung growth.
Objetivos : Avaliar se a fun??o pulmonar (FP) pode ser usada para predizer o risco de infec??o viral da via a?rea inferior (IVAI) em lactentes prematuros. Avaliar o impacto do n?mero e da gravidade das IVAI no crescimento pulmonar. M?todos : Medidas longitudinais da FP pela t?cnica de compress?o tor?cica r?pida a partir de volumes pulmonares elevados foram obtidas nos primeiros seis meses de vida e ap?s um ano de seguimento. N?mero e gravidade das infec??es das IVAI foram registrados prospectivamente. O desfecho principal foi a associa??o entre as medidas de FP e o n?mero e a gravidade das IVAI. Resultados : Testes de FP foram obtidos em 71 lactentes. Houve uma associa??o negativa entre FP e IVAI. Comparados com lactentes que tiveram um ou nenhum epis?dio de infec??o (n=41), aqueles com dois ou mais epis?dios (n=30) tiveram fluxos expirat?rios mais baixos (p < 0.05 para zVEF0.5, zFEF50, zFEF75, zFEF25-75 and zFEFV0.5/FVC) no primeiro teste (n=71). N?o houve diferen?as significativas quanto a sexo, idade gestacional, peso ao nascimento, irm?os na idade escolar e exposi??o ao tabaco em rela??o ao n?mero e gravidade da IVAI. Na an?lise multivariada, recebimento de suporte respirat?rio na unidade neonatal e FP estiveram associadas a maior frequ?ncia de infec??es. Hospitaliza??o por IVAI pode ser predita por tabagismo passivo e zFEV0.5 reduzido. Na an?lise longitudinal, a mudan?a na FP ajustada para comprimento, sexo e tabagismo gestacional n?o foi afetada pelo n?mero e pela gravidade de IVAI. O crescimento pulmonar dessa coorte de prematuros n?o foi significativamente diferente do crescimento do grupo controle de refer?ncia composto de beb?s a termo. Conclus?o : Nossos resultados sugerem que a fun??o pulmonar ? um fator que medeia diretamente a morbidade respirat?ria em lactentes. A FP foi um melhor preditor do n?mero de IVAI do que fatores perinatais e s?cio-demogr?ficos. Esses achados sugerem que fatores pr?-natais, principalmente aqueles que promovem o parto prematuro, determinam o desenvolvimento pulmonar no in?cio da vida. Eventos p?s-natais, como IVAI virais, n?o apresentam um efeito detect?vel no crescimento pulmonar.

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Jorild, Elina, and Kristin Staf. "Perinatala utfall hos kvinnor som genomgått könsstympning." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-411118.

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SAMMANFATTNING Bakgrund Kvinnlig könsstympning (Female Genital Mutilation, FGM) är en uråldrig tradition med starka band till kulturell och etnisk identitet. Mer än 200 miljoner kvinnor och flickor beräknas vara könsstympade och årligen riskerar cirka 3,9 miljoner ytterligare flickor att utsättas. Andelen kvinnor från länder där FGM är vanligt förekommande och som föder barn i Sverige har ökat i och med ökad invandring från dessa länder. FGM är internationellt betraktat som en kränkning av de mänskliga rättigheterna samt ett brott mot kvinnor och barns rättigheter. Syfte Att jämföra förekomsten och risken för perinatala komplikationer hos kvinnor med en diagnos av FGM med kvinnor utan denna diagnos som fött barn i Sverige mellan åren 2007 - 2017. Metod En populationsbaserad kohortstudie. Resultat Det huvudsakliga resultatet i denna studie är att barn födda av kvinnor med en FGM diagnos har en signifikant ökad risk för låg Apgar, födas lätta för tiden (SGA), drabbas av kramper, perinatal död inklusive intrauterin fosterdöd samt att födas överburna. Slutsats FGM är förknippat med ett flertal allvarliga perinatala komplikationer. Störst risk kunde ses mellan FGM och att födas lätt för tiden, födas överburen och intrauterin fosterdöd. Dessa samband var robusta oavsett vilket land kvinnan är född. Det går att dra slutsatsen att kvinnor med en FGM-diagnos och deras nyfödda barn tillhör en riskgrupp. Det är av stor vikt att arbeta preventivt för att skydda dessa kvinnor och barns hälsa.
ABSTRACT Background Female Genital Mutilation (FGM) is an ancient tradition with strong ties to cultural and ethnic identity. More than 200 million women and girls are estimated to be exposed, and about 3.9 million more girls are at risk each year. The proportion of women from countries where female genital mutilation is common, and which gives birth to children in Sweden has increased with an increased immigration. Female genital mutilation is internationally considered as a violation of human rights and a violation of women's and children's rights. Aim To compare the incidence and risk of perinatal complications among women with a diagnosis of FGM with women without this diagnosis who has given birth to a child in Sweden during the years 2007 - 2017. Method A population-based cohort study. Results The main result of this study is that children born of women with an FGM-diagnosis have a significantly increased risk of low apgar scores, being born Small for Gestational Age, convulsions, perinatal death and prolonged pregnancy could be observed. Conclusion FGM is associated with a number of serious perinatal complications. The greatest risk was seen between female genital mutilation and being born Small for Gestational Age, prolonged pregnancy and intrauterine fetal death. These relationships were robust regardless of which country the woman was born. It can be concluded that women with an FGM diagnosis and their newborn children belong to a risk group. It is very important to work preventively to protect these women and children's health.

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Velayutham, Thangaratinam Shakila Selvambigai. "Health technology assessment in maternal and perinatal medicine : delphi survey of practice, systematic reviews of evidence and meta analyses." Thesis, University of Birmingham, 2011. http://etheses.bham.ac.uk//id/eprint/1614/.

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Objective To undertake Health Technology Assessment (HTA) in maternal and perinatal medicine for tests and treatment in the areas of pre eclampsia, preterm labour, epilepsy and congenital heart disease (CHD) in newborn. Methods The work undertaken in the thesis is divided into 4 sections: Delphi survey of practice; Systematic review of reviews; Systematic reviews of therapeutic effectiveness; Systematic reviews of test accuracy Results The Delphi survey identified blood pressure to be the best predictor of complications. A significant benefit of progestational agents was observed in reducing preterm delivery before 37 weeks (OR 0.42, 95% CI 0.31 to 0.57). The combined rate of seizure deterioration was 0.40 (95% CI 0.26 to 0.55) in pregnant women with epilepsy on lamotrigine dosage based on serum levels compared to 0.73 (95% CI 0.56 to 0.86) in those managed by clinical features only. The abstracts of 19,500 citations were reviewed to identify the studies of accuracy of tests in pre eclampsia including proteinuria, uric acid, liver function tests, symptoms and blood pressure. The sensitivity and specificity were 0.63 (95% CI 0.39, 83) and 0.998% (95% CI, 0.99, 100) respectively for detecting CHD in the newborn by pulse oximetry. Conclusion Through the HTA of tests and treatment in priority areas of maternal and perinatal medicine, the thesis has led to the generation of clinical recommendation where there was clear evidence of benefit and for further research where there were gaps in evidence.

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Rocha, Hermano Alexandre Lima. "Desenvolvimento de aplicativo para avaliaÃÃo institucional colaborativa da saÃde neonatal intensiva." Universidade Federal do CearÃ, 2015. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16012.

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nÃo hÃ
A mortalidade infantil apresentou importante reduÃÃo no Brasil e no mundo entre 1990 e 2014, concentrando os Ãbitos na mortalidade neonatal (50% dos Ãbitos infantis, atualmente), que Ã menos sensÃvel Ãs intervenÃÃes mais simples de cuidado infantil direto. O Brasil hoje tem elevada mortalidade neonatal, iniquamente dividida entre as regiÃes do paÃs. As principais causas de mortalidade neonatal sÃo evitÃveis, e dependentes do acesso e da qualidade do serviÃo prestado no atendimento hospitalar ao parto e ao neonato. HÃ evidÃncia que Ã mais custo-efetivo realizar intervenÃÃes em regiÃes com piores indicadores e mais necessitadas. Este trabalho justifica-se pela prioridade da melhoria da qualidade da assistÃncia neonatal para reduÃÃo da mortalidade neonatal. O objetivo deste trabalho Ã contribuir para a reduÃÃo da mortalidade neonatal, atravÃs do desenvolvimento de uma ferramenta avaliativa comparativa dinÃmica das unidades de terapia intensiva neonatal, que identifique os pontos que precisam ser melhorados. Utilizou-se dados oriundos do estudo RENOSPE (Rede Nordeste de SaÃde Perinatal), coorte prospectiva multicÃntrica de base hospitalar nos nove estados da regiÃo Nordeste, no perÃodo de julho a dezembro de 2007, compreendendo 5.148 nascidos vivos. Inicialmente, foram utilizados modelos de riscos proporcionais para avaliar a associaÃÃo entre os fatores determinantes e a sobrevivÃncia dos recÃm-nascidos, com o modelo regressivo de Cox. ApÃs a identificaÃÃo dos determinantes, foram realizados mÃltiplos modelos regressivos simples de Cox com estas variÃveis e a variÃvel instituiÃÃo de origem do caso como fatores do modelo e o tempo de sobrevida como dependente. ApÃs, foi realizada anÃlise de comparaÃÃo das variÃveis representativas do atendimento prestado nas unidades atravÃs de grÃficos de controle do tipo mÃdia menos desvio padrÃo e controles de atributos. Para as representativas, foi criado aplicativo na web para utilizaÃÃo continuada pelas instituiÃÃes. Foram identificados diversos fatores determinantes de reduÃÃo da sobrevida neonatal, e dentre estes vÃrios impactados pela instituiÃÃo. Os grÃficos de controle mostraram-se relevantes para a sinalizaÃÃo grÃfica de variÃveis importantes. O aplicativo estÃ totalmente funcional, hospedado no site www.renospeweb.org. Conclui-se que este trabalho fornece ferramenta efetiva aos gestores das unidades de terapia intensiva neonatal, com a utilizaÃÃo de variÃveis criteriosamente selecionadas, para melhoria da assistÃncia prestada aos recÃm-nascidos. Palavras Chave: 1. AssistÃncia Perinatal; 2. Qualidade da AssistÃncia Ã SaÃde; 3. Medicina Preventiva; 4. InstituiÃÃes de SaÃde. ABSTRACT Infant mortality showed important reduction in Brazil and in the world between 1990 and 2014, focusing mortality on neonatal deaths (50% of infant deaths, currently), which is less sensitive to the simplest direct interventions of child care. Brazil today has high neonatal mortality, unevenly divided between regions of the country. The main causes of neonatal mortality are preventable, and dependent on the access to and the quality of service provided in the inpatient delivery and to the neonate. There is evidence that it is more cost-effective to carry out interventions in regions with worst indicators and most in need. This work is justified by the priority of improving the quality of neonatal assistance for neonatal mortality reduction. The aim of this study is to reduce neonatal mortality, through the development of an evaluative tool dynamic comparative neonatal intensive care units, which identify the points that need to be improved. We used data from the RENOSPE study (Northeast of Perinatal Health Network), a prospective multicentric cohort of hospital based in the nine States of the Northeast region in the period from July to December 2007, comprising 5,148 live births. Initially, proportional hazards models were used to evaluate the association between the determining factors and survival of newborns, with the regressive model of Cox. After the identification of the determinants, multiple regressive models were made simple to Cox with these variables and the variable home institution of the case as the model factors and survival time as dependent. After analysis, comparison of variables representing the service provided in the units by means of control charts of type less average standard deviation and attributes. To the representative, was created in the web application for continued use by the institutions. Several factors were identified determinants of reducing neonatal survival, and among these various impacted by the institution. The control charts were relevant for signaling graphically important variables. The application is fully functional, hosted on the website www.renospeweb.org. It is concluded that this job provides an effective tool to managers of neonatal intensive care units, with the use of carefully selected variables, to improving the assistance provided to newborns.

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GENOVESE, ELEONORA. "Towards universal health coverage and health system equity. Estimating health outcomes and healthcare access in undocumented migrants. Key issues in maternal & perinatal health and the COVID-19 pandemic." Doctoral thesis, Università degli Studi di Milano-Bicocca, 2022. http://hdl.handle.net/10281/392355.

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Le popolazioni migranti presentano uno stato di salute carente con esiti peggiori rispetto alla popolazione generale. Vulnerabilità e diseguaglianza sono esacerbate nei migranti irregolari, i più invisibili ai sistemi sanitari. Questa sfida di salute pubblica necessita di azione per la copertura sanitaria universale e l'equità del sistema sanitario. Obiettivi: Stimare i bisogni di salute nei migranti irregolari nelle aree di salute materna & perinatale e di COVID-19; Testare metodologie di monitoraggio e valutazione sistematici. Metodi: Questa ricerca si basa su tre studi retrospettivi (coorte e trasversali ) con fonti complementari per cogliere la complessità degli esiti di salute e dell’accesso alle cure nei migranti irregolari: i flussi sanitari amministrativi nazionali/regionali, i sistemi d’informazione delle strutture sanitarie del terzo settore, e le inchieste presso un campione di strutture sanitarie. Coorte: I migranti irregolari che hanno avuto accesso a: (i) percorso nascita tramite Servizio Sanitario Nazionale/Regionale nella Regione Lombardia (Italia) dal 2016 al 2020; (ii) cure sanitarie attraverso una struttura del terzo settore a Milano (Italia) dal 24 febbraio al 24 maggio 2020; (iii) cure sanitarie tramite strutture selezionate in Svizzera (Regione di Ginevra), Stati Uniti (Città di Baltimora), Italia (Regione Lombardia), e Francia (Regione di Paris) da febbraio a maggio 2021. Risultati: (i) Lo studio sulla salute materno-perinatale ha incluso 1595 donne migranti irregolari e i loro neonati. Il 57.37% delle donne ha avuto ≥4 visite ostetriche, 68.21% la prima entro la 12a settimana di gravidanza, 63.45% ≥2 ecografie di cui la prima entro la 12a sett. di gravidanza, e 6.21% esami di laboratorio completi. I parti cesarei totali sono stati il 26.89%, le rianimazioni neonatali in urgenza per asfissia alla nascita il 2.63%, l’allattamento materno entro 2 ore dalla nascita il 49.03%. L’80.56% delle gravidanze ha avuto decorso fisiologico ma 2.26% emorragia grave (>1000ml). Il 4.76% dei feti ha riportato difetto di accrescimento, 9.28% dei neonati è nato pre-termine, 17.24% risultato piccolo per età gestazionale, 7.2% nato sotto-peso (<2.5Kg), 1.44% riportato un punteggio Apgar sfavorevole, e 3.07% malformazioni. (ii) Lo studio sulla malattia da COVID-19 ha incluso 272 migranti irregolari. I fattori di rischio sono risultati frequenti, tra cui ipertensione, immunodepressione, precedente contatto stretto con caso di COVID-19. I sintomi sono risultati peggiori rispetto a pazienti con altre patologie respiratorie. (iii) Lo studio sulla propensione alla vaccinazione contro COVID-19 ha incluso 812 migranti irregolari. Il 14.1% ha dichiarato precedente infezione da SARS-CoV-2, 29.5% fattori di rischio, 26.2% paura di sviluppare malattia grave. L’accessibilità percepita alla vaccinazione anti COVID-19 è risultata elevata (86.4%), ma la propensione a vaccinarsi scarsa (41.1%) in correlazione con età, co-morbidità, e opinioni positive sulla vaccinazione. Queste sono risultate migliori per la vaccinazione in generale (77.3%) rispetto alla vaccinazione anti COVID-19 (56.5%). Le fonti di informazione sono risultate prevalentemente i media tradizionali e sociali. Conclusioni: Gli esiti di salute e l’accesso alle cure nei migranti sono risultati carenti, indicando vulnerabilità e diseguaglianza rispetto alla popolazione generale. I fattori di rischio quali la fragilità socio-economica insieme alle barriere legali e linguistiche alle cure sanitarie necessitano interventi mirati: la promozione della salute a livello comunitario, la formazione del personale sanitario, la mediazione linguistico-culturale, e corsi di lingua funzionale. Inoltre, è necessario un sistema di monitoraggio continuo per raccogliere, integrare, e analizzare dati essenziali tramite i flussi sanitari amministrativi e le strutture del terzo settore, da complementare tramite inchieste per dati specifici.
Migrant populations experience poor health, and their outcomes tend to be poorer in comparison with the general population. Vulnerability and inequality are further exacerbated in undocumented migrants, as the most invisible to healthcare systems. This a public health challenge requiring tailored action towards universal health coverage and health system equity. Objectives: To estimate health needs among undocumented migrants in the areas of maternal & perinatal health and COVID-19; and to test a combination of methodologies for systematic monitoring and evaluation. Methods: This research is based on three retrospective studies (cohort and cross-sectional) using a combination of diverse and complementary data sources to reflect the complex nature of health outcomes and healthcare access in undocumented migrants, including: national/regional health management information systems, third sector healthcare provider health information systems, and surveys at selected healthcare facilities. Cohort: Undocumented migrants having accessed: (i) maternity healthcare through National/Regional Health Services in Lombardy Region (Italy) from 2016 to 2020; (ii) healthcare through a third sector healthcare providers in Milan (Italy) from February 24th to May 24th, 2020; (iii) healthcare through participating healthcare providers in Switzerland (Geneva Canton), USA (Baltimore City), Italy (Lombardy Region), and France (Paris Region) from February to May 2021. Results: (i) The study on maternal and perinatal health included 1595 undocumented migrant women and their neonates. 57.37% women had ≥4 antenatal visits, 68.21% the first one within 12 weeks of gestation, 63.45% at least two ultrasound tests including one within 12 weeks of gestation, and 6.21% complete laboratory tests. Total cesarean sections were 26.89%. Emergency neonatal resuscitation for birth asphyxia was conducted in 2.63% births, and 49.03% neonates initiated breastfeeding within 2 hours from birth. 80.56% pregnancies were physiological though severe hemorrhage (>1000ml) occurred in 2.26% women. Intra-uterine growth retardation affected 4.76% fetuses, 9.28% neonates were pre-term, 17.24% small for gestational age, 7.2% had a low weight at birth (<2.5Kg), 1.44% poor Apgar score, and 3.07% malformations. (ii) The study on COVID-19 illness included 272 undocumented migrants. Risk factors were frequent and included hypertension, immune depression, and prior close contact with COVID-19 cases. Presenting symptoms were worse, compared with patients with other respiratory conditions. (iii) The study on COVID-19 vaccination demand included 812 undocumented migrants. Overall, 14.1% of participants reported prior COVID-19 infection, 29.5% risk factors, and 26.2% fear of developing severe COVID-19 infection. Self-perceived accessibility of COVID-19 vaccination was high (86.4%), yet demand was low (41.1%) correlating with age, co-morbidity, and views on vaccination which were better for vaccination in general (77.3%) than vaccination against COVID-19 (56.5%) Participants mainly searched for information about vaccination in the traditional and social media. Conclusions: Health outcomes and healthcare access were poor in undocumented migrants. Socio-economic and health outcomes showed vulnerability and inequality in comparison to general population. Known risk factors including fragile socio-economic conditions along with legal and linguistic barriers to healthcare need to be addressed through tailored interventions including outreach health promotion focusing, healthcare provider training, cultural mediation, translation, and functional language learning. Furthermore, a systematic monitoring and evaluation system is needed to routinely collect, integrate, and analyze data on key indicators from both National/Regional Health Services in combination with ad hoc surveys for specific data outside routine information systems.

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Ticona, Chacón Henry David. "Prevalencia y factores asociados al síndrome de Burnout en médicos residentes de la especialidad de Ginecología-Obstetricia del Instituto Nacional Materno Perinatal, octubre 2013." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/9753.

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Determina la prevalencia y los factores asociados al síndrome de Burnout en los médicos residentes de la especialidad de Ginecología-Obstetricia del Instituto Nacional Materno Perinatal en Octubre del 2013. Se utilizó el Maslach Burnout Inventory (MBI) que evalúa las tres dimensiones del síndrome de Burnout; agotamiento emocional, despersonalización y realización personal; y una ficha de recolección de datos individuales, laborales y organizacionales; edad, género, estado civil, número de hijos, año de residencia, horas de trabajo por semana, guardias por mes, laborar fuera de la residencia, ingreso económico mensual, años de ejercicio de la profesión médica y presencia de enfermedad crónica. Se investigó la asociación de estos factores con las dimensiones del Maslach Burnout Inventory utilizando la prueba de Chi-cuadrado. Se invitó a participar a 33 médicos residentes, aceptando participar en el estudio 30 médicos residentes (91%); el 26,7% presentó alto agotamiento emocional, el 36,7% alta despersonalización y el 6,7% baja realización personal; el 46,7% de los médicos residentes participantes presentó síndrome de burnout. Se encontró asociaciones estadísticamente significativas (p < 0,05) en la dimensión de agotamiento emocional con las variables año de residencia, horas de trabajo por semana y años de ejercicio de la profesión médica; en la dimensión de realización personal hubo asociación significativa con la variable laborar fuera de la residencia; no se encontró asociación significativa en la dimensión de despersonalización con ninguna de las variables estudiadas. Se concluye que la prevalencia de síndrome de burnout en los médicos residentes de ginecología-obstetricia es alta y se asocia significativamente con el año de residencia, las horas de trabajo por semana, los años de ejercicio de la profesión médica y el laborar fuera de la residencia.
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Elliott, Catherine. "Perinatal outcome in mothers with heart disease attending the combined Obstetric and Cardiology Clinic at Groote Schuur Hospital." Master's thesis, University of Cape Town, 2014. http://hdl.handle.net/11427/13115.

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Includes bibliographical references.
ith the advances made in the management of cardiac conditions, much importance has been placed on the maternal outcome in pregnancies complicated by heart disease. However, to enable attending clinicians to provide suitable counseling and manage the pregnancy appropriately, the potential complications arising in the fetus and neonate also require attention. Adverse neonatal and perinatal outcome is more common in pregnant women with cardiac disease. Analysis of the available data pertaining to the South African population is important, as this population’s profile, like that of Africa, differs from that of industrialized countries. The relevance of maternal heart disease is highlighted by the National Committee for the Confidential Enquiries into Maternal Deaths (NCCEMD) in South Africa ( http://www.doh.gov.za/docs/reports/2012/Report_on_Confidential_Enquiries_into_ Maternal_Deaths_in_South_Africa ). Objectives To describe the perinatal outcome in women with heart disease and to determine whether there is an associated adverse outcome related to babies born to mothers with heart disease. Methods 82 patients were collected serially over 18 months. Neonatal outcome was recorded. Adverse neonatal outcome was defined as perinatal mortality, admission to NICU and the need for delivery room resuscitation. Results Perinatal mortality rate in this cohort was good, and better than the rate in the general population from whence this cohort came, but was linked to a high rate of obstetric intervention. The rate of adverse neonatal outcome is better than the rate in industrialized countries. Conclusion Perinatal outcome is good when mothers with heart disease are managed in a multidisciplinary clinic.

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Budak, Ayse Meltem. "Perinatal trauma and the aftermath : attachment, social support, parental rearing, meaning of loss & mental health." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/4864/.

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This thesis investigates perinatal trauma and perinatal mental health, including obsessive compulsive, post-traumatic stress, panic, social phobia, agoraphobia, general anxiety, major depression and postnatal depression symptoms within attachment theory's perspective. It aims to give insight into both caregiving and caretaking experiences of mothers in the pursuit of understanding the aftermath of perinatal trauma Thus it aims to understand first of all, interrelated factors like attachment styles, social support and parental rearing experience in predicting perinatal mental health including anxiety specific symptoms. Then it examines the mediational relationship between support and attachment styles and draws attention to understanding the importance of this relationship in relation to practical implications. This thesis also aims to understand the differences and similarities in various trauma experiences. The final aim of this thesis focuses on the experience of perinatal trauma and the relationship between mothers who experienced previous perinatal trauma and the subsequent infant. The thesis employs both qualitative and quantitative design and analysis techniques.

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Diderholm, Barbro. "Perinatal Energy Substrate Metabolism : Glucose Production and Lipolysis in Pregnant Women and Newborn Infants with Particular Reference to Intrauterine Growth Restriction (IUGR)." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4842.

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El, Halal Camila dos Santos. "Depress?o materna no per?odo perinatal e macroarquitetura do sono ao final do primeiro ano de vida." Pontif?cia Universidade Cat?lica do Rio Grande do Sul, 2018. http://tede2.pucrs.br/tede2/handle/tede/8369.

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES
The period extending from pregnancy to the months following delivery, although usually associated to positive feelings, represents a moment of great vulnerability to the development of major depressive disorders. Perinatal depression is a frequent pathology, and its consequences extend beyond the mother, potentially affecting the relationship with her partner and family functioning. Early exposure to maternal depression is associated to lower breastfeeding rates, impairment of mother-infant bonding, and consequences over child growth and development. Perinatal depression has been linked to infant sleep disturbances as early as in the neonatal period, with description of more night wakings, shorter sleep duration and more fragmented sleep. Sleep plays a fundamental role in child cognitive, social, and emotional development, and its disturbances, in a crucial moment of brain development, may facilitate significant and persistent dysfunctions. Studies associating maternal depression to child sleep disturbances show important heterogeneity in terms of design as in moment of sleep assessment. Sleep patterns go through important changes throughout the first twelve months of life, rendering impaired the association?s precise evaluation, as well as that of its potential long-term consequences. This study aimed to investigate the association between perinatal depression and altered infant sleep macrostructure at one year of life among participants in a birth cohort. In this population-based study, recruitment was carried out from pregnancy to soon after delivery, aiming to include all livebirths in the municipality of Pelotas throughout the year of 2015. Participants to one or both cohort-nested trials and those lacking information on maternal depression were excluded from these analyses. For the diagnosis of perinatal depression, the Edinburgh Postnatal Depression Scale (EPDS) was completed during pregnancy and 3 months after delivery, having been considered perinatally depressed mothers who scored ?13 points in one or both follow-ups. Infant sleep was assessed at 3 months through the Brief Infant Sleep Questionnaire (BISQ) and, at 12 months, through the same subjective questionnaire added to objective data derived from continuous 24-hour actigraphy. Main sleep outcomes were number of night time wakings, night vigil time and total sleep duration in 24 hours. The sample consisted of 2222 mothers/infants, in which prevalence of perinatal depression was of 22.3% (CI 95% 20.5-24). Adjusted analyses using Poisson?s regression from BISQ-derived data showed greater risk of >3 night time wakings at 12 months among infants of depressed mothers (RR 1.52; CI 95% 1.06-2.18; p=0.02). Actigraphic data did not, however, confirm those findings (adjusted RR=1.24; CI 95% 0.85-1.81; p=0.26). No association was found between perinatal depression and the other investigated sleep variables. This study suggests a potential defining role of dysfunctional cognition among mothers with a history of perinatal depression on infant sleep characteristics at the end of the first year of life.
O per?odo que se estende da gesta??o at? os meses seguintes ao parto, apesar de normalmente associado a sentimentos positivos, representa um momento de grande vulnerabilidade ao desenvolvimento de quadros depressivos maiores. A depress?o perinatal ? um dist?rbio frequente, cujas consequ?ncias se estendem para al?m da mulher acometida, potencialmente exercendo efeito sobre a rela??o com o parceiro e o funcionamento familiar. Exposi??o precoce a depress?o materna associa-se a menores taxas de amamenta??o, preju?zo do v?nculo com o beb?, e consequentes efeitos sobre o crescimento e desenvolvimento infantis. Evid?ncias associam a depress?o perinatal a dist?rbios do sono da crian?a desde o per?odo neonatal, sob a forma de maior n?mero de despertares noturnos, menor dura??o de sono e maior fragmenta??o. O sono, por sua vez, exerce papel primordial no desenvolvimento cognitivo, social e emocional da crian?a, e seus dist?rbios, em um per?odo crucial do desenvolvimento cerebral, podem favorecer disfun??es significativas e permanentes. Existe uma importante heterogeneidade em rela??o tanto ao delineamento dos estudos que associam depress?o materna a dist?rbios do sono na crian?a, quanto ao momento de avalia??o do sono, que sofre mudan?as significativas no decorrer dos primeiros doze meses de vida. Com isso, a avalia??o dessa poss?vel associa??o fica prejudicada, assim como a mensura??o de suas consequ?ncias a longo prazo. Este estudo objetivou investigar a presen?a de associa??o entre depress?o perinatal e altera??es da macroarquitetura do sono de lactentes com um ano de vida, participantes de uma coorte de nascimentos. Neste estudo de base populacional, o recrutamento ocorreu desde a gesta??o at? logo ap?s o parto, visando incluir todos os nascidos vivos na cidade de Pelotas no transcorrer de 2015. Participantes de uma das interven??es aninhadas ? coorte e aqueles sem informa??es referentes ? depress?o materna foram exclu?dos desta an?lise. Para diagn?stico de depress?o perinatal, foi aplicada a Escala de Depress?o P?s-natal de Edimburgo (EPDS) na gesta??o e 3 meses ap?s o parto, tendo sido consideradas deprimidas as m?es com pontua??o ?13 em um ou ambos os acompanhamentos. O sono dos lactentes foi avaliado aos 3 meses atrav?s do Brief Infant Sleep Questionnaire (BISQ) e, aos 12 meses, a partir dos mesmos dados subjetivos somados a informa??es objetivas obtidas a partir de 24 horas cont?nuas de actigrafia. Os principais desfechos de sono analisados foram o n?mero de despertares noturnos, dura??o da vig?lia noturna, e tempo total de sono em 24 horas. A amostra constituiu-se de 2.222 m?es e lactentes, na qual a preval?ncia de depress?o perinatal foi de 22,3% (IC95% 20,5-24). Pelo BISQ, as an?lises ajustadas atrav?s de regress?o de Poisson mostraram maior risco para >3 despertares noturnos aos 12 meses entre filhos de m?es deprimidas (RR 1,52; IC95% 1,06-2,18; p=0,02). No entanto, a avalia??o dos dados actigr?ficos n?o confirmou este achado (RR ajustado=1,24; IC95% 0,85-1,81; p=0,26). N?o houve associa??o entre depress?o perinatal e as demais vari?veis do sono. Este estudo sugere um potencial papel definidor da impress?o disfuncional entre m?es com hist?ria de depress?o perinatal sobre as caracter?sticas do sono dos lactentes ao final do primeiro ano de vida.

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Dextre, Hidalgo Tatiana Lizeth. "Capacidad predictiva del test estresante para el diagnóstico de compresión funicular. Unidad de medicina fetal del Instituto Nacional Materno Perinatal, mayo – julio del 2015." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2016. https://hdl.handle.net/20.500.12672/5186.

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Determina la capacidad predictiva del test estresante para el diagnóstico de compresión funicular en las gestantes atendidas en la Unidad de Medicina Fetal del Instituto Nacional Materno Perinatal de mayo a julio del 2015. Es un estudio tipo observacional con diseño retrospectivo, correlacional. Utiliza una muestra de 254 test estresantes con signos sugestivos de compresión funicular y 145 sin signos sugestivos de compresión funicular durante los meses de mayo, junio y julio del 2015. Utiliza la prueba no paramétrica Chi-cuadrado. Considera significativo cuando existe un valor p <0.05. Estima la capacidad predictiva de la prueba mediante los valores de sensibilidad, especificidad, valor predictivo positivo y valor predictivo negativo. Encuentra que el 50.7% de casos con presencia de signos sugestivos de compresión funicular culmina con ese diagnóstico al final del parto, mientras que el 33% no lo hizo. Por lo que existe una relación significativa entre la presencia de signos sugestivos de compresión funicular evaluados por el test estresante y la compresión funicular (p=0.004). El test estresante muestra una sensibilidad del 51%, una especificidad del 67%, un valor predictivo positivo del 26% y valor predictivo negativo del 85% para diagnosticar compresión funicular. Concluye que el test estresante tuvo la capacidad predictiva para diagnosticar compresión funicular en las gestantes atendidas en la Unidad de Medicina Fetal del Instituto Nacional Materno Perinatal de mayo a julio del 2015.
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Camarena, Estela Hugo Cristian. "Medición de la translucencia nucal fetal como marcador único del síndrome de Down. Instituto Nacional Materno Perinatal – año 2009." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2011. https://hdl.handle.net/20.500.12672/15545.

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Determina la utilidad de la medición de la translucencia nucal fetal por ultrasonografía transvaginal entre las 11 – 13.6 semanas de gestación como marcador único del síndrome de Down en el Instituto Especializado Materno Perinatal de Lima, Perú durante el período comprendido entre el 01 enero y el 31 de diciembre de 2009. Realiza un estudio observacional analítico, retrospectivo, transversal, de tipo validez de prueba diagnóstica. Encuentra que un total de un total de 329 gestantes cumplieron los criterios de inclusión. La incidencia de síndrome de Down fue 0.2% (36/17.182). La media de la edad de la población estudiada fue 29,7 +/- 6,9 años (14 – 43). La longitud corono-nalga varió entre los 35 - 84 milímetros (media 66,1 +/- 12,0 mm). El 0,6% (n = 2) de pacientes no tuvo antecedentes de aneuploidias. La medición de la translucencia nucal varió entre los 0,08 y 10,8 mm (media 1,63 +/- 1,15 mm). El antecedente de aneuploidias aumentó el riesgo de Síndrome de Down (OR 1,87; 95% IC 0,47 – 7,44; p < 0,06). El 8,2% (n = 27) de pacientes tuvo translucencia nucal aumentada (> 2.5mm) y este hallazgo aumentó en 4,46 (IC al 95%: 2,2 – 9,02; p < 0,001) veces el riesgo de Síndrome de Down.Un valor de 2,34mm se consideró como el punto de corte óptimo por encima del cual la translucencia nucal puede predecir síndrome de Down. La translucencia nucal mostró una sensibilidad 87,5%, especificidad de 98,0%, valor predictivo negativo del 99,0%, valor predictivo positivo del 77,8% y razón de verosimilitud positiva del 43,8. Concluye que la medición de la translucencia nucal fetal fue útil como marcador único del síndrome de Down.
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29

Holele, Pearl. "Seeing HIV through the eyes of perinatally infected adolescents living with HIV, on antiretroviral treatment." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/10869.

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Includes bibliographical references.
As perinatally infected adolescents living with HIV (ADLHIV) grow older and gain a greater sense of independence, disclosure issues and adherence to antiretroviral treatment (ART) have become major concerns. However, research on how adolescents view and cope with these challenges remains limited, especially in Sub-Saharan Africa. We explored ADLHIV's understanding of their infection and its perceived effects on their well-being, and ultimately, on their attitude towards life-long adherence to ART.

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Strand, Brodd Katarina. "Delayed Development of Visuomotor Capacity in Very Preterm Infants." Doctoral thesis, Uppsala universitet, Pediatrik, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-156518.

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To coordinate visual perception and motor control in daily life where we are constantly surrounded by motion, we are dependent on normal visuomotor capacity. One essential prerequisite for normal visuomotor capacity is smooth pursuit eye movements (SP). Infants born very preterm (VPT = born <32 gestational weeks) are at high risk of developing disabilities in higher brain functions i.e. perception, cognition, concentration and coordination. In this thesis visuomotor capacity was investigated in a cohort of VPT infants (n = 113) and compared to control groups of full term (FT) infants. Levels of SP were measured at 2 and 4 months’ corrected age (CA). At 8 months’ CA reaching capacity toward a moving object was evaluated as this represents an executive activity guided by vision that develops at an early age. Lower levels of SP were found in the VPT infants compared to FT controls. The VPT boys showed higher levels of SP compared to the VPT girls. In VPT infants without major neonatal morbidities lower levels of SP was found compared to the FT controls. No difference in total capacity of gaze tracking was found, although the VPT infants lagged the object more at 4 months’ CA and used more saccades at 2 months’ CA. With age the VPT infants’ SP levels increased, but with a wider dispersion compared to the FT controls, and the levels of SP at 4 months’ CA corresponded to the levels of the FT infants at 2 months. A number of perinatal risk factors were found to be negatively associated to lower levels of SP, and this effect was more pronounced in VPT infants with multiple risk factors,. When evaluating the capacity to reach a moving object at 8 months’ CA, the VPT infants showed significantly more bimanual reach and more curved reaching paths to catch the object as compared to the FT control group. In conclusion, a delayed visuomotor capacity was found in VPT infants compared to FT control infants at 2, 4 and 8 months’ CA. Some VPT infants with perinatal risk factors did not develop in levels of SP between 2 and 4 months’ CA.

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Hoots, Valerie M., R. A. Stephens, Andrea D. Clements, and Beth A. Bailey. "Perinatal Risk Factors of Postpartum Depression in Adolescent Mothers of South-Central Appalachia." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7224.

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Chakr, Valentina Coutinho Baldoto Gava. "Influência de infecções da via aérea inferior e de fatores perinatais na função e no crescimento pulmonares em lactentes prematuros." Pontifícia Universidade Católica do Rio Grande do Sul, 2014. http://hdl.handle.net/10923/5762.

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Objectives : To assess if lung function could be used to predict risk of viral lower respiratory tract infections in prematurely born infants. In addition, we want to assess the impact of number and severity of LRTI episodes on lung growth. Methods : Longitudinal measurements of lung function by raised volume rapid thoracic compression technique were obtained in the first 6 months of life and after one year of follow-up in preterm infants. Number and severity of LRTI were recorded prospectively. The main outcome is an association between lung function measurements and number and severity of LRTI episodes. Results : Lung function tests were obtained in 71 preterm infants. There was a negative association between lung function and LRTI. Compared with infants with one or no LRTI episode (n=41), those with two or more episodes of LRTI (n=30) had significantly lower expiratory flows at first test (p<0. 05 for zVEF0. 5 zFEF50, zFEF75, zFEF25-75 and zFEFV0. 5/FVC). No significant differences in gender distribution, gestational age, birth weight, school age siblings and smoke exposure were detected in relation to number or severity of LRTI. In the multivariate analysis, lung function and respiratory support in the neonatal intensive care unit was associated with higher number of LRTI. Severe LRTI was predicted by passive smoking and reduced zFEV0. 5. In the longitudinal analysis, the change in lung function, adjusted for length, sex and smoke exposure during pregnancy was not affected by the number and severity of LRTI. Lung growth in this preterm birth cohort was not significantly different from a reference control group composed of full term babies. Conclusion : Our data suggest that lung function is a direct factor that mediates respiratory morbidity in premature infants. Lung function was a better predictor of number of LRTI than gestational age, sex and social demographics factors. The findings suggest that prenatal factors, particularly those that promote premature birth, determine lung development early in life. Postnatal events, like viral LRTI, do not have a detectable effect on lung growth.
Objetivos : Avaliar se a função pulmonar (FP) pode ser usada para predizer o risco de infecção viral da via aérea inferior (IVAI) em lactentes prematuros. Avaliar o impacto do número e da gravidade das IVAI no crescimento pulmonar.Métodos : Medidas longitudinais da FP pela técnica de compressão torácica rápida a partir de volumes pulmonares elevados foram obtidas nos primeiros seis meses de vida e após um ano de seguimento. Número e gravidade das infecções das IVAI foram registrados prospectivamente. O desfecho principal foi a associação entre as medidas de FP e o número e a gravidade das IVAI. Resultados : Testes de FP foram obtidos em 71 lactentes. Houve uma associação negativa entre FP e IVAI. Comparados com lactentes que tiveram um ou nenhum episódio de infecção (n=41), aqueles com dois ou mais episódios (n=30) tiveram fluxos expiratórios mais baixos (p < 0. 05 para zVEF0. 5, zFEF50, zFEF75, zFEF25-75 and zFEFV0. 5/FVC) no primeiro teste (n=71). Não houve diferenças significativas quanto a sexo, idade gestacional, peso ao nascimento, irmãos na idade escolar e exposição ao tabaco em relação ao número e gravidade da IVAI. Na análise multivariada, recebimento de suporte respiratório na unidade neonatal e FP estiveram associadas a maior frequência de infecções. Hospitalização por IVAI pode ser predita por tabagismo passivo e zFEV0. 5 reduzido. Na análise longitudinal, a mudança na FP ajustada para comprimento, sexo e tabagismo gestacional não foi afetada pelo número e pela gravidade de IVAI. O crescimento pulmonar dessa coorte de prematuros não foi significativamente diferente do crescimento do grupo controle de referência composto de bebês a termo. Conclusão : Nossos resultados sugerem que a função pulmonar é um fator que medeia diretamente a morbidade respiratória em lactentes. A FP foi um melhor preditor do número de IVAI do que fatores perinatais e sócio-demográficos. Esses achados sugerem que fatores pré-natais, principalmente aqueles que promovem o parto prematuro, determinam o desenvolvimento pulmonar no início da vida. Eventos pós-natais, como IVAI virais, não apresentam um efeito detectável no crescimento pulmonar.

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Hammar, Maria. "Prehospitalt förlossningsarbete inom ambulansverksamhet : tankar, känslor och erfarenheter bland sjuksköterskor/ambulanssjuksköterskor." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-384230.

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Bakgrund: Oplanerade prehospitala förlossningar kan ske i närvaro av ambulanspersonal, vilka är avsevärt mindre utbildade för förlossningar än barnmorskor men tvingas ändå handha samma situation. Detta kan vara en dramatisk och stressande upplevelse både för födande och ambulanspersonal. Syfte: Beskriva sjuksköterskors/ambulanssjuksköterskors upplevelser, tankar och känslor om prehospitala förlossningssituationer i sitt arbete. Metod: En kvalitativ intervjustudie med deskriptiv design. Elva semistrukturerade intervjuer analyserades med kvalitativ innehållsanalys. Resultat: Förlossningssituationer beskrevs som verkligt fantastiska, häftiga, spännande, som de roligaste körningarna och som en euforisk glädje att få se ett liv ta sin början, jämfört med alla liv som ambulanspersonal ser slockna. Förlossningskörningarna benämndes som skräckblandad förtjusning, nervöst och läskigt. Dels eftersom dessa var så ovanligt förekommande och ambulanspersonalen upplevde sig underutbildade för situationen, vilket gav känslor av obehag, kompetensbrist och skräck att inte kunna hantera en eventuellt kritisk situation. Dels då körningar involverande barn gav extra kraftigt adrenalinpåslag, skärpa, närvaro och fokus. Ytterligare försvårande faktorer upplevdes vara platsbristen i en ambulans, dålig arbetsställning, underbemanning, utrustnings- och resursbrist, språksvårigheter, kulturskillnader eller sjukt/missbildat/dött/oönskat barn. Bristen på erfarenhet och kunskap var dock det primära och mer förlossningshospitering önskades. Slutsats: Förlossningssituationer väcker mycket starka känslor hos sjuksköterskor/ambulanssjuksköterskor både på ett positivt och negativt sätt. Dessa upplevs som de roligaste, mest spännande och mest glädjebringande körningar samtidigt som stressande, pressande, adrenalinframkallande samt som annorlunda alla andra körningar. Förlossningskörningar sker så sällan att det är svårt att upprätthålla en god kunskapsnivå, varför en ökning av utbildning önskas.
Background: Unplanned prehospital births can occur in the presence of ambulance staff, who are considerably less educated for childbirth than midwives but are still forced to handle the same situation, a potentially dramatic and stressful experience for both patient and paramedic. Purpose: Describing paramedics' experiences, thoughts and feelings about prehospital birth situations. Method: A qualitative interview study with descriptive design. Eleven semi-structured interviews analyzed with qualitative content analysis. Results: Childbirth situations were described as amazing, exciting and the euphoric joy seeing a life begin, compared to all lives paramedics see end. Childbirth situations were called a "horrified delight". Partly, because these were so unusual and the paramedics felt under-educated, which gave feelings of discomfort, inadequacy and fear of being unable to handle a potentially critical situation. Partly, because missions involving children gave stronger adrenaline-rushes, sharpness and focus. Further aggravating factors were the compact ambulance, poor working posture, understaffing, equipment- and resource-shortages, language difficulties, cultural differences or sick/malformed/dead/unwanted children. However, the lack of experience and knowledge was the primary one where more practical experiences at the delivery ward was desired. Conclusion: Childbirth situations evoke very strong emotions among nurses/paramedics both in positive and negative ways. These are considered the most enjoyable and exciting missions as well as stressful, pressing, adrenaline-inducing and different from all other missions. Childbirth missions are so unusual that it is difficult to maintain a good level of knowledge, which is why an increase in education is desired.

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Seale, Anna Catherine. "The clinical and molecular epidemiology of Streptococcus agalactiae in Kenya : maternal colonisation and perinatal outcomes." Thesis, University of Oxford, 2015. http://ora.ox.ac.uk/objects/uuid:6e7d952a-dc5b-4af0-b0bb-f2ae2184eed0.

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Garcia, Rodrigo Ferreira. "Satisfação com os cuidados perinatais e tipo de parto de adolescentes da zona urbana da cidade de Pelotas." Universidade Catolica de Pelotas, 2013. http://tede.ucpel.edu.br:8080/jspui/handle/tede/315.

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PURPOSE: This descriptive study to determine factors influencing the perception of adolescents with perinatal care, type of delivery and choice of future procedures. METHODS: Cross-sectional study nested in a cohort study conducted in the city of Pelotas included 481 pregnant teenagers up to 19 years. Frequency analysis of the independent variables (age, skin color, social class, education, living with a partner and perform pre-natal) and perception of perinatal care (satisfaction with the type of delivery) were made eight variables were listed (birth to term, baby with syndrome or problem at birth, type of delivery, pain, satisfaction with health care professionals, control of the situation, or would recommend the procedure and required ICU) which were compared with the type of delivery. RESULTS: It was found that 49,1% (235) of the babies were delivered vaginally and 50,9% (244) by caesarean section. 77,3% (368) of the adolescents showed themselves satisfied with the quality of care provided by health professionals during childbirth, the greatest degree of dissatisfaction was those who underwent cesarean delivery (67,9%). The pain was experienced intensely by 43,7% (209) of adolescents, reported not having felt pain was higher among those who underwent cesarean delivery (71,2%). About how much control of the situation felt 35,3% (159) felt inserted in the process, with no significant difference between the different types of delivery. Recommend or repeat the same procedure experienced 45,9 % (213) of the adolescents, and of these 65,3% (139) underwent vaginal delivery and 34,7% (74) C-section. CONCLUSION: Although the percentage of pain sensation in pregnant adolescents who underwent vaginal delivery was higher than in those who underwent cesarean delivery, most of these proved to be satisfied with the quality of the care and recommend and/or do the same procedure on future
OBJETIVO: Estudo descritivo para determinar fatores capazes de influenciar a percepção de adolescentes com o atendimento perinatal, tipo de parto e a escolha de futuros procedimentos. MÉTODOS: estudo transversal aninhado em um estudo de coorte, realizado na cidade de Pelotas-RS, incluiu 481 gestantes adolescentes com até 19 anos. Foram feitas análises de frequência das variáveis independentes (idade, cor da pele, classe social, escolaridade, morar com companheiro e realizar pré-natal) e para percepção do atendimento perinatal (satisfação com o tipo de parto) foram elencadas oito variáveis (nascimento a termo, bebê com síndrome ou problema ao nascer, tipo de parto, dor, satisfação de cuidados com os profissionais de saúde, controle da situação, recomendaria ou faria o procedimento e precisou de UTI) as quais foram comparadas com o tipo de parto. RESULTADOS: foi constatado que 49,1% (235) dos partos foram realizados por via vaginal e 50,9% (244) por cesariana. 77,3% (368) das adolescentes se mostravam satisfeitas com a qualidade dos cuidados prestados pelos profissionais de saúde durante o parto, o maior grau de insatisfação foi daquelas que realizaram parto cesariano (67,9%). A dor foi vivenciada de forma intensa por 43,7% (209) das adolescentes, o relato de não ter sentido dor foi maior naquelas que realizaram parto cesariano (71,2%).Sobre o quanto sentiu controle da situação 35,3% (159) sentiram-se inseridas no processo, não havendo diferença significativa entre os diferentes tipos de parto.Recomendariam ou repetiriam o mesmo procedimento vivenciado 45,9% (213) das adolescentes, sendo que destas 65,3% (139) realizaram parto por via vaginal e 34,7% (74) cesariana.CONCLUSÃO: Embora o percentual de sensação de dor nas gestantes adolescentes que realizaram parto normal tenha sido maior do que naquelas que realizaram parto cesariano, a maioria destas se mostrou satisfeita com a qualidade dos cuidados dos profissionais e recomendaria e/ou faria o mesmo procedimento no futuro

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Rashid, Cetewayo S. "AN INVESTIGATION OF PERINATAL POLYCHLORINATED BIPHENYL EXPOSURE ON BODY COMPOSITION AND GLUCOSE HOMEOSTASIS." UKnowledge, 2013. http://uknowledge.uky.edu/nutrisci_etds/9.

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Recent advancements have uncovered environmental contributions to obesity and diabetes etiology. In fact, perinatal malnutrition resulting in low birth weight (LBW) has been shown to correlate with later life obesity and impaired glucose tolerance in aged offspring. LBW can result from a myriad of developmental perturbations including macronutrient restriction, hypoxia, maternal stress and toxin exposure. Polychlorinated biphenyls (PCBs) are ubiquitous environmental pollutants that bioaccumulate in the food chain resulting in dietary exposure in humans. Maternal and cord blood PCB levels are inversely associated with birth weight, and recent studies indicate that perinatal exposures to PCBs contribute to gender-specific obesity development in children. PCBs have also been shown to enter breast milk resulting in direct exposure in early postnatal life. Therefore, we hypothesized that perinatal PCB exposure cause developmental blight resulting in decreased birth weight and increased adiposity and glucose intolerance with aging. We found that mice perinatally exposed to PCBs did not differ in birth weight, but exhibited sex-specific effects on adiposity. Females perinatally exposed to PCBs were significantly more obese at 7 weeks of age while male offspring exhibited no difference in fat mass but had decreased lean mass compared to controls. With aging, the differences in females dissipated while the male offspring decreased lean mass persisted. Male offspring perinatally exposed to PCBs displayed impaired glucose tolerance at 7 weeks of age but normalized over time, while the females were glucose intolerant only after 6 months of age. This impairment of glucose tolerance was not attributed to insulin resistance. These data illustrate time-dependent and sex-specific perturbations of maternal PCB exposure on offspring body composition and glucose homeostasis. As the liver is a major facilitator in glucose homeostasis and xenobiotic detoxification, we investigated PCB-induced alterations in hepatic gene expression and found attenuated expression of glycolytic genes and increased expression of detoxifying and antioxidant genes in both PCB-exposed maternal and offspring livers. Taken together, these data demonstrate a role for perinatal pollutant exposure in the etiology of glucose intolerance. Further studies are required to elucidate the mechanisms causing sex-specific modulation of body composition and glucose intolerance.

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Valladares, Gutiérrez Elías Alexis, and Meléndez Cecilia María Gómez. "Medición ecográfica transvaginal del cuello uterino en la predicción del parto pretérmino espontáneo en el Instituto Materno Perinatal durante el año 2002." Universidad Nacional Mayor de San Marcos. Programa Cybertesis PERÚ, 2003. http://www.cybertesis.edu.pe/sisbib/2003/valladares_ge/html/index-frames.html.

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En el Instituto Materno Perinatal durante el año 2002 se realizó un estudio observacional analítico de tipo cohorte con el objetivo de determinar el valor en la predicción del parto pretérmino espontáneo de la longitud cervical medida por ecografía transvaginal entre las 22 – 24 semanas de gestación. Un total de 1218 pacientes cumplieron los criterios de inclusión, de las cuales 18 se perdieron al seguimiento. La incidencia de parto pretérmino fue 11,8%. La longitud cervical estuvo normalmente distribuida. La longitud cervical media fue 35,1 +/-8,5 mm (rango, 11 – 72 mm). La longitud cervical, el antecedente de parto pretérmino, la multiparidad y el riesgo social alto se asociaron significativamente con parto pretérmino. El riesgo relativo de parto pretérmino espontáneo (_ 37 semanas de gestación) para pacientes con longitud cervical _ 15 mm y _ 25 mm fue 10,9 (IC 95% 8,3 – 14,2; P _ 0,0001) y 9,0 (IC 95% 7,7 – 10,6; P _ 0,0001); respectivamente. Para parto pretérmino espontáneo una longitud cervical _ 14,5 mm tuvo un valor predictivo positivo de 100%, un valor predictivo negativo de 100%, una sensibilidad de 6,4% y una especificidad de 97%. Concluimos que un cérvix corto medido por ultrasonografía transvaginal entre las 22- 24 semanas de gestación fue un importante predictor de parto pretérmino espontáneo.

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Gómez, Meléndez Cecilia María, and Gutiérrez Elías Alexis Valladares. "Medición ecográfica transvaginal del cuello uterino en la predicción del parto pretérmino espontáneo en el Instituto Materno Perinatal durante el año 2002." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2003. https://hdl.handle.net/20.500.12672/2056.

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En el Instituto Materno Perinatal durante el año 2002 se realizó un estudio observacional analítico de tipo cohorte con el objetivo de determinar el valor en la predicción del parto pretérmino espontáneo de la longitud cervical medida por ecografía transvaginal entre las 22 – 24 semanas de gestación. Un total de 1218 pacientes cumplieron los criterios de inclusión, de las cuales 18 se perdieron al seguimiento. La incidencia de parto pretérmino fue 11,8%. La longitud cervical estuvo normalmente distribuida. La longitud cervical media fue 35,1 +/-8,5 mm (rango, 11 – 72 mm). La longitud cervical, el antecedente de parto pretérmino, la multiparidad y el riesgo social alto se asociaron significativamente con parto pretérmino. El riesgo relativo de parto pretérmino espontáneo (_ 37 semanas de gestación) para pacientes con longitud cervical _ 15 mm y _ 25 mm fue 10,9 (IC 95% 8,3 – 14,2; P _ 0,0001) y 9,0 (IC 95% 7,7 – 10,6; P _ 0,0001); respectivamente. Para parto pretérmino espontáneo una longitud cervical _ 14,5 mm tuvo un valor predictivo positivo de 100%, un valor predictivo negativo de 100%, una sensibilidad de 6,4% y una especificidad de 97%. Concluimos que un cérvix corto medido por ultrasonografía transvaginal entre las 22- 24 semanas de gestación fue un importante predictor de parto pretérmino espontáneo.
Tesis de segunda especialidad

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Schouten, Esther [Verfasser], and Andreas [Akademischer Betreuer] Schulze. "Viewpoints and motives on religion and spirituality of professionals in perinatal medicine : a survey among midwives, nurses, obstetricians and neonatologists. / Esther Schouten. Betreuer: Andreas Schulze." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2016. http://d-nb.info/1106854535/34.

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Kita, Lauren Elizabeth. "Investigating the relationship between sleep and postpartum depression : a longitudinal study examining the relationships between subjective and objective sleep during the perinatal period and postpartum depression." Thesis, Bournemouth University, 2013. http://eprints.bournemouth.ac.uk/21200/.

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Research has suggested that a bi-directional relationship exists between sleep disruption and depression. Not only is poor sleep a commonly reported symptom in those with depression, some aspects of sleep have also been shown to predict the onset of depression. Despite sleep problems being a commonly reported occurrence throughout the perinatal period, the field of perinatal sleep research remains in its relative infancy. However, recent studies suggest that sleep disturbances during this time may increase the risk of developing postpartum depression. Currently, research in this area is limited by studies that have failed to control for depressive symptoms at baseline, relied upon subjective, often retrospective, measures of sleep, and have only measured symptoms of postpartum depression in the early postpartum period. Few studies have used polysomnography, considered the ‘gold standard’ of sleep, and no studies to date have specifically compared the relationship between subjective and objective sleep. Therefore, the major aim of this thesis was to gain a better understanding of the specific aspects of sleep that were most relevant to postpartum depression. In order to address this aim, studies were carried out to: explore the aspects of sleep most relevant to major depressive disorder; examine differences in sleep between pregnant and non-pregnant women; investigate the relationships between subjective and objective measures of sleep; explore longitudinal changes in sleep, fatigue and depression throughout the perinatal period, and finally; examine which aspects of sleep at which time-point were most relevant to the development of postpartum depression. Overall this thesis found that women experience significant changes to their sleep throughout the perinatal period. While the sleep of third trimester women is considerably poorer than that of non-pregnant women (both objectively and subjectively), the most significant changes occur in the transition between late pregnancy and the early postpartum period. Furthermore, increased amounts of sleep and reports of difficulty falling asleep during late pregnancy predicted the development of postpartum depressive symptoms. This suggests that certain aspects of sleep during late pregnancy may serve as markers for women at risk of developing postpartum depression.

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Aracca, Alcos Francisco. "Valor predictivo del ultrasonido en el diagnóstico de macrosomía en gestantes a término, en la Unidad de Medicina Fetal del Instituto Nacional Materno Perinatal, enero a diciembre 2010." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/13265.

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Objetivo: Evaluar el valor predictivo del ultrasonido en el diagnóstico de macrosomía fetal, en gestantes entre las 37 y 41 semanas, en la Unidad de Medicina Fetal del Instituto Nacional Materno Perinatal, Enero a Diciembre 2010 Métodos: El estudio consistió en contrastar los datos obtenidos de las estimaciones ecográficas de fetos con los pesos de los recién nacidos. De la base de datos de gestantes evaluadas en la "unidad de medicina fetal", seleccionamos las mujeres con embarazos únicos, entre las 37 y 41 semanas, por grupos que tenían macrosomía y las que no tenían macrosomía por ultrasonido. Al final del embarazo por parto vaginal o cesárea, comparamos nuestras estimaciones con el peso del recién nacido (macrosómico o no). Se calcularon el valor predictivo, la sensibilidad y especificidad de la ultrasonografía. Resultados: Un total de 840 pacientes participaron en este estudio. el valor predictivo positivo del ultrasonido para predecir el peso al nacer de 4000g o más fue de 71 %, con una sensibilidad del 77 % y una especificidad del 94%. Conclusión: La estimación del ponderado fetal de macrosomía por ultrasonido en gestantes a término en la Unidad de Medicina Fetal está acorde a los valores referenciales a nivel internacional.
Trabajo académico

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Bezerra, Patr?cia Costa Fonseca Meirelles. "Agrega??o familiar e resultados maternos e perinatais da pr?-ecl?mpsia severa em popula??o do Rio Grande do Norte." Universidade Federal do Rio Grande do Norte, 2007. http://repositorio.ufrn.br:8080/jspui/handle/123456789/13114.

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To determine whether there is familiar aggregation of severe preeclampsia in a Brazilian population from Rio Grande do Norte and to characterize the maternal and perinatal outcomes in the studied population. Methods: A case control study was performed with 412 participants who were admitted at Maternidade Escola Janu?rio Cicco (MEJC) for medical care. Of these, 264 subjects presented normal blood pressure and 148 were cases. Cases were composed of eclampsia (n=47), HELLP Syndrome (n=85) and Eclampsia associated with HELLP syndrome (n=16). The diagnosis of these illness were based on the citeria developed by National High Blood Pressure Education Program Working (2000). An interview was performed with each subject and questions related to personal and familiar history of hypertension, preeclampsia, HELLP syndrome and eclampsia. Statistical analysis was performed and comparison of median and mean between cases and controls were performed, with the level of significance of 5%. The Odds-Ratio was determined to estimate the risk of preeclampsia within the families. Results: There were no difference in the demographic data between cases and controls. Previous history of chronic hypertension and preeclampsia was more frequent in the case group. Headaches were more frequent in eclampsia and epigastric pain in the HELLP syndrome cases. Bleeding and oliguria were more frequently found in the eclampsia associated with HELLP syndrome cases. Acute Renal insufficiency was a common complication in the case group, but these cases did not evolve to chronic renal insufficiency. The maternal mortality was 0.4% and the perinatal mortality was high, 223 per 1,000 live births. The 111 risk of a woman to develop preeclampsia whose mother has hypertension or had preeclampsia was respectively 2.5 and 3.5. This risk was increased 5 times, when a sibling has hypertension and 6 times when both sibling and mother had previous history of preeclampsia. Conclusions: This study confirms that there is familiar aggregation of preeclampsia in this Brazilian population. The potential for cardiovascular complications due to development of chronic hypertension indicates the need of closely follow up of women who develop preeclampsia
Determinar a agrega??o familiar na pr?-ecl?mpsia severa em popula??o brasileira do Rio Grande do Norte e caracterizar os resultados maternos e perinatais desta popula??o. M?todos: Estudo de caso controle, no qual foram arroladas 412 pacientes internadas na Maternidade Escola Janu?rio Cicco (MEJC). Dessas, 264 pacientes normotensas, grupo controle, e 148 com pr?-ecl?mpsia severa, grupo dos casos. Os casos foram compostos por ecl?mpsia (n=47), s?ndrome HELLP (n=85) e por ambas, ecl?mpsia e s?ndrome HELLP (n=16). O diagn?stico, destas doen?as, foram baseados nos crit?rios adotados pelo National High Blood Pressure Education Program Working (2000). Foi realizado inqu?rito familiar quanto ? agrega??o familiar, sendo questionadas informa??es a respeito de antecedentes de hipertens?o cr?nica, pr?-ecl?mpsia, ecl?mpsia e s?ndrome HELLP. An?lise estat?stica foi realizada para avaliar associa??es e correla??es entre vari?veis, bem como compara??o de m?dias ou medianas, adotando-se um n?vel de signific?ncia de 5%. O Odds-Ratio foi calculado para estimar o risco da pr?-ecl?mpsia severa nas fam?lias. Resultados: N?o houve diferen?a nos par?metros demogr?ficos entre casos e controles. A hist?ria pr?via de hipertens?o cr?nica e pr?-ecl?mpsia foram mais frequentes nas pacientes com pr?-ecl?mpsia severa. A cefal?ia foi o sintoma mais freq?ente na ecl?mpsia e a epigastralgia na s?ndrome HELLP. A hemorragia e a olig?ria foram mais presentes quando associado ecl?mpsia e s?ndrome HELLP. A insufici?ncia renal aguda foi uma complica??o freq?ente, sem, no entanto, evoluir para a insufici?ncia renal cr?nica. A mortalidade xii materna foi baixa 0,4% e a mortalidade perinatal alta de 223 por 1000 nascidos vivos. O risco de uma mulher, cuja m?e teve hipertens?o ou pr?-ecl?mpsia, vir a ter pr?-ecl?mpsia ?, respectivamente, 2,5 e 3,5 vezes. Esse risco aumenta para cinco vezes, quando a irm? tem antecedente de hipertens?o e seis vezes quando, tanto a m?e quanto a irm? t?m antecedentes de pr?-ecl?mpsia. Conclus?es: Este estudo confirma a agrega??o familiar da pr?-ecl?mpsia em popula??o brasileira. O risco aumentado para doen?as cardiovasculares e hipertens?o cr?nica nestas mulheres, indica a necessidade de seguimento das pacientes que desenvolvem pr?-ecl?mpsia

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Jordán, García Iolanda. "Óxido nítrico espirado y nitritos y nitratos en sangre en el recién nacido con riesgo de infección perinatal." Doctoral thesis, Universitat de Barcelona, 2004. http://hdl.handle.net/10803/2468.

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El óxido nítrico (ON) es una molécula endógena, de señalización intercelular y que se forma a partir del aminoácido L-arginina, a través de la enzima ON-sintasa (ONS). Está involucrado en un amplio espectro de procesos fisiopatológicos, dentro de los cuales cabe destacar los que afectan la vía respiratoria y los que implican fenómenos infecciosos. Los nitritos y nitratos (ONx) en sangre y orina son sus metabolitos estables y se utilizan como marcadores de la cuantía de su síntesis endógena
El objetivo del estudio fue determinar el óxido nítrico expirado (ON exp) en los tres primeros días de vida del recién nacido en relación a: las horas de vida, edad gestacional, tipo de parto y riesgo de infección perinatal.
Nuestra hipótesis fue que el ON exp aumentaría en recién nacidos con alto riesgo de infección perinatal. El gas expirado fue recogido utilizando una máscara facial y la concentración de ON determinada mediante quimioluminiscencia. Para la validación del sistema de recogida se realizaron diferentes experimentos: Limpieza del aire inspirado por el neonatos para evitar la contaminación con el ON ambiental; confirmación de la estanqueidad del sistema de recogida; descartar la interacción del ON con el material de recogida; limpieza del ON ambiental del sistema de recogida antes de la aplicación al recién nacido; estabilidad de las concentraciones de ON y ON2 con el tiempo; reproducibilidad intrasujeto; influencia del llanto y la sedación;
El ON exp se recogió en 166 recién nacidos: 108 sanos (63 a término y 45 pretérmino). Treinta fueron neonatos con bajo riesgo de infección perinatal, y 28 con alto riesgo de infección perinatal (tratada con antibióticos pero que no tuvieron hemocultivo positivo). El ON exp total no correlacionó con la edad gestacional, el peso de nacimiento el tipo de parto ni los nitratos en sangre, si que existió relación con las horas de vida. El ONexp en el subgrupo de menos de 36 horas de vida (mediana, rango intercuartil) fue mayor en los recién nacidos con alto riesgo de infección perinatal (n= 8; 5.33 (4.5-7.2) nL/min*Kg) que en los recién nacidos sanos (n= 59; 4.13 (3.5-4.7) nL/min*Kg) o los de bajo riesgo de infección perinatal (n= 18; 3.99 (3.4-4.7) nL/min*Kg). En el subgrupo de 37 a 72 horas de vida también existieron diferencias entre los recién nacidos sanos (n= 49; 4.683 (4.1-5.3) nL/min*Kg) y los bajo riesgo de infección perinatal (n= 12; 4.55 (3.9-5.2) nL/min*Kg) por un lado y los de alto riesgo de infección perinatal por otra parte (n= 20; 9.69 (7.6-11.1) nL/min*Kg). Por lo tanto, los recién nacidos sanos, los de bajo riesgo de infección perinatal y los de alto riesgo, tienen diferencias significativas, respecto a las cifras de ONe en ppm (P= 0.026) como respecto a las cifras de ONet (p= 0.037) tanto si se examinan antes de las 36 horas de vida como después. El análisis univariado de la varianza de las cifras de ONet en relación a dos factores (nivel de riesgo de infección y horas de vida) y tres covariables (peso al nacimiento, edad gestacional y ON ambiental) mostraron que el modelo era adecuado (corrección R2= 0.530, p<0.001) y que el único factor con significación fue el nivel de riesgo de infección (sano, bajo riesgo, alto riesgo; p < 0.001).
En relación a los nitritos y nitratos en sangre, no existieron diferencias significativas en relación a la edad gestacional, tipo de parto, horas de vida y riesgo de infección, ni correlación con el ON expirado. Tampoco se encontraron diferencias para dichas variables en los nitritos y nitratos en orina, ni los nitritos y nitratos/creatinina en orina.

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Castañeda, Guillén Celina Julia. "Tasa de cesáreas aplicando el modelo de clasificación de Robson en el Instituto Nacional Materno Perinatal, periodo enero - diciembre 2015." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2017. https://hdl.handle.net/20.500.12672/6134.

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Analiza las tasas de cesáreas en el Instituto Nacional Materno Perinatal (INMP) utilizando el modelo de clasificación de cesáreas de Robson con el objetivo de determinar en qué grupo o categoría se encuentra el mayor porcentaje de tasa de cesáreas. La muestra censal estuvo integrada por 8970 mujeres quienes culminaron la gestación por cesárea en el periodo enero - diciembre 2015 de un total de 20243 partos, representando una tasa de cesárea de 44.3%. La aplicación del modelo de Robson permite identificar que los grupos que más contribuyeron a la tasa de cesáreas fueron el grupo 1 con el 29.2%, el grupo 5 con el 21.3% y el grupo 3 con el 14.6%. El uso de este modelo de clasificación de cesáreas en factible, reproducible y permite implementar estrategias dirigidas a optimizar las tasas de cesáreas.
Tesis

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Karlsson, Sandra. "Riskfaktorer för negativa eller traumatiska förlossningsupplevelser och hur dessa påverkar kvinnor och deras partners framtida psykiska hälsa." Thesis, Högskolan i Skövde, Institutionen för hälsovetenskaper, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:his:diva-19788.

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Inledning: Att föda barn är något som kvinnor har gjort i urminnes tider och är vanligen förknippat med glädje och kärlek. Men ibland inträffar oförutsägbara händelser som lämnar de nyblivna föräldrarna med en känsla av att förlossningen upplevdes som traumatisk. Syfte: Syftet med denna litteraturöversikt var att beskriva kvinnornas psykiska ohälsa efter en förlossning samt hur detta kan påverka kvinnan och hennes partners framtida psykisk hälsa. Metod: Val av metod till denna studie var litteraturöversikt. Tio vetenskapliga artiklar söktes via de vetenskapliga databaserna PubMed och CINAHL för att svara på studiens syfte. Tematisk analys användes för att analysera artiklarna och de teman som skapades var perinatal PTSD, lågt socialt stöd och traumatisk förlossning. Resultat: Resultatet visade att en traumatisk förlossning var en riskfaktor för att drabbas av perinatal depression, ångest samt perinatal PTSD. Vidare var lågt socialt stöd från vårdgivare, historik av traumatiska händelser samt instrumentella förlossningar riskfaktorer för att de nyblivna föräldrarna skulle uppfatta förlossningen som traumatisk. Slutsats: En negativ eller traumatisk förlossningsupplevelse kan leda till att de nyblivna föräldrarna får psykisk ohälsa. Det finns ett behov av ökad förståelse kring traumatiska förlossningsupplevelser för att minska prevalensen av perinatal psykisk ohälsa. Resultaten i denna studie är viktigt då den skapar förståelse för kvinnan och hennes partners utsatthet vid en negativ eller traumatisk förlossning samt vilka skyddsfaktorer som mer fokus borde läggas på av hälso-och sjukvården.
Introduction: Giving birth is something that women have done for many years and is usually associated with joy and love. But sometimes unpredictable events occur that leaves the new parents with a feeling that the birth was experienced as traumatic. Aim: The purpose of this literature review was to describe women's mental illness after childbirth and how this may affect the future mental health of the woman and her partner. Method: Choice of method for this study was literature review. Ten scientific articles were searched via the scientific databases PubMed and CINAHL to answer the purpose of the study. Thematic analysis was used to analyze the articles and the themes that were developed were perinatal PTSD, low social support and traumatic birth.Results: The results showed that a traumatic birth was a risk factor for suffering from perinatal depression, anxiety and perinatal PTSD. Furthermore, low social support from caregivers, history of traumatic events and instrumental births were risk factors for the new parents to perceive the birth as traumatic.Conclusion: A negative or traumatic birth experience can lead to that the new parents get mental illness. There is a need for increased understanding of risk factors correlated to traumatic birth experiences to reduce the prevalence of mental illness. The results of this study are important as it creates an understanding of the woman and her partner's vulnerability in the event of a negative or traumatic birth as well as which protective factors more focus should be placed on by the healthcare.joy and love. But sometimes unpredictable events occur that leaves the new parents with a feeling that the birth was experienced as traumatic.Aim: The purpose of this literature review was to describe women's mental illness after childbirth and how this may affect the future mental health of the woman and her partner.Method: Choice of method for this study was literature review. Ten scientific articles were searched via the scientific databases PubMed and CINAHL to answer the purpose of the study. Thematic analysis was used to analyze the articles and the themes that were developed were perinatal PTSD, low social support and traumatic birth.Results: The results showed that a traumatic birth was a risk factor for suffering from perinatal depression, anxiety and perinatal PTSD. Furthermore, low social support from caregivers, history of traumatic events and instrumental births were risk factors for the new parents to perceive the birth as traumatic.Conclusion: A negative or traumatic birth experience can lead to that the new parents get mental illness. There is a need for increased understanding of risk factors correlated to traumatic birth experiences to reduce the prevalence of mental illness. The results of this study are important as it creates an understanding of the woman and her partner's vulnerability in the event of a negative or traumatic birth as well as which protective factors more focus should be placed on by the healthcare.

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Di, Liberto Moreno Giuliana Paola. "Predición de macrosomia fetal por medición ultrasonografica de la circunferencia abdominal y resultados perinatales según via de parto, Hospital Ramon Rezola-Cañete . Agosto -Diciembre 2010." Bachelor's thesis, Universidad Ricardo Palma, 2011. http://cybertesis.urp.edu.pe/handle/urp/248.

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RESUMEN Objetivos: Demostrar que la medición de la circunferencia abdominal por ultrasonografía transabdominal en fetos únicos a término es eficaz para predecir macrosomía fetal en el Hospital Ramón Rezola de Cañete - Lima durante el período comprendido entre el 01 de agosto y el 31 de diciembre de 2010 y determinar cuál fue la vía de parto y que complicaciones presentaron estos recién nacidos. Métodos: Se realizó un estudio prospectivo, longitudinal y descriptivo con gestaciones a término (37 a 41 semana 6 días) que tuvieron sospecha de macrosomía fetal por ecografía de la institución realizada dentro de los 3 días antes del parto que haya consignado peso ≥ 4000 gramos. Se recolectó los datos por observación documental y entrevista a la paciente. Se trabajo con el total de la población durante el período de estudio. Para el análisis estadístico se utilizó el programa SPSS versión 15.0. Resultados: La incidencia de macrosomia fetal fue de 58.7%.La media de la edad gestacional de las pacientes fue de 39,5 +/- 0,9 semanas. La circunferencia abdominal varió entre 352 – 394 milímetros, siguió una distribución bimodal y su media fue de 365,01 milímetros. Se observó diferencia estadísticamente significativa (p < 0,001) entre la circunferencia abdominal de los bebes macrosómicos y aquellos sin macrosomía (367,6 +/- 7,6 versus 361,2 +/- 5,9 mm). El análisis de curva ROC de la circunferencia abdominal tuvo una capacidad de predicción estadísticamente significativa (área bajo la curva = 0,76; IC 95%: 0,67 - 0,86). Un valor de 359,5mm se consideró como el punto de corte óptimo de la medición de la circunferencia abdominal por encima del cual se puede predecir macrosomía fetal. La macrosomía fetal no incrementó el riesgo de parto por cesárea (OR: 1,30; IC al 95%: 0,95 – 1,78). El parto vaginal tuvo mayor riesgo de hemorragia postparto (OR 1,71; IC al 95%: 1,46 – 2,01) y de lesión del canal de parto (OR 1,60; IC al 95%: 1,21 – 2,10) que la cesárea. Conclusiones: Se concluyó que la medición ultrasonográfica de la circunferencia abdominal es un predictor independiente de macrosomía fetal y que el parto vaginal se asoció con mayor riesgo de complicaciones perinatales.

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Oberholzer, Leana. "Elective delivery of women with a previous unexplained intra-uterine fetal death at term (≥ 39 weeks) : a prospective cohort study at Tygerberg Hospital, South Africa." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/96107.

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Thesis (MMed)--Stellenbosch University, 2014.
ENGLISH ABSTRACT: Introduction Pregnancies in women with a previous unexplained stillbirth may be jeopardized by increased antenatal surveillance and higher rates of induction of labour and caesarean delivery without clear evidence of benefit. Despite the fact that there have been no studies that adequately tested fetal benefit in routine induction of labour for a previous stillbirth, a policy of routine induction of labour at 38 weeks, with all the associated maternal, fetal and health-care associated costs, was in practice at Tygerberg Hospital for the past 30 years. This study aimed to investigate the safety of continuation of these pregnancies until term (≥39 weeks). Aims and Objectives To assess the clinical outcome and impact on the health service in a pregnancy with a previous unexplained intra-uterine demise (IUD) by routine induction of labour at term instead of at 38 weeks. Methodology This was a prospective observational study on the safety of a new hospital protocol which was introduced in 2012. The protocol extended the gestation for induction after a previous IUD from 38 weeks to term. The study population included all pregnant patients with a current singleton pregnancy, and a previous unexplained or unexplored (no data available) singleton fetal demise ≥24 weeks/500grams. All patients with a previous stillbirth in the metropolitan drainage area of Tygerberg Hospital are referred to Tygerberg for further care; and all referrals during 2012 were recruited for the study. Patients with known or recurrent risks for intra-uterine death were managed according to the relevant clinical condition and were excluded from the study. Results During the audit period, 306 patients with a previous intra-uterine fetal death were referred for further management. Of these, 161 had a clear indication for either earlier intervention or no intervention and were excluded from the protocol. Of the remaining 145 patients, 9 met exclusion criteria and there were 2 patients who defaulted. Forty-two of the study patients (with no known previous medical problems) developed complications during their antenatal course that necessitated a change in clinical management and earlier (<39 weeks) delivery. Of the remaining 92 patients in the audit, 47 (51%) went into spontaneous labour before their induction date. There were no intra-uterine deaths prior to delivery. Conclusions Careful follow up at a high risk clinic identifies new or concealed maternal or fetal complications in 29% of patients with a previous IUD and no obvious maternal or fetal disease in the index pregnancy. When all risks are excluded and the pregnancy allowed to progress to 39 weeks before an induction is offered, 51% will go into spontaneous labour.
AFRIKAANSE OPSOMMING: Inleiding Swangerskappe in vroue met vorige onverklaarbare stilgeboorte mag in gevaar gestel word deur meer intense voorgeboorte sorg en ‘n groter hoeveelheid induksies van kraam en keisersnitte sonder duidelike bewyse dat dit tot voordeel strek. Ten spyte van die feit dat daar geen studies is wat bewys het dat roetine induksie van kraam vir ‘n vorige stilgeboorte op 38 weke tot voordeel van die baba was nie, was ‘n beleid van roetine induksie van kraam op 38 weke, met al die geassosieërde moederlike en fetale risikos daaraan verbonde; asook die hoë gesondheidskostes, roetine praktyk in Tygerberg Hospitaal vir die afgelope 30 jaar. Hierdie studie het ten doel gehad om die veiligheid van voortsetting van hierdie swangerskappe tot voltyd (≥39 weke) te ondersoek. Doelwitte Om die kliniese uitkoms; asook die impak op gesondheidsdienste te evalueer in ‘n swanger vrou met n vorige onverklaarbare intra-uteriene sterfte; deur roetine induksie van kraam aan te bied op voltyd in plaas van 38 weke. Metodologie Hierdie was n prospektiewe kohort studie om die veiligheid van ‘n nuwe hospitaal protokol wat in 2012 geïmplimenteer is, te bepaal. Hierdie protokol het die gestasie tydperk van induksie van kraam van alle swanger pasiënte na ‘n vorige onverklaarbare stilgeboorte van 38 weke na voltyd verleng. Die studiepopulasie het alle swanger pasiënte met ‘n huidige enkelswangerskap en ‘n vorige onverklaarbare of onbekende (geen data beskikbaar) enkelvoudige fetale sterfte ≥24 weke/500gram, ingesluit. Alle pasiënte in die metropolitaanse dreineringsarea van Tygerberg Hospitaal met ‘n vorige stilgeboorte word na Tygerberg verwys vir verdere hantering, en alle verwysings gedurende 2012 was gewerf vir die studie. Pasiënte met bekende of herhalende risikofaktore vir ‘n intra-uteriene sterfte was hanteer volgens die relevante kliniese inligting en was uitgesluit by die studie. Resultate Drie-honderd-en-ses pasiënte met ‘n vorige intra-uteriene fetale sterfte was gedurende die oudit periode verwys vir verdere hantering. In 161 pasiënte was daar ‘n duidelike indikasie vir of vroeër intervensie of geen intervensie nie; en hulle was uitgesluit van die protokol. Van die oorblywende 145 pasiënte is 9 pasiënte uitgesluit as gevolg van die uitsluitingskriteria en daar was 2 pasiënte wat versuim het om op te volg. Twee-en-veertig pasiënte (met geen bekende vorige mediese probleme nie) het komplikasies gedurende hulle voorgeboorte verloop ontwikkel wat gelei het tot verandering in kliniese hantering en vroeëre verlossing (≤39 weke) genoodsaak het. Van die oorblywende 92 pasiënte in die oudit, het 47 (51%) in spontane kraam gegaan voor hulle induksiedatum. Daar was geen intra-uteriene sterftes voor verlossing nie. Gevolgtrekkings Noukeurige opvolg by ‘n hoërisiko kliniek identifiseer nuwe of versteekte moederlike en fetale komplikasies in 29% van pasiënte met ‘n vorige intra-uteriene sterfte sonder enige duidelike moederlike of fetale siekte in die indeks swangerskap. Wanneer alle risikos uitgesluit word en die swangerskap toegelaat word om voort te gaan tot 39 weke voor ‘n induksie aangebied word, sal 51% van pasiënte spontaan in kraam gaan.

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Cáceres, Cari Karina Adi. "Satisfacción de la usuaria externa atendida en el Servicio de Emergencia del Instituto Nacional Materno Perinatal, 2017." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2018. https://hdl.handle.net/20.500.12672/7752.

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Publicación a texto completo no autorizada por el autor
Establece el nivel de satisfacción de la usuaria externa respecto a la atención recibida en el servicio de emergencia del Instituto Nacional Materno Perinatal (INMP) durante el mes de diciembre del 2017. Estudio de tipo observacional, descriptivo y de corte transversal. La muestra estuvo conformada por 378 usuarias externas. Los datos recolectados fueron ingresados al programa estadístico SPSS v.23.0 para Windows y Ms. Excel 2013. Se aplicaron estadísticas descriptivas como frecuencias y porcentajes, las cuales son presentadas en tablas univariadas. Se obtuvo que con respecto al nivel de satisfacción global, las usuarias externas atendidas en el Servicio de Emergencia se encuentran "satisfechas" (45.8%), "medianamente satisfechas" (38.4%) e "insatisfechas" (15.9%). Para el nivel de satisfacción en la dimensión de fiabilidad se encuentran "satisfechas" (63%), "medianamente satisfechas" (26.7%) e "insatisfechas" (10.3%). En la dimensión de capacidad de respuesta indican estar "satisfechas" (25.1%), "medianamente satisfechas" (58.2%) e "insatisfechas" (16.7%). Para la dimensión de seguridad manifiestan sentirse "satisfechas" (26.2%), "medianamente satisfechas" (51.6%) e "insatisfechas" (22.2%). En la dimensión de empatía se encuentran "satisfechas" (27.5%), "medianamente satisfechas" (42.1%) e "insatisfechas" (30.4%). Y por último, en la dimensión de aspectos tangibles indican estar "satisfechas" (90.2%), "medianamente satisfechas" (8.7%) e "insatisfechas" (1.1%). Las usuarias externas se encuentran "satisfechas" (45.8%) respecto a la atención recibida en el Servicio de Emergencia del Instituto Nacional Materno Perinatal durante el mes de diciembre del 2017. La dimensión con la cual manifestaron "más satisfacción" fue la de aspectos tangibles (90.2%). Por otra parte, la dimensión con la cual mostraron "más insatisfacción" fue la de empatía (30.4%).
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Ramos, Diaz Crysthian Willian. "Complicaciones obstétricas en gestantes con sobrepeso y obesidad en el Instituto Nacional Materno Perinatal, Lima 2013." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/9712.

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Publicación a texto completo no autorizada por el autor
Determina las complicaciones obstétricas más frecuentes en gestantes con sobrepeso y obesidad en el Instituto Nacional Materno Perinatal (INMP) Lima, Perú. DISEÑO: Estudio cuantitativo, descriptivo, transversal, retrospectivo realizado en el INMP. El estudio es transversal, retrospectivo de una muestra de 300 gestantes con sobrepeso y obesidad. Se correlacionó el IMC con la presencia de complicaciones obstétricas usando chi-cuadrado. El peso promedio de las gestantes al inicio del embarazo fue 73,9 ± 11,65 kilogramos, la media del IMC fue 31,22 ± 4,35 Kg/m2. Se encontró 134 (44,7%) gestantes que presentaron sobrepeso, 115 (38,3%) obesidad tipo I, 42 (14%) obesidad tipo II y 9 (3%) presentaron obesidad mórbida. Las complicaciones obstétricas más frecuentes fueron la preeclampsia (25,6%), inducción del parto (23%), la hipertensión gestacional (16,3%). El tipo de parto predominante fue parto vaginal, encontrándose en un 89.3% de gestantes con sobrepeso y obesidad al inicio del embarazo en el INMP. Se concluye que la complicación obstétrica en gestantes obesas en el INMP más frecuente es la preeclampsia. El tipo de parto predominante en las gestantes con sobrepeso y obesidad al inicio del embarazo fue parto vaginal.
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Johnsson, Kajsa. "Icke farmakologiska behandlingsmetoder vid depression under graviditet : En systematisk litteraturöversikt." Thesis, Uppsala universitet, Institutionen för kvinnors och barns hälsa, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-368309.

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SAMMANFATTNING Bakgrund Depression är vanligt bland unga kvinnor i fertil ålder vilket innebär att barnafödande infaller under en del av livet då många kvinnor är psykisk sårbara. Cirka 10 till 20 procent av alla gravida kvinnor drabbas av depression av varierande grad under den antenatala perioden. Depression ökar risken för tillväxthämning hos fostret, prematur förlossning och postpartum-depression samt försvårar anknytningen mellan mor och barn. Den rådande uppfattningen är att kvinnor som medicinerat med antidepressiva läkemedel innan graviditet bör fortsätta medicinera samt att insättning bör göras när behov finns. Många kvinnor vill dock inte använda antidepressiva läkemedel under graviditet av rädsla för negativ påverkan på fostret och för dessa kvinnor behövs alternativ. I barnmorskans arbete ingår att stödja och vårda kvinnor under graviditet varför kunskap om behandlingsalternativ är vikt för yrkesgruppen. Syfte Syftet med detta examensarbete var att undersöka vilka icke-farmakologiska behandlingar som finns för depression under graviditet samt dess för- och nackdelar. Metod En systematisk litteraturstudie har gjorts där 28 artiklar inkluderades av totalt 659 granskade titlar, 110 granskade abstracts och 44 artiklar granskade i sin helhet. De inkluderade artiklarna analyserades med kvalitativ innehållsanalys och kvalitetsgranskades i enlighet med Willman, Stoltz och Bahtsevani, (2016). Resultat Analysen av studiernas resultat visade attmånga former av ickefarmakologisk behandling kan ha mildrande eller botande effekt vid depression under graviditet. Det framkommer att behandling med yoga, behandling med mind-body terapi, behandling given till par, behandling given digitalt, behandling given i grupp samt behandling med psykoterapi eller samtalsstöd har positiv effekt om än i olika grad.Resultatet ger stöd för att komplement till basprogrammet vid sedvanlig mödrahälsovård är eftersträvansvärt och hjälper kvinnor med antenatal depression och att den positiva effekten ofta kvarstår efter förlossningen. Slutsats Detta examensarbete visade att många icke-farmakologiska behandlingsmetoder kan hjälpa kvinnor med antenatal depression. Tilltron till behandlingsmetoderna var oftast hög och få negativa effekter framkom. Kvinnor kan utifrån detta informeras om att forskning visat att utöver antidepressiv medicinering finns icke-farmakologiska behandlingsmetoder med god effekt på depression under graviditet. Vidare forskning får visa om behandlingsformerna skulle kunna erbjudas inom ramen för mödrahälsovårdens basprogram, samt om det är möjligt att genom dessa alternativa terapier minska graviditetskomplikationer orsakade av depression. NYCKELORD Antenatal depression, behandling, depression, graviditet, moderskap, perinatal terapi
ABSTRACT Background Depression is common among young women of childbearing age, which means that childbirth occurs during a part of life when many women are mentally vulnerable. About 10 to 20 percent of all pregnant women suffer from depression of varying degree during the antenatal period. Depression increases the risk of growth retardation in the fetus, premature birth and postpartum depression and complicates the bonding between mother and child. The current perception is that women who are taking antidepressants before pregnancy should continue to medicate and that insertation should be made when needed. However, many women do not want to use antidepressant drugs during pregnancy out of fear of adverse affects on the fetus, and for these women more options are needed. Midwifery includes supporting and nursing women during pregnancy, why knowledge about treatment options is important to the occupational group. Purpose The purpose of this thesis was to investigate the non-pharmacological treatments available in pregnancy depression and their advantages and disadvantages. Method A systematic review has been made where 28 articles were included in a total of 659 reviewed titles, 110 reviewed abstracts and 44 articles reviewed in full text. The included articles were analyzed with qualitative content analysis and quality assayed according to Willman, Stoltz and Bahtsevani, (2016). Results The analysis of the results showed that many forms of non-pharmacological treatments may have mitigating or curing effects in the event of depression during pregnancy. It appears that treatment with yoga, treatment with mind-body therapy, treatment given to couples, treatment given digitally, treatment given in a group and treatment with psychotherapy or counseling has a positive effect, albeit to a different extent. The result provides support for complementing the basic program of customized maternity care, which is desirable and helps women with antenatal depression and that the positive effect often persists after childbirth. Conclusion This degree project showed that many non-pharmacological treatment methods can help women with antenatal depression. Access to treatment methods was usually high and few negative effects were observed. Women can from this be informed that research has shown that in addition to antidepressant medication there are non-pharmacological treatment methods that have a good effect on depression during pregnancy. Further research can show whether treatment options could be offered within the framework of maternal health care programs, and whether it is possible to reduce pregnancy complications caused by depression through these alternative therapies. KEYWORDS Antenatal depression, depression, maternity, perinatal depression, pregnancy, therapy, treatment

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Dissertations / Theses on the topic 'Medicina perinatale'

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