In the presence of fetal microcephaly associated with Zika virus infection, CNS malformations are frequently detected. © 2016 John Wiley & Sons, Ltd.

BackgroundGestation is a period that can positively or negatively influence the life of a woman in the pregnancy-puerperal cycle. Thus, evaluating the quality of life of this population can redirect the implementation of innovative practices, with the goal of making them more effective and practical or the promotion of humanized care. The present study aimed to evaluate the predictors that influence the health-related quality of life of low-risk pregnant women, as well as to describe the main areas affected in the quality of life of pregnant women.MethodsA correlational, quantitative and cross-sectional study was carried out in two public units that provide prenatal care services and a private unit in the city of Fortaleza, a municipality in the Northeast of Brazil. The sample consisted of 261 pregnant women who were interviewed from September to November 2014. The collection instruments were a questionnaire covering sociodemographic, obstetric and quality of life variables, in addition to the Brazilian version of the Mother-Generated Index (MGI). The data were compiled and analyzed through the Statistical Package for the Social Sciences (SPSS) software, version 20.0. A descriptive analysis was performed through the application of Pearson’s chi-square test, Fisher’s exact test and one-way ANOVA. Maternal predictors for the quality of life of pregnant woman were identified through a multivariate analysis/multiple regression.ResultsThe response rate was 100%, corresponding to 261 respondents. Occupation, parity, partner support, marital status and persons with whom the women live were the predictors that positively interfered in the quality of life of pregnant women. In contrast, gestational age, type of housing, occupation, use of illicit drugs, non-receipt of partner support and maternal age were the predictors that negatively influenced quality of life.ConclusionOur results indicate that happiness to become a mother and body image were areas with the greatest positive and negative influence on health-related quality of life, which suggests being relevant aspects in the planning and implementation of actions aimed at its improvement.

Objetivou-se analisar as percepções de enfermeiras quanto à assistência de enfermagem prestada a mulheres diante do diagnóstico de óbito fetal. Pesquisa com abordagem qualitativa, realizada em uma maternidade-escola de Fortaleza-CE, Brasil, entre setembro e outubro/2009. A amostra constou de nove enfermeiras que atuavam no serviço de gestação de alto risco. Os resultados evidenciaram que o foco da assistência prestada era a oferta de apoio psicológico, através da permissão fornecida às mulheres ou familiares para verem o feto morto. As dificuldades mais citadas estiveram associadas à questão estrutural da maternidade, que não possuía uma enfermaria específica para as mães com diagnóstico de óbito fetal. Ademais, citaram a sobrecarga de trabalho, uma vez que exerciam funções que não integravam os procedimentos de práxis. Destaca-se, portanto, a necessidade de uma assistência diferenciada às mulheres ante o óbito fetal, que abranja, além dos recursos humanos, questões estruturais dos serviços de saúde.

Objective:to test the effects of behavioral and educational intervention by telephone on adherence of women with inappropriate periodicity to colpocytological examination. Method:quasi-experimental study with a sample of 524 women, selected with the following inclusion criteria: be aged between 25 and 64 years, have initiated sexual activity, have inappropriate periodicity of examination and have mobile or landline phone. The women were divided into two groups for application of behavioral and educational intervention by telephone. It was used an intervention script according to the principles of Motivational Interviewing. Results:on comparing the results before and after the behavioral and educational interventions, it was found that there was a statistically significant change (p = 0.0283) with increase of knowledge of women who participated in the educational intervention. There was no change in the attitude of women of any of the groups and there was an increase of adherence to colpocytological examination in both groups (p < 0.0001), with greater adherence of women participating in the behavioral group (66.8%). Conclusion:the behavioral and educational interventions by phone were effective in the adherence of women to colpocytological examination, representing important strategies for permanent health education and promotion of care for the prevention of cervical cancer.

Premature birth and its complications are the largest contributors to infant death in the United States and globally. A short cervical length and the depletion of Lactobacillus species are known risk factors for preterm birth. However, in many resource-poor areas of the world, the technology to test for their occurrence is unavailable, and pregnant women with these risk factors are neither identified nor treated. In this study, we used path analysis to gain an unprecedented understanding of interactions between vaginal microbiome composition, the concentrations of various compounds in vaginal secretions, and cervical length. We identified low-cost point-of-care measures that might be used to identify pregnant women at risk for preterm birth. The use of these measures coupled with appropriate preventative or treatment strategies could reduce the incidence of preterm births in poor areas of the world that lack access to more sophisticated diagnostic methods.

The new epidemic of Zika virus infection raises grave concerns, especially with the increasingly-recognized link between emerging cases of microcephaly and this infectious disease. Besides small cranial dimensions, there are striking morphologic anomalies in the fetal brain. Key anomalies include cortical developmental malformations and a peculiar distribution of pathologic calcifications. These potentially indicate a new pattern of congenital central nervous system infection. Methods: Eight women underwent fetal MRI. Four infants also underwent postnatal CT. Five of the women underwent amniocentesis. Results: All neonates were born with microcephaly. On fetal MRI, ventriculomegaly, marked reduction of white matter thickness, severe sylvian fissure simplification, abnormal sulcation, and diffuse volumetric loss of cerebellar hemispheres were consistently seen. On postnatal CT, diffuse subcortical and basal ganglia calcifications were observed. The Zika virus was detected in two amniocenteses by polymerase chain reaction assays. Conclusion: We hope to assist the medical community in recognizing the spectrum of encephalic changes related to congenital Zika virus infection.Keywords:Zika virus; microcephaly; tomography, X-ray computed; magnetic resonance imaging. RESUMOOs novos casos epidêmicos de infecção pelo vírus Zika suscitam grande preocupação, sobretudo com o crescente reconhecimento da ligação entre casos emergentes de microcefalia e esta doença infecciosa. Além da cabeça de pequenas dimensões, existem profundas alterações morfológicas no encéfalo fetal. Anomalias mais típicas incluem malformações do desenvolvimento cortical e uma distribuição peculiar de calcificações patológicas. Estes dados potencialmente indicam um novo padrão de infecção congênita do sistema nervoso central. Métodos: Oito mulheres foram submetidas a RM fetal. Quatro crianças também realizaram TC pós-natal. Cinco mulheres foram submetidas a amniocentese. Resultados: Todos os neonatos nasceram com microcefalia. Na RM fetal, ventriculomegalia, acentuada redução da espessura da substância branca, acentuada simplificação da fissura sylviana, sulcação anormal e redução volumétrica difusa dos hemisférios cerebelares foram constantes. Na TC pós-natal, calcificações difusas subcorticais e nos núcleos da base foram observadas. O vírus Zika foi detectado por PCR em duas amniocenteses. Conclusão: Esperamos dar suporte à comunidade médica em reconhecer este padrão de imagem potencialmente específico.Palavras-chave: Zika vírus; microcefalia; tomografia computadorizada por raios X; imagem por ressonância magnética.

Among WHO's criteria for severe maternal morbidity and near miss, eclampsia, low oxygen saturation, ICU admission, intubation, mechanical ventilation, and cardiopulmonary resuscitation were most associated with maternal death. Use of magnesium sulfate was a protective factor.

Cad. Saúde Colet., 2014, Rio de Janeiro, 22 (2): 165-72 165 Artigo OriginalResumo Objetivo: Avaliar a prevalência de realização da prevenção do câncer do colo uterino e fatores associados à coleta anual. Métodos: Estudo transversal conduzido entre agosto de 2010 e junho de 2011 por meio de entrevistas domiciliares com 144 mulheres de 25 a 52 anos em uma comunidade de baixa renda em Fortaleza (CE). Utilizou-se o teste do χ 2 de Pearson e a aná-lise de variância (ANOVA) na comparação entre os grupos que nunca realizaram coleta, realizaram não anualmente e aquelas que o fizeram com frequência anual. As variáveis com valores de p<0,20 foram submetidas à regressão logística para estimativa da razão de chances (odds ratio − OR). Resultados: A proporção de mulheres que relatou coleta anual foi de 59,3%. Trabalho remunerado (p=0,04) e renda familiar (p<0,01) mostraram associação significativa. Na regressão logística simples, o trabalho remunerado (OR=2,15), a classe econômica (OR=3,32) e a ocorrência de no máximo uma gestação (OR=2,73) e, na regressão logística múltipla, o trabalho remunerado (OR=2,63) e ocorrência no máximo de uma gestação (OR=2,60) mostraram-se associados à realização da coleta anual. Conclusão: Mulheres com trabalho remunerado e que tiveram no máximo uma gestação apresentaram uma chance maior de realização da citologia anual para prevenção do câncer de colo uterino.Palavras-chave: saúde da mulher; detecção precoce de câncer; câncer do colo do útero; citologia; programas de rastreamento. AbstractObjective: To evaluate the prevalence of prevention of cervical cancer and the factors associated with annual collection. Methods: Cross-sectional study conducted between August 2010 and June 2011 through interviews with 144 women 25−52 years old in a low income urban community in Fortaleza (CE). Were used the χ 2 test and ANOVA comparing the groups never did collect, held annually and not those who made an annual basis. Variables with p values <0.20 were subjected to logistic regression to estimate odds ratios (OR). Results: The proportion of women who reported annual collection was 59.3%. Remunerated employment (p=0.04), and family income (p<0.01) showed significant association. In simple logistic regression, remunerated employment (OR=2.15), economic status (OR=3.32) and the having had the maximum of one pregnancy (OR=2.73) and, in multiple logistic regression, remunerated employment (OR=2.63) and the having had the maximum of one pregnancy (OR=2.60) were associated with annually periodicity for cervicovaginal smear. Conclusion: Women with remunerated employment and had no more than one pregnancy had a greater chance of achieving an annual frequency of cytology for preventing cervical cancer.