Objective: To analyze the prevalence of breastfeeding and the introduction of complementary food for zero to 24-month-old infants.Methods: This is a population-based cross-sectional study of children aged less than 24 months in Montes Claros, Minas Gerais, Brazil. Data were collected in 2015, by interviews with people in charge of infant care in the house. The questionnaire administered assessed the sociodemographic status of the family, maternal and infant characteristics and food consumption habits. Survival analysis was used to calculate median prevalence and duration of breastfeeding and the introduction of complementary feeding. Results: With 180 days of life, 4.0% of the children were exclusively breastfed, 22.4% were mostly breastfed and 43.4% were fed breast milk as complementary food. In the third month of life, children were consuming water (56.8%), fruit juice or formula (15.5%) and cow’s milk (10.6%). At the age of 12 months, 31.1% were consuming artificial juice and 50.0% were eating candies. Before the age of 1 year, 25.0% of them had already eaten instant noodles.Conclusions: The introduction of drinks, honey, sugar and candies as complementary food was found to be premature; and solid and semi-solid foods were almost appropriate. The habits described can directly affect the success of breastfeeding. Given that the inadequate eating practices identified can compromise the infant’s health, actions that promote breastfeeding and provide guidance on the introduction of complementary foods are important.
O óbito fetal é uma das principais causas de mortalidade perinatal, e o entendimento das suas causas é essencial para melhorar a assistência pré-natal oferecida às gestantes. Nesse sentido, o estudo caracterizou os casos de óbito fetal intra-útero anteparto registrados em uma maternidade no Norte de Minas entre janeiro de 2010 e dezembro de 2012. Foram avaliadas fichas médicas obtidas junto ao Comitê de Mortalidade Infantil da Maternidade. Foram incluídas na amostragem 26 fichas de gestantes com diagnóstico de óbito fetal ocorrido antes do início do trabalho de parto, com idade gestacional igual ou superior a 20 semanas e ou peso fetal maior que 500g. Os dados foram coletados por meio de questionário estruturado e avaliados por estatística descritiva. A maioria das gestantes tinha entre 18 e 29 anos e apresentavam gestação a termo. Observou-se que 69% dos casos de óbito não apresentaram nenhum fator de risco associado, o que é um índice superior aos apresentados na literatura médica. Nos casos com causas identificáveis, atribuiu-se 7,7% das ocorrências a doenças hipertensivas específicas da gestação, 3,8% a diabetes mellitus, 3,8% a infecção do trato urinário, 3,8% a polidrâmnio e 11,5% a múltiplas intercorrências. A alta frequência de óbitos sem fatores de risco associados indica que é baixa qualidade da informação sobre o óbito perinatal, especialmente o óbito fetal. Palavras-chave:Óbito fetal. Gestação. Anteparto.The stillbirth is a major cause of perinatal mortality, and understanding its causes is essential to improve prenatal care provided to pregnant women. In this sense, the study characterized the cases of antepartum intrauterine fetal death recorded in a maternity ward in the North of Minas Gerais between January 2010 and December 2012. Medical records obtained were evaluated by the Child Mortality Committee of Motherhood. They were included in the sample 26 records of pregnant women with fetal death diagnosis occurred before the onset of labor, gestational age less than 20 weeks and birth weight or greater than 500g. Data were collected using a structured questionnaire and evaluated by descriptive statistics. Most of the women were between 18 and 29 years and had a pregnancy to term. It was observed that 69% of cases of death had no associated risk factor, which is a higher rate to those presented in the medical literature. In cases with identifiable causes, attributed to 7.7% of cases the specific hypertensive disorders of pregnancy, 3.8% diabetes mellitus, 3.8% to urinary tract infection, 3.8% to 11.5 and polyhydramnios 11,5% multiple complications. The high frequency of deaths without risk factors indicates that poor quality of information on perinatal death, especially fetal death.
This is a case of a 41 year old Gravida 5, Para 4 IVF conception with 2 normal vaginal deliveries and 2 previous Caesarean sections, one for placenta previa and the second an elective repeat. She presented with some PV spotting at 16 weeks gestation, a missed miscarriage was identified with a fetal size of between 12-13 weeks. The ultrasound images were suspicious for placental adhesive disorder with a vascular lower segment and a low lying placenta.An MRI performed was consistent with the ultrasound images. She was initially managed with intramuscular methotrexate but developed a fever consistent with a septic miscarriage. A suction curette was performed under ultrasound guidance without event.The histology was consistent with a missed miscarriage and a limited post mortem was consistent with normal fetus with female karyotype with no genetic imbalance. The patient had persistent bleeding post surgery and ultrasound suggested retained products of conception in the Caesarean section scar. This was successfully managed conservatively.Confirmed cases of placental adhesive disorder in the first trimester have been reported in the literature, usually identified at hysterectomy for massive hemorrhage at suction curettage. Studies have identified ultrasound features in the first trimester may increase the likelihood of placental adhesive disease. These features include a low lying gestational sac, low lying placenta, irregular appearance of the placental-myometrial interface and diffuse dilatation of the intraplacental lacunae in the lower uterine corpus. These findings have a lower sensitivity and positive predictive value compared to 2D ultrasound in the second and third trimesters.One study examined the validity of MRI below 24 weeks gestation finding that only 41% of cases identified on MRI went on to have abnormally invasive placentation.This case illustrates the difficulty in diagnosing this condition in the first and early second trimester with imaging.EP15.14 An optimal timing of Caesarean delivery in placenta previa S. Hong, S. Lee, J. Oh, M. Jung, C. Park, J. Park, J. Jun Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of KoreaObjectives: Elective delivery at 36-37 weeks of gestation is recommended in patients with placenta previa which is different from that of other indications of Caesarean section. Main concerns are the risks of maternal morbidities which may increase at 38-39 weeks of gestation. However, the actual risk for maternal/neonatal morbidity in placenta previa with advanced gestational age in clinical setting has not been well evaluated. The objective of this study was to determine the maternal/neonatal morbidities according to gestational age in women with placenta previa. Methods: A total of 292 women in who were delivered by Caesarean section because of placenta previa in Seoul National University Hospital were included. Out of them, 25 cases were delivered before 36 weeks of gestation and excluded. We compared maternal and neonatal mor...
Suporte financeiro: Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG). Apoio financeiro por meio de bolsa de iniciação científica. RESUMO Introdução: o leite materno é o melhor alimento para a criança nos primeiros meses de vida, contribuindo para o crescimento e desenvolvimento adequado a curto e longo prazo. Objetivo: caracterizar o perfil das publicações brasileiras com a temática aleitamento materno. Método: trata-se de um estudo bibliométrico, com análise da produção do conhecimento científico de estudos conduzidos no país entre 2009 e 2013. As palavras-chave "breastfeeding and Brazil" na base de dados Pubmed e "aleitamento materno" no Scielo, Medline e Lilacs. Resultados: foram avaliadas 466 publicações, sendo que, entre os anos de 2009 e 2012, houve gradativo aumento do número. A temática mais prevalente foi "determinantes e fatores associados ao aleitamento materno/desmame" (33,9%). Identificaram-se 579 descritores entre os textos publicados, sendo aleitamento materno (397) e desmame (109) os mais citados. A maior parte dos artigos eram estudos quantitativos (n=301). A qualificação B1 foi a mais prevalente entre as revistas e a região Sudeste teve o maior número de publicações ao longo dos cinco anos. Destacam-se enfermeiros (28,5%), nutricionistas (21,7%) e médicos (15,1%) e predomínio de doutores (45,1%) e mestres (24,5%) entre os titulares das publicações. Conclusões: há relativa homogeneidade para os primeiros quatro anos do período estudado, com declínio no último ano da série. Apesar de a situação do aleitamento estar longe da ideal, foram conquistados avanços relativos à prática no país.
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