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Opioid use disorder (OUD) among pregnant people has increased dramatically during the opioid epidemic, affecting a significant number of families with young children. Parents with OUD commonly face significant challenges as they are often balancing the stress of caring for young children with maintaining recovery and co‐occurring psychosocial challenges (e.g., mental health, low social support). Toward designing interventions to address parenting needs among parents with OUD, we conducted a mixed‐methods study to understand the acceptability of receiving parenting support prenatally among pregnant people with OUD residing in the United States. Semi‐structured interviews were conducted among 18 pregnant and early postpartum people recruited from a substance use treatment program specializing in the care of pregnant and parenting populations. Among all participants, a prenatal parenting program that comprehensively addresses recovery, parenting, and wellbeing was found to be widely acceptable. Regarding content most desirable within a parenting intervention, participants indicated an interest in breastfeeding, caring for newborns with in‐utero opioid exposure, parent‐infant bonding, infant soothing techniques, their own wellbeing/mental health, and parenting skills. We introduce a prenatal adaptation of the well‐established Family Check‐up parenting intervention as a novel, prenatal intervention to prevent negative outcomes for caregivers in recovery and their children. [ABSTRACT FROM AUTHOR]

An efficient, multidimensional instrument is needed to screen non‐optimal prenatal parental representations predictive of postnatal parenting behavior and child attachment. The present work aimed to revise and validate the Prenatal Caregiving Expectations Questionnaire—Revised (PCEQ‐R). Survey data from two independent samples of pregnant, primarily Danish, women (N = 300/322) were collected to 1) test the factor structure and select items for a 20‐item version, and 2) confirm the factor structure, examine internal consistency, and establish initial construct validity. Confirmatory factor analysis supported a three‐factor model of helpless‐dysregulated, anxious‐hyperactivated, and avoidant‐deactivated caregiving representations. Internal consistency was acceptable (α >.73). Construct validity analyses showed that higher helpless‐dysregulated caregiving was associated with low maternal antenatal attachment quality (rs = −.36) and intensity (rs = −.11), increased risk of perinatal depression (rs=.37), and trait anxiety (rs=.37). Higher anxious‐hyperactivated caregiving was associated with better maternal antenatal attachment quality (rs=.20) and higher intensity (rs =.26), while avoidant‐deactivated caregiving was not associated with maternal antenatal attachment. These findings support the validity and multidimensional structure of the measure. The homogenous nature of the sample limits generalizability of results. Future studies should examine predictive validity of the PCEQ‐R and include clinical samples. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Neonatal is the property of Fundacion para la Salud Materno Infantil (FUNDASAMIN) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To present an unusual case of anal squamous cell carcinoma (SCC) in a young pregnant woman. Material and Methods: The information was collected based on the clinical record after the informed consent of the patient. Results: This is a 34-year-old pregnant woman with stage IIIB anal SCC. She was managed with chemotherapy before delivery, followed by a caesarean section and chemoradiotherapy after birth. The patient experienced complete clinical and imaging regression after treatment, but she presented early tumor regrowth requiring abdomino-perineal amputation, with negative surgical margins. Discussion: The treatment of anal cancer (AC) in pregnant women is based on a multidisciplinary approach, adapting current clinical guidelines. It establishes a challenge from an ethical point of view that must consider the impact on the health of the mother and the fetus. Proctological symptoms and their confusion with benign pathology and those typical of pregnancy can work against early diagnosis. [ABSTRACT FROM AUTHOR]

Objective: the aim of our study was to assess the effect of bariatric surgery on obstetric outcomes. Material and methods: a retrospective cohort study was conducted, including 54 pregnancies post-bariatric surgery and 219 pregnancies in non-operated obese women, from December 2018 to January 2023. Various maternal and obstetric characteristics were evaluated, ranging from baseline data to antepartum, intrapartum, postpartum, and neonatal outcomes. Results: bariatric surgery showed a significant 69 % reduction in the risk of gestational diabetes (GDM) (p = 0.045) and a 63.1 % reduction in cesarean sections p = 0.014), but also a notable increase in the risk of miscarriage (3.5 times more, p = 0.046) and intrauterine growth restriction (35 times more, p = 0.009). Bariatric surgery was associated with a significant prolongation of postpartum hospital stay (7.5 times more, p = 0.001) and a decrease in the average weight of the newborn (213.71 g, p = 0.006). Conclusion: pregnancy after bariatric surgery presents benefits, such as a reduced risk of gestational diabetes (GDM) and cesarean section, but also presents challenges, such as an increased risk of miscarriage and intrauterine growth restriction (IUGR). These results highlight the importance of specialized obstetric care to optimize maternal-fetal outcomes in pregnant women with a history of bariatric surgery. [ABSTRACT FROM AUTHOR]

Studies on nutritional recommendations for pregnant women who exercise are scarce. The objective of this article is not to focus on the diet of pregnant women as a whole, but to review those aspects of it that may be related to physical exercise. To this end, the nutritional and hydration recommendations contained in the main clinical practice guides on physical exercise during pregnancy are collected, including the first Spanish guides. Likewise, the energy requirements required by pregnant women who perform physical exercise during pregnancy for adequate gestational weight gain are addressed, aspects related to macronutrients in the aforementioned population group, and two specific topics, such as nutritional needs in the adolescent who practices physical exercise during pregnancy and eating disorders in pregnant athletes It is concluded by stating that pregnant women who exercise regularly should eat a varied and balanced diet, such as the Mediterranean diet, avoid long periods of fasting to avoid the appearance of hypoglycemia and maintain adequate fluid intake before, during and after physical exercise. Pregnant adolescents who engage in physical exercise require nutritional supervision to achieve adequate gestational weight gain. The pregnant athlete with an eating disorder has a higher risk of complications during pregnancy and childbirth, gynecological, fetal and neonatal, and, therefore, requires close monitoring by specialists in maternal-fetal medicine. [ABSTRACT FROM AUTHOR]

Copyright of Medicina Naturista is the property of Sociedad Europea de Medicina Naturista Clasica (Seccion Espanola) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of GeSec: Revista de Gestao e Secretariado is the property of Sindicato das Secretarias e Secretarios do Estado de Sao Paulo (SINSESP) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción. El parto prematuro es un problema médico, social y económico importante, causa gran mortalidad y morbilidad neonatal, tiene un impacto importante en el sistema de salud y afecta la calidad de vida de las familias. El peso de los recién nacidos de madres con enfermedad periodontal es significativamente menor en comparación con los de madres no afectadas por esta enfermedad bucal. Este resultado adverso se considera un problema de salud pública global según los datos epidemiológicos. Objetivo. Determinar la asociación entre la prevalencia de parto prematuro y la enfermedad periodontal en Bolivia, Chile y Colombia entre el 2000 y el 2020. Materiales y métodos. Este estudio ecológico consideró las poblaciones de mujeres de Bolivia, Chile y Colombia, y la prevalencia de partos prematuros y enfermedad periodontal, discriminadas por grupos de edad. El estudio abarcó el período entre el 2000 y el 2020. La estrategia de búsqueda con la herramienta de investigación del Institute for Health Metrics and Evaluation incluyó prevalencia, grupos de edad, años entre 2000 y 2020, causas de parto prematuro y enfermedad periodontal, contexto y ubicaciones, mujeres y tasas. El análisis estadístico incluyó una regresión lineal simple entre parto prematuro y enfermedad periodontal para cada grupo de edad dentro de cada país. Resultados. Las tasas de partos prematuros fueron mayores en el grupo de 15 a 19 años (Bolivia: 697.563, Chile: 844.864, Colombia: 804.126). La prevalencia de la enfermedad periodontal aumentó con la edad, particularmente en el grupo de 45 a 49 años (Bolivia: 22’077.854, Chile: 34’297.901, Colombia: 32'032,830). Según los grupos de edad, la regresión lineal fue estadísticamente significativa (p < 0,001) para todos los grupos evaluados de la población boliviana, en los grupos mayores de 30 años para las colombianas y solo en el grupo de 15 a 19 años para las mujeres chilenas. Conclusión. Se encontró asociación entre el parto prematuro y la enfermedad periodontal en todos los grupos de edad en Bolivia, solo en el grupo de 15 a 19 años en Chile, y de 30 años y más en Colombia en el período evaluado de 20 años.

La investigación se centró en analizar los efectos adversos de la falta de regulación legislativa sobre la maternidad subrogada en Colombia, un tema que ha sido abordado por la Corte Constitucional, priorizando los derechos de niños, niñas y adolescentes. Utilizando una metodología hermenéutica basada en la revisión e interpretación de fuentes jurídicas, se descubrió que esta práctica ha ganado popularidad como una alternativa para quienes desean ser padres y, en algunos contextos, como fuente de remuneración para las mujeres gestantes. Sin embargo, su atipicidad legal ha creado vacíos normativos que pueden vulnerar derechos fundamentales, incluyendo los derechos sexuales y reproductivos de las mujeres y el derecho del nasciturus a tener una familia. En conclusión, la ausencia de regulación ha originado serios problemas legales, especialmente en la filiación de los niños nacidos por subrogación. La Corte Constitucional ha subrayado la necesidad de una regulación que proteja los derechos de los menores y ofrezca soluciones a posibles controversias entre las partes.

Introducción. Estudios cualitativos o etnográficos sobre el embarazo adolescente realizados en las últimas dos décadas en América Latina, centrados en las experiencias y el sentido dado a las mismas por las propias adolescentes, han realizado aportes relevantes a la comprensión del tema. La investigación de la que surge este texto se ubica en ese tipo de estudios y abordaje novedoso en Panamá. En ella indagamos en las causas y consecuencias de estos embarazos, identificando específicamente los contextos, las relaciones y los significados dados por adolescentes panameñas en sus propios análisis y testimonios. Metodología. Diseñamos para ello un estudio cualitativo que generó tres productos etnográficos: la construcción coral de una tipología de casos de adolescentes embarazadas, el autodiagnóstico del fenómeno realizado por las adolescentes y sus propios relatos testimoniales. Todo ello recogido en 5 grupos focales en los que participaron 29 adolescentes embarazadas o madres de contextos territoriales y socioculturales diversos del país, y entrevistas testimoniales a 22 de ellas. Resultados. Los resultados muestran dimensiones normalmente ocultas en la problematización dominante del embarazo a estas edades, entre ellas, las condiciones preexistentes de abandono familiar, social e institucional, pero también el estigma y la discriminación que sufren cuando se quedan embarazadas, y que determinarían consecuencias perjudiciales. A nivel más subjetivo, las ideas que mantienen las adolescentes sobre la sexualidad, el noviazgo o la maternidad, son determinantes para entender la ocurrencia y la significación de un embarazo a estas edades. Discusión. Los hallazgos de este estudio son novedosos para el país y dialogan con los resultados de estudios cualitativos y etnográficos realizados en la región, contribuyendo al conocimiento de las causas y consecuencias del embarazo adolescente que pone en diálogo las condiciones objetivas o estructurales con las subjetivas de las adolescentes. Más allá de eso nos permite señalar algunos asuntos hasta ahora menos considerados, como la relación entre el trato recibido por las adolescentes embarazadas y las consecuencias perjudiciales de dichos embarazos o maternidades, así como alcanzar conclusiones sobre lo que revelan este tipo de estudios a la comprensión del tema y para la intervención social. Conclusiones. El abordaje etnográfico y la consideración de la dimensión subjetiva del tema facilita una comprensión de las causas y consecuencias del embarazo en la adolescencia profunda y diversificada en Panamá. El conocimiento generado permite diseñar intervenciones de mayor impacto en la prevención de estos embarazos no deseados, así como evaluar responsabilidades sociales e institucionales en la configuración del problema o sus consecuencias perjudiciales.

Resumen: El asma bronquial una de las patologías crónicas más frecuentes en el embarazo, afectando entre el 6 al 10% de la población de mujeres en gestación según reportes internacionales. De este grupo de pacientes, aproximadamente un tercio presentará un deterioro importante de los síntomas, exponiendo a la madre y el feto a un alto riesgo de exacerbaciones y uso de corticoides sistémicos. El mal control de los síntomas del asma se debe en muchos casos a dosis subóptimas, e incluso suspensión de la terapia con corticosteroide inhalado, que constituye la base de la terapia antiinflamatoria y controladora en el asma. Está demostrado que el asma mal controlada en el embarazo aumenta el riesgo de complicaciones obstétricas. El manejo respiratorio de estas pacientes debe ser proactivo, basado en la educación y el uso informado de los tratamientos antiasmáticos, altamente efectivos y de fácil acceso para la mayoría de las pacientes. En este artículo se revisará la fisiopatología, el diagnóstico y manejo farmacológico del asma en el embarazo. Abstract: Bronchial asthma is considered one of the most common chronic pathologies in pregnancy, affecting between 6 to 10% of pregnant women according to international reports. In this group of patients, approximately one third will present a significant aggravation in asthma symptoms, exposing the mother and fetus to a high risk of exacerbations and use of systemic corticosteroids. Poor control of asthma symptoms is in many cases due to suspension or suboptimal therapy with inhaled corticosteroid, which constitutes the basis of anti-inflammatory and controller therapy in asthma. It has been shown that poorly controlled asthma during pregnancy increases the risk of obstetric complications. The respiratory management of these patients must be proactive, patient education based and with informed use of anti-asthmatic treatments, which are highly effective and, for most patients, easily accessible. This article will review the pathophysiology, diagnosis and pharmacological management of asthma in pregnancy.

Introducción. Los trastornos hipertensivos durante el embarazo son una causa importante de morbilidad grave, muerte y discapacidad a largo plazo. El tratamiento farmacológico adecuado es uno de los pilares de la gestión de estos trastornos. Objetivos. Sintetizar las recomendaciones desarrolladas por la Organización Mundial de la Salud (OMS) con el fin de mejorar la calidad del cuidado y los desenlaces en salud de las mujeres embarazadas con trastornos hipertensivos y abordar aspectos sobre su implementación. Métodos. Se llevó a cabo una síntesis de las recomendaciones de dos guías de la OMS (Tratamiento farmacológico de la hipertensión severa en el embarazo y Tratamiento farmacológico de la hipertensión no severa en el embarazo). Las guías elaboradas por la OMS siguen los métodos de elaboración de las guías GRADE (Grading of Recommendations Assessment Development and Evaluation) del Manual para el Desarrollo de Guías de la OMS. Adicionalmente, se realizó una búsqueda sistemática en PubMed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en las Américas con el fin de identificar barreras, facilitadores y estrategias de implementación, así como para identificar indicadores. Resultados. Se formularon cuatro recomendaciones dirigidas a las mujeres con trastornos hipertensivos. Se identificaron barreras y facilitadores para la implementación, y se crearon indicadores de adherencia y resultado. Conclusiones. Las recomendaciones formuladas buscan orientar sobre cómo enfocar el tratamiento farmacológico de la hipertensión en el embarazo, con consideraciones para su implementación en América Latina y el Caribe.

During pregnancy, physiological changes in the immune response make pregnant women more susceptible to serious infection, increasing the risk for the mother as well as the foetus, newborn and infant. All women should be correctly and fully vaccinated as they enter their reproductive years, especially against diseases such as tetanus, hepatitis B, measles, rubella and varicella. In addition to the recommended vaccines, in risk situations, inactivated vaccines could be administered to women who were not correctly vaccinated before, while attenuated vaccines are contraindicated.Despite the fact that vaccination during pregnancy is a very important preventive measure and the existing recommendations from public health authorities, scientific societies and health professionals, the vaccination coverage could clearly be improved, especially against influenza and SARS-CoV-2, so any health professional involved in the care of pregnant women should proactively recommend these vaccines.The Spanish Association of Pediatrics (AEP), through its Advisory Committee on Vaccines, and the Spanish Society of Gynaecology and Obstetrics (SEGO) recommend vaccination against the following diseases during pregnancy: against influenza and COVID-19, in any trimester of pregnancy and during the postpartum period (up to 6 months post birth) in women not vaccinated during pregnancy; against pertussis, with the Tdap vaccine, between weeks 27 and 36 of gestation (in the CAV-AEP recommendations, preferably between weeks 27 and 28); and against RSV, with RSVPreF, between weeks 24 and 36 of gestation, preferably between weeks 32 and 36. Resumen: Durante el embarazo, los cambios fisiológicos en la respuesta inmunitaria favorecen que las gestantes sean más susceptibles a infecciones graves, tanto para ellas como para el feto, recién nacido y lactante. Todas las mujeres deberían entrar en el período reproductivo con su calendario vacunal correctamente cumplimentado, sobre todo en lo que respecta a enfermedades como tétanos, hepatitis B, sarampión, rubeola y varicela. Además de las vacunas recomendadas, en situaciones de riesgo las vacunas inactivadas podrían ser administradas en aquellas mujeres que no estuvieran correctamente inmunizadas con anterioridad, mientras que las atenuadas están contraindicadas.A pesar de que la vacunación durante el embarazo es una medida preventiva muy importante, y de las recomendaciones de autoridades sanitarias, sociedades científicas y profesionales sanitarios, las coberturas vacunales son claramente mejorables, especialmente en lo que respecta a gripe y COVID-19, por lo que todo profesional sanitario que atienda a la embarazada debe ser proactivo en aconsejarlas.La Asociación Española de Pediatría, a través de su Comité Asesor de Vacunas, y la Sociedad Española de Ginecología y Obstetricia recomiendan las siguientes vacunaciones durante la gestación: frente a gripe y COVID-19, en cualquier trimestre del embarazo, y durante el puerperio (hasta los 6 meses) en aquellas que no hubieran sido vacunadas durante la gestación; frente a tosferina con Tdpa, entre las 27 y 36 semanas de gestación (el CAV-AEP da preferencia entre las 27 y 28 semanas); y frente al VRS con RSVPreF, entre las 24 y 36 semanas de gestación, de preferencia entre las 32 y 36 semanas.

Diseñar un protocolo asistencial en las artritis inflamatorias crónicas durante el período preconcepcional, el embarazo, el posparto y la lactancia. Este protocolo tiene como objetivo ser práctico y aplicable en las consultas donde se atienden a pacientes con enfermedades inflamatorias reumatológicas crónicas, ayudando así a un mejor control de estas pacientes. Asimismo, se ofrecen recomendaciones sobre en qué momento se podría consultar/remitir a las pacientes a un centro especializado por parte del facultativo. Un panel multidisciplinar de médicos expertos de diferentes especialidades identificó los puntos claves, analizó la evidencia científica y se reunió para elaborar el protocolo asistencial. Las recomendaciones elaboradas se han dividido en 3 bloques: reumatología, ginecología y pediatría. El primer bloque se ha dividido en visita pregestacional, gestación y posparto. Este protocolo intenta homogeneizar el seguimiento de las pacientes desde el momento del deseo gestacional hasta el año de vida de los lactantes. Es importante realizar análisis en las pacientes en edad fértil y usar fármacos compatibles con la gestación. Si procede, se debe derivar a la paciente a unidades especializadas. La multidisciplinariedad (reumatología, ginecología y pediatría) es fundamental para mejorar en el control y en el seguimiento de estas pacientes y sus recién nacidos. To design a care protocol in chronic inflammatory arthritis during the pre-conceptional period, pregnancy, postpartum and lactation. This protocol aims to be practical and applicable in consultations where patients with chronic inflammatory rheumatological diseases are treated, thus helping to better control these patients. Likewise, recommendations are offered on when patients could be consulted/referred to a specialized center by the physician. A multidisciplinary panel of expert physicians from different specialties identified the key points, analyzed the scientific evidence, and met to develop the care protocol. The recommendations prepared have been divided into three blocks: rheumatology, gynecology and pediatrics. The first block has been divided into pre-pregnancy, pregnancy and postpartum visits. This protocol tries to homogenize the follow-up of the patients from the moment of the gestational desire until the year of life of the infants. It is important to perform tests in patients of childbearing age and use drugs compatible with pregnancy. If appropriate, the patient should be referred to specialized units. Multidisciplinarity (rheumatology, gynecology and pediatrics) is essential to improve the control and monitoring of these patients and their offspring. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pregnant individuals and parents have experienced elevated mental health problems and stress during COVID‐19. Stress during pregnancy can be harmful to the fetus and detrimental to the parent–child relationship. However, social support is known to act as a protective factor, buffering against the adverse effects of stress. The present study examined whether (1) prenatal stress during COVID‐19 was associated with parent–infant closeness at 6 months postpartum, and (2) social support moderated the effect of prenatal stress on the parent–infant relationship. In total, 181 participants completed questionnaires during pregnancy and at 6 months postpartum. A hierarchical linear regression analysis was conducted to assess whether social support moderated the effect of stress during pregnancy on parent–infant closeness at 6 months postpartum. Results indicated a significant interaction between prenatal stress and social support on parents' perceptions of closeness with their infants at 6 months postpartum (β =.805, p =.029); parents who experienced high prenatal stress with high social support reported greater parent–infant closeness, compared to those who reported high levels of stress and low social support. Findings underscore the importance of social support in protecting the parent–infant relationship, particularly in times of high stress, such as during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: malnutrition due to excess is a serious public health problem currently affecting 53 % of children and adolescents in Chile. The early identification of associated factors is key in prevention and necessary to guide interventions from early stages of life. Objective: to identify factors associated with the development of malnutrition due to excess in three-year-old children under control at Ancora Family Health. Methods: a case-control study was carried out in three Ancora Family Health Centers located in the communes of La Pintana and Puente Alto; it included 133 children and their mothers. Factors dependent on the child and the mother were analyzed and their importance in the development of malnutrition due to excess was determined. Results: logistic regression showed maternal smoking during pregnancy as a risk factor (OR = 4.065, 95 % CI: 1.119-14.770, p = 0.033) and as protective factors birth weight < 4,000 g (OR = 0.112, 95 % CI: 0.026-0.483, p = 0.003) and weight gain during the first year of life < 6.4 kg in women and < 6.9 kg in men (OR = 0.060, 95 % CI: 0.017-0.210, p = 0.000). Conclusions: the most important risk factor was maternal smoking and the protective factors were birth weight and weight gain in the first year. Health programs and public policies should focus on modifiable factors such as smoking during pregnancy and adequate weight gain in the first year of life. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cesarean section represents a procedure whose frequency has increased over time. As a consequence of this history, a complication of pregnancy is reported, the previous cesarean scar pregnancy (PCBS). Some include it as a type of ectopic pregnancy, most do not as such. This complication represents implantation of the blastocyst in a scar defect, described as isthmocele. ECCP can be of two types. The endogenous or type 1, where the gestational sac grows towards the uterine cavity and therefore the myometrium will be thicker; and the exogenous or type 2, with a growth towards the bladder, where the myometrium is very thinned. The management of this pathology is not standardized. Because of the severe maternal morbidity that can occur, and the still controversial management, we report a clinical case managed surgically at the Hospital Nacional Dos de Mayo. [ABSTRACT FROM AUTHOR]

Autoimmune hepatitis (AIH) is a complex condition with unclear origins, involving genetic susceptibility and environmental triggers that lead to immune system dysfunction. We report a case of a pregnant woman from a mosquito-borne disease-endemic area who presented jaundice, abdominal pain, and pruritus, complicated by acute liver failure. Immunological markers showed AIH triggered by dengue virus infection, which was confirmed by a positive IgM test. Treatment with supportive care followed by steroids and azathioprine resulted in favorable outcomes, averting the need for a liver transplant. Although AIH can be triggered by viruses, the role of dengue in its pathogenesis remains poorly understood. Regular clinical monitoring is vital for managing AIH, particularly during pregnancy, due to variable immune status and treatment responses. Further research is necessary to understand the link between dengue infection and AIH. Individualized treatment strategies are crucial, especially during pregnancy, in order to ensure favorable outcomes. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the vertical transmission of SARS-CoV-2 in pregnant women with COVID-19 in the Gynecology and Obstetrics Department of the Edgardo Rebagliati Martins National Hospital (HNERM). Twelve pregnant women who met the inclusion criteria were included. Real-time PCR (RT-PCR) tests for SARS-CoV-2 were performed when each woman was admitted to the hospital, placenta samples were collected for pathological evaluation as well. The results showed that vertical transmission of the virus was rare, with an overall low positivity rate in newborns. Although the study has limitations, such as the small number of cases and the lack of electron microscope analysis, it is the first attempt to evaluate vertical transmission in Peru. It is concluded that more research is needed to better understand the relationship between COVID-19 infection and complications during pregnancy. [ABSTRACT FROM AUTHOR]

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Objetivos: describir la prevalencia y caracterizar la anemia gestacional en mujeres que asisten a control prenatal en el departamento del Quindío (Colombia), y describir los factores de riesgo asociados. Materiales y métodos: estudio analítico de corte transversal. De 1.003 embarazadas se seleccionaron 307 mujeres. Se incluyeron gestantes ≥ 18 años, que asistieron al programa de control prenatal en tres instituciones privadas de alta complejidad, en Armenia (Quindío, Colombia), entre 2018 y 2023, para una ventana de observación de cinco años. Se excluyeron embarazadas con diagnóstico de malformaciones fetales y enfermedad hemolítica, las que se cambiaron de centro de atención o se mudaron del Quindío. Resultados: la edad media de las participantes fue de 28,14 ± 5,27 años. Se identificó una prevalencia de anemia gestacional del 26,38 %, siendo la hemoglobina promedio de 9,82 ± 1,74 g/dL. El 12,37 % presentó hemoglobina de 10,1-10,9 g/dL (anemia leve), 8,46 % de 7,1-10,0 g/dL (anemia moderada) y 5,53 % inferior a 7,0 g/dL (anemia severa). En el tercer trimestre la prevalencia de anemia aumentó al 41,97 % (n = 34/81), siendo anemia ferropénica en el 91,35 % (n = 74/81). El IMC < 18,5 (OR: 15,46; IC 95 %: 7,13-28,59), embarazo múltiple (OR: 9,73; IC 95 %: 1,49-26,83) y antecedente de anemia pregestacional (OR: 7,43; IC 95 %: 4,52-9,13), se asocian con anemia gestacional. Conclusiones: la prevalencia de anemia gestacional es mayor del 25 % y aumenta en el tercer trimestre. Es importante identificar los factores de riesgo durante la evaluación preconcepcional y en el control prenatal.

Introducción: el baclofeno es un agonista de los receptores GABA en el sistema nervioso central (SNC), cuyo efecto es la disminución de la espasticidad. La dosis utilizada en la terapia por bomba intratecal de baclofeno es de hasta 100 veces menor que por vía oral. Existen reportes de síndrome de abstinencia en neonatos expuestos a baclofeno en el útero. Presentación del caso: se presenta el caso de una paciente de 31 años con antecedente de espasticidad secundaria a hipoxia neonatal en manejo con bomba intratecal de baclofeno desde el año 2012, quien en el 2023 cursó con embarazo. La paciente presentó cesárea a las 37+2 semanas de gestación, bajo anestesia general y sin complicaciones con desenlaces materno-fetales favorables. Discusión: es necesario evaluar la seguridad del uso de tecnologías como bombas intratecales en el embarazo, ya que en este caso y con el uso de baclofeno se encontraron múltiples interrogantes dada la ausencia de estudios aleatorizados, así como su posible efecto teratogénico en el feto y el posible síndrome de abstinencia sobre el neonato. El presente caso clínico reporta el uso de esta tecnología con desenlace materno-fetales favorables y lo compara con los casos hallados en la literatura, encontrando además posibles efectos secundarios relacionados. Conclusiones: la información hasta la fecha parece demostrar que el uso de baclofeno vía intratecal durante el embarazo es completamente seguro, dadas sus bajas concentraciones en plasma.

Introducción. El embarazo se caracteriza por un estado de inmunodepresión que, asociado a los cambios fisiológicos y mecánicos, predispone a infecciones, entre ellas la causada por el virus SARS-CoV-2. Objetivo. Establecer la caracterización clínica y epidemiológica de las gestantes con infección por SARS-CoV-2 en un hospital de segundo nivel y mediana complejidad. Métodos. Estudio descriptivo y retrospectivo en el cual se incluyeron gestantes con diagnóstico de COVID-19 atendidas en el periodo 2020-2021; se identificaron mediante los códigos CIE-10 reportados al SIVIGILA. Resultados. Se analizaron 111 gestantes, la edad media fue de 35 años; el 96.40 % procedente de área urbana, el 3.60 % de área rural. El 0.90 % con antecedentes de viajes previos y el 23.4 % reportó contacto estrecho con un paciente con COVID-19. El antecedente patológico más frecuente fue hipertensión arterial en 7.21 % de los casos, seguido por obesidad en 5.41 %. Los síntomas más reportados fueron adinamia, fiebre, cefalea y tos; el 65.59 % de las pacientes fueron hospitalizadas y la media de edad gestacional al momento del diagnóstico fue de 30.2 semanas. El 81.98 % se trasladó a hospitalización, el 12.61 % permaneció en observación de urgencias, el 4.50 % se transfirió a la Unidad de Cuidado Intensivo Adultos y el 0.90 % recibió tratamiento en la Unidad de Cuidado Intermedio Adulto. Las indicaciones para la terminación del embarazo fueron: el 4.5 % por infección por SARS-CoV-2, el 81.08 % por causas obstétricas; el 14.42 % de las mujeres gestantaes fueron remitidas o presentaban embarazos tempranos. La vía de parto más frecuente fue la cesárea (48.65 %). El 43.24 % tuvo el parto en el contexto de la infección por SARSCoV-2; el 2.08 % con edad gestacional < 28 semanas, el 27.08 % entre 29 y 36 semanas y el 70.83 % > 37 semanas. El 90.09 % de las mujeres fueron dadas de alta y el 4.50 % remitidas. La mortalidad reportada en este estudio fue del 5.41% asociada a sepsis, neumonía y falla ventilatoria. Conclusiones. Los efectos de la pandemia han tenido un gran impacto en el embarazo y el COVID-19 tiene una connotación especial de gravedad, favorecida por los cambios fisiológicos de la gestación.

Introducción: los temores, dudas y el estrés emocional durante el embarazo pueden desencadenar respuestas fisiológicas en el cuerpo que podrían contribuir a complicaciones de salud en el periodo gestacional. Es de vital importancia la psicoprofilaxis obstétrica para la preparación psicológica y emocional de la mujer embarazada para el parto y la maternidad. Objetivo: describir las técnicas de la psicoprofilaxis obstétrica y su impacto en el periodo gestacional. Métodos: se realizó un estudio descriptivo mediante una búsqueda de literatura científica con las palabras: psicoprofilaxis obstétrica, gestación, parto, puerperio, en las bases de datos PubMed, SciELO, Google Académico. Fueron excluidos aquellos documentos que ofrecían recomendaciones desactualizadas. Desarrollo: en la psicoprofilaxis obstétrica se utilizan diversas técnicas para preparar a la mujer embarazada y a su pareja para el parto. Algunas de las técnicas más comunes son la relajación, la respiración controlada, los ejercicios físicos suaves, la visualización positiva, la comunicación efectiva y la información sobre el proceso del parto. El médico obstetra desempeña un papel fundamental, proporciona información detallada sobre el proceso del embarazo, el parto y el puerperio, ayudando a la mujer a comprender lo que puede esperar y disipando dudas y temores. Conclusiones: se conseguirá una reducción de la morbilidad materna y perinatal a través de la psicoprofilaxis obstétrica, donde se integran conocimientos, gimnasia obstétrica, técnicas de respiración y relajación; y la estimulación prenatal para potenciar el desarrollo físico, mental, sensorial y social de las embarazadas y sus familiares.

Objetivo: Relatar desde las voces narrativas las experiencias de las mujeres después del Parto en una IPS en la Ciudad de Cartagena Colombia. Materiales y Métodos: Se realizó un estudio de tipo Descriptivo, cualitativo, de diseño fenomenológico con pacientes de posparto en una clínica ginecológica. Resultados: Se entrevistaron 18 mujeres que habían pasado por la experiencia del parto en una clínica ginecobstétrica de la ciudad de Cartagena. Los relatos, evidencian aún una gran necesidad de mejorar la atención del parto. Las mujeres relatan las amplias barreras para mejor acceso, problemas en el manejo de la comunicación y debilidades por parte de los profesionales para brindar un buen trato a las gestantes. Se evidencian aun algunas prácticas consideradas deshumanizantes como la episiotomía, uso enemas entre otros. Conclusiones: Múltiples barreras desde lo cultural interfieren aun en la atención del embarazo y el parto. Las usuarias reconocen que la atención cumple con algunos criterios de calidad, sin embargo, hay algunos aspectos que deben mejorarse como la comunicación constante, acortar los tiempos de atención y el fortalecimiento del buen trato. El derecho de acompañamiento permanente debe ser respetado a todas las gestantes.

Foundation: birth weight constitutes one of the valuable aspects to outline maternal and child health actions and assess prenatal care. Objective: determine the relationship between maternal hemoglobin and the intergenic period with the baby's birth weight. Method: a descriptive and cross-sectional study was carried out on pregnant women treated at a hospital of the Ecuadorian Social Security Institute during the first semester of 2023. The study population was made up of the 305 pregnant women who received care in the first semester of 2023. The sample It corresponded to the total population. To determine the relationship between the variables, Pearson's correlation was used. Results: the neonates of 81 of the pregnant women had low birth weight. The mean hemoglobin in pregnant women with children with low birth weight was 11.65 ± 1.68 mg/dl and the birth interval were 24.56 ± 15.64 months. In those whose children did not have low birth weight, the mean hemoglobin was 13.72 ± 2.01 mg/dl and the birth interval were 44.71 ± 14.93 months. A statistically significant positive correlation (r = 0.665; p < 0.001) was identified between maternal hemoglobin, interpregnancy interval (r = 0.527; p < 0.05) and newborn weight. Conclusions: factors such as maternal hemoglobin during pregnancy and the duration of the intergenic period influence birth weight. The presence of maternal anemia and a short birth period are related to low birth weight.

Background: Childbirth is considered a critical experience in a woman's life when she needs mental adaptation and reorganization of relationships. Factors such as personality and self-perception can help facing and solving crises. This study aimed to investigate the relationship between personality types and stress resilience among pregnant women. Methods: This was a cross-sectional study on 210 multiparous and nulliparous pregnant women who were 32–37 weeks pregnant and referred to Shiraz medical hospitals for delivery selected via convenience sampling. Data collection tools were personal and midwifery information questionnaires and the Goldberg personality and visual pain assessment scale that were completed through interviews. Data analysis was performed by SPSS software using descriptive tests to describe the data and the Pearson correlation test to analyze the data. Results: The highest personality type was conscientiousness (48.1%) and the lowest was extraversion (2.4%). Maternal resilience had a significant positive relationship with extraversion (p=.001) and conscientiousness (p=.001). There was no significant relationship between the 2 variables of neuroticism and maternal resilience (p=.12). There was a significant positive relationship between the 2 variables of openness to experience and maternal resilience (p=.005). Conclusion: Women's healthcare providers can help to mitigate the negative effects of psychological distress, and psychologically empower this vulnerable group by considering the resilience and personality type of pregnant women during prenatal care. Resumen: Antecedentes: El parto se considera una experiencia crítica en la vida de una mujer cuando necesita adaptación mental y reorganización de las relaciones. Factores como la personalidad y la autopercepción pueden ayudar a afrontar y resolver las crisis. Este estudio tuvo como objetivo investigar la relación entre los tipos de personalidad y la resiliencia al estrés entre mujeres embarazadas. Materiales y métodos: Este fue un estudio transversal en 210 mujeres embarazadas multíparas y nulíparas que tenían entre 32 y 37 semanas de embarazo y remitidas a hospitales médicos de Shiraz para el parto, seleccionadas mediante muestreo por conveniencia. Las herramientas de recolección de datos fueron cuestionarios de información personal y de partería y la escala de evaluación visual del dolor y la personalidad de Goldberg que se completaron mediante entrevistas. El análisis de los datos se realizó mediante el software SPSS utilizando pruebas descriptivas para describir los datos y la prueba de correlación de Pearson para analizar los datos. Resultados: El tipo de personalidad más alto fue la escrupulosidad (48,1%) y el más bajo la extraversión (2,4%). La resiliencia materna tuvo una relación positiva significativa con la extraversión (p = 0,001) y la escrupulosidad (p = 0,001). No hubo relación significativa entre las dos variables de neuroticismo y resiliencia materna (p = 0,12). Hubo una relación positiva significativa entre las dos variables de apertura a la experiencia y resiliencia materna (p = 0,005). Conclusión: Los proveedores de atención médica para mujeres pueden ayudar a mitigar los efectos negativos de la angustia psicológica y empoderar psicológicamente a este grupo vulnerable al considerar la resiliencia y el tipo de personalidad de las mujeres embarazadas durante la atención prenatal.

Background: the underlying cause of the deficiency of ornithine carbamoyltransferase (OTCD) is a gene mutation on the X chromosome. In females, the phenotype is highly variable, ranging from asymptomatic to neurologic compromise secondary to hyperammonemia and it can be prompted by numerous triggers, including pregnancy. Objective: the objective of this article is to report a case of two pregnancies of an OTCD-carrier, and to review the literature describing OTCD and pregnancy, parturition and postpartum. Methods: an extensive search in PubMed in December 2021 was conducted using different search terms. After screening all abstracts, 23 papers that corresponded to our inclusion criteria were identified. Results: the article focuses on the management of OTCD during pregnancy, parturition, and the postpartum period in terms of clinical presentation, ammonia levels and treatment. Conclusions: females with OTCD can certainly plan a pregnancy, but they need a careful management during delivery and particularly during the immediate postpartum period. If possible, a multidisciplinary team of physicians, dietitians, obstetrician-gynecologist, neonatologists, pharmacists, etc. with expertise in this field should participate in the care of women with OTCD and their children during this period and in their adult life. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular diseases represent an important cause of morbidity and mortality during pregnancy, cardiomyopathy is notable as a syndrome of heart failure. Objective: To characterize patients with peripartum cardiomyopathy according to clinical and epidemiological variables of interest for the investigation. Methods: A descriptive and cross-sectional study of 18 patients with diagnosis of peripartum cardiomyopathy was carried out. They were assisted at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba from October, 2015 to December, 2022. Results: In the series there was a prevalence of patients over 35 years (32.6 average age), besides African descendant (50.0 %), chronic hypertension (44.4 %) and multiparity (8.9 %) as risk factors and the left ventricle failure as clinical manifestation. The ejection fraction of this ventricle was regularly diminished and the pharmacological treatment response was satisfactory in all the sample. Conclusions: Peripartum cardiomyopathy is of low incidence in this center; however, due to its seriousness, the early diagnosis and the specialized staff intervention are necessary to avoid complications. [ABSTRACT FROM AUTHOR]

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