Search

To identify the obstetric practices used in childbirth care and the association between obstetric and sociodemographic conditions of women and the route of delivery. This was a concurrent mixed-method study with 399 postpartum women, which used structured and semi-structured interviews, data from medical records, and the pregnant woman’s health record between August 2017 and March 2018 in a public maternity hospital in the state of Paraná. Content analysis and a chi-square test were used to analyze the data. Frequent obstetric interventions in childbirth care were identified, mainly the use of oxytocin, amniotomy, repeated vaginal exams, and episiotomy. Vaginal birth was associated with maternal age, usual risk, ruptured membranes, absent uterine dynamics, and uterine dilation greater than five on admission. In conclusion, there is frequent use of harmful, ineffective, or inappropriately used practices and incipient use of practices that should be encouraged. [ABSTRACT FROM AUTHOR]

Few studies in the literature have related organisational well-being and temperament according to Cloninger's bio-psycho-social model. This paper investigates the relationship between dimensions of temperament (NS; HA; RD) and character (CO; SD; ST; P) and dimensions of organisational well-being in Obstetrics and Gynaecology personnel. Thirty-eight subjects, predominantly women (89.5%) aged between 18 and 63 years, participated in the study (M=50.20 SD=9.81). The Temperament and Character Inventory of R. Cloninger et al. (1994) extended version and the C.I.V.I.T. questionnaire. Positive correlations emerged between Self- Directedness and positive perceptions of the context and work and negative correlations between Self-Directedness and negative perceptions of job security and discrimination. Work well-being may be related to certain character traits rather than temperament and this correlation suggests a connection between personality and work adaptation. [ABSTRACT FROM AUTHOR]

The pelvis, formed by the ilium, ischium and pubis, forms the coxal, which is the largest of the flat bones of the skeleton, with an important role in the physiology of birth. Vastly studied in domestic animals, there is still much to be investigated regarding the anatomical classification in wild animals, mainly aiming to improve the understanding of the reproductive management of the species. Tamandua tetradactyla is one of these species in which morphological studies are still scarce, especially when it comes to reproductive aspects. In this context, we carried out the pelvimetry of T. tetradactyla using radiographic images to anatomically and obstetrically classify the pelvis of this species, classifying it as dolicopelvic, with evidence of homoscedasticity of the samples. Verification of the existence of a relationship between the variables studied by the statistical method of Pearson coefficients showed positive correlations of high intensity for the diameters studied (P < 0.01). Thus, we believed that our findings may support future reproductive studies in this species. [ABSTRACT FROM AUTHOR]

Ultrasonography is one of the main methods of gestational diagnosis, in which it performs: biometry, monitoring of beats and organogenesis, detection of abnormalities and evaluation of maternal-fetal blood circulation. In this regard, intrauterine sonographic diagnosis of fetal abnormalities has been gaining space with the development of more advanced equipment, and has the potential to become a screening tool for this purpose. Based on the scarcity observed in this aspect, this study aims to report the intrauterine ultrasound diagnosis of a fetal abnormality in a pregnant feline. The patient was a 3-year-old Persian female with a history of natural mounting for 40 days. At ultrasonography, four live fetuses were visualized at approximately 38 days of age. A second ultrasonographic evaluation was performed after 12 days, and one fetus with cardiomegaly, heart rate oscillation and fetal distress was observed, while the other fetuses were within normal limits. The third scan was performed after four days, showing absence of heartbeat and presence of fluid in the pleural space in the fetus in question, confirming the death. Natural delivery occurred after one week, with the birth of three live pups and one stillborn. At necroscopic examination of the stillborn, generalized cardiomegaly was confirmed. We conclude that ultrasonography is a gold standard method for diagnosing fetal abnormalities, allowing birth planning and early intervention according to the situation. Thus, this study enriches the literature with more information related to fetal malformations observed before delivery, thus contributing to obstetric management in small animals. [ABSTRACT FROM AUTHOR]

Objective: Delimit parturient service profile and the OBGYN practices developed in the West Region Hospital between January and December of 2019. Methods: Consists of a quantitative transversal, retrospective, observational and descriptive research. Results: High rates of cesarean sections in the service (40%). Low rate of use of the partograph in care. According to the Robson Classification, most parturients (88%) fit between groups one to five, and 12% between groups six to ten. Conclusion: Cesarean rates higher than recommended by the World Health Organization due to a number of factors. The low rate of use of the partograph may indicate insecurity or lack of knowledge by professionals, lack of protocols, objections to its use, or outdated and lack of credibility of the instrument. National and international studies have shown a high rate of women between groups one to five being referred for cesarean section due to the lack of encouragement to good practices and the use of non-pharmacological methods and the failure to use the recommended instruments (partograph). [ABSTRACT FROM AUTHOR]

Background: Sirenomelia is a condition characterized by the abnormal development of the caudal body of a fetus, with partial or complete lower extremity fusion, also known as Mermaid Syndrome. The anomaly is a serious multisystemic malformation, generally involving the gastrointestinal, genitourinary, cardiovascular and musculoskeletal systems. The exact cause of sirenomelia is unknown, and it is believed that environmental and genetic factors may play a role in the development of this anomaly. The prognosis for sirenomelia is poor, with a median survival of less than a week, and more than half of cases end in stillbirth. Aim: To report a case of sirenomelia treated in our Hospital. Method: This is a case report of a pregnant woman treated at the Gynecology and Obstetrics Service of the Hospital Universitário São Francisco na Providência de Deus - HUSF, located in the city of Bragança Paulista - SP, Brazil. Case Report: 17-year-old patient referred to the Fetal Medicine Service after a morphological ultrasound during pregnancy which demonstrated multiple malformations, including renal agenesis and severe oligohydramnios. The child was born prematurely and with sirenomelia, dying four hours after birth. Analysis of the placenta and umbilical cord revealed abnormalities in the fetus implantation, in addition to a single umbilical artery. Conclusion: Sirenomelia is a rare and fatal congenital anomaly, characterized by fusion of the lower extremities, often associated with additional malformations. Its etiology is poorly understood and possible risk factors include maternal diabetes, exposure to teratogenic drugs, genetic susceptibility, infections and maternal age. Based on the case described, it is suggested that ultrasound is crucial for early diagnosis and decision-making in cases of sirenomelia. Furthermore, raising awareness about preventing teenage pregnancy and controlling blood glucose levels in diabetic pregnant woman are essential to reduce the incidence of the syndrome. [ABSTRACT FROM AUTHOR]

Background: Congenital malformations are defects in the development of organs and body regions present from birth. Genetic and environmental factors can cause malformations, with some phenotypic associations sharing common etiological mechanisms. Understanding the epidemiological profile of malformations is essential for prevention campaigns and systematic care. Aim: To identify the epidemiological profile of congenital malformations diagnosed in the Gynecology and Obstetrics Department of a University Hospital located in the city of Bragança Paulista - SP, Brazil. Method: This is a retrospective, descriptive, and quantitative study that includes internal notifications of congenital malformations identified in the fetuses of pregnant women treated at the Gynecology and Obstetrics Service of the Hospital Universitário São Francisco na Providência de Deus - HUSF. Results: The sample of this study consisted of 95 malformation notifications, 21 in 2017 (22.11%), 10 in 2018 (10.53%), 10 in 2019 (10.53%), 13 in 2020 (13.69%), 12 in 2021 (12.63%), 14 in 2022 (14.73%) and 15 in 2023 (15.78%). The frequency of malformations in 2017 was significantly higher than that observed in the rest of the years evaluated (p = 0.04). The average maternal age during the studied period was 29.3 ± 7.4 years. The most commonly identified malformations were those occurring in structures of the central nervous system, as well as those identified in the cardiovascular system. Conclusion: In our study, the most frequent malformations were associated with structures of the central nervous system, as well as cardiovascular structures. Despite the fact that this specific survey did not evaluate risk factors in pregnant women, it is noteworthy that contact with agricultural products may beassociated with malformations, suggesting the need to create campaigns to inform pregnant women about the dangers of exposure to these compounds. [ABSTRACT FROM AUTHOR]

Background: Acute fatty liver of pregnancy is rare and potentially lethal, occurring mainly in the third trimester of pregnancy, and can also occur in the immediate postpartum period, with a prevalence of 1 in every 16,000 pregnancies. It mainly occurs in primigravida women and is associated with preeclampsia, male newborn, multiple pregnancies, BMI < 20, and maternal obesity. The signs and symptoms are nonspecific and can progress to severe cases, even leading to maternal and fetal death. Diagnosis is based on Swansea criteria. The only effective treatment is delivery, and supportive treatment is essential. Aim: To report a case of acute fatty liver of pregnancy treated in our service. Case report: Patient a 28-year-old primigravida with untreated gestational diabetes mellitus, at term gestational age, presenting with lower abdominal pain, decreased fetal movement, and fetal bradycardia. A cesarean section was performed, and premature placental abruption was observed. The patient developed hypoglycemia, poor general condition, coagulopathy, and jaundice. The patient developed hepatic encephalopathy, which was reversed. After 19 days of hospitalization, she showed clinical improvement, was discharged, and followed up with a multidisciplinary team. Conclusion: Acute fatty liver of pregnancy (AFLP) is pregnancy-exclusive pathology, associated with a potentially fatal clinical course that can lead to multiple organ failure. Regardless of the timing of occurrence, AFLP presents with a similar and indistinguishable presentation. The only consideration that must be taken into account is the appropriate treatment for each period, always considering that delivery is the only treatment that establishes a cure. [ABSTRACT FROM AUTHOR]

Undoubtedly, great advances have been made in terms of maternal and infant morbidity and mortality. However, in Mexican Social Security System, the quality of maternal care is questionable, as reflected in proportions of cesarean births three times higher than those recommended by WHO, abandonment of exclusive breastfeeding and the fact that up to one in three women is a victim of abuse during delivery. Given this, the IMSS decides to implement the model called Integral Maternal Care AMIIMSS, focused on users experience and based on friendly obstetric care, along different stages of the reproductive process. Four pillars underpin the model, women's empowerment, infrastructure adaptation, training and adaptation of processes and standards. Although there are advances, with 73 pre-labor rooms enabled and 14,103 friendly attentions granted, there are pending tasks and challenges. In terms of empowerment, the birth plan needs to be included as an institutional practice. In terms of infrastructure adequacy, a budget is required to build and adapt friendly spaces. In addition, it is necessary to update the staffing tables and include new categories, for an adequate operation of the program. On training, the adaptation of academic plans for doctors and nurses is pending. In terms of processes and regulations, there is a lack of qualitative evaluation of the impact of the program on people's experience and satisfaction and elimination of obstetric violence. [ABSTRACT FROM AUTHOR]

The worldwide incidence of acute kidney injury (AKI) in pregnancy is 1.6 to 6.3 per 10,000 pregnancies. In developing countries, maternal mortality due to secondary complications of acute kidney injury is 4 to 5.8%. As it is well known, most cases of acute kidney injury in obstetrics occur during the puerperium, its presentation has been associated with an increase in fetal morbidity and mortality, compared to normoevolutive pregnancies. [ABSTRACT FROM AUTHOR]

Objectives: To determine agreement in assessing the need for postpartum pharmacological prophylaxis between the scale of the Royal College of Obstetricians and Gynaecologists and the Colombian guideline scale in a Level IV institution in Bogota, Colombia. Material and methods: Diagnostic agreement study assembled on a cross-sectional study. The included population consisted of pregnant women with 24 or more weeks of pregnancy admitted between March 1 and April 30 of 2021 to a high complexity private institution in Bogotá, Colombia, for labor induction, in active labor, for elective cesarean section, or who required urgent cesarean section. Convenience sampling was used. Measured variables included demographics, risk factors, risk classification and pharmacological prophylaxis according to the two scales. The prevalence of risk factors for each scale was estimated and agreement regarding prophylaxis indication between the two scales was measured using the weighted kappa value. Results: Overall, 320 patients were included. According to the scale of the Royal College Obstetricians and Gynaecologists, 54.7 % patients were classified as low risk, 42.5 % as intermediate risk and 2.8 % as high risk. The Colombian scale classified 80 % of patients as low risk, 17.2 % as intermediate risk, 2.2 % as high risk, and 0.6 % as very high risk. The weighted kappa value for agreement regarding the indication was 0.47 (95 % CI: 0.38-0.56). Conclusions: Agreement between the two scales to determine the need for postpartum pharmacological prophylaxis is moderate. Risk classification criteria for the Colombian scale should be validated in a second cohort. Moreover, the predictive ability of the Colombian guideline tool should be assessed at different cut-off points in terms of the consequences of false positive and false negative results. [ABSTRACT FROM AUTHOR]

The study aimed to describe and analyze everyday aspects of childbirth care in a university hospital in southern Brazil. The expression “taking off the coat” serves as a metaphor to illuminate the process of converting the obstetrician nurse into a researcher in a hospital environment. This is a qualitative research work that made use of the perspective socio-anthropology as a theoretical and methodological framework. The results showed a recurrent lack of information about medical conduct and decisions given to women, disregarding them as subjects of rights, despite what the policy of humanization of childbirth, revealing nuances of childbirth and birth based on the model assistance technocracy. This current care model in teaching hospitals requires important changes through the incorporation of practices with scientific foundations, the inclusion of obstetric nurses and respect for women as the protagonists of this event. [ABSTRACT FROM AUTHOR]

Background: Body Stalk Syndrome (BSS) is a rare condition with a reported frequency of one case in every 31,000 pregnancies, and is characterized by severe congenital malformations, mainly thoracoschisis, abdominoschisis, limb defects and exencephaly. Its exact etiology is unknown and no teratogenic factor has been described so far. Furthermore, reports of familial recurrence suggest the possibility of a genetic origin for the condition. Aim: To report a case of SBS seen in our Service. Case report: This was a 23-year-old patient, with no comorbidities and a primigravida, who was referred to high-risk prenatal care due to a 2.5 mm nuchal translucency, observed by a morphological ultrasound (USG) performed with a gestational age (GA) of 11 weeks and 4 days. Two subsequent USGs showed signs suggestive of increasing SBS. The patient spontaneously went into labor with a GA of 33 weeks and 6 days. The fetus didn't have any cardiac activity since it's cefalicus disattachtment. After birth, multiple malformations were found confirming SBS. The mother received puerperal care and was discharged the following day. Conclusion: SBS is a rare and lethal malformation, justifying case reports that contribute to continuing medical education in Gynecology and Obstetrics. As seen in the case reported here, USG is important in the hypothesis of early diagnosis of SBS, allowing the pregnant woman to choose whether or not to terminate her pregnancy. There is also evidence that fetal magnetic resonance imaging could provide bases for a prenatal diagnosis of the syndrome during the beginning of the second gestational semester, as well as the diagnostic capacity of USGs for fetuses with GA at 11 and 12 weeks. [ABSTRACT FROM AUTHOR]

Background: Dandy-Walker Syndrome (DSW) is a complex malformation that involves the posterior fossa and the cerebellum, being considered a rare condition with an estimated incidence of 1 in 30,000 births. Hydrocephalus is its most common finding, identified in approximately 80% of cases, and SDW is present in between 4% and 12% of cases of hydrocephalus in infants. The "classical triad" of SDW is defined by complete or partial agenesis of the vermis, enlargement of the posterior fossa with upward displacement of the tentorium, transverse and torcular sinuses, and cystic dilatation of the fourth ventricle. Objective: To report a case of SDW attended in our Service. Method: This is a single case report treated at the Gynecology and Obstetrics Service of the São Francisco University Hospital in Providência de Deus - HUSF, located in the city of Bragança Paulista, SP, Brazil. The patient authorized the use of information about the case by signing an informed consent form. Conclusion: This report demonstrated the importance of imaging techniques, such as magnetic resonance imaging, ultrasound, for the identification, even during the prenatal period, of fetuses with the syndrome, allowing the medical team to design the treatment suitable for the future newborn. The findings provided by the imaging analyzes allowed us to investigate in great detail all the changes indicative of SDW after the 18th week of gestation, as well as after delivery. [ABSTRACT FROM AUTHOR]

Background: Neuroblastoma is a tumor of poorly differentiated embryonic nerve cells. Although most commonly found in the adrenal gland (90%), it can also be found in the posterior mediastinum or along the sympathetic neural chain. Furthermore, congenital neuroblastoma is the second most common tumor in the neonatal period, corresponding to 20% of all congenital tumors. Aim: To report a case of fetal neuroblastoma diagnosed in our Service. Case report: It was a pregnancy where the patient had gestational diabetes mellitus and gestational age of 38 weeks and 3 days. The fetus, according to morphological ultrasonography (USG), presented a tumor lesion in its right adrenal gland, in addition to macrosomia. Due to the observed results, a cesarean delivery was performed, without intercurrences. At postpartum USG, the tumor lesion remained, however, no clinical repercussions were observed. The newborn was discharged from the Service with outpatient referral to the pediatric surgery team, and a third USG showed a solid-cystic lesion in his right adrenal gland measuring 2.8 x 2.7 x 2.0 cm, still without clinical repercussions. Conclusion: Fetal neuroblastoma has an excellent prognosis, and reports of spontaneous tumor remission are common. However, caution is required when dealing with this type of tumor, as it is possible that in utero metastases or compression of the fetal/newborn spinal cord may occur. The importance of prenatal imaging tests, mainly USG and magnetic resonance imaging, is highlighted for the prior identification of neuroblastoma, and postpartum for the identification of tumor staging. Furthermore, tumors classified as 4S have a better prognosis, with the possibility of spontaneous remission. [ABSTRACT FROM AUTHOR]

The article reports the results of a study conducted to examine midwifery and nursing students' perceptions of body intimacy and the factors affecting their perceptions. This was a cross-sectional study, with 389 midwifery and nursing students at a public university volunteering to participate in the study. Data were collected using a "Personal Information Form", the "Body Confidentiality Scale for Obstetrics and Gynecology" and the "Rosenberg Self-Esteem Scale". The participants had a mean age of 20.89 ± 1.86 years. The mean score they gave to the question whether they paid attention to privacy was 8.21 ±1.88. The mean Rosenberg self-esteem score was 29.44 ± 4.83 (minimum = 10, maximum = 40). The mean overall privacy score was 36.10 ± 6.84 (min = 9, max = 45), rights and privacy was 20.80 ± 3.71 (min = 5, max = 25), ethics and privacy was 20.45 ± 3.67 (min = 5, max = 25), and clinical privacy was 75.22 ± 12.33 (min = 18, max = 90). According to the results, obstetrics and nursing students, who would later intervene in women's health, had higher than average self-esteem and perception of privacy. Nevertheless, the establishment of the concept of "privacy" is an issue that should be addressed and reinforced in the training of obstetrics and nursing students who will provide services in such a sensitive field as gynecology and obstetrics. [ABSTRACT FROM AUTHOR]

Background: The risk of prematurity includes a wide variety of complications at birth, such as infectious diseases, intraventricular hemorrhage, neurosensory deficiencies, respiratory failure and involvement of other systems, as well as growth and developmental problems. Therefore, the achievement of the Millennium Development Goal of reducing child mortality depends largely on the reduction of mortality related to premature birth, making it one of the most important challenges for modern public health. Objetive: To identify maternal factors associated with prematurity. Material and Methods: A retrospective case-control study was conducted on 2000 live newborns in a public hospital in Trujillo, between 2015-2019. The groups were divided according to the criteria of gestational age. The paired maternal clinical variables were analyzed according to prematurity or term, and a bivariate and multivariate analysis was made by logistic regression adjusted for confusers. Results: It was demonstrated that the number of prenatal controls less than four during gestation, is associated to prematurity (OR 2.65; IC95%: 2.21-3.18). On the other hand, the absence of a urinary tract infection (OR 0.73; IC95%: 0.56-0.95), is associated with lower risk of prematurity. Conclusions: The number of prenatal controls is an important associated factor for preterm delivery, while the absence of a UTI may be associated with a lower rate of preterm delivery in at-risk pregnancies. [ABSTRACT FROM AUTHOR]

Objective: To analyze, from the point of view of the preceptors, how the training process in the residency modality addresses the good practices recommended by the national and international guidelines for assistance in normal childbirth. Methods: Qualitative, exploratory-descriptive study carried out with thirty-five preceptors, 14 nurses and 21 doctors who work in the obstetrics services of the State Department of Health of the Federal District. Data were collected between March and June 2018 through interviews and analyzed according to Bardin's Content Analysis with the support of NVivo® Software. Results: Five thematic categories were identified: addressing good practices in care for normal childbirth; unnecessary practices that remain; norms and routines in the assistance to normal childbirth; work processes in the residency setting, and search and update the evidence for teaching good clinical practices. Conclusion: The study showed the need to reorganize the teaching scenario for residency programs with continuous actions aimed at strengthening the pedagogical processes in order to expand the disruptive potential of new health professionals. [ABSTRACT FROM AUTHOR]

The article aims to arouse reflection in defense of the use of the term obstetric violence in the face of the position of the Ministry of Health and the Federal Council of Medicine in avoiding and abolishing it. It is understood that this posture cancels the social, historical and cultural constitution of the expression and trivializes the aggression suffered by women, during and after birth. Thus, it sought to demonstrate the importance of the use of the vocable using concepts and characterizations, as well as by the brief historical approach to its gradual notoriety as a question of violation of fundamental human rights. Moreover, the work suggests the maintenance of the expression and hopes to collaborate to sensitize the reader about this type of violence. [ABSTRACT FROM AUTHOR]

Objectives: to present scientific recommendations for perinatal care in the context of the COVID-19 pandemic. Methods: a narrative review was carried out between March and September in 2020 from BIREME, the Scientific Electronic Library Online and the Virtual Health Library databases, based on the descriptors: "Perinatal Care''; "Coronavirus"; "Coronavirus Infection''; "Obstetrics"and "Newborns". The information was grouped into four categories, namely, prenatal care; labor and birthcare; care for puerperal women and the newborn. Results: 14 publications were found, 9 scientific articles and 5 technical standards pursuant to the Ministry of Health in Brazil. In the first category, generally, it is recommended that prenatal consultations should be continued, if necessary, by means of telemedicine; hospitalization of positive pregnant women in case symptoms are severe and considering pregnant women's clinical and emotional aspects. In the second, screening and testing on suspected cases, discouraging skin-to-skin contact and breastfeeding in the first hour of life. In the third, change the arrangement of beds in shared accommodations and have early discharge. In the fourth category, it is also recommended late clamping of the umbilical cord and observe differences in laboratorial testing of asymptomatic neonates. Conclusions: scientific evidence based on studies with methodological designs and more robust analyzes are necessary to guide perinatal care in the context of the harm-free COVID- 19 pandemic. [ABSTRACT FROM AUTHOR]

Responses to the systemic limitations of health care in Mexico have included public policies for universal access implemented through inter-institutional agreements. Those focused on emergency obstetric care are a vivid example of these efforts. Based on a case study, this article describes a general picture of the ways in which healthservice networks operate in the state of Chiapas. We review their infrastructure and analyze their capacity to respond to obstetric emergencies. We also assess the current condition of these networks in terms of being able to function as a collaborative network. Our findings demonstrate that public institutions in the Mexican health sector have made little or no use of the benefits offered by inter-institutional agreements, and identify the strengths and obstacles in their utilization. The results of our research can help optimize obstetric care for women in Chiapas. [ABSTRACT FROM AUTHOR]

Background: Improvements in medical technologies have seen over-medicalization of childbirth. Caesarean section (CS) is a lifesaving procedure proven effective in reducing maternal and perinatal mortality across the globe. However, as with any medical procedure, the CS intrinsically carries some risk to its beneficiaries. In recent years, CS rates have risen alarmingly in high-income countries. Many exceeding the World Health Organisation (WHO) recommendation of a 10 to 15% annual CS rate. While this situation poses an increased risk to women and their children, it also represents an excess human and financial burden on health systems. Therefore, from a health system perspective this study systematically summarizes existing evidence relevant to the factors driving the phenomenon of increasing CS rates using Italy as a case study.Methods: Employing the WHO Health System Framework (WHOHSF), this systematic review used the PRISMA guidelines to report findings. PubMed, SCOPUS, MEDLINE, Cochrane Library and Google Scholar databases were searched up until April 1, 2020. Findings were organised through the six dimensions of the WHOHSF framework: service delivery, health workforce, health system information; medical products vaccine and technologies, financing; and leadership and governance.Results: CS rates in Italy are affected by complex interactions among several stakeholder groups and contextual factors such as the hyper-medicalisation of delivery, differences in policy and practice across units and the national context, issues pertaining to the legal and social environment, and women's attitudes towards pregnancy and childbirth.Conclusion: Mitigating the high rates of CS will require a synergistic multi-stakeholder intervention. Specifically, with processes able to attract the official endorsement of policy makers, encourage concensus between regional authorities and local governments and guide the systematic compliance of delivery units with its clinical guidelines. [ABSTRACT FROM AUTHOR]

Objective: Discuss the experience of nurses who work in care during the home birth, evidencing obstetric practices, challenges and obstacles. Methods: Qualitative study carried out from August 2019 to March 2020 with nine Obstetric Nurses who work in home birth. Data were collected through an in-depth interview, and analyzed by thematic analysis, considering the life narrative method proposed by Daniel Bertaux. Results: Three themes emerged: The option for home birth: profile of women and choices; The rescue of the physiological process, and the care of the obstetric nurse in home birth; Home birth in Brazil: obstacles and challenges for the performance of obstetric nursing. Conclusions: Through this study, it was found that obstetric nursing in planned home birth is presented as an option for the rescue of physiological childbirth. The experience of obstetric nurses shows that there are still numerous obstacles in the PDP scenario, but even so, obstetric nursing has managed to strengthen itself as one of the pillars in the humanization process of childbirth. [ABSTRACT FROM AUTHOR]

The pregnant woman does not seem to be more vulnerable than the general population, however, it can be said that there is not much data or it is scarce, and that the physiological changes and the immune response of patients are similar to that of pregnant women. When a pregnant patient infected with COVID-19 is identified in the general office, her gynecologist or intensivist should be consulted, depending on her conditions. The pregnant patient can go through different situations and it should be considered that she can reach intensive care if preventive measures are not enough. Obstetric assessment must always be individual and the prenatal control that is carried out must be oriented with a risk approach, early identification of risk factors and comorbidities of both the mother and the fetus. [ABSTRACT FROM AUTHOR]

This study aimed to develop a scale to ethically evaluate the privacy of the body in gynecology and obstetrics. It was carried out in a university research and application hospital and in a private hospital in Turkey. A stratified sample was adopted with a total of 2,159 participants, including physicians, nurses, and midwives, OB/GYN patients, surgical patients, internal medicine patients, and healthy individuals. The Law she method was used. The results showed that physical space is important in protecting privacy; the participants perceived privacy as a right; women, married people, primary school graduates, older people and those closest to rural culture are more sensitive to privacy than others; Among healthcare providers, physicians are more privacy conscious than nurses and midwives; no participant had in-depth knowledge of patient rights and relevant legislation. The body privacy scale in gynecology and obstetrics proved to be a valid and reliable scale. With it, the privacy of the body in obstetrics and gynecology can be evaluated in future research, as well as the perceptions of body privacy of those who receive and provide medical care. By applying this scale, the privacy of gynecological and obstetric patients can be protected and the results reflected in clinical practice. This scale can also be used in education and in improving ethical sensitivity in physicians. [ABSTRACT FROM AUTHOR]

Introduction: A partograph is the graphic representation of labor from its early stages, which allows observing the changes during the labor process. Objective: To determine partograph-related knowledge among nurses and doctors in a maternity hospital. Materials and Methods: A cross-sectional study was conducted with nurses and doctors from a maternity hospital in northeastern Brazil. The sample consisted of 8 nurses and 39 doctors. Results: Most health professionals have taken courses or training related to the instrument itself. However, there were some doubts about partograph handling in 27.6% of cases. Work overload, lack of knowledge to fill out the instrument and lack of continuity affected this matter. As for the situations in which the instrument should be used, women in active labor and normal labor were listed. Discussion: The importance and necessity of partographs during labor are beyond question. The information obtained through this instrument guides professionals through the next steps of labor and delivery. Conclusion: The use of partograph is considered essential in labor and knowledge related to its handling is critical in practical settings. However, the use of this instrument is just beginning in the maternity ward. [ABSTRACT FROM AUTHOR]

Foundation: diversity of activities carried out by the family doctor, heterogeneity of teachers who evaluate them and different phases in which this doctor can be found, among other circumstances, cause his evaluation in the healthcare context to be riddled by innumerable subjective criteria and that there is no uniformity. Objective: to design an evaluation guide, for direct observation of clinical skills development of the Comprehensive General Medicine resident in gynecobstetric care. Methods: this research was carried out by using theoretical and empirical methods. Clinical skills prioritization was developed on the basis of the identified problems. Direct observation of the resident's behavior was done in their actual outpatient appointments. Professors of Comprehensive General Medicine observed the performance while patient's assistance. Based on the main problems identified in the resident's performance, the guide was prepared and submitted to expert judgment for approval. Results: the guide includes the evaluation of the following clinical skills: physical obstetric examination, auscultation of the fetal heart rate, physical examination of the postpartum woman, physical examination of the breasts, placement and removal of intrauterine device, cytological test, canal brushing and Schiller test. Conclusion: the guide is easy to apply and allows identifying the resident's difficulties during the execution of the procedure. Its systematic implementation contributes to the diagnosis of learning needs. [ABSTRACT FROM AUTHOR]

The paper proposes a genealogy of the biomedical paradigm surrounding childbirth, with the aim of deconstructing the principles of rationalism that led to the objectification of the body and to the consequent commodification of birth. We intend to demonstrate how such a conception of the body and of sensibility determines the birth process, which leads us to consider it an event that is relational in nature. Methodologically, this deconstruction is carried out through a critical-descriptive genealogy of the theoretical assumptions of the rationalist conception of the body. By developing the concept of ecology of childbirth, we intend to call into question this relational nature of the body and to recover the value of corporeality and embodiment as a language of proximity, within a theoretical framework of the ethics of difference. This vindication of the ecologicalrelational nature of sensibility has the potential to establish a dynamic of responsibility and cooperation capable of subverting the rationalist logic of control and the dominion of the current biomedical paradigm. [ABSTRACT FROM AUTHOR]

Introduction: According to the World Health Organization, depression is the most prevalent mental disorder and burnout syndrome can occur among individuals whose work involves care or assistance to people, and, given that residents may have heavy workloads, it is important to study burnout's frequency in them. Objective: To know the frequency of burnout syndrome and depression in Obstetrics and Gynecology (OB/GYN) residents. Methods: A prospective, observational, cross-sectional, and descriptive study was carried out in OB/GYN residents. Two instruments were applied: Beck Depression Inventory and Maslach Burnout Inventory, in order to assess depression and burnout, respectively. For the statistical analysis, it was used descriptive statistics, frequencies, measures of central tendency and dispersion, as well as Spearman correlation analysis. Results: 28 second-year residents, 33 from third-year, and 17 fourth-year residents were studied. In secondyear residents, mild and moderate depression prevailed; in third-year residents, moderate depression, and in fourth-year residents, minimal depression. Only secondyear, and third-year residents presented burnout syndrome. Correlation between depression and burnout syndrome showed a rho = 0.591, p < 0.001. Conclusion: Depression is related to burnout syndrome in OB/GYN residents. [ABSTRACT FROM AUTHOR]

Objective: to analyze the profile of obstetric patients admitted to the Intensive Care Unit. Method: quantitative, descriptive and retrospective study, developed through searches and retrieval of data referring to socioeconomic and clinical profile of pregnant or postpartum patients' records admitted for obstetric cause, between January 2017 and December 2018, in the Intensive Care Unit of a public hospital in Pernambuco, Brazil. The results were analyzed using the Statistical Package for the Social Sciences. Results: most women were between 19 and 29 years (56.1%), and pardas (88.6%). The majority was hospitalized in the postpartum (75.6%), the most prevalent delivery type was cesarean section (87.2%), hypertensive syndromes were the major cause of hospitalization (61.8%). The main hypertensive disorder was pre-eclampsia (39.8%). Conclusion: the young adult puerperal patients, whose delivery route was cesarean section, with hypertensive syndromes are hospitalized more frequently in the Intensive Care Unit. [ABSTRACT FROM AUTHOR]

Obstetric violence consists of any conduct or act that leads to the misappropriation of women's bodily and reproductive processes. The objective of the present study was to identify the forms of obstetric violence pointed out in the Brazilian literature. This was an integrative review of the literature, using the Scientific Electronic Library Online (Scielo), Latin American and Caribbean in Health Sciences (Lilacs), Nursing Database (BDENF) databases. It was found that there were more than 40 characterizations of obstetric violence among the reviewed studies. The types of physical, verbal and psychological violence, as well as the performance of unnecessary procedures are present in 100% of the researches. Concludes that there is a need for disclouse the topic through public policies and public awareness about normal humanized delivery, as well as a change in care model and the training of professionals, since both are based on interventionist practices. [ABSTRACT FROM AUTHOR]

Objective: Investigate concepts, understanding and recognition of obstetric violence, means of approaching the subject within the university and types of obstetric violence observed, experienced and practiced by nursing and medical scholars. Methodology: A cross-sectional, analytical study, with a quantitative approach, conducted at a public university between November 2017 and April 2018. The sample consisted of 220 students, of which 76 were nursing students and 144 were medical students. Data was collected through a questionnaire. For the analysis, the absolute and percentage values were adopted and the Student's t-test was applied for statistical significance. Results: The academics converge regarding the recognition of psychological, verbal aggression and the prohibition of the presence of a companion. They differ in respect to: procedures and behaviors that for some are routine obstetric practice, not being considered obstetric violence; inclusion of the theme in the curriculum; discussion of the theme in the classroom. Conclusion: The academics presented more divergences than convergences. Thus, there is a need to raise awareness and reinforce the discussion of obstetric violence. [ABSTRACT FROM AUTHOR]

The gradual assumption of the Art of Parting by Surgery since the eighteenth century is seen, from the current historiography of midwives, as an illegitimate usurpation protected by a legal corpus supported by a non-objectified premise: that of the high human cost derived from the inexperience of midwives that would be remedied by the competence of surgeons. Focusing on the second aspect, the objective is to know if the surgeons showed that competence in birth. After the review of primary documentation of the 18th and 19th centuries in the city of Vitoria (Álava, Spain), there have been identified 3 direct actions of surgeons in relation to birth, 7 indirect or contextual actions and 3 expert opinions that allow to establish that the surgeons who exercised in Vitoria lacked of demonstrated competences on childbirth both before 1750 and after, when it was requisite to examine themselves to practice as a midwife surgeon, not appreciating more line of development of those competences than the one that can be conjectured by the continuity in the municipal contract replacing midwives; although documentally this continuity came from the economic difficulties of the city council and not from the greater competences demonstrated by the surgeons. [ABSTRACT FROM AUTHOR]

Obstetric violence is any act or conduct carried out by a health professional that violates the rights of a woman during childbirth and can cause physical, sexual or emotional harm. This is a resonant theme, since movements for the humanization of childbirth have gained momentum today. OBJECTIVE: To identify the perception of health professionals, patients and students about obstetric violence, and evaluate the impact of this on the physician-patient relationship. METHODOLOGY: Cross - sectional, quantitative and qualitative study. Questionnaires were used to identify the perception of patients, students and health professionals about obstetric violence. RESULTS: We interviewed 158 people (80 patients, 46 students, 32 health professionals). Regarding patients, 49% consider obstetric violence as poor medical care or anti-ethical care, followed by verbal violence (39%). Of these, 16% witnessed or experienced episodes of violence. In relation to health professionals, 60% consider performing procedures without indication as violence. Finally, medical students considered obstetric violence as unnecessary procedures during labor (71.5%). CONCLUSION: we obtained slightly divergent opinions about the perception of obstetric violence among the groups studied, differing according to cultural and socioeconomic aspects. However, it was consistent that this type of violence is mainly related to any act that reflects an affront to women's right to choose and prioritize. [ABSTRACT FROM AUTHOR]

Objective: to reflect on the appropriate technologies used by generalist nurses and obstetricians in the process of humanized labor. Methodology: This is a reflection about the hard, light and light-hard technologies used in childbirth. The process of childbirth in the present time was related to the concepts of technologies according to Merhy. Results: the use of light and hard-light technologies as appropriate tools for humanized childbirth, as they favor women's autonomy and subjectivity, were pointed out in this course, however, hard technologies are sometimes important in the parturition process, such as a surgical intervention according to the recommendations of the Ministry of Health.. Conclusions: The applicability of light and hard-light technologies is favorable to humanized labor, thus reducing the risks of infection and maternal and neonatal mortality caused by unnecessary interventions from hard technologies. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to address and analyze the medical care provided to low-income Quechua women who use the Seguro Integral de Salud (SIS, in Spanish) (comprehensive health insurance) to access family planning services, and to determine whether there is a significant fear toward contraceptive methods because of the forced sterilizations occurred in the past. Materials and Methods. One hundred (100) in-depth interviews were conducted with 70 women, 10 husbands, and 20 health workers in three health centers in the province of Vilcashuaman in Ayacucho. Results. It was found that there is no significant fear of family planning due to past sterilizations, as hypothesized. No significant language barrier was found either, as most health workers spoke or were willing to learn Quechua. There were some misunderstandings and abuse between patients and health workers referred to the use of healthcare services provided by the state. A widespread fear of contraception-related cancer became evident. Conclusions. No significant fear of past sterilizations was found; on the contrary, women are more afraid of the relationship between cancer and contraception. Health worker training should focus on understanding patient perspectives and reducing stigma around poverty, as well as explaining the reasons for being a recipient of the SIS and the "JUNTOS" program. [ABSTRACT FROM AUTHOR]

Introduction: Reportable, preventable events are potential causes for medical liability litigation. It is important to determine whether the occurrence of such events increases the risk of unfavorable legal or ethical decisions. Objective: To assess the association between the occurrence of a reportable preventable event and unfavorable legal and ethical decisions in medical liability processes against obstetricians. Materials and methods: Case-control study. Population: obstetricians affiliated to FEPASDE, with legal or ethical claims closed between 1999 and 2014 in Colombia. Cases: obstetricians with unfavorable judicial decision in malpractice claims. Controls: obstetricians with a favorable judicial decision. Sample: 322 subjects (64 cases, 258 controls). Analysis: variables concerning the obstetrician, the institution, the process, and the patient were measured. Bi-varied and multivaried analyses with a logistic regression model were conducted, using a propensity score or index. Results: An association was identified between the occurrence of the reportable preventable event and an unfavorable ruling (OR=4,4; CI 95%: 2,23 - 8,76). Other associated factors included: private institution (OR=2.3 95% CI: 1.14-4.51), type of civil claim (OR=14.1 95% CI: 5.51-36.04), product diagnosis--demise (OR=3.1 95% CI: 1.64-5.94), history of other unfavorable proceedings (OR= 2.3 95% CI: 1.27-4.06). Inadequacies in the prevention and medication therapy were associated with an unfavorable ruling (P<0.05). Conclusion: The presence of reportable preventable events is associated with an unfavorable legal or ethical decision in malpractice claims involving obstetricians. Inadequate patient management and poor functioning of the hospital care system provide opportunities for intervention to reduce the risk of an unfavorable legal or ethical decisions in malpractice claims. [ABSTRACT FROM AUTHOR]

Justification: The existence of ethnic groups in Mexico, gives an important cultural significance for the care of pregnant women. In Sitalá, Chiapas, Mexico, midwives have built their trajectory through traditional generational knowledge, with a different way of treating maternal and child health problems with respect to the biomedical care system. Objectives: Understand the cultural practices of midwives in the care of the pregnant woman of the Tseltal ethnic group. Methodology: Ethnographic study of 8 participants, content analysis until saturation. Theoretical references of the Model Rachel Spector and Model of Cultural Competence of Larry Purnell. Results and discussion: The sobada, is a manipulation of the traditional midwife used by the traditional health care system in indigenous communities of the Tzeltal ethnic group, they cure, accompany and advise in the primordial moments of family development. Conclusion: Living midwifery provides accompanied care during pregnancy with safety, physical and emotional comfort. They are non-formal leaders of the communities and a means to generate changes in health; so the communication of the nursing professional is paramount in the conservation of health or self-care that can be achieved in these communities. [ABSTRACT FROM AUTHOR]

The objective was to analyze the admission of women of childbearing age to an Obstetric Intensive Care Unit. A cross-sectional, documentary and retrospective study was carried out in an Obstetric Intensive Care Unit, located in Fortaleza/Ceará, with women of childbearing age admitted to the unit in 2016. Data were collected from 106 medical records that met the inclusion criteria during the month of April 2017, using a semi-structured form, and analyzed by means of descriptive statistics. The majority of the women were between 20 and 29 years old, common-law married, with complete secondary education, primiparous, had initiated prenatal care in the first trimester of pregnancy, and attended 4 to 6 consultations. Among the direct obstetric causes (61.1%), the most frequent were Eclampsia (34.4%), HELLP syndrome (15.1%) and Severe preeclampsia (11%). The indirect obstetric causes (38.9%) included Renal insufficiency (13.5%), Acute lung edema (11.5%) and Heart disease (9.6%). Data revealed a fragile health care for women within the pregnant-puerperal cycle. [ABSTRACT FROM AUTHOR]

Objective: To identify the perception of women about delivery care by the obstetrician nurse. Methodology: a descriptive, exploratory, qualitative study was carried out in Recife / PE, Brazil, in the year 2016, with 28 postpartum women attended by obstetrical nurses. Semi-structured interviews were conducted, guided by the guiding question: What is your view about the assistance of the obstetrician nurse that accompanied your delivery? The speeches were submitted to the thematic content analysis proposed by Bardin. Results: based on the analysis of the speech, two thematic categories emerged: Obstetric nurse care and previous delivery experience. Conclusion: Although obstetrical nursing has expanded and its attendance satisfactory, the low quality of the information transmitted in the prenatal consultations and the little knowledge of the nursing activity, demonstrates the need to spread this profession in different ways. Sectors of society and complexity levels in the area of education and health. [ABSTRACT FROM AUTHOR]

Background: The maternal-child simulation replaces or amplifies a real experience with supervision, being able to be applied in several levels of attention to health. Objective: To evaluate the realistic maternal-child simulation through the Design and Self-confidence scales. Methodology: Descriptive cross-sectional study with a quantitative approach performed with 47 students of the Nursing course submitted to realistic simulation. After the simulation and debriefing, they answered two validated instruments that evaluated student satisfaction and self-confidence and the design of the scenario. Data were analyzed through descriptive statistics and inferential statistics. Results: The factorial analysis and the internal consistency analysis revealed good values (0.94 for the Satisfaction Scale, 0.92 for Design). The mean subscale scores for the elements of satisfaction and self-confidence ranged from 3.51 to 4.12 (from a possible score of 5); and the elements of the simulation design ranged from 3.91 to 4.51 (from a possible score of 5). Conclusion: The Scales of Design and Self-confidence revealed good indexes both of the scenario design and student self-confidence and the results were similar to other studies. [ABSTRACT FROM AUTHOR]

Background: The maternal-child simulation replaces or amplifies a real experience with supervision, being able to be applied in several levels of attention to health. Objective: To evaluate the realistic maternal-child simulation through the Design and Self-confidence scales. Methodology: Descriptive cross-sectional study with a quantitative approach performed with 47 students of the Nursing course submitted to realistic simulation. After the simulation and debriefing, they answered two validated instruments that evaluated student satisfaction and self-confidence and the design of the scenario. Data were analyzed through descriptive statistics and inferential statistics. Results: The factorial analysis and the internal consistency analysis revealed good values (0.94 for the Satisfaction Scale, 0.92 for Design). The mean subscale scores for the elements of satisfaction and self-confidence ranged from 3.51 to 4.12 (from a possible score of 5); and the elements of the simulation design ranged from 3.91 to 4.51 (from a possible score of 5). Conclusion: The Scales of Design and Self-confidence revealed good indexes both of the scenario design and student self-con- fidence and the results were similar to other studies. [ABSTRACT FROM AUTHOR]

Introduction: There is a high rate of deliveries in adolescents in Mexico. This age group is vulnerable to obstetric complications, including lacerations of the anal sphincter. Objective: To determine the prevalence of third and fourth degree perineal tears in adolescents during childbirth, and to evaluate risk factors in comparison with deliveries with lacerations of adult women. Methods: All obstetric care episodes were reviewed from a public tertiary hospital data in Monterrey, Mexico in 2014. Age, primiparity, delivery instrumentation, episiotomy, body mass index, product weight and tear s degree were documented at the deliveries with tears of third and fourth degree. Results: The prevalence of third and fourth degree tears of 2.0% was found in the general population, being adolescents the most affected with 2.5%. The unadjusted odds ratio of high-grade tears in adolescent females at delivery, compared to adult females, was 1.36 (95% CI = 0.99-1.86, p= 0.05). No difference was found when comparing risk factors among high-grade tear deliveries in adolescents versus adults. Conclusions: A higher prevalence than previous reported for high grade tears during delivery was found. The data suggest adolescence as a risk factor for high-grade tears during delivery. [ABSTRACT FROM AUTHOR]

This study had as objective to characterize the demand for care from an outpatient clinic for pregnant women at high risk. The study was of character of descriptive and exploratory with quantitative approach. The data collection was from December 2016 to January 2017, totaling 104 pregnant women of high risk were cared for in an outpatient setting of a pregnancy of high risk of a hospital in São Paulo. The data were analyzed by means of descriptive statistical analysis and presented in tables in the form of absolute frequency and percentage. As a result, it is possible to detect that the majority of pregnant women attended in the outpatient clinic are some of the cities of the region, are married, have up to 30 years of age, had not planned the current pregnancy, no history of diseases obstetric and fewer than half of them made more than six queries relating to the prenatal. The reasons of the high risk pregnancies present were: gestational diabetes, hypertension in pregnancy and pre-eclampsia. It is concluded that having the knowledge of the clinical features and the conditions-demographic characteristics of pregnant women in high-risk, assists health professionals to develop a care plan where present better resolvability and that is able to provide the prevention of disease, taking into account the reality of individual way of every pregnant woman. [ABSTRACT FROM AUTHOR]

The objective of this study was to report the cesarean section procedure in a case of dystocic delivery in goats. A four-year-old Anglo-Nubian goat, weighing 40kg, was attended at the Veterinary Hospital Antônio Francisco Fonzar of the Faculty of Agrarian Sciences of Andradina, presenting difficulty in parturition. On physical examination, the animal was restless, with a present appetite and good body condition. The vaginal examination revealed vaginal prolapse, rectal, insufficient cervical dilatation, but without fetal observation and fetal membranes. In the clinical examination it was verified that the rectal temperature and heart and respiratory rate were within the limits considered normal for the species. A uterine ultrasound was performed observing twin pregnancy, fetal viability and abnormal fetal presentation due to the transverse position of one fetus. The therapeutic plan chosen for cesarean section, the postoperative treatment consisted of administration of Flunixin meglumine (2 mg/kg body weight for 3 days), Oxytetracycline 20% (20 mg/kg body weight in a single application) and Benzathine Penicillin (20,000 IU/kg every 48 hours, totaling 5 applications). For the local dressing was used ointment based on gentamicin, silver sulfadiazine, vitamin A and ointment. After two weeks the animal already had full recovery, it is concluded that the surgical procedures and conduct were successful. [ABSTRACT FROM AUTHOR]

In this study, the perception of human anatomy students faced with constructing a three-dimensional (3-D) pelvis model (to scale) was studied. Few studies evaluate the perception of students facing learning and teaching methodologies with 3-D models. The activity was performed with students from a human anatomy course as part of the obstetrics degree, in which models of pelvic zone bone structures (to scale) were supplied in order to incorporate the anatomic structures (ligaments, muscles, vascularization and innervation). Once the activity was finished, a perception questionnaire was taken. 60 students participated in the activity of constructing the 3-D anatomical model and also completed the questionnaire. It was found that over 93% of the students felt motivated, believed the activity facilitated learning and also that the activity was well planned. Some of the negative factors that were reported included time taken and the associated costs. Due to the positive perception of the students involved in the activity of constructing anatomical models, this is considered to be a suitable methodology for use during the process of teaching and learning about human anatomy. [ABSTRACT FROM AUTHOR]

Background: Ovarian torsion is a condition which the ovary and the ovarian pedicle twist around the ovary suspensory ligament. No report regarding this condition was reported. The aim of the report was to describe a case of unilateral ovarian torsion in a 2-year-old primipara Golden Retriever dog. Case: A 2-year-old female primipara Golden Retriever dog weighting was referred to the Veterinary Hospital, for purulent vaginal discharge evaluation. The dog was presenting anorexia, weight loss, and intermittent diarrhea and vomiting. A cesarean section was performed nine months before her presentation and the oestrus cycle was recorded six months after the cesarean section. Discomfort was observed during the palpation of the abdomen and purulent vaginal was observed. Vaginal swab was performed and followed by cytological examination. The ultrasonographic examination was consistent with pyometra. The ovariohysterectomy was performed and were observed torsion of the left ovary. The histopathological examination of the left ovary and uterus were consistent with ovary necrosis and pyometra. Ten days after surgery the vaginal discharge had resolved and the sutures were removed. Six months postoperatively the dog revealed no further abnormalities. Grossly, the left ovary had firm consistency, dark red surface and 8 cm diameter. The histopathology examination findings were consistent with a diagnosis of diffuse necrosis of left ovary due to ovarian torsion, and uterine suppurative inflammatory process - pyometra. Discussion: Ovarian torsion is uncommon in small animals, but can be observed high incidence in pregnant female dogs than in non-pregnant ones. The 360° an asynchronous ovarian torsion described in the present case is also an unusual condition in primipara female dogs due to the smaller stretching of the ovary suspensory ligament. The ovarian torsion is considerate an emergency condition due to acute abdominal pain. The mild abdominal discomfort observed during the physical examination was associated to pyometra or to ovarian torsion. The histopathological findings as hemorrhage, edema and necrosis were associated to compromised arterial circulation and ovarian torsion in late stage. The size of the pregnant uterus and/or the pyometra has contributed to ovary torsion. The dog of the present report had pyometra and previous cesarean sections; and these conditions may have contributed to ovarian torsion. The condition was incidentally found during the ovariohysterectomy, and the ovarian torsion diagnosis was determinate through histopathological examination. Computed tomography and magnetic resonance image could be used to diagnose, furthermore, they were not conducted due to the high cost. The leukocytosis and red blood cells Rouleaux was associated with ovarian necrosis and pyometra. Ovariohysterectomy was the treatment of choice to pyometra and ovarian torsion, and the surgery was performed without ovarian torsion reversion to minimize the reperfusion lesions. Ovarian torsion is a rare event in dogs, and it was clinically diagnosed during the surgery. To the best of the authors' knowledge, this is the first report of ovarian torsion associate with pyometra in primipara female dogs in Brazil. [ABSTRACT FROM AUTHOR]

This paper presents the results of an ethnographic study of an obstetric center within a hospital of Greater Buenos Aires and an analysis of the spatio-temporal dimension of hospital care. The fieldwork, carried out between 2007 and 2011, followed the everyday dynamics of the hospital and included observation in the obstetrics unit (waiting areas, the obstetric center where births and emergencies receive care, and the ambulatory care, ultrasound, and hospitalization rooms, among others) as well as spaces such as the appointments and statistics offices, the office of social services, the central hall, the pharmacy, and hallway waiting areas. Interviews were carried out with department heads, obstetricians, nurses, social workers, staff of the laboratory and the appointment and statistics offices, volunteers and patients. In this way, the article analyzes the medicalbureaucratic routines in the admission and hospitalization of women in the obstetrics center; the disputes, transactions and negotiations occurring among professionals, patients and families; the delimitation of spaces; and the temporal sequences and hierarchies involved in the passage from the “outside” to the “inside” of the hospital. [ABSTRACT FROM AUTHOR]

This work analyzes the descriptions of obstetricians from the city of Rio de Janeiro regarding the use of the caesarian section. We aimed to understand the aspects related to the formation of a thinking style that coalesces in the idea of the surgery as a simple and low-risk form of delivery. By using the method of oral narratives, we discuss the construction of an obstetric practice that sees the caesarian section as a suitable option for any kind of labor situation; the association of different values with the caesarian section based on its technical development; and the representations of obstetricians regarding the regulation of their work. We conclude that the normalization of the caesarian section as a form of giving birth is related to the development of a thinking style by the community practice of obstetricians. This community shifts the very concept of the caesarian section from a surgical procedure to a form of regular birth. [ABSTRACT FROM AUTHOR]

Aim: to report the implementation of the National Residency Program in Obstetrical Nursing from the perspective of the obstetrical nurses who graduated in the first class of the southern region of Brazil. Method: report of experience. The training scenarios of obstetrical nurses are represented by a public maternity unit, a Basic Health Unit and two Family Health Strategies. Results: many advances have been achieved through joint discussions and exchanges of knowledge among all actors involved in the program implementation process. Currently, teamwork, discussion of behaviors and prescriptions, and trust in the work of the residents are possible. Final considerations: the Residency Program in Obstetric Nursing is in the process of being implemented and, therefore, new challenges arise, and, in some cases, limitations and difficulties also arise, which contribute to its improvement and reorients the qualification actions of nurses Obstetricians. [ABSTRACT FROM AUTHOR]