Search

INTRODUCTION: The most used indicator to cope with prenatal control is gestational weight gain (GWG), which is related to a lower or higher health risk for the mother and her child. OBJECTIVE: to analyze the relationship between sociodemographic factors and weight gain in pregnant patients. METHODOLOGY: analytical, observational, prospective, descriptive and cross-sectional study on a sample of 78 pregnant women residing in Toluca de Lerdo between January and April 2023. RESULTS: the weight gain is shown according to the schooling of the participants, having a maximum of 20 kg and a minimum of -9 kg with a mean of 5.71 (± 6) in women with a bachelor's degree, while women with primary they obtained a maximum of 32 kg and a minimum of 2 kg with a mean of 9.07 (± 7.96). CONCLUSIONS: in the gestational weight gain, a participant weighing 32 kg was identified, gaining three times what is recommended, which is between 9 and 11 kg (not exceeding 12 kg or falling below 6-7 kg)., INTRODUÇÃO: O indicador mais utilizado para o enfrentamento do controle pré-natal é o ganho de peso gestacional (GPG), que está relacionado a menor ou maior risco à saúde da mãe e do filho. OBJETIVO: analisar a relação entre fatores sociodemográficos e ganho de peso em pacientes gestantes. METODOLOGIA: estudo analítico, observacional, prospectivo, descritivo e transversal com uma amostra de 78 gestantes residentes em Toluca de Lerdo entre janeiro e abril de 2023. RESULTADOS: o ganho de peso é demonstrado de acordo com o nível de escolaridade das participantes, tendo um máximo de 20 kg e mínimo de -9 kg com média de 5,71 (± 6) nas mulheres com bacharelado, enquanto as mulheres com ensino fundamental obtiveram máximo de 32 kg e mínimo de 2 kg com média de 9,07 (± 7,96). CONCLUSÕES: no ganho de peso gestacional foi identificada uma participante com peso de 32 kg, ganhando três vezes o recomendado, que fica entre 9 e 11 kg (não ultrapassando 12 kg nem caindo abaixo de 6-7 kg)., INTRODUCCIÓN: Es el indicador más usado para sobrellevar el control prenatal es la ganancia de peso gestacional (GPG), el cual se relaciona con un menor o mayor riesgo de salud para la progenitora y el de su producto. OBJETIVO: analizar la relación de los factores sociodemográficos y la ganancia de peso en pacientes en estado gestacional. METODOLOGÍA: estudio analítico, observacional, prospectivo, descriptivo y transversal sobre una muestra de 78 mujeres gestantes residentes de Toluca de Lerdo entre enero y abril del 2023. RESULTADOS: se muestra la ganancia de peso de acuerdo a la escolaridad de las participantes, teniendo un máximo de 20 kg y un mínimo de -9 kg con una media de 5.71 (± 6) en mujeres con licenciatura, mientras que las mujeres con primaria obtuvieron un máximo de 32 kg y un mínimo de 2 kg con una media de 9.07 (± 7.96). CONCLUSIONES: en la ganancia de peso gestacional se identificó un participante peso 32 kg, ganando tres veces lo recomendado que es entre 9 y 11 kg (no sobrepasando los 12 kg ni bajando de los 6-7 kg).

INTRODUCTION: The most used indicator to cope with prenatal control is gestational weight gain (GWG), which is related to a lower or higher health risk for the mother and her child. OBJECTIVE: to analyze the relationship between sociodemographic factors and weight gain in pregnant patients. METHODOLOGY: analytical, observational, prospective, descriptive and cross-sectional study on a sample of 78 pregnant women residing in Toluca de Lerdo between January and April 2023. RESULTS: the weight gain is shown according to the schooling of the participants, having a maximum of 20 kg and a minimum of -9 kg with a mean of 5.71 (± 6) in women with a bachelor's degree, while women with primary they obtained a maximum of 32 kg and a minimum of 2 kg with a mean of 9.07 (± 7.96). CONCLUSIONS: in the gestational weight gain, a participant weighing 32 kg was identified, gaining three times what is recommended, which is between 9 and 11 kg (not exceeding 12 kg or falling below 6-7 kg)., INTRODUÇÃO: O indicador mais utilizado para o enfrentamento do controle pré-natal é o ganho de peso gestacional (GPG), que está relacionado a menor ou maior risco à saúde da mãe e do filho. OBJETIVO: analisar a relação entre fatores sociodemográficos e ganho de peso em pacientes gestantes. METODOLOGIA: estudo analítico, observacional, prospectivo, descritivo e transversal com uma amostra de 78 gestantes residentes em Toluca de Lerdo entre janeiro e abril de 2023. RESULTADOS: o ganho de peso é demonstrado de acordo com o nível de escolaridade das participantes, tendo um máximo de 20 kg e mínimo de -9 kg com média de 5,71 (± 6) nas mulheres com bacharelado, enquanto as mulheres com ensino fundamental obtiveram máximo de 32 kg e mínimo de 2 kg com média de 9,07 (± 7,96). CONCLUSÕES: no ganho de peso gestacional foi identificada uma participante com peso de 32 kg, ganhando três vezes o recomendado, que fica entre 9 e 11 kg (não ultrapassando 12 kg nem caindo abaixo de 6-7 kg)., INTRODUCCIÓN: Es el indicador más usado para sobrellevar el control prenatal es la ganancia de peso gestacional (GPG), el cual se relaciona con un menor o mayor riesgo de salud para la progenitora y el de su producto. OBJETIVO: analizar la relación de los factores sociodemográficos y la ganancia de peso en pacientes en estado gestacional. METODOLOGÍA: estudio analítico, observacional, prospectivo, descriptivo y transversal sobre una muestra de 78 mujeres gestantes residentes de Toluca de Lerdo entre enero y abril del 2023. RESULTADOS: se muestra la ganancia de peso de acuerdo a la escolaridad de las participantes, teniendo un máximo de 20 kg y un mínimo de -9 kg con una media de 5.71 (± 6) en mujeres con licenciatura, mientras que las mujeres con primaria obtuvieron un máximo de 32 kg y un mínimo de 2 kg con una media de 9.07 (± 7.96). CONCLUSIONES: en la ganancia de peso gestacional se identificó un participante peso 32 kg, ganando tres veces lo recomendado que es entre 9 y 11 kg (no sobrepasando los 12 kg ni bajando de los 6-7 kg).

Maternal mortality rates within the United States have reached an all-time high.  Annually, nearly seven hundred women die from pregnancy-related complications, a number of which were highly preventable.  When taking a closer look at these statistics, these deaths disproportionately affect Native American and African American women, making them two to three times more likely to suffer from poorer pregnancy outcomes.  This paper examines the variety of factors that contribute to such a disproportionate maternal mortality rate, including geographic differences, racial and economic inequalities, and the accessibility of healthcare.  Despite attempts to fix these issues, systemic and intrinsic issues persist, and individuals continue to suffer.  This paper highlights the need to address maternal mortality disparities that affect marginalized groups, improved accessibility to healthcare for all, and overall policy reform in order to solve this issue indefinitely.

BACKGROUND: Obstetricians-gynecologists (OB/GYNs) play a critical role for their pregnant patients during their perinatal period, but research on OB/GYNs knowledge, attitudes, and perceptions regarding plant-based dietary patterns (PBDP) and how this may influence recommendations to patients is lacking. An online cross-sectional survey was conducted to examine OB/GYNs knowledge, attitudes, and perceptions towards a PBDP. METHODS: Postcards were mailed in June 2023 to a convenience sample of 5,000 OB/GYNs across the US using a mailing list provided by the American College of Obstetricians and Gynecologists. Postcards had a brief study description and a QR code that linked to an online survey asking questions about demographics, behavior (e.g., nutritional habits), and other factors that may influence knowledge, attitudes, and perceptions towards a PBDP for their patients. RESULTS: Ninety-six OB/GYNs completed the full questionnaire (~2% response rate). Most (92%) felt that it is within an OB/GYNs role to incorporate nutrition education and counseling within practice. However, 72% felt inadequately trained to discuss nutrition and diet-related issues with patients. Despite a perceived lack of nutrition training, 86% reported that a PBDP was safe and health-promoting, and 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients. CONCLUSION: Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients. These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinicians ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.

Ecological nutrition aims to unravel the extensive web of nutritional links that drives animals in their interactions with their ecological environments. Nutrition plays a key role in the success of European wild rabbit (Oryctolagus cuniculus) and could be affected by the breeding status of the animals and reflected in the metabolome of this species. As nutritional needs are considerably increased during pregnancy and lactation, the main objective of this work was to determine how the breeding status (pregnant and lactating) of European wild rabbit does affects nutritional requirements and their metabolome (using targeted and untargeted metabolomics), aiming to find a useful biomarker of breeding status and for monitoring nutritional requirements. To address this gap, 60 wild European rabbits were studied. Animals were divided according to their breeding status and only pregnant (n = 18) and lactating (n = 11) rabbit does were used (n = 29 in total). The body weight and length of each animal were analyzed. The relative and absolute chemical composition of the gastric content and whole blood sample were taken, and targeted and untargeted metabolomics were analyzed. As a main result, there were no differences in biometric measurements, gastric content, and targeted metabolomics, except for live weight and nonesterified fatty acids (NEFA), as pregnant animals showed higher live weight (+12%; p = 0.0234) and lower NEFA acid levels (−46%; p = 0.0262) than lactating females. Regarding untargeted metabolomics, a good differentiation of the metabolome of the two breeding groups was confirmed, and it was proven that pregnant animals showed higher plasmatic levels of succinic anhydride (3.48 more times; p = 0.0236), succinic acid (succinate) (3.1 more times; p = 0.0068) and propionic acid (3.98 more times; p = 0.0121) than lactating animals. However, lactating animals showed higher levels of N-[(3a,5b,7b)-7-hydroxy-24-oxo-3-(sulfoxide) cholan-24-yl]-Glycine (cholestadien) (2.

During pregnancy and before delivery, this fear often occurs in pregnant women. Anxiety is a feeling of worry, such as fear or uncertainty, as well as an unclear personal emotional condition about specific objects. The incidence of anxiety for primigravida mothers is 66.2% compared to multigravida mothers, which is 42.2%. Feelings of anxiety during pregnancy will have a negative impact on the growth and development of the fetus. Prenatal yoga helps the mind focus on pregnant women in regulating breathing techniques and provides comfort, security, calm and relaxation. This study aimed to determine the effectiveness of prenatal yoga in reducing the anxiety of pregnant women facing childbirth. The research design used was an experiment, purposive sampling with a sample of 32 third-trimester pregnant women—direct data collection using the STAI questionnaire instrument. The research results were analyzed using the Wilcoxson test. The results showed that all respondents experienced a decrease in their level of anxiety from moderate to mild after doing prenatal yoga. The results of the analysis obtained the value of Asymp.Sig. (2-tailed) 0.000 <0.05, meaning there is a correlation between the effectiveness of prenatal yoga in reducing anxiety for pregnant women facing labour. In conclusion, the study's results found that prenatal yoga can reduce the anxiety of pregnant women. Mothers should routinely do prenatal yoga so they do not experience anxiety during pregnancy.

During pregnancy and before delivery, this fear often occurs in pregnant women. Anxiety is a feeling of worry, such as fear or uncertainty, as well as an unclear personal emotional condition about specific objects. The incidence of anxiety for primigravida mothers is 66.2% compared to multigravida mothers, which is 42.2%. Feelings of anxiety during pregnancy will have a negative impact on the growth and development of the fetus. Prenatal yoga helps the mind focus on pregnant women in regulating breathing techniques and provides comfort, security, calm and relaxation. This study aimed to determine the effectiveness of prenatal yoga in reducing the anxiety of pregnant women facing childbirth. The research design used was an experiment, purposive sampling with a sample of 32 third-trimester pregnant women—direct data collection using the STAI questionnaire instrument. The research results were analyzed using the Wilcoxson test. The results showed that all respondents experienced a decrease in their level of anxiety from moderate to mild after doing prenatal yoga. The results of the analysis obtained the value of Asymp.Sig. (2-tailed) 0.000 <0.05, meaning there is a correlation between the effectiveness of prenatal yoga in reducing anxiety for pregnant women facing labour. In conclusion, the study's results found that prenatal yoga can reduce the anxiety of pregnant women. Mothers should routinely do prenatal yoga so they do not experience anxiety during pregnancy.

Hintergrund: Gehörlose Frauen werden in der Gesundheitsversorgung sowie spezifisch in der Schwangerenvorsorge benachteiligt und begegnen dabei vielen Herausforderungen. Durch unterschiedliche Methoden kann diesen Herausforderungen entgegengewirkt werden. Ziel: Anhand von diesem systematisierten Literaturreview sollen Herausforderungen eruiert werden, welchen gehörlosen schwangeren Frauen in der Schwangerenvorsorge begegnen. Hierzu sollen für die Gesundheitsfachpersonen Empfehlungen für die Praxis ausgearbeitet werden. Methode: Um die Fragestellung zu beantworten, wurde mittels definierten Keywords in drei verschiedenen online Datenbanken nach Literatur gesucht. An-hand von spezifischen Ein- und Ausschlusskriterien wurden drei qualitative, eine quantitative und eine Mixed Method Studie ausgesucht. Die Literatur wurde mit Hilfe vom CanMEDS Modell analysiert und diskutiert. Ergebnisse: Die Kommunikation, der Zugang zu gesundheitlichen Informationen und die Einstellung von Gesundheitsfachpersonen gegenüber gehörlosen Frauen stellen Herausforderungen in der Schwangerenvorsorge für gehörlose schwangere Frauen dar. Gesundheitsfachpersonen können eine zentrale Rolle darin spielen, diese Herausforderungen für die schwangere Frauen zu minimieren. Schlussfolgerungen: Anhand der Ergebnisse wird aufgezeigt, dass gehörlose schwangere Frauen vielen Herausforderungen in der Schwangerenvorsorge begegnen. Eine der wichtigsten Faktoren dabei, ist die Kommunikation. Um dieser Problematik entgegenzuwirken, ist das Hinzuziehen von Gebärdensprachdolmetscher:innen von Bedeutung. Um aussagekräftigere Ergebnisse zu erreichen, ist weitere Forschung nötig.

Pregnant women are one of the populations at risk of transmitting HIV-AIDS, Hepatitis B, and Syphilis to their children during pregnancy. This activity aims to increase pregnant women's knowledge about and implementing triple elimination examinations. The activity method involves audio-visual counseling and triple elimination examination. The results showed increased knowledge; 76.3% had good knowledge, and 23.7% had sufficient knowledge. The results of the examination showed that 100% of pregnant women (30 people) were non-reactive for HIV, syphilis, and hepatitis B. Audio-visual education was effective in increasing knowledge so that awareness of pregnant women to carry out triple elimination examinations increased. It is recommended that the counseling video be played continuously in the waiting room.

Pregnant women are one of the populations at risk of transmitting HIV-AIDS, Hepatitis B, and Syphilis to their children during pregnancy. This activity aims to increase pregnant women's knowledge about and implementing triple elimination examinations. The activity method involves audio-visual counseling and triple elimination examination. The results showed increased knowledge; 76.3% had good knowledge, and 23.7% had sufficient knowledge. The results of the examination showed that 100% of pregnant women (30 people) were non-reactive for HIV, syphilis, and hepatitis B. Audio-visual education was effective in increasing knowledge so that awareness of pregnant women to carry out triple elimination examinations increased. It is recommended that the counseling video be played continuously in the waiting room.

Background: Hyperemesis gravidarum (HG) is severe nausea and repeated vomiting that prevents oral intake of food and leads to dehydration, ketoacidosis and nutritional deficiencies that may need hospitalization. Methods: This systematic review focused on full-text English literature published between 2014 and 2024 using the PRISMA 2020 guidelines. Editorials and review pieces published in the same journal as the submission without a DOI were not accepted. The literature was compiled using Medline, Science Direct, Scopus and Embase, among other online venues. Result: Five publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: Several pharmaceuticals are currently in use, but there is no evidence regarding which is preferable, when to commence treatment, or what dosage or administration route is most beneficial.

Background: Hyperemesis gravidarum (HG) is severe nausea and repeated vomiting that prevents oral intake of food and leads to dehydration, ketoacidosis and nutritional deficiencies that may need hospitalization. Methods: This systematic review focused on full-text English literature published between 2014 and 2024 using the PRISMA 2020 guidelines. Editorials and review pieces published in the same journal as the submission without a DOI were not accepted. The literature was compiled using Medline, Science Direct, Scopus and Embase, among other online venues. Result: Five publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: Several pharmaceuticals are currently in use, but there is no evidence regarding which is preferable, when to commence treatment, or what dosage or administration route is most beneficial.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

BackgroundThe development and quality assurance of perinatal eHealth self-monitoring systems is an upcoming area of inquiry in health science. Building patient engagement into eHealth development as a core component has potential to guide process evaluation. Access, 1 attribute of patient engagement, is the focus of study here. Access to eHealth self-monitoring programs has the potential to influence pregnancy health and wellness outcomes. Little is known about how pregnant users' ability to obtain resources is influenced by their own adaptive activities and the mediating activities of eHealth systems during the process of real-world testing of these systems.ObjectiveHere, we examine the patient engagement process of access occurring during the adaptation of eHealth self-monitoring use from a sociomaterial perspective.MethodsIn this mixed methods convergent evaluation design, we interviewed women about perceptions of the adaptation process of using an eHealth self-monitoring system. Deductive analysis was conducted guided by the definition of access as an attribute of patient engagement. After initial qualitative and quantitative data collection and analysis, participants were spilt based on their level of use of the eHealth system (physical wear time of self-monitoring device). Content analysis was then conducted according to user group, using a conceptual matrix developed from ontological perspectives of sociomateriality.ResultsPregnant users' adaptive activities and the mediation activities of the eHealth system represent a cocreation process that resulted in user group-specific characteristics of accessing and using the system. The high- and low-use groups experienced different personal adaptation and eHealth mediation during this process of cocreation. Differences were noted between high- and low-use groups, with the high-use group giving attention to developing skills in recording and interpreting data and the low-use group discussing the manual adding of acti

Background: Pregnant women who drink herbal medicine can increase the risk of meconium amniotic fluid, and meconium amniotic fluid is a risk factor for asphyxia in newborns. Objectives: Identify three forms of culture in drinking herbal medicine in pregnant women, namely the mother's values and ideas about drinking herbal medicine, herbal drinking activities, and material on the culture of drinking herbal medicine. Methods: This research is a qualitative method with a phenomenological approach. Informants in this study consisted of pregnant women and key informants consisted of families of pregnant women, cadres, ustadzah, midwives, and herbal medicine providers. Results: The cultural forms of drinking herbal medicine include: 1) Values and Ideas. Drinking herbal medicine for pregnant women is still practiced because of their subjective norms and normative beliefs from the surrounding environment. All informants believed that herbal medicine could provide benefits rather than negative effects, and only midwives stated that herbal medicine had negative effects, namely meconium amniotic fluid, and even asphyxia. 2) The activity of drinking herbal medicine. Pregnant women drink herbal medicine from the beginning of pregnancy until delivery. The frequency of taking herbal medicine was various. Religious figures and community leaders have an important role in the culture of drinking herbal medicine. 3) Herbal ingredients. The herbs consumed by each informant were different, there were informants who consumed homemade herbs and bought them at the market. Conclusions: The culture of drinking herbal medicine is still carried out because the local community's belief about the benefits of herbal medicine is still high, and lack of public knowledge about the effects of drinking herbal medicine on pregnant women.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

HIV acquisition risks remain high for pregnant and breastfeeding populations in South Africa. Oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine (TDF-FTC) can be used daily during periods of sexual activity to prevent HIV infections for cisgender women. In 2021, oral PrEP became the standard of care for HIV prevention during pregnancy and breastfeeding periods. The objective of this dissertation was to evaluate trends in oral PrEP initiation, continuation, and adherence among adolescent girls and young women, women experiencing intimate partner violence, and by sexual behaviors throughout gestational periods and postpartum. We used data from the PrEP in Pregnancy and Postpartum (PrEP-PP) study, a prospective cohort in Cape Town of 1200 participants without HIV. The PrEP-PP study provided HIV prevention counselling and offered PrEP to pregnant and breastfeeding women.The first study evaluated the oral PrEP cascade framework among adolescent girls and young women (AGYW) in the PrEP-PP study. Approximately 83% of AGYW initiated PrEP at their first antenatal care (ANC) visit, 34% continued PrEP at 6 months, and 11% stopped and restarted. AGYW with a higher HIV risk had an increased adjusted likelihood of continuing PrEP through 6 months (adjusted odds ratio[aOR]:1.91 [95% CI, 1.15-3.16]). About 7% of AGYW had high adherence to PrEP at 6 months. The second study examined the relationship between recent and past-year intimate partner violence (IPV) experienced by pregnant and postpartum women and oral PrEP continuation and adherence. Women who experienced past-year IPV were less likely to discontinue PrEP(adjusted hazards ratio: 0.80 (95% CI: 0.61, 1.06) and had higher adherence(quantifiable tenofovir-diphosphate[TFV-DP] in dried blood spots; aOR=1.82 (95% CI: 1.02, 3.25) at 6-month follow-up visits. The third study evaluated prevention-effective adherence by gestational trimesters of pregnancy and postpartum. Prevention-effective adhere

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

BACKGROUND: Adolescent girls and young women (AGYW) in South Africa are at a higher risk of acquiring HIV. Despite the increasing availability of daily oral pre-exposure prophylaxis (PrEP) for HIV prevention, knowledge on PrEP use during pregnancy and postpartum periods at antenatal care (ANC) facilities remains inadequate. METHODS: Data from HIV-uninfected pregnant women in Cape Town, South Africa, were used in this study. These women aged 16-24 years were enrolled in the PrEP in pregnancy and postpartum (PrEP-PP) cohort study during their first ANC visit. Using the PrEP cascade framework, the outcomes of the study were PrEP initiation (prescribed tenofovir disoproxil fumarate and emtricitabine at baseline), continuation (returned for prescription), and persistence [quantifiable tenofovir diphosphate (TFV-DP) in dried blood samples]. The two primary exposures of this study were risk perception for HIV and baseline HIV risk score (0-5), which comprised condomless sex, more than one sexual partner, partner living with HIV or with unknown serostatus, laboratory-confirmed sexually transmitted infections (STIs), and hazardous alcohol use before pregnancy (Alcohol Use Disorders Identification Test for Consumption score ≥ 3). Logistic regression was used to examine the association between HIV risk and PrEP, adjusting for a priori confounders. RESULTS: A total of 486 pregnant women were included in the study, of which 16% were adolescents (aged 16-18 years) and 84% were young women (aged 19-24 years). The adolescents initiated ANC later than the young women [median = 28 weeks (20-34) vs. 23 weeks (16-34), p = 0.04]. Approximately 41% of the AGYW were diagnosed with sexually transmitted infection at baseline. Overall, 83% of the AGYW initiated PrEP use during their first ANC. The percentage of PrEP continuation was 63% at 1 month, 54% at 3 months, and 39% at 6 months. Approximately 27% consistently continued PrEP use through 6 months, while 6% stopped and restarted on PrEP

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Introducción: Los traumatismos en gestantes fueron la primera causa de morbi-mortalidad no obstétrica, alcanzando valores del 5-10%. Durante la gestación, se producen cambios anatomo-fisiológicos a todos los niveles, aumentando la gravedad y el número de complicaciones respecto a una mujer no grávida. Estas modificaciones se deben tener presentes para realizar el correcto manejo y evaluación de la politraumatizada. Objetivo: Valorar el manejo general de la gestante politraumatizada en conformidad con sus características y cambios fisiológicos producidos. Metodología: Se realizó una revisión bibliográfica desde el año 2012 hasta la actualidad en fuentes y bases de datos biomédicas; PubMed, Dialnet, SciELO y Google Scholar. Finalmente, a través de los criterios de inclusión y exclusión y el proceso de selección de artículos, se aceptaron 22 documentos para efectuar el estudio. Se incluyeron los Journal Impact Factor (JIF) de las revistas en el año de publicación de estos. Resultados: La atención a la gestante politraumatizada constó de dos etapas: la evaluación primaria y secundaria. Durante la estabilización inicial se siguieron las normas Advanced Trauma Life Support (ATLS), realizando una serie de modificaciones en función de los cambios producidos. En la evaluación secundaria se llevó a cabo la atención materna incluyendo historial clínico y obstétrico, examen físico, pruebas de laboratorio, prevención de aloinmunización Rhesus y estudios radiográficos; y fetal, iniciando la monitorización de la frecuencia cardíaca fetal (FCF). Conclusiones: Los cambios fisiológicos producidos y las posibles complicaciones derivadas suponen mayor dificultad para realizar un correcto manejo del politraumatismo. Sin embargo, las prioridades durante su atención son idénticas que en otro paciente, ya que la supervivencia de la madre prevalece sobre la del feto. La evidencia científica demuestra la necesidad de seguir investigando sobre el tema para definir el enfoque óptimo de evaluac, Introdución: Os traumatismos en xestantes foron a primeira causa de morbi-mortalidade non obstétrica, acadando datos do 5-10%. Durante a xestación, prodúcense cambios anatomo-fisiolóxicos a todos os niveis, aumentando a gravidade e o número de complicacións respecto a unha muller non grávida. Estas modificacións débense ter en conta á hora de realizar o correcto manexo e avaliación da politraumatizada. Obxectivo: Valorar o manexo xeral da xestante politraumatizada en conformidade coas súas características e cambios fisiolóxicos producidos. Metodoloxía: Realizouse unha revisión bibliográfica desde o ano 2012 ata a actualidade en fontes e bases de datos biomédicas; PubMed, Dialnet, SciELO e Google Scholar. Finalmente, a través dos criterios de inclusión e exclusión e do proceso de selección de artigos, aceptáronse 22 documentos para efectuar o estudo. Incluíronse os Journal Impact Factor (JIF) das revistas no ano de publicación destes. Resultados: A atención á xestante politraumatizada constou de dúas etapas: a avaliación primaria e secundaria. Durante a estabilización inicial seguíronse as normas Advanced Trauma Life Support (ATLS), realizando unha serie de modificacións en función dos cambios producidos. Na avaliación secundaria levouse a cabo a atención materna incluíndo historia clínica e obstétrica, exame físico, probas de laboratorio, prevención de aloinmunización Rhesus e estudos radiográficos; e fetal, iniciando a monitorización da frecuencia cardíaca fetal (FCF). Conclusións: Os cambios fisiolóxicos producidos e as posibles complicacións derivadas supoñen unha maior dificultade para realizar o correcto manexo do politraumatismo. Sen embargo, as prioridades durante a súa atención son idénticas ca noutro paciente, xa que a supervivencia da nai prevalece sobre a do feto. A evidencia científica demostra a necesidade de seguir investigando sobre o tema para definir o enfoque óptimo de avaliación e tratamento, Introduction: Injuries in pregnant women were the first cause of non-obstetric morbi-mortality, reaching values of 5-10%. During pregnancy, anatomo-physiological changes occur at all levels, increasing the severity and number of complications compared to a non-pregnant woman. These modifications must be considered when carrying out the correct management and evaluation of the polytraumatized. Objective: Assess the general management of the pregnant woman according to her characteristics and the physiological changes produced. Methodology: A literature review was carried out from 2012 to the present day in biomedical sources and databases, such as PubMed, Dialnet, SciELO and Google Scholar. Finally, through the inclusion and exclusion criteria and the article selection process, 22 documents were accepted for the review. In addition, the Journal Impact Factor (JIF) of the journals in the year of their publication. Results: The attention to the pregnant woman consisted of two stages: primary and secondary evaluation. During the initial stabilization, the Advanced Trauma Life Support (ATLS) standards were followed, making a series of modifications according to the changes produced. In the secondary evaluation, maternal care including clinical and obstetric history, physical examination, laboratory tests, prevention of Rhesus alloimmunization and radiographic studies; and fetal care, were performed starting fetal heart rate (FHR) monitoring. Conclusions: The physiological changes produced and the possible complications derived from them, suppose greater difficulty to carry out a correct management of polytraumatism. However, the priorities during care are the same as in any other patient, since the survival of the mother prevails over that of the foetus. Scientific evidence demonstrates the need for further research on the subject to define the optimal approach to evaluation and treatment

BACKGROUND: Valacyclovir is the only treatment demonstrated to be effective for the prevention of vertical transmission of cytomegalovirus within a clinical randomized, placebo-controlled trial and has been reimbursed by the Italian National Health System since December 2020. OBJECTIVE: This study reported the results of a real-life Italian multicenter observational study on cytomegalovirus infection in pregnancy evaluating the effect of the introduction of valacyclovir in the clinical practice for the prevention of vertical transmission of cytomegalovirus. STUDY DESIGN: The outcomes of women who received valacyclovir treatment and their fetuses or newborns were compared with those of a retrospective cohort observed between 2010 and 2020 who did not receive the antiviral treatment. The inclusion criterion was the diagnosis of cytomegalovirus primary infection occurring in the periconceptional period or up to 24 weeks of gestation. The primary outcome was the transmission by the time of amniocentesis. The secondary outcomes were termination of pregnancy, transmission at birth, symptomatic infection at birth, and a composite outcome (termination of pregnancy or transmission at birth). RESULTS: A total of 447 pregnant women from 10 centers were enrolled, 205 women treated with valacyclovir (called the valacyclovir group, including 1 twin pregnancy) and 242 women not treated with valacyclovir (called the no-valacyclovir group, including 2 twin pregnancies). Valacyclovir treatment was significantly associated with a reduction of the diagnosis of congenital cytomegalovirus infection by the time of amniocentesis (weighted odds ratio, 0.39; 90% confidence interval, 0.22–0.68; P=.005; relative reduction of 61%), termination of pregnancy (weighted odds ratio, 0.36; 90% confidence interval, 0.17–0.75; P=.0021; relative reduction of 64%), symptomatic congenital cytomegalovirus infection at birth (weighted odds ratio, 0.17; 90% confidence interval, 0.06–0.49; P=.006; relative re

Introduction: Effects of daily iron supplementation in iron replete pregnancy are unclear. This systematic review aimed to assess benefits and harms of oral iron supplements in pregnant women without anemia and iron deficiency. Material and methods: We predefined and registered a protocol in PROSPERO (CRD42020186210) and performed the review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched for randomized clinical trials (RCTs) and observational studies comparing daily oral iron supplementation with no iron supplements in non-anemic iron replete pregnant women. Searches were conducted in MEDLINE (by PubMed), EMBASE (by OVID), Cochrane Library, and ClinicalTrials.gov from inception to September 2022 without language restrictions. Two authors independently screened records, extracted data, and assessed risk of bias using the revised Cochrane risk of bias tool (RoB2). One author read full-texts, assessed certainty of evidence by GRADE and conducted meta-analyses using a random-effects model. Primary outcomes included iron deficiency anemia, iron deficiency, hemoglobin >130 g/L, elevated iron status, small for gestational age newborns, low birthweight newborns, preterm birth, and congenital anomalies. Results: Eight RCTs (2822 women) but no observational studies were eligible for inclusion. Daily oral iron supplementation in pregnancy probably reduces iron deficiency anemia at term (risk ratio [RR]: 0.51, 95% confidence interval [CI]: 0.38–0.70; 4 RCTs, 1670 women; I2 = 13%; moderate-certainty evidence) and the incidence of low birthweight babies (RR: 0.30, 95% CI: 0.13–0.68; 2 RCTs, 361 infants; I2 = 0%; moderate-certainty evidence). In addition, it may reduce iron deficiency at term (RR: 0.74, 95% CI: 0.60–0.92; 4 RCTs, 1663 women; I2 = 58%; low-certainty evidence) and the incidence of small for gestational age babies (RR: 0.39, 95% CI: 0.17–0.86; 1 RCT, 213 infants

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Objective: This systematic review aimed to assess scientific evidence regarding the association between body image and the decision to breastfeed during pregnancy. Methods: This study used the methodology proposed by the Joanna Briggs Institute and included studies from Scopus, Web of Science, B-On, and EBSCO. Inclusion criteria were primary studies published within the last 12 years, while gray literature, communications, and studies focusing on postpartum, body image, and newborn feeding were excluded. Results: The initial search yielded 77 articles, of which 73 were excluded after the identification process. Our analysis revealed that (i) there was a relationship between body image and the decision and duration of breastfeeding, and (ii) the decision to breastfeed seems to depend on a woman's positive or negative perception of her body. Conclusions: Understanding the influence of body image on the decision to breastfeed is crucial for health professionals to develop effective strategies for promoting this practice. However, the limited number of publications on this topic highlights the need for further research. Therefore, we suggest that future studies should investigate the relationship between body image and the decision to breastfeed and promote breastfeeding literacy among the general population., Objetivo: Esta revisão sistemática teve como objetivo avaliar as evidências científicas sobre a associação entre a imagem corporal e a decisão de amamentar ao longo da gravidez. Métodos: O estudo utilizou a metodologia proposta pelo Instituto Joanna Briggs, e incluiu estudos identificados nas bases de dados Scopus, Web of Science, B-On e EBSCO. Os critérios de inclusão foram estudos primários publicados nos últimos 12 anos, enquanto literatura cinzenta, comunicações, estudo com foco no pós-parto, imagem corporal e alimentação do recém-nascido foram excluídos. Resultados: A pesquisa inicial resultou em 77 artigos, dos quais 73 foram excluídos após o processo de identificação. A nossa análise revelou que (i) há uma relação entre a imagem corporal e a decisão e duração da amamentação e (ii) a decisão do aleitamento materno parece depender da perceção positiva ou negativa da mulher em relação ao seu corpo. Conclusões: Compreender a influência da imagem corporal na decisão de amamentar é fundamental para que os profissionais de saúde desenvolvam estratégias eficazes para promover essa prática. No entanto, o número limitado de publicações sobre este tópico destaca a necessidade de mais pesquisas. Portanto, sugerimos que estudos futuros investiguem a relação entre a imagem corporal e a decisão em amamentar, e promovam a literacia sobre o aleitamento materno diz respeito junto da população em geral.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Nutritional assessment is an intervention that contributes to the prevention of risks associated with inadequate maternal nutrition. Malnutrition can have a negative impact on maternal and infant health, likewise, the fetus resulting from the preg-nancy of an obese mother has a greater risk of being born preterm, presenting respiratory distress syndrome, transient neonatal hypoglycemia, low weight, IUGR, being large for gestational age, have fetal macrosomia, present congenital malformations and even perinatal mortality. This research is framed within a documentary bibliographic type methodology. Since it is a systematized process of collection, selection, evaluation and analysis of information, which has been obtained through electronic means in different repositories and search engines such as Google Scholar, Science Direct, Pubmed, among others, using the different Boolean operators for them. and that will serve as a documentary source, for the topic raised above. Based on the bibliography consulted and the meta-analyses presented here, there is no doubt that there is a positive relationship between maternal obesity and perinatal outcomes, which put not only the life of the pregnant woman at risk, but also the development of the fetus and neonate when she is born. . It is of vital importance, the prenatal controls that the pregnant woman must carry out, since it depends on these controls that there is a gestation process and a full-term delivery with the minimum possible complications., A avaliação nutricional é uma intervenção que contribui para a prevenção dos riscos associados a uma nutrição materna inadequada. A desnutrição pode ter um impacto negativo na saúde materna e infantil, assim como um feto nascido de uma mãe obesa corre um maior risco de parto prematuro, síndrome de angústia respiratória, hipoglicemia neonatal tran-sitória, baixo peso ao nascer, RCIU, grande para a idade gestacional, macrossomia fetal, malformações congénitas e até mortalidade perinatal. Esta investigação enquadra-se numa metodologia bibliográfica documental. Uma vez que se trata de um processo sistematizado de recolha, seleção, avaliação e análise da informação, que foi obtida por via eletrónica em diferentes repositórios e motores de busca como o Google Scholar, Science Direct, Pubmed, entre outros, utilizando para tal os diferentes operadores booleanos e que servirão de fonte documental, para a temática acima levantada. Com base na literatura consultada e nas meta-análises aqui apresentadas, não restam dúvidas de que existe uma relação positiva entre a obesidade materna e os resultados perinatais, que colocam em risco não só a vida da gestante, mas também o desenvolvimento do feto e do neonato ao nascer. Os exames pré-natais que a gestante deve realizar são de vital impor-tância, pois são essenciais para garantir que o processo de gestação e o parto a termo sejam realizados com o mínimo de complicações possíveis., La evaluación nutricional es una intervención que contribuye con la prevención de riesgos asociados a la inadecuada nutrición materna. La malnutrición puede impactar de forma negativa sobre la salud materna y del infante, asimismo, el feto producto de la gestación de una madre obesa tiene mayor riesgo de nacer pretérmino, presentar síndrome de dificultad respiratoria, hipoglucemia neonatal transitoria, bajo peso, RCIU, ser grande para la edad gestacional, tener macrosomía fetal, presentar malformaciones congénitas e incluso mortalidad perinatal. La presente investigación se enmarca dentro de una metodología de tipo bibliográfica documental. Ya que es un proceso sistematizado de recolección, selección, evaluación y análisis de la información, que se ha obtenido mediante medios electrónicos en diferentes repositorios y buscadores tales como Google Académico, Science Direct, Pubmed, entre otros, empelando para ellos los diferentes operadores booleanos y que servirán de fuente documental, para el tema antes planteado. En base a la bibliografía consultada y los metaanálisis aquí presentados, no queda dudas que existe una relación positiva entre la obesidad materna y los resultados perinatales, que ponen en riesgo no solo la vida de la gestante sino el desarrollo del feto y neonato cuando nace. Es de vital importancia, los controles prenatales que debe realizar la gestante, ya que de estos controles depende que haya un proceso de gestación y un parto a término con las mínimas complicaciones posibles.

Introduction: Effects of daily iron supplementation in iron replete pregnancy are unclear. This systematic review aimed to assess benefits and harms of oral iron supplements in pregnant women without anemia and iron deficiency. Material and methods: We predefined and registered a protocol in PROSPERO (CRD42020186210) and performed the review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We searched for randomized clinical trials (RCTs) and observational studies comparing daily oral iron supplementation with no iron supplements in non-anemic iron replete pregnant women. Searches were conducted in MEDLINE (by PubMed), EMBASE (by OVID), Cochrane Library, and ClinicalTrials.gov from inception to September 2022 without language restrictions. Two authors independently screened records, extracted data, and assessed risk of bias using the revised Cochrane risk of bias tool (RoB2). One author read full-texts, assessed certainty of evidence by GRADE and conducted meta-analyses using a random-effects model. Primary outcomes included iron deficiency anemia, iron deficiency, hemoglobin >130 g/L, elevated iron status, small for gestational age newborns, low birthweight newborns, preterm birth, and congenital anomalies. Results: Eight RCTs (2822 women) but no observational studies were eligible for inclusion. Daily oral iron supplementation in pregnancy probably reduces iron deficiency anemia at term (risk ratio [RR]: 0.51, 95% confidence interval [CI]: 0.38–0.70; 4 RCTs, 1670 women; I2 = 13%; moderate-certainty evidence) and the incidence of low birthweight babies (RR: 0.30, 95% CI: 0.13–0.68; 2 RCTs, 361 infants; I2 = 0%; moderate-certainty evidence). In addition, it may reduce iron deficiency at term (RR: 0.74, 95% CI: 0.60–0.92; 4 RCTs, 1663 women; I2 = 58%; low-certainty evidence) and the incidence of small for gestational age babies (RR: 0.39, 95% CI: 0.17–0.86; 1 RCT, 213 infants

Fe tablet that consumed during pregnancy could help in requirements iron suplement for pregnant women needed. Deficiency of iron suplement for pregnant women could lead various of disorder toward baby and pregnant itself. The aim of research to obtain The Effect of Health Education on Obedience of Pregnant Women in Taking Fe Tablets in the Class of Pregnant Women in Tinigi Village, Galang Sub-district, Tolitoli Regency. This is quantitative research with pre experiment method and used one group pretest posttest design. Total of population is 32 respondents and sampling only 10 respondents that taken by purposive sampling technique. Data analysed by Paired sampel t test with health education as an independent variable and obedience of pregnant women in consumed of Fe tablet as a depeddent variable. The result of research in pretest toward 10 respondents found about 80% have low obedience and 20% have moderate obedience, and in posttest found that about 40% have high obedience, 40% have moderate obedience and 20% have low obedience. The result of bivariate analyses with paired sampel t test found p value = 0,000 less than 0,05. So, it concluded that have The Effect of Health Education on Obedience of Pregnant Women in Taking Fe Tablets in the Class of Pregnant Women in Tinigi Village, Galang Sub-district, Tolitoli Regency. It expected that health staffs should provide the continuity of health education toward pregnant women regarding the importance of Fe tablet consumed during pregnancy.

As we already know, the pregnant woman is very vulnerable to suffer from any vaginal infection caused by different microorganisms: yeast, bacteria, and parasites. This study is prospective, its main objective is to determine the incidence of vaginal infection more frequent in pregnant women, once the diagnosis has been established, give proper treatment in order to avoid complications during pregnancy and childbirth. The pop-ulation studied corresponds to the patients of the outpatient clinic of the Guasmo Sur General Hospital during the months of September 2018-February 2019. Giving a total of 100 patients, aged between 16 and 45 years. The results are the most frequent microorganism with a high incidence of 40% of vaginal candidiasis, we also obtained the ages where there is a higher incidence of infections that are between 21 and 25 years old 41%. It is recommended to promote and prevent the incidence of vaginal infections in women who are or are not pregnant in all possible medical units to carry a pregnancy without future complications., Como ya sabemos la mujer en estado de gestación es muy vulnerable a padecer cualquier infección vaginal causada por distintos microorganismos: levaduras, bacterias, parásitos. Este estudio es de tipo prospectivo, su objetivo principal determinar la incidencia de la infección vaginal más frecuente en las mujeres embaraza-das, una vez que se tenga el diagnostico establecido dar su debido tratamiento con el fin de evitar complicaciones durante el embarazo y el parto. La población que se estudió corresponde a las pacientes de la consulta externa del Hospital General Guasmo Sur durante los meses de septiembre 2018- febrero 2019. Dando un total de 100 pacientes, con edades entre los 16 a 45 años. Se obtiene los resultados el microorganismo más frecuente con una incidencia alta 40% de candidiasis vaginal, también obtuvimos las edades en donde hay mayor incidencia de infecciones que son entre los 21- 25 años 41%. Se recomienda promover y prevenir la incidencia de infecciones vaginales en las mujeres estén o no estén embarazadas en todas las unidades médicas posibles para llevar un embarazo sin complicaciones futuras.

As we already know, the pregnant woman is very vulnerable to suffer from any vaginal infection caused by different microorganisms: yeast, bacteria, and parasites. This study is prospective, its main objective is to determine the incidence of vaginal infection more frequent in pregnant women, once the diagnosis has been established, give proper treatment in order to avoid complications during pregnancy and childbirth. The pop-ulation studied corresponds to the patients of the outpatient clinic of the Guasmo Sur General Hospital during the months of September 2018-February 2019. Giving a total of 100 patients, aged between 16 and 45 years. The results are the most frequent microorganism with a high incidence of 40% of vaginal candidiasis, we also obtained the ages where there is a higher incidence of infections that are between 21 and 25 years old 41%. It is recommended to promote and prevent the incidence of vaginal infections in women who are or are not pregnant in all possible medical units to carry a pregnancy without future complications., Como ya sabemos la mujer en estado de gestación es muy vulnerable a padecer cualquier infección vaginal causada por distintos microorganismos: levaduras, bacterias, parásitos. Este estudio es de tipo prospectivo, su objetivo principal determinar la incidencia de la infección vaginal más frecuente en las mujeres embaraza-das, una vez que se tenga el diagnostico establecido dar su debido tratamiento con el fin de evitar complicaciones durante el embarazo y el parto. La población que se estudió corresponde a las pacientes de la consulta externa del Hospital General Guasmo Sur durante los meses de septiembre 2018- febrero 2019. Dando un total de 100 pacientes, con edades entre los 16 a 45 años. Se obtiene los resultados el microorganismo más frecuente con una incidencia alta 40% de candidiasis vaginal, también obtuvimos las edades en donde hay mayor incidencia de infecciones que son entre los 21- 25 años 41%. Se recomienda promover y prevenir la incidencia de infecciones vaginales en las mujeres estén o no estén embarazadas en todas las unidades médicas posibles para llevar un embarazo sin complicaciones futuras.

As we already know, the pregnant woman is very vulnerable to suffer from any vaginal infection caused by different microorganisms: yeast, bacteria, and parasites. This study is prospective, its main objective is to determine the incidence of vaginal infection more frequent in pregnant women, once the diagnosis has been established, give proper treatment in order to avoid complications during pregnancy and childbirth. The pop-ulation studied corresponds to the patients of the outpatient clinic of the Guasmo Sur General Hospital during the months of September 2018-February 2019. Giving a total of 100 patients, aged between 16 and 45 years. The results are the most frequent microorganism with a high incidence of 40% of vaginal candidiasis, we also obtained the ages where there is a higher incidence of infections that are between 21 and 25 years old 41%. It is recommended to promote and prevent the incidence of vaginal infections in women who are or are not pregnant in all possible medical units to carry a pregnancy without future complications., Como ya sabemos la mujer en estado de gestación es muy vulnerable a padecer cualquier infección vaginal causada por distintos microorganismos: levaduras, bacterias, parásitos. Este estudio es de tipo prospectivo, su objetivo principal determinar la incidencia de la infección vaginal más frecuente en las mujeres embaraza-das, una vez que se tenga el diagnostico establecido dar su debido tratamiento con el fin de evitar complicaciones durante el embarazo y el parto. La población que se estudió corresponde a las pacientes de la consulta externa del Hospital General Guasmo Sur durante los meses de septiembre 2018- febrero 2019. Dando un total de 100 pacientes, con edades entre los 16 a 45 años. Se obtiene los resultados el microorganismo más frecuente con una incidencia alta 40% de candidiasis vaginal, también obtuvimos las edades en donde hay mayor incidencia de infecciones que son entre los 21- 25 años 41%. Se recomienda promover y prevenir la incidencia de infecciones vaginales en las mujeres estén o no estén embarazadas en todas las unidades médicas posibles para llevar un embarazo sin complicaciones futuras.

As we already know, the pregnant woman is very vulnerable to suffer from any vaginal infection caused by different microorganisms: yeast, bacteria, and parasites. This study is prospective, its main objective is to determine the incidence of vaginal infection more frequent in pregnant women, once the diagnosis has been established, give proper treatment in order to avoid complications during pregnancy and childbirth. The pop-ulation studied corresponds to the patients of the outpatient clinic of the Guasmo Sur General Hospital during the months of September 2018-February 2019. Giving a total of 100 patients, aged between 16 and 45 years. The results are the most frequent microorganism with a high incidence of 40% of vaginal candidiasis, we also obtained the ages where there is a higher incidence of infections that are between 21 and 25 years old 41%. It is recommended to promote and prevent the incidence of vaginal infections in women who are or are not pregnant in all possible medical units to carry a pregnancy without future complications., Como ya sabemos la mujer en estado de gestación es muy vulnerable a padecer cualquier infección vaginal causada por distintos microorganismos: levaduras, bacterias, parásitos. Este estudio es de tipo prospectivo, su objetivo principal determinar la incidencia de la infección vaginal más frecuente en las mujeres embaraza-das, una vez que se tenga el diagnostico establecido dar su debido tratamiento con el fin de evitar complicaciones durante el embarazo y el parto. La población que se estudió corresponde a las pacientes de la consulta externa del Hospital General Guasmo Sur durante los meses de septiembre 2018- febrero 2019. Dando un total de 100 pacientes, con edades entre los 16 a 45 años. Se obtiene los resultados el microorganismo más frecuente con una incidencia alta 40% de candidiasis vaginal, también obtuvimos las edades en donde hay mayor incidencia de infecciones que son entre los 21- 25 años 41%. Se recomienda promover y prevenir la incidencia de infecciones vaginales en las mujeres estén o no estén embarazadas en todas las unidades médicas posibles para llevar un embarazo sin complicaciones futuras.

Maternal stress and anxiety levels during pregnancy are highly prevalent and are associated with numerous poor outcomes, the most serious of which are the increased rates of infant mortality, preterm birth, and low birth weight infants. There is evidence that mindfulness training is beneficial in reducing perinatal stress and anxiety. However, traditional mindfulness training entails in-person meetings, which creates barriers, limiting accessibility. The purpose of this study was to determine if a more accessible form of mindfulness meditation (MM) training, specifically, the Headspace app, can help reduce stress and anxiety during pregnancy. To evaluate this, a longitudinal, single-arm pilot study was implemented with 20 pregnant women, who were instructed to practice meditation twice/day during the month-long trial. Validated scales were used to measure study participant’s levels of stress, anxiety, and pregnancy anxiety pre-and post-intervention. Physiological measures reflective of stress (heart rate/heart rate variability [HR/HRV] and sleep) were collected via the Oura Ring, a highly accurate sleep tracking device. Analysis indicated statistically significant reductions in self-report levels of stress (p=0.005), anxiety (p=0.011), and pregnancy anxiety (p=0.0001). Analysis of physiological data on HR/HRV and sleep, using hierarchical linear modeling, yielded a statistically significant decrease in 1 of 6 HR/HRV metrics, the low-frequency (LF) power band of the HRV; which decreased by 13% (p=0.006). LF is reflective of both sympathetic and parasympathetic activities, with lower values indicating relaxation/reduced mental stress. There was a trend towards statistical significance in two other metrics. The first is the ratio of the low frequency/high frequency (LF/HF) band, reflecting parasympathetic dominance/relaxed state, which decreased by 2% (p=0.086). The second is sleep which improved by 2% (p=0.092). In addition, 65% of study participants believed their sl

Since the 1980s, many papers have been published showing the advantages of vaginal delivery after a previous cesarean section, in terms of cost reduction and maternal morbidity, without worsening fetal prognosis. Advances in the management of labor in women with a previous cesarean section have prompted obstetrician-gynecologists to allow labor for patients with a history of two uterine scars. The methodology used for this research work is part of a documentary bibliographical review, since we are going to deal with issues raised at a theoretical level such as post-cesarean vaginal delivery. The data collection technique is made up of electronic materials, the latter such as Google Scholar, PubMed, among others, relying on the use of descriptors in health sciences or MESH terminology. The information obtained here will be reviewed for further analysis. Based on the cases analyzed here and contrasted on the basis of the consulted bibliography, it can be concluded that a post-cessation vaginal delivery is possible as long as there is a rigorous evaluation by the treating physician, since vaginal deliveries tend to be more successful when there have been other previous vaginal deliveries in the pregnant woman, since the cesarean section due to the surgical procedure that is performed, can cause future complications that prevent a vaginal delivery, however, the scientific community has established the Flamm score as one of the predictors of success for a vaginal delivery, for this reason the insistence of the World Health Organization on stimulating a worldwide increase in vaginal deliveries before cesarean section procedures, due to its low cost, lower complication rates, higher probability of existence in other vaginal deliveries in the same pregnant woman, even though the hospital stay and recovery are longer than the cesarean section., Desde los años ochenta se han publicado muchos trabajos en los que se muestran las ventajas del parto vaginal después de una cesárea previa, en cuanto a la reducción de costes y morbilidad materna, sin empeoramiento del pronóstico fetal. Los avances en el manejo del parto en mujeres con una cesárea previa han inclinado a los gineco-obstetras a permitir el trabajo del parto a pacientes con antecedentes de dos cicatrices uterinas. La metodología utilizada para el presente trabajo de investigación, se enmarca dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas planteados a nivel teórico como es Parto vaginal post cesárea. La técnica para la recolección de datos está constituida por materiales electrónicos, estos últimos como Google Académico, PubMed, entre otros, apoyándose para ello en el uso de descriptores en ciencias de la salud o terminología MESH. La información aquí obtenida será revisada para su posterior análisis. En base a los casos aquí analizados y contrastados en base a la bibliografía consultada, se puede concluir que si es posible un parto vaginal post cesaría siempre y cuando haya una evaluación rigurosa por parte del médico tratante, ya que los partos vaginales tienden a ser más exitosos cuando ya han habidos otros partos vaginales previos en la gestante, ya que la cesárea por el procedimiento quirúrgico que se realiza, puede ocasionar complicaciones a futuro que impidan un parto vaginal, sin embargo, la comunidad científica ha establecido el puntaje de Flamm como uno de los predictores de éxito para un parto vaginal, por ello la insistencia de la Organización Mundial de la Salud en estimular un aumento a nivel mundial de los partos vaginales antes que los procedimientos de cesárea, por su bajo costo, menos tasas de complicaciones, mayor probabilidad de existo en otros partos vaginales en la misma gestante, aunque la estancia hospitalaria y la recuperación sean más larga que la cesárea.

As we already know, the pregnant woman is very vulnerable to suffer from any vaginal infection caused by different microorganisms: yeast, bacteria, and parasites. This study is prospective, its main objective is to determine the incidence of vaginal infection more frequent in pregnant women, once the diagnosis has been established, give proper treatment in order to avoid complications during pregnancy and childbirth. The pop-ulation studied corresponds to the patients of the outpatient clinic of the Guasmo Sur General Hospital during the months of September 2018-February 2019. Giving a total of 100 patients, aged between 16 and 45 years. The results are the most frequent microorganism with a high incidence of 40% of vaginal candidiasis, we also obtained the ages where there is a higher incidence of infections that are between 21 and 25 years old 41%. It is recommended to promote and prevent the incidence of vaginal infections in women who are or are not pregnant in all possible medical units to carry a pregnancy without future complications., Como ya sabemos la mujer en estado de gestación es muy vulnerable a padecer cualquier infección vaginal causada por distintos microorganismos: levaduras, bacterias, parásitos. Este estudio es de tipo prospectivo, su objetivo principal determinar la incidencia de la infección vaginal más frecuente en las mujeres embaraza-das, una vez que se tenga el diagnostico establecido dar su debido tratamiento con el fin de evitar complicaciones durante el embarazo y el parto. La población que se estudió corresponde a las pacientes de la consulta externa del Hospital General Guasmo Sur durante los meses de septiembre 2018- febrero 2019. Dando un total de 100 pacientes, con edades entre los 16 a 45 años. Se obtiene los resultados el microorganismo más frecuente con una incidencia alta 40% de candidiasis vaginal, también obtuvimos las edades en donde hay mayor incidencia de infecciones que son entre los 21- 25 años 41%. Se recomienda promover y prevenir la incidencia de infecciones vaginales en las mujeres estén o no estén embarazadas en todas las unidades médicas posibles para llevar un embarazo sin complicaciones futuras.

Since the 1980s, many papers have been published showing the advantages of vaginal delivery after a previous cesarean section, in terms of cost reduction and maternal morbidity, without worsening fetal prognosis. Advances in the management of labor in women with a previous cesarean section have prompted obstetrician-gynecologists to allow labor for patients with a history of two uterine scars. The methodology used for this research work is part of a documentary bibliographical review, since we are going to deal with issues raised at a theoretical level such as post-cesarean vaginal delivery. The data collection technique is made up of electronic materials, the latter such as Google Scholar, PubMed, among others, relying on the use of descriptors in health sciences or MESH terminology. The information obtained here will be reviewed for further analysis. Based on the cases analyzed here and contrasted on the basis of the consulted bibliography, it can be concluded that a post-cessation vaginal delivery is possible as long as there is a rigorous evaluation by the treating physician, since vaginal deliveries tend to be more successful when there have been other previous vaginal deliveries in the pregnant woman, since the cesarean section due to the surgical procedure that is performed, can cause future complications that prevent a vaginal delivery, however, the scientific community has established the Flamm score as one of the predictors of success for a vaginal delivery, for this reason the insistence of the World Health Organization on stimulating a worldwide increase in vaginal deliveries before cesarean section procedures, due to its low cost, lower complication rates, higher probability of existence in other vaginal deliveries in the same pregnant woman, even though the hospital stay and recovery are longer than the cesarean section., Desde los años ochenta se han publicado muchos trabajos en los que se muestran las ventajas del parto vaginal después de una cesárea previa, en cuanto a la reducción de costes y morbilidad materna, sin empeoramiento del pronóstico fetal. Los avances en el manejo del parto en mujeres con una cesárea previa han inclinado a los gineco-obstetras a permitir el trabajo del parto a pacientes con antecedentes de dos cicatrices uterinas. La metodología utilizada para el presente trabajo de investigación, se enmarca dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas planteados a nivel teórico como es Parto vaginal post cesárea. La técnica para la recolección de datos está constituida por materiales electrónicos, estos últimos como Google Académico, PubMed, entre otros, apoyándose para ello en el uso de descriptores en ciencias de la salud o terminología MESH. La información aquí obtenida será revisada para su posterior análisis. En base a los casos aquí analizados y contrastados en base a la bibliografía consultada, se puede concluir que si es posible un parto vaginal post cesaría siempre y cuando haya una evaluación rigurosa por parte del médico tratante, ya que los partos vaginales tienden a ser más exitosos cuando ya han habidos otros partos vaginales previos en la gestante, ya que la cesárea por el procedimiento quirúrgico que se realiza, puede ocasionar complicaciones a futuro que impidan un parto vaginal, sin embargo, la comunidad científica ha establecido el puntaje de Flamm como uno de los predictores de éxito para un parto vaginal, por ello la insistencia de la Organización Mundial de la Salud en estimular un aumento a nivel mundial de los partos vaginales antes que los procedimientos de cesárea, por su bajo costo, menos tasas de complicaciones, mayor probabilidad de existo en otros partos vaginales en la misma gestante, aunque la estancia hospitalaria y la recuperación sean más larga que la cesárea.

As we already know, the pregnant woman is very vulnerable to suffer from any vaginal infection caused by different microorganisms: yeast, bacteria, and parasites. This study is prospective, its main objective is to determine the incidence of vaginal infection more frequent in pregnant women, once the diagnosis has been established, give proper treatment in order to avoid complications during pregnancy and childbirth. The pop-ulation studied corresponds to the patients of the outpatient clinic of the Guasmo Sur General Hospital during the months of September 2018-February 2019. Giving a total of 100 patients, aged between 16 and 45 years. The results are the most frequent microorganism with a high incidence of 40% of vaginal candidiasis, we also obtained the ages where there is a higher incidence of infections that are between 21 and 25 years old 41%. It is recommended to promote and prevent the incidence of vaginal infections in women who are or are not pregnant in all possible medical units to carry a pregnancy without future complications., Como ya sabemos la mujer en estado de gestación es muy vulnerable a padecer cualquier infección vaginal causada por distintos microorganismos: levaduras, bacterias, parásitos. Este estudio es de tipo prospectivo, su objetivo principal determinar la incidencia de la infección vaginal más frecuente en las mujeres embaraza-das, una vez que se tenga el diagnostico establecido dar su debido tratamiento con el fin de evitar complicaciones durante el embarazo y el parto. La población que se estudió corresponde a las pacientes de la consulta externa del Hospital General Guasmo Sur durante los meses de septiembre 2018- febrero 2019. Dando un total de 100 pacientes, con edades entre los 16 a 45 años. Se obtiene los resultados el microorganismo más frecuente con una incidencia alta 40% de candidiasis vaginal, también obtuvimos las edades en donde hay mayor incidencia de infecciones que son entre los 21- 25 años 41%. Se recomienda promover y prevenir la incidencia de infecciones vaginales en las mujeres estén o no estén embarazadas en todas las unidades médicas posibles para llevar un embarazo sin complicaciones futuras.

Since the 1980s, many papers have been published showing the advantages of vaginal delivery after a previous cesarean section, in terms of cost reduction and maternal morbidity, without worsening fetal prognosis. Advances in the management of labor in women with a previous cesarean section have prompted obstetrician-gynecologists to allow labor for patients with a history of two uterine scars. The methodology used for this research work is part of a documentary bibliographical review, since we are going to deal with issues raised at a theoretical level such as post-cesarean vaginal delivery. The data collection technique is made up of electronic materials, the latter such as Google Scholar, PubMed, among others, relying on the use of descriptors in health sciences or MESH terminology. The information obtained here will be reviewed for further analysis. Based on the cases analyzed here and contrasted on the basis of the consulted bibliography, it can be concluded that a post-cessation vaginal delivery is possible as long as there is a rigorous evaluation by the treating physician, since vaginal deliveries tend to be more successful when there have been other previous vaginal deliveries in the pregnant woman, since the cesarean section due to the surgical procedure that is performed, can cause future complications that prevent a vaginal delivery, however, the scientific community has established the Flamm score as one of the predictors of success for a vaginal delivery, for this reason the insistence of the World Health Organization on stimulating a worldwide increase in vaginal deliveries before cesarean section procedures, due to its low cost, lower complication rates, higher probability of existence in other vaginal deliveries in the same pregnant woman, even though the hospital stay and recovery are longer than the cesarean section., Desde los años ochenta se han publicado muchos trabajos en los que se muestran las ventajas del parto vaginal después de una cesárea previa, en cuanto a la reducción de costes y morbilidad materna, sin empeoramiento del pronóstico fetal. Los avances en el manejo del parto en mujeres con una cesárea previa han inclinado a los gineco-obstetras a permitir el trabajo del parto a pacientes con antecedentes de dos cicatrices uterinas. La metodología utilizada para el presente trabajo de investigación, se enmarca dentro de una revisión bibliográfica de tipo documental, ya que nos vamos a ocupar de temas planteados a nivel teórico como es Parto vaginal post cesárea. La técnica para la recolección de datos está constituida por materiales electrónicos, estos últimos como Google Académico, PubMed, entre otros, apoyándose para ello en el uso de descriptores en ciencias de la salud o terminología MESH. La información aquí obtenida será revisada para su posterior análisis. En base a los casos aquí analizados y contrastados en base a la bibliografía consultada, se puede concluir que si es posible un parto vaginal post cesaría siempre y cuando haya una evaluación rigurosa por parte del médico tratante, ya que los partos vaginales tienden a ser más exitosos cuando ya han habidos otros partos vaginales previos en la gestante, ya que la cesárea por el procedimiento quirúrgico que se realiza, puede ocasionar complicaciones a futuro que impidan un parto vaginal, sin embargo, la comunidad científica ha establecido el puntaje de Flamm como uno de los predictores de éxito para un parto vaginal, por ello la insistencia de la Organización Mundial de la Salud en estimular un aumento a nivel mundial de los partos vaginales antes que los procedimientos de cesárea, por su bajo costo, menos tasas de complicaciones, mayor probabilidad de existo en otros partos vaginales en la misma gestante, aunque la estancia hospitalaria y la recuperación sean más larga que la cesárea.

BackgroundPre-exposure prophylaxis (PrEP) is safe and effective in postpartum women. Human immunodeficiency virus self-testing (HIVST) for male partners combined with biofeedback counseling through real-time adherence measures may improve PrEP use among postpartum women.MethodsBetween August 2020 and April 2021, we randomized postpartum women who initiated PrEP in pregnancy 1:1 to the intervention group (HIVST + biofeedback counseling after urine tenofovir test) or to standard of care ([SOC] facility-based human immunodeficiency virus [HIV] tests and routine counseling without biofeedback). The outcomes of interest were PrEP adherence in the past 48-72 hours via urine tenofovir tests and partner HIV testing, measured 1-month after randomization. Secondary outcomes included the proportion of partners who tested for HIV and the discrepancy between self-reported PrEP adherence and urine tenofovir result.ResultsWe enrolled 106 women (median age = 26 years). At enrollment, 72% of women reported missing <2 doses in the past 7 days; 36% of women had tenofovir present in her urine. One month after enrollment, 62% (n = 33) of women in the intervention arm had tenofovir present in their urine compared to 34% (n = 18) in SOC (risk ratio [RR] = 1.83; 95% confidence interval [CI] = 1.19-2.82; P = .001). Two thirds of women in the intervention arm reported that her partner tested for HIV (66%; n = 35), compared to 17% (n = 9) in SOC (RR = 3.89; 95% CI = 2.08-7.27; P < .001). Self-reported PrEP adherence (took PrEP >5 of last week) with no tenofovir in urine test was lower in the intervention group (17% vs 46%; RR = 0.33; 95% CI = 0.17-0.67; P = .03). No social or clinical adverse events were reported in the intervention arm.ConclusionsThe HIVST for partners and biofeedback counseling increased levels of recent PrEP adherence, pointing to the importance of these interventions to support PrEP use in this population.

IntroductionPre-exposure prophylaxis (PrEP) is a safe and effective prevention strategy to reduce women's risk of HIV in pregnancy and postpartum. Effective PrEP protection requires daily PrEP adherence, but little is known about maternal PrEP continuation and factors that influence PrEP use.MethodsThe PrEP in pregnancy and postpartum (PrEP-PP) study enrolled consenting pregnant, HIV-negative women at first antenatal care (ANC) visit with follow-up through 12 months postpartum. Eligible and consenting women and girls ≥16 years received HIV prevention counselling and were offered PrEP. Interviewers collected socio-demographic and behavioural data from participants at each visit. We analysed the proportion of women who initiated PrEP and the proportion who continued PrEP after 3 months with associated correlates by estimating the prevalence ratio adjusting for a priori confounders.ResultsBetween August 2019 and October 2021, we enrolled 1201 pregnant women (median gestation 21 weeks; age 26 years); 84% of women initiated PrEP at their first ANC visit (n = 1014); 55% were married or cohabiting. Overall, 66% of women on PrEP returned for a repeat prescription at 1 month; 58% returned at 3 months (n = 493 of 844). Almost one-half of women on PrEP reported a side effect at 1 month, mostly nausea/vomiting. Women on PrEP in the first and second trimesters had higher odds of reporting side effects (aOR 2.61; 95% CI 1.17-5.84) versus postpartum women. Women who reported side effects continued with PrEP less than those who did not report side effects (aPR = 0.87; 95% CI 0.77-0.97). Women with ≥1 previous pregnancy (aPR = 0.76; 95% CI 0.57-1.01) or were postpartum (aPR 0.85; 95% CI 0.75-0.97) were less likely to continue PrEP compared to women who were primigravid or pregnant. Women who reported having an HIV+ partner (aPR = 1.45; 95% CI 1.13-1.85) or high HIV risk perception (aPR = 1.20, 95% CI = 1.01-1.41) were more likely to continue on PrEP than those who had HIV-negative p

Cisgender women, particularly pregnant and postpartum women in Eastern and Southern Africa, face an unacceptably high risk of HIV acquisition. Oral pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention that can reduce HIV acquisition and vertical transmission. In this qualitative study, we interviewed 21 postpartum women from Cape Town, South Africa who initiated PrEP during pregnancy and who self-reported low PrEP adherence or missed > 1 PrEP follow-up collection. We identified multiple overlapping barriers to PrEP continuation and/or adherence. Individual factors included forgetting to take PrEP daily, being away from home when PrEP should be taken, anticipated stigma and limited disclosure of PrEP use. Women also reported pill-related factors such as side effects and having to take PrEP in addition to other tablets during pregnancy and the postpartum period. Facility-related barriers included logistics around PrEP collection especially when not in antenatal care, as well as transport and financial barriers.

IntroductionDaily oral pre-exposure prophylaxis (PrEP) can reduce HIV acquisition. However, prevention effectiveness requires daily adherence prior to and during periods of sexual activity. Little is known about pharmacologic measures of PrEP adherence during pregnancy and postpartum and the factors related to optimal adherence during periods of sexual activity in this population.MethodsBetween August 2019 and October 2021, we enrolled pregnant women without HIV at their first antenatal care visit followed-up through 12 months postpartum. Eligible women ≥16 years old received HIV prevention counselling and were offered oral PrEP (TDF-FTC). We quantified tenofovir-diphosphate (TFV-DP) in dried blood spots in women who reported taking PrEP in the past 30 days (at quarterly follow-up visits). We used regression models with generalized estimating equations to evaluate correlates of TFV-DP (any vs. none, and ≥2 vs. <2 doses/week), adjusting for maternal age and pregnancy status.Results and discussionIn 382 women who started PrEP in pregnancy, returned for follow-up and reported PrEP use in the past 30 days, the median age was 27 years (interquartile range [IQR] = 23-32), and the median time on PrEP was 168 days (IQR = 84-252 days). Half of the samples had quantifiable TFV-DP at any time point (52%), declining from 67% of pregnant women 3 months post-initiation to 31% of postpartum women by 12 months. Overall, 72% had concentrations corresponding to <2 doses/week; 25% ≥2 doses/week; 3% 7 doses/week. Concentrations were lower in postpartum versus pregnancy (age-adjusted odds ratio [aOR] = 0.44; 95% confidence interval [CI] = 0.35-0.54). The correlation of self-reported adherence and TFV-DP ranged from -0.07 in pregnancy to 0.25 in postpartum women. Variables associated with having quantifiable TFV-DP included partner living with HIV/unknown serostatus (aOR = 1.50; 95% CI = 1.01-2.22), and reported frequency of sexual activity in the past month (aOR sex >5/month vs

HIV incidence among pregnant and postpartum women remains high in South Africa. Pre-exposure prophylaxis (PrEP) use remains suboptimal in this population, particularly during the postpartum period when women's engagement with routine clinic visits outside PrEP decreases. Key barriers to sustained PrEP use include the need for ongoing contact with the health facility and suboptimal counseling around effective PrEP use. Stepped Care to Optimize PrEP Effectiveness in Pregnant and Postpartum women (SCOPE-PP), is a two-stepped unblinded, individually randomized controlled trial (RCT) that aims to optimize peripartum and postpartum PrEP use by providing a stepped package of evidence-based interventions. We will enroll 650 pregnant women (> 25 weeks pregnant) who access PrEP at a busy antenatal clinic in Cape Town at the time of recruitment and follow them for 15 months. We will enroll and individually randomize pregnant women > 16 years who are not living with HIV who are either on PrEP or interested in starting PrEP during pregnancy. In step 1, we will evaluate the impact of enhanced adherence counselling and biofeedback (using urine tenofovir tests for biofeedback) and rapid PrEP collection (to reduce time required) on PrEP use in early peripartum compared to standard of care (SOC) (n = 325 per arm). The primary outcome is PrEP persistence per urine tenofovir levels and dried blood spots of tenofovir diphosphate (TFV-DP) after 6-months. The second step will enroll and individually randomize participants from Step 1 who discontinue taking PrEP or have poor persistence in Step 1 but want to continue PrEP. Step 2 will test the impact of enhanced counseling and biofeedback plus rapid PrEP collection compared to community PrEP delivery with HIV self-testing on PrEP use (n = up to 325 postpartum women). The primary outcome is PrEP continuation and persistence 6-months following second randomization (~ 9-months postpartum). Finally, we will estimate the cost effecti

Climate change is accelerating the intensity and frequency of wildfires globally. Understanding how wildfire smoke (WS) may lead to adverse pregnancy outcomes and alterations in placental function via biological mechanisms is critical to mitigate the harms of exposure. We aim to review the literature surrounding WS, placental biology, biological mechanisms underlying adverse pregnancy outcomes as well as interventions and strategies to avoid WS exposure in pregnancy. This review includes epidemiologic and experimental laboratory-based studies of WS, air pollution, particulate matter (PM), and other chemicals related to combustion in relation to obstetric outcomes and placental biology. We summarized the available clinical, animal, and placental studies with WS and other combustion products such as tobacco, diesel, and wood smoke. Additionally, we reviewed current recommendations for prevention of WS exposure. We found that there is limited data specific to WS; however, studies on air pollution and other combustion sources suggest a link to inflammation, oxidative stress, endocrine disruption, DNA damage, telomere shortening, epigenetic changes, as well as metabolic, vascular, and endothelial dysregulation in the maternal-fetal unit. These alterations in placental biology contribute to adverse obstetric outcomes that disproportionally affect the most vulnerable. Limiting time outdoors, wearing N95 respirator face masks and using high quality indoor air filters during wildfire events reduces exposure to related environmental exposures and may mitigate morbidities attributable to WS.

BackgroundOral daily preexposure prophylaxis (PrEP) using emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF) is recommended as standard of care for prevention in individuals at high risk for HIV infection, including pregnant and postpartum cisgender women. FTC/TDF is also active against hepatitis B virus (HBV); however, concern has been raised that providing PrEP to individuals infected with HBV could lead to hepatitis flares and liver injury, especially in the setting of suboptimal PrEP use.MethodsWe conducted a cross-sectional analysis of baseline data from the PrEP in pregnant and postpartum women (PrEP-PP) cohort study from February 2020-March 2022 in one antenatal care clinic in Cape Town, South Africa (SA) to evaluate: (1) the field performance of a point of care test (POCT) (Determine II, Abbott Inc., Japan) for diagnosis of hepatitis B surface antigen (HBsAg) in a maternity setting, (2) the prevalence of HBV in a cohort of pregnant women not living with HIV.ResultsWe enrolled 1194 HIV sero-negative pregnant women at their first antenatal visit. Median age was 26 years (IQR = 22-31 years); 52% were born before 1995 (before universal HBV vaccination had started in South Africa). Median gestational age was 22 weeks (IQR = 16-30 weeks). There were 8 POCT and laboratory confirmed HBV cases among 1194 women. The overall prevalence of 0.67% (95% CI = 0.34-1.32%). In women born before 1995, 8 of 622 women were diagnosed with HBsAg; the prevalence was 1.29% (95% CI = 0.65-2.52%), and in women born in 1995 or after (n = 572); the prevalence was 0% (95% CI = 0.0-0.67%). We confirmed the test results in 99.8% of the rapid HBsAg (Determine II). Sensitivity was 100% (95% CI = 68-100%). Specificity was 100% (95% CI = 99.67-100%).ConclusionThe prevalence of HBV was very low in pregnant women not living with HIV and was only in women born before the HBV vaccine was included in the Expanded Program of Immunization. The Determine II POCT HBsAg showed e