This article provides a comprehensive review of current evidence on the challenges and controversies in obstetrics, with a focus on shoulder dystocia, fetal monitoring, and the use of oxytocin in labor and delivery. A systematic search was conducted in three databases (Scielo, Google Scholar, and LILACS), resulting in the selection of 10 relevant studies for an integrative review. The studies encompassed various research methodologies, including systematic reviews, cohort studies, clinical trials, qualitative studies, and narrative reviews. The findings provided important insights into the investigated topics, including risk factors associated with shoulder dystocia, effectiveness of fetal monitoring, comparison of oxytocin use protocols, women’s experiences with shoulder dystocia, obstetric complications, controversies surrounding oxytocin use, incidence of shoulder dystocia, and utilization of fetal monitoring. These findings contribute to a better understanding of these topics and may guide clinical practice towards safer and more effective obstetric care. However, further research is needed to fill existing knowledge gaps and inform evidence-based decision-making in obstetrics.
This article presents an integrative review of the main challenges in the treatment of gynecological diseases among rural female workers in Brazil. Through the analysis of 11 articles published in the last 9 years, we identified that rural female workers face significant barriers in accessing preventive screening and gynecological healthcare. The main obstacles include a lack of adequate access to healthcare services, a scarcity of trained healthcare professionals in rural areas, a lack of awareness about the importance of gynecological health, and gender-based violence. These challenges are compounded by the remote location of rural areas, the lack of suitable healthcare facilities in these regions, and limited transportation availability. To improve access to and the quality of gynecological healthcare for rural female workers, it is necessary to invest in healthcare infrastructure, strengthen the training of healthcare professionals, promote targeted educational programs, and implement public policies that address gender-based violence.
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