Introdução: A assistência pré-natal (PN) é um dos pilares do cuidado à saúde materno-infantil, cuja relevância para a redução da morbimortalidade dessa população já se encontra estabelecida. A ausência ou inadequação da assistência durante o período PN pode trazer graves consequências para a saúde da mãe e do feto. Segundo a Organização Mundial da Saúde, calcula-se que, em 2015, 303 mil mulheres morreram de causas evitáveis inerentes à gravidez, 2,7 milhões de bebês morreram no período neonatal e 2,6 milhões de fetos eram natimortos. No Brasil, entre 1990 e 2015, houve queda na razão de mortalidade materna de 141 para 60 mortes a cada 100 mil vivos. Essa queda ocorreu em virtude de avanços significativos nas políticas de saúde, entre eles a implantação do Sistema Único de Saúde (SUS) e das políticas de saúde materno-fetal associadas a ele. Objetivo: Avaliar a assistência PN prestada a gestantes de baixo risco usuárias do SUS da cidade de Joinville. Métodos: Trata-se de um estudo observacional transversal realizado de março de 2018 a fevereiro de 2019, mediante entrevista e análise do Cartão da Gestante de puérperas maiores de 18 anos, procedentes de Joinville, que realizaram o PN no SUS, sendo excluídas as puérperas desistentes. Avaliou-se a assistência PN por critérios preconizados pelo Programa de Humanização do Pré-Natal e Nascimento. Resultados e conclusão: Foram entrevistadas 683 puérperas. Os critérios com maiores índices de adequação foram acessibilidade (99,6%), início precoce do PN (92,7%) e realização de seis ou mais consultas (87,15). Os critérios que apresentaram as menores taxas de adequação foram o conjunto de orientações (17,7%) e os exames do terceiro e primeiro trimestre (42,5% e 63,5%, respectivamente). Conclui-se que a assistência PN realizada pelo SUS da cidade de Joinville, não obstante a acessibilidade praticamente universal, o início precoce e a prevalência de puérperas com mais de seis consultas, demonstrou declínio acentuado na análise dos indicadores preconizados.
Objective: To evaluate the changes in the venous system during pregnancy and childbirth in pregnant and postpartum women without previous venous disease. Methods: This is an observational, analytical prospective cohort study carried out from May 2021 to October 2021, in pregnant women undergoing caesarean section on their first postoperative day, with duplex mapping being performed to assess the diameter and reflux of the great and small saphenous veins, mean venous flow velocity in the common femoral veins in dorsal decubitus and the comparison of velocities when adopting the left and right lateral decubitus position before caesarean section and on the first postpartum day. Result: 49 pregnant women were evaluated, and an increase in flow velocity was observed when adopting the right and left lateral positions in relation to pre- and post-cesarean section in dorsal decubitus. The mean velocity of venous flow from the common femoral vein increased in the postpartum period, regardless of the decubitus adopted. Conclusion: There was an improvement in flow in the femoral vein with the change from dorsal decubitus to right and left lateral decubitus and after termination of pregnancy.
Alterações na qualidade ambiental provenientes de ações antrópicas são precursoras de impactos sobre o meio físico, a diversidade biológica e a funcionalidade dos ecossistemas. O presente estudo objetivou analisar a concentração de metais pesados por ICP-OES no rio Cachoeira, localizado na região nordeste de Santa Catarina, por meio do método de biomonitoramento, utilizando macroinvertebrados bentônicos e a macrófita aquática Echinodorus grandiflorus (Alismataceae), e por ensaios ecotoxicológicos ex situ com Eruca sativa (Brassicaceae). Coletas padronizadas de água, sedimento e material biológico foram realizadas em cinco pontos amostrais ao longo do canal principal do rio. As amostras foram preparadas em solução ácida e lidas em ICP-OES para a determinação qualiquantitativa de alumínio, chumbo, cromo, níquel e zinco. Em adição, amostras de água foram utilizadas em testes ecotoxicológicos por meio de ensaio de germinação, alongamento radicular e índice de germinação. Água e sedimento também foram usados para a caracterização físico-química dos pontos amostrais. O conjunto de dados foi estatisticamente analisado por meio da Análise de Componentes Principais. Os resultados obtidos indicaram elevadas concentrações dos metais pesados identificados nas amostras de água e sedimento influenciando na composição da fauna bentônica e na bioacumulação em tecidos radiculares por E. grandiflorus, excetuando-se o chumbo. Igual influência foi demonstrada pelo teste ecotoxicológico, indicando que os pontos amostrais localizados em trechos do rio inseridos em meio à malha urbana e industrial da cidade são mais nocivos aos organismos e, por conseguinte, detentores de uma baixa qualidade ambiental.Palavras-chave: qualidade ambiental, rio urbano, biomonitoramento ativo e passivo, ICP-OESAnalysis of Heavy Metals by the Biomonitoring Method in the Cachoeira River, Northeast Region of Santa CatarinaA B S T R A C TChanges in environmental quality resulting from human actions are precursors of impacts on the physical environment, biological diversity and the functionality of ecosystems. The present study aimed to analyze the concentration of heavy metals by ICP-OES in the Cachoeira River, located in the northeast region of Santa Catarina, through the biomonitoring method, using benthic macroinvertebrates and the aquatic macrophyte Echinodorus grandiflorus (Alismataceae), and by ecotoxicological assays ex situ with Eruca sativa (Brassicaceae). Standardized collections of water, sediment and biological material were carried out at five sampling points along the main channel of the river. The samples were prepared in acidic solution and read in ICP-OES for the qualiquantitative determination of aluminum, lead, chromium, nickel and zinc. In addition, water samples were used in ecotoxicological tests through germination, root elongation and germination index tests. Water and sediment were also used for the physicochemical characterization of the sampling points. The dataset was statistically analyzed using Principal Component Analysis. The results obtained indicated high concentrations of heavy metals identified in the water and sediment samples, influencing the composition of the benthic fauna and the bioaccumulation in root tissues by E. grandiflorus, with the exception of lead. The same influence was demonstrated by the ecotoxicological test, indicating that the sampling points located in stretches of the river inserted in the middle of the urban and industrial fabric of the city are more harmful to organisms and, therefore, holders of a low environmental quality.Key-words: environmental quality, urban river, active and passive biomonitoring, ICP-OES
Preterm newborns (PTNBs) are challenged by their physiological immaturity and need intensive care and, therefore, are considered patients at nutritional risk. The present study aimed to monitor the nutritional evolution of premature newborns (<1,500g) admitted to the neonatal intensive care unit of a public maternity hospital in southern Brazil. This is an observational, descriptive and prospective study with a quantitative approach, based on the review of 24 medical records analyzed using simple descriptive statistics. The average gestational age (GA) at birth was 27 weeks and 2 days for group 01 and 29 weeks and 5 days for group 02, and the average birth weight found was 820g and 1223g, respectively. The average weight gain of both groups was 21 to 23.6g per day of hospitalization. Regarding the caloric value achieved by the diet, in both groups the average was 138.24 to 140.34 kcal/kg/day, with a maximum of 159.4 kcal/kg/day. The research made it possible to know the nutritional profile of preterm infants based on growth parameters and also through the practices carried out at the unit.
Assess associations and perinatal adverse outcomes related to macrosomia. An observational, analytical and cross-sectional study was carried out, focusing on adverse perinatal outcomes related to macrosomia, carried out in a Public Maternity Hospital in the south of Brazil, from August to December 2020. The sample consisted of postpartum women, divided into two groups, with and without associated macrosomia. In calculating the adjusted odds ratio (OR), a confidence interval (CI) of 95% was used. Confounding factors adopted were: age, prematurity, previous cesarean sections, smoking, alcoholism and other drugs. Postpartum women who had macrosomic newborns >4000 g (n=119/7.1%) and non-macrosomic <4000 g (n=1551/92.8%). Regarding maternal characteristics, patients with macrosomic newborns had greater weight gain during pregnancy, when compared to pregnant women with non-macrosomic newborns. After calculating the adjusted odds ratio, it was observed that only the significance of excessive weight gain increases the chance of macrosomic newborns with OR 2.0 (95%CI 1.3-2.9).
Introduction: Abnormal pregestational and gestational maternal nutritional status is an undeniable health problem which can result in gestational changes and interfere in fetal and maternal health conditions. Objective: To analyze the influence of pre-pregnancy nutritional status on mother-newborn pair outcomes. Methods: This is an observational, analytical, and cross-sectional study carried out in a public Maternity Hospital in Joinville, SC, Brazil. A total of 1,670 puerperal women were interviewed and classified according to BMI. The outcomes evaluated were: cesarean delivery, Gestational Diabetes Mellitus, Pregnancy-induced Hypertension, small for Gestational age newborns, large for gestational age newborns, premature birth, low weight at birth and admission to the neonatal intensive care unit. Results: Low-weight pregnant women had a higher risk of cesarian delivery. Overweight and obese patients had a greater chance of GDM, with the odds ranging from 1.5 to 7.2 times, and PIH with the odds ranging from 1.7 to 4.6 times. Conclusion: Low-weight pregnant women have a higher chance of cesarian delivery. Meanwhile, overweight and all classes of obesity in pregnancy progressively increase the risk of GDM and PIH.
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