Perinatologia y Reproduccion Humana最新文献

Introduction

A significant proportion of HIV-infected women of reproductive age wish to become pregnant, even when they know the risk for their health and for their children, as well as the probability of vertical transmission of the infection. During this process, stress produces adverse neonatal events, affecting mother-child relationship. Therefore, it is important to determine the stress level of these patients.

Objective

To determine the stress levels in HIV positive pregnant patients of the National Institute of Perinatology, Mexico.

Material and method

An observational, cross-sectional, descriptive study was carried out on 73 HIV-positive pregnant patients, and the stress level was evaluated using the Nowack test.

Results

The areas comprising the Nowack stress profile were within the limits of a healthy population, with the exception of type «A» behaviours (internalized anger, expressed anger, time haste, work speed, impatience, search for improvement, bad driving of vehicles, distrust, anger, hostility), and ARC reagents (substance abuse, alcohol and tobacco use), whose scores were lower than the average, acting as protective resources against this type of behaviour.

Conclusions

The majority of HIV-positive pregnant patients presented a level of stress within the average of the healthy population. This is probably associated with the feeling of control that represents the fact of being attached to a first-level institution receiving integrated care.

Introduction

The rupture of membranes increases perinatal morbidity and mortality due to the risk of chorioamnionitis, prematurity, respiratory distress syndrome, among others, for both the mother and foetus. The platelet-to-lymphocyte ratio has been previously used as an inflammatory biomarker in various pathologies, including the pre-term premature rupture of membranes.

Materials and methods

A retrospective, descriptive, and observational, case-control study was conducted on 206 pregnant patients over 22 weeks of gestational age with rupture of membranes (at term and pre-term). A control group included 93 patients with a diagnosis of cephalopelvic disproportion without any other pathology that were interrupted at the Hospital Angeles Pedregal, Mexico, from 2012 to 2017.

Results

The platelet-to-lymphocyte ratio was calculated in these patient groups, and was found to be statistically significantly elevated in the group with pre-term premature rupture of membranes compared to the control group. A tendency for a higher platelet count was found in patients with rupture of membranes at both pre-term and at term, and statistically significant when compared to the control group.

Conclusions

The results in this study are of great importance due to the diagnostic use of an accessible and low-cost test such as the biometric blood test used to calculate de platelet-to-lymphocyte ratio in patients with pre-term premature rupture of membranes.

This work is a partial research report whose objective is to highlight the importance of the inclusion of affected third parties in the research on mobbing, seeking the reduction or elimination of the damage. This is done by reflecting on the different realities and how the passages are operated from one level to another. In the Introduction, the question and objective of the investigation and the justification of the method, which is an analytical reflection from the complexity, as well as the problematization of the part of the mobbing concept that has to do with the involved actors, from where the present is made proposal to consider affected third parties. Next, the method adopted is applied to the problem, section that has been subtitled Affected third parties. And because it is an article of reflection, one goes directly to the Discussion with the selected theoretical referents. Finally, the Conclusions are included.

A study of enmity is presented in order to understand the meaning of the rupture of a relationship between 2 or more people, which can be modelled as prolonged harassment and group siege prolonged in the workplace. The methodology to develop this study focused on the qualitative ethnographic method and an interpretation of texts that addressed the issue of group bullying. The techniques applied are in-depth interviews and case analysis, based on friendship and enmity. We were interested in knowing what is fragmented in a friendship to move to enmity or animosity, anger and hatred. The findings showed that enmity is one of several triggers of a prolonged aggression process that manifests itself with specific characteristics in the workplace, which has been called mobbing.

Objective

To describe the experience with the use of paracetamol in the pharmacological closure of the patent ductus arteriosus with haemodynamic repercussion.

Material and methods

A retrospective observational study was conducted from 1 January 2014 to 1 June 2017, in a population of less than 35 weeks of gestation, less than 5 days of life. A total of 70 cases were included and 10 were excluded. Out of the remaining 60 cases, and of these, 6 were offered a second cycle of haemodynamic repercussion. Intravenous paracetamol was used at a dose of 15 mg per kg every 6 hours, for a total of twelve doses, on those with persistence of the ductus arteriosus, with hemodynamic repercussion. Platelets, liver and kidney function tests were performed, including a transfontanelle ultrasound at 24 hours before and after each cycle, as well as a record of the fluid balance from the first to the fifth day.

Results

Gestational age and birth weight was unrelated to the closure of the ductus arteriosus (P = .622 and P = .215). The use of the prenatal corticosteroids is revalidated as a favourable factor for the closure of the patent ductus arteriosus (P < .001). An effectiveness of 90% was obtained in a total of 60 patients. There was no evidence of interventricular bleeding in the first cycle. There was no increase in liver enzymes or renal function. Two patients died during the study.

Conclusions

Paracetamol for the closure of the ductus arteriosus, in contraindication of ibuprofen, showed adequate effectiveness and safety in affected neonates in the city of Bogotá.

The aim of this paper is to make clear to the health workers in Mexico, mainly those of the National Institute of Perinatology, Mexico City, what is mobbing and how to identify it, placing it within the current national dynamics and the organization of work. This is important in order to eradicate it. To do this, the information gathered on mobbing was systematised, along with an analysis performed on a bibliography search on work-related harassment in health institutions in Google Scholar. Using the key words “mobbing health institutions” a separate search was made on the same platform, concluding that at an international level its presence in health institutions has been a concern. However, it is a pending task in Mexico, where its documentation and analysis has yet to be carried out.

Objective

Compare the characteristics of the preterm newborns who received myofunctional therapy with those who didn’t received it, and to analyze the time each group takes to reach effective sucking since the first sucking to the best one during their intrahospital stay.

Methods

Retrospective cohort study which included 442 preterm newborns between 28 to 36.6 weeks of gestational age admitted to the Neonatal Intensive Care Unit of Hospital Español de México between March 2014 to October 2016. The patients were divided in two groups: 1) the ones that received myofunctional therapy carried out by two people specialized in early intervention of the premature, and 2) the ones that did not. We registered perinatal history and measure the time it was taken to achieve an efficient sucking since the first sucking according to gestational age and weight.

Results

123 were exposed to myofunctional therapy. We observed a significant difference between both groups, being the exposed group the patients with lower gestational age and weight at birth and the ones presenting more comorbidities and days in hospital. The group that did not received myofunctional therapy achieved an earlier effective sucking than the one that received myofunctional therapy adjusted by gestational age and weight presented in the first sucking (mean 2.18 to 6.15 days; p = 0.06 to p < 0.001).

Conclusion

Small for gestational age, lower gestational weight at birth, more comorbidities and longer length of stay are factors that may delay the acquisition of efficiency in sucking. The myofunctional therapy should be started before starting nutritive sucking.

Introduction

The vaccines during pregnancy are a practice with an evidence level of 1A, and are used to prevent the development of communicable diseases in the mother and the foetus. However, there is evidence of ignorance and lack of application in routine practice.

Objectives

To develop and validate a tool to measure the level of knowledge of gynaecologists and obstetricians, as well as medical residents on vaccination in pregnant and breast-feeding women.

Type of study

A descriptive, cross-sectional-type questionnaire.

Methods

The questionnaire was constructed and validated by 30 gynaecologists and residents in obstetrics and gynaecology during a shift chosen randomly.

Statistical analysis

Descriptive statistics were used with frequencies and percentages. Reliability testing (test-retest reliability, Cronbach's alpha) and validity (construct Content and appearance), and reproducibility (Kappa index) will be performed.

Results

Construction, standardisation and validation of the questionnaire was achieved with a Cronbach's alpha of 0.85 and 0.95 Kappa index. A second phase evaluation should be performed after the implementation of the questionnaire, and validated with the target population to determine the knowledge regarding vaccination in pregnancy and lactation.

Conclusions

The final instrument (Appendix 1) contains the appropriate items depending on the accuracy and reliability required to present the knowledge of medical staff (obstetricians-gynaecologists and gynaecology-obstetrics residents) on the subject of vaccination in pregnancy and lactation.