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BACKGROUND: The first 100 days after childbirth are important for women recovering from pregnancy and birth. AIM: To describe the most common clinical events or health needs documented in women's primary care records in the first 100 days after childbirth. DESIGN AND SETTING: Cross-sectional study using electronic health records from UK primary care data. METHOD: Primary care records were examined from childbirth up to 100 days after childbirth for women aged 16-49 years who had given birth to a single live infant between 2006 and 2016 using IQVIA Medical Research Data. The most common clinical events or health needs based on documented symptoms, diagnoses, and medications were identified. How these varied by patient characteristic was explored. RESULTS: In total, 925 712 contacts were identified during the 100 days following 309 573 births. Women were most likely to use primary care to have a postnatal visit or check (60.6%, n = 187 455), for monitoring (such as a blood pressure reading) (49.9%, n = 154 328), and to access contraception (49.7%, n = 153 876). Younger women were more likely to have contacts for preventive care compared with older women, but were less likely to have contacts for ongoing mental and physical symptoms or conditions and pre-existing conditions. The highest peak in contacts occurred 42 days after birth, and related to a postnatal check or visit, monitoring a patient, and recording lifestyle factors (such as smoking status). CONCLUSION: Primary care services should seek to match the needs of new mothers, taking account of a high volume of contacts, for a broad range of planned and responsive care following childbirth.

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We present the case of a 25-year-old African American female patient (G1P0) with a past medical history of brain arteriovenous malformation repair, pneumonia, and a urinary tract infection who was admitted to the labor and delivery floor at 39 weeks for a spontaneous vaginal delivery of a 4.025 kg female baby. In the immediate postpartum (PP) period, the patient presented with severe pelvic pain and trouble ambulating. Conservative management of oral non-narcotic analgesics was initiated until the diagnosis of PP pubic symphysis diastasis (PSD) was made. Due to the persistence of pelvic pain, the patient underwent a pubic symphysis joint steroid injection and was discharged on day 8. Within 24 hours of discharge, the patient was readmitted to the emergency department with severe pain and an inability to walk. Her pain was managed conservatively with intravenous narcotics and non-steroidal anti-inflammatories, which quickly dissipated the pain. She was observed and discharged once she reported improvement in pain, and she was reassessed five days later at her obstetrician's clinic. In the clinic, the patient presented with mild tenderness in the pubic symphysis region but demonstrated improvement in her antalgic gait with an ability to walk and urinate without difficulty. Despite a lack of follow-up imaging, the patient was reassured that her PSD and associated tenderness should completely resolve within three to four months.

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Access to nutritious foods, a social determinant of health, contributes to disparities in maternal and infant health outcomes such as mental health, breastfeeding intensity and cardiometabolic risk. This study explored perceived nutrition access and intake among pregnant or post-partum women eligible for Medicaid. Qualitative, semistructured interviews were conducted with 18 women who were either currently pregnant (n = 4) or up to 12 months post-partum (n = 14) in 2021-2022. Mothers spoke English (n = 11) or Spanish (n = 7) and lived in the Texas Panhandle. Interviews were audio-recorded, transcribed, translated (Spanish to English) and verified. Two or more researchers coded each interview until consensus was reached using thematic analysis with ATLAS.ti software. The study revealed five drivers for nutrition access. (1) Social factors influenced nutrition; those with less support expressed limited ability to eat healthfully. (2) The Women, Infants and Children program was perceived as a helpful resource for some, while others faced challenges obtaining it. (3) Stress was bidirectionally related to unhealthy food choices, with food sometimes used as a coping mechanism. (4) Mothers prioritized their babies and others and had limited ability and time to prepare healthy meals. (5) Most participants felt they received inadequate nutrition guidance from their healthcare providers. Participants provided positive responses to a proposed nutritious home-delivered meal intervention. Low-income women may experience nutritional challenges specific to this life stage. Interventions that reduce stress and burden of household tasks (e.g. cooking) and improve education and access to nutritious foods may improve mothers' ability to consume nutritious foods.

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A 2-year-old Pomeranian-Spitz dog (5.8 kg) was admitted with symptoms of uterine prolapse and lethargy 1 day after whelping three puppies. The prolapsed uterus was corrected, but the next day, prolapse reoccurred. To fix the cervix to the abdominal wall, the dog underwent a surgery operation where intussusception in the left horn of the uterus was found. Ovariohysterectomy was performed as the treatment of choice. The diagnosis of intussusception is challenging, and exploratory laparotomy is the reliable diagnostic approach. Although uterine intussusception is rare, it should be one of the important considerations in dogs within the post-partum period.

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Cesarean delivery rates have been increasing which leads to a rise the problems experienced. After cesarean deliveries important problems for the mother and baby may be seen. The most common problems in the mothers after cesarean delivery are; bleeding, infection, fatigue, sleep disorders, breast problems, self-care issues, and sense of inadequacy in care of the newborn. The method used in this study was narrative review. A literature review was conducted by searching the materials published in databases including Web of Science, PubMed, Google Scholar search engine and, the WHO website. Pain, maternal death, breastfeeding problems, worsened sleep quality and comfort, anxiety, delayed recovery, prolonged hospitalization and infection rates in the cesarean deliveries are higher than in vaginal deliveries. Nurses can facilitate adaptation to the role of motherhood and prevent risky situations by evaluating mothers' care needs and providing proper interventions and support. Nurses should not only focus on the physical care needs of the mother and baby; they should also ensure the physical and psychosocial adaptation of family members in the face of role changes.

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The authors aimed to determine the plasma melatonin concentration in mares and their new-born foals in the early post-partum period. Blood samples were collected from the jugular vein of 53 mare-foal pairs within twelve hours after parturition. Plasma melatonin levels were measured by ELISA. The melatonin concentration, adjusted for the moment of parturition using a generalised linear model, was 34.58 pg mL-1 in mares. It was significantly lower (27.63 pg mL-1) in the new-born foals. However, the melatonin concentration declined differently by the end of the twelve hours, it decreased less in the offspring than in the mothers. An artificial light supplementation at the end of gestation reduced the melatonin concentration both in mares and their foals by about 10 pg mL-1, compared to the controls. An elevated melatonin production may be related to preparation of mares for parturition and ensures the chances of survival of offspring, therefore the melatonin may reach its peak at the moment of foaling regardless of its actual time. The effect of low melatonin concentration in new-born foals might be associated with the foal's health and subsequent performance. The need to monitor the melatonin concentration in the offspring justifies further studies.

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Introduction: Initiation of family planning in the early post-partum period is a strategic move to reduce maternal, neonatal, and child mortality due to the negative consequences of short interbirth interval and the complications of unintended pregnancy. Antenatal care (ANC) is the noteworthy predictor of scaling up early initiation of post-partum family planning (PPFP) and preventing unintended pregnancy before menses resume. Despite the great role of ANC, information is scant about the effect of content, timing, and the number of ANC visits on the early initiation of PPFP in Ethiopia. Objective: This study aimed to assess the association of ANC services with the early initiation of PPFP in Ethiopia. Methods: The study was based on Ethiopian Demographic and Health Survey 2016 data, which was a cross-sectional survey from 18 January 2016 to 27 June 2016. A total weighted sample size of 2,920 post-partum women was included. A multilevel logistic regression model was used because of the hierarchical data, and variables with a p-value of ≤0.2 in the bivariable multilevel analysis were taken to multivariable multilevel analysis. An adjusted odds ratio with a 95% confidence interval (CI) was used to declare both the direction and strength of the association, and variables with a p-value of <0.05 were considered as statistically significant for the outcome variable. Results: The early initiation of PPFP was 20.4%. Women with at least four ANC visits [adjusted odds ratio (AOR) = 1.31; CI 1.12-2.32], women who started ANC within the first trimester (AOR = 1.25; CI 1.10-2.23), complete routine ANC (AOR = 1.11; CI 1.01-2.03), post-natal care (AOR = 1.45; CI 1.19-1.87), resumption of menses (AOR = 1.67; CI 1.18-1.93), urban residency (AOR = 2.14; CI 1.18-2.51), and high community women's education (AOR = 1.71; CI 1.51-2.11) were variables significantly associated with the early initiation of PPFP. Conclusion: The early initiation of PPFP in Ethiopia was very low. Attention needs to be given to the quality of ANC, post-natal care, resumption of menses, residency, and community-level education of women to increase the prevalence of the early initiation of PPFP in Ethiopia. Therefore, the government should design a program targeting the quality of ANC in rural communities, considering women without menses and scaling up the education of women at the community level to the culture of the early initiation of PPFP in order to achieve reduced maternal, neonatal, and child mortality.

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We describe the case of a 19-year-old woman with no significant medical history who developed progressive right-sided neck pain and palpitations one month following a pregnancy complicated by preeclampsia. Family history was significant for unprovoked deep vein thrombosis (DVT) and pulmonary embolism (PE) in her father at age 44. Systemic examination revealed mild swelling of the right upper extremity with pain on palpation. Computed tomography (CT) of the thorax with contrast demonstrated extensive occlusion of right upper extremity veins and collateralization of chest wall veins. Pulmonary emboli were present bilaterally in the segmental and subsegmental branches of the lower lobe pulmonary arteries. CT of the abdomen with contrast revealed thrombi in the left common and external iliac veins. Thrombophilia screening was normal. The patient was treated with enoxaparin and ampicillin/sulbactam. Her clinical condition improved, and she was discharged with an outpatient clinic follow-up appointment.

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The SPROUT (Survey on reproduction in RheUmaTology) study explored current practice in women of childbearing age with systemic autoimmune rheumatic diseases, investigating the counselling on contraception, the prescription of low dose acetylsalicylic acid (LDASA) to pregnant patients and the management of disease activity in the post-partum period. The SPROUT questionnaire was designed ad hoc and promoted in the three months before the "11th International Conference on Reproduction, Pregnancy and Rheumatic Disease". Between June and August 2021, 121 physicians responded to the survey. Even though 66.8% of the participants declared themselves to be confident in counselling surrounding birth control, only 62.8% of physicians always discuss contraception and family planning with women of childbearing age. Approximately 20% of respondents do not prescribe LDASA to pregnant women with rheumatic diseases, and wide heterogeneity exists in the dose and timing of LDASA prescription. Most respondents (43.8%) restart treatment with biological agents soon after delivery to prevent disease flares, opting for a drug compatible with breastfeeding while 41.3% of physicians continue biologics throughout pregnancy and post-partum. The SPROUT study highlighted the necessity to further foster physicians' education and identified the management of disease activity after delivery as a matter for discussion between all the clinicians involved in the care of pregnant women with rheumatic conditions.

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Sepsis is a severe affection, that requires an urgent and specific treatment sequence. Physiological changes occurring during pregnancy make the diagnosis of sepsis more challenging in this setting, with possible delay in treatment initiation, that in turn is responsible for poorer maternal and fetal outcome. This review aims to summarize current knowledge on the diagnosis and treatment of maternal sepsis, as well as persistent knowledge gaps in the field.

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The immediate postpartum period is a great time to encourage the acceptance of contraceptive methods; the time is influenced by both emotional and physical factors. At this stage, the administration of intrauterine contraceptives is relatively easier with lesser complications due to the prior obstetric event. A single-center cross-sectional study was conducted using a self-constructed questionnaire-based interview on 331 women in their immediate postpartum period who had delivered a healthy live-born infant. The majority (59.8%) of study participants had unplanned pregnancies. We conducted behavior change communication sessions for postpartum family planning which resulted in 89% of participants accepting the methods with the prime reasons for acceptance being temporary child spacing (41%) and a definitive desire for no more children (34%). The odds were higher in women with more than five pregnancies [adjusted odds ratio (AOR) = 1.951, 95% CI = 1.389-2.925] and women whose last pregnancy was planned [AOR = 1.248, 95% CI = 1.002-3.215].The hindrance to adopt and adhere to postpartum contraception stems from a variety of socio-economic factors which are unique to low-income countries. Individually tailored behavior change communication/counseling approaches may help overcome misconceptions and meet the heterogeneous needs for family planning in the immediate postpartum phase.

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Magnetic resonance imaging of the sacroiliac joints is now frequently performed to help identify patients with early axial spondyloarthritis. However, differential diagnoses exist and should be recognized. The aim of this article is to review the most frequent differential diagnoses that may mimic inflammatory sacroiliitis in clinical practice.

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Iodine deficiency during pregnancy and in the post-partum period may lead to impaired child development. Our aim is to describe iodine status longitudinally in women from pregnancy until 18 months post-partum. Furthermore, we explore whether iodine status is associated with dietary intake, iodine-containing supplement use and breastfeeding status from pregnancy until 18 months post-partum. We also assess the correlation between maternal iodine status 18 months post-partum and child iodine status at 18 months of age. Iodine status was measured by urinary iodine concentration (UIC) during pregnancy (n = 1,004), 6 weeks post-partum (n = 915), 6 months post-partum (n = 849), 12 months post-partum (n = 733) and 18 months post-partum (n = 714). The toddlers' UIC was assessed at 18 months of age (n = 416). Demographic variables and dietary data (food frequency questionnaire) were collected during pregnancy, and dietary data and breastfeeding practices were collected at all time points post-partum. We found that iodine status was insufficient in both pregnant and post-partum women. The UIC was at its lowermost 6 weeks post-partum and gradually improved with increasing time post-partum. Intake of milk and use of iodine-containing supplements significantly increased the odds of having a UIC above 100 µg/L. Neither the mothers' UIC, vegetarian practice, nor exclusion of milk and dairy products were associated with the toddlers UIC 18 months post-partum. Women who exclude milk and dairy products from their diets and/or do not use iodine-containing supplements may be at risk of iodine deficiency. The women possibly also have an increased risk of thyroid dysfunction and for conceiving children with nonoptimal developmental status.

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BACKGROUND: Family planning services in the post-partum period, termed post-partum family planning (PPFP) is critical to cover the unmet need for contraception, especially when institutional delivery rates have increased. However, the intention to choose PPFP methods such as post-partum intrauterine devices (PPIUD) remains low in countries such as Nepal. Community health workers such as Female Community Health Volunteers (FCHVs) could play an important role in improving the service coverage of PPFP in Nepal. However, their knowledge of PPFP and community-based services related to PPFP remain unclear. This study aims to assess the effect on community-based PPFP services by improving FCHV's knowledge through orientation on PPFP. METHODS: We conducted this mixed-methods study in Morang District in Nepal. The intervention involved orientation of FCHVs on PPFP methods. We collected quantitative data from three sources; via a survey of FCHVs that assessed their knowledge before and after the intervention, from their monthly reporting forms on counseling coverage of women at different stages of pregnancy from the communities, and by interviewing mothers in their immediate post-partum period in two selected hospitals. We also conducted six focus group discussions with the FCHVs to understand their perception of PPFP and the intervention. We performed descriptive and multivariable analyses for quantitative results and thematic analysis for qualitative data. RESULTS: In total, 230 FCHVs participated in the intervention and their knowledge of PPFP improved significantly after it. The intervention was the only factor significantly associated with their improved knowledge (adjusted odds ratio = 24, P < 0.001) in the multivariable analysis. FCHVs were able to counsel 83.3% of 1872 mothers at different stages of pregnancy in the communities. In the two hospitals, the proportion of mothers in their immediate post-partum period whom reported they were counseled by FCHVs during their pregnancy increased. It improved from 7% before the intervention to 18.1% (P < 0.001) after the intervention. The qualitative findings suggested that the intervention improved their knowledge in providing PPFP counseling. CONCLUSION: The orientation improved the FCHV's knowledge of PPFP and their community-based counseling. Follow-up studies are needed to assess the longer term effect of the FCHV's role in improving community-based PPFP services.

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PROBLEM: Epigenetic age indices are markers of biological aging determined from DNA methylation patterns. Accelerated epigenetic age predicts morbidity and mortality. Women tend to demonstrate slower blood epigenetic aging compared to men, possibly due to female-specific hormones and reproductive milestones. Pregnancy and the post-partum period are critical reproductive periods that have not been studied yet with respect to epigenetic aging. The purpose of this paper was to examine whether pregnancy itself and an important pregnancy-related variable, changes in body mass index (BMI) between pregnancy and the post-partum period, are associated with epigenetic aging. METHOD OF STUDY: A pilot sample of 35 women was recruited as part of the Healthy Babies Before Birth (HB3) project. Whole blood samples were collected at mid-pregnancy and 1 year post-partum. DNA methylation at both time points was assayed using Infinium 450K and EPIC chips. Epigenetic age indices were calculated using an online calculator. RESULTS: Paired-sample t-tests were used to test differences in epigenetic age indices from pregnancy to 1 year after birth. Over this critical time span, women became younger with respect to phenotypic epigenetic age, GrimAge, DNAm PAI-1, and epigenetic age indices linked to aging-related shifts in immune cell populations, known as extrinsic epigenetic age. Post-partum BMI retention, but not prenatal BMI increases, predicted accelerated epigenetic aging. CONCLUSION: Women appear to become younger from pregnancy to the post-partum period based on specific epigenetic age indices. Further, BMI at 1 year after birth that reflects weight retention predicted greater epigenetic aging during this period.

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Objective ­ To identify the risk factors for postpartum depression in the reports of postpartum women who had this disorder, and to compare differences and similarities with the literature. When addressing the postpartum depression is essential to identify women with risk factors, by monitoring during prenatal care, and child care, the current health policy of women adopted by the Ministry of Health includes the nurse as professional able to develop actions in all phases of the female life cycle, the puerperal phase stands out, because in this situation the greatest organic and social changes that a woman can face, altering her state of health and well-being. Methods ­ A qualitative approach to the field of study in which ten women with a diagnosis of postpartum depression were selected by snowball sampling technique following a semi-structured interview form whose responses were analyzed by the Bardin content analysis technique. Results ­ Ten women were interviewed and, based on their responses, the topic emerged: understanding the symptoms and factors that favor postpartum depression. and two categories: Feelings and relationships of women interviewed with their mothers, fathers and their current socio-family context and their connections to postpartum depression. Conclusion ­ Through this study, it was possible to verify the symptoms and risk factors presented by the women, although they are in agreement with the literature, it was verified the necessity of qualitative studies in this area as well as evaluation on the assistance practices given to these patients

Objetivo ­ Identificar os fatores de risco frente à depressão pós-parto por relatos de puérperas que tiveram esse transtorno, e confrontar diferenças e semelhanças com a literatura. Ao se tratar a depressão puerperal é imprescindível identificar as mulheres com fatores de risco, por meio do acompanhamento durante o pré-natal e na puericultura. A atual política de saúde da mulher adotada pelo Ministério da Saúde inclui o enfermeiro como profissional apto para desenvolver ações em todas as fases do ciclo de vida feminino, com foco na fase puerperal, pois nesta estão as maiores alterações orgânicas e sociais que uma mulher pode enfrentar alterando seu estado de saúde e bem-estar. Métodos ­ Estudo de campo de abordagem qualitativa, no qual dez mulheres com diagnóstico médico de depressão pósparto foram selecionadas pela técnica snowball sampling, seguido de uma entrevista com formulário semiestruturado, cujas respostas foram analisadas por meio da técnica de análise de conteúdo de Bardin. Resultados ­ Foram entrevistadas dez mulheres e a partir de suas respostas emergiu o tema: "compreendendo os sintomas e fatores que favorecem a depressão pós-parto", e duas categorias: "Sentimentos" e "Relações das mulheres entrevistadas com suas mães, pais e seu contexto sociofamiliar atual e suas conexões com a depressão pós-parto". Conclusão ­ Por meio deste estudo, foi possível verificar os sintomas e fatores de risco apresentados pelas mulheres, muito embora estejam de acordo com a literatura. Verificou-se também a necessidade de estudos qualitativos nessa área, assim como avaliação sobre práticas assistenciais prestadas a essas pacientes

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O estudo objetivou analisar a experiência de mulheres no pós-parto, sobre o planejamento familiar. Neste período, a mulher tende a receber menor atenção dos profissionais de saúde, uma vez que os olhares estão mais voltados ao recém-nascido, e as questões relacionadas à sexualidade não recebem atenção. Pesquisa qualitativa, descritivo-exploratória, realizada com 17 mulheres no período de até um ano pós-parto. Foi utilizada a técnica da entrevista semiestruturada para a coleta de dados e a análise temática de Bardin para a sua organização. Após a análise do material verbal coletado, três categorias emergiram: Gravidez não planejada pela 'falha' do método; Consulta puerperal; e Planejamento familiar após o parto. O planejamento familiar preconizado pelo Ministério da Saúde não é compatível com as ações realizadas pela Estratégia de Saúde da Família (ESF). Isso porque as mulheres entrevistadas experienciaram, em sua maioria, gravidez indesejada e continuam vulneráveis a adquirir outras futuras gestações.

Current research analyzed the experience of post-partum females on family planning. During this period, females tend to receive less attention by health professionals since the newly born baby comes foremost and sexual issues are not focused. Current qualitative, descriptive and exploratory research was undertaken with 17 females during a period of up to one year after birth. The half-structured interview was prepared for data collection and Bardin´s thematic analysis for organization. After analyzing the verbal material, three categories emerged: non planned pregnancy due to the method´s failure; puerperal attendance, family planning after child birth. Family planning as conceived by the Ministry of Health is not compatible with activities by the Family Health Strategy due to the fact that most interviewed females had undesired pregnancy and remained vulnerable to other future ones.

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INTRODUCTION: Socio-economic status (SES) is an important determinant of health. Low SES is associated with higher rates of prenatal and post-partum depression, and prenatal and post-partum depression are associated with sub-optimal maternal and infant health. Furthermore, increased negative effects of post-partum depression have been reported in children from low SES backgrounds. OBJECTIVE: To assess whether SES was related to the risk of a medical or psychiatric hospitalization associated with depression (HAWD) and the risk of a HAWD by anti-depressant (AD) use during the years around a birth. METHODS: This retrospective cohort study used linked birth, hospitalization, prescription and tax-file records of the study cohort. We linked registry data of 243,933 women delivering 348,273 live infants in British Columbia (1999-2009). The outcomes of interest were a HAWD and a HAWD with the associated patient AD use. Ranked area-based measures of equivalised, family disposable income were used to create income deciles, our proxy for SES. Decile-1 represented the lowest income areas, and mothers from Decile-6 (middle-income) were the comparator group. Anti-depressant use was defined as having a prescription for a selective serotonin reuptake inhibitor (SSRI) or other AD during the years around a birth, defined as the period beginning 12 months before conception and ending 12 months after the birth. We analysed by pregnancy using mixed effects logistic regression whilst adjusting for maternal age and parity. RESULTS: Compared to mothers from middle-income areas (Decile-6), mothers from low income areas (Decile-1, Decile-2) had increased odds of a HAWD [adjusted OR=1.77 (CI: 1.43, 2.19); adjusted OR=1.56 (CI: 1.26, 1.94)]. Mothers from low income areas with depression and no AD use had even higher odds of a HAWD [adjusted OR=1.83 (CI: 1.33, 2.20); adjusted OR=1.71(CI: 1.33, 2.20)]. CONCLUSIONS: This study provides preliminary evidence to suggest that barriers to treating depression with ADs in mothers from low income areas during the years around a birth might contribute to their increased risk of a HAWD associated with non-pharmacologically treated depression. Further research is needed to understand the reasons for this increased risk. DISCLAIMER: All inferences, opinions, and conclusions drawn in this manuscript are those of the authors and do not reflect the opinions or policies of the Data Stewards of Population Data BC.

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Introducción. En el embarazo, las dermatosis afectan a menos del 20 % de las gestantes y representan un grupo heterogéneo de afecciones cutáneas, con una forma variada de presentación y evolución. El objetivo es presentar un caso de erupción polimorfa de inicio durante el puerperio, con una breve revisión de la literatura en torno a la patología y su tratamiento. Reporte de caso. Se presenta el caso de una paciente de 38 años en puerperio de su primera gestación, quien debutó con un cuadro clínico de erupción cutánea y prurito que inició en la zona abdominal y se extendió hacia los miembros inferiores. Las lesiones estaban constituidas por pápulas eritematosas que confluían hasta formar placas. Se diagnosticó con erupción polimorfa del embarazo y se dio manejo con antihistamínicos logrando la resolución de la patología. Discusión. La erupción polimórfica del embarazo es un trastorno inflamatorio benigno de la piel. Inicia con la aparición de pápulas pruriginosas que confluyen hasta formar placas eritematosas, que aparecen primero en el abdomen con excepción de la zona umbilical y parten, generalmente, de las estrías y se diseminan a las extremidades. El tratamiento consiste en la utilización de emolientes y antihistamínicos para el control de las lesiones y el prurito. Conclusiones. Aunque se trata de una patología benigna y autolimitada, es importante llegar al diagnóstico correcto e iniciar un manejo médico adecuado ya que síntomas como el prurito pueden generar lesiones por rascado que suelen infectarse y comprometer el estado de salud de las pacientes. Cómo citar: Picón-Jaimes YA, Orozco-Chinome JE, Mejía-Antolínez LA, Garcés-Salamanca CT. Erupción polimorfa durante el puerperio inmediato. MedUNAB. 2019;22(1):64-70. doi:10.29375/01237047.3461

Introduction. During pregnancy, at least 20% of the expectant mothers are affected by several forms of dermatosis, which involve a heterogeneous group of skin conditions with a variety of manifestations and evolution. The objective is to present a case of initial polymorphic eruption during the postpartum period with a brief review of the literature related to the pathology and its treatment. Case report. We present the case of a 38 year-old postpartum patient in her first pregnancy, who exhibited a clinical case of skin eruption and pruritus that started in the abdominal area and extended to the lower limbs. The lesions consisted of erythematous papules that clustered together to form plaques. She was diagnosed with polymorphic eruption of pregnancy and was treated with antihistamines, which resolved the pathology. Discussion. Polymorphic eruption of pregnancy is a benign inflammatory disorder of the skin It starts with the appearance of pruritic papules that cluster together to form erythematous plaques that initially appear in the abdomen (with the exception of the umbilical area) and generally start at the stretch marks and disseminate to the extremities. Treatment consists of the use of emollients and antihistamines to control the lesions and the pruritus. Conclusions. Although this is a benign, self-limiting condition, it is important to reach a correct diagnosis and initiate adequate medical treatment, as symptoms like pruritus can generate lesions from scratching that usually become infected and compromiso the patients' health. Cómo citar: Picón-Jaimes YA, Orozco-Chinome JE, Mejía-Antolínez LA, Garcés-Salamanca CT. Erupción polimorfa durante el puerperio inmediato. MedUNAB. 2019;22(1):64-70. doi:10.29375/01237047.3461

Introdução. Na gravidez, as dermatoses afetam menos de 20% das gestantes e representam um grupo heterogêneo de condições da pele, com uma forma variada de apresentação e evolução. O objetivo é apresentar um caso de erupção polimorfa que iniciou durante o puerpério, com uma breve revisão de literatura sobre a patologia e seu tratamento. Relato de caso. Apresentamos o caso de uma paciente de 38 anos no puerpério de sua primeira gestação, quem desenvolveu um quadro clínico de erupção cutânea e prurido que iniciou na região abdominal e espalhou-se nos membros inferiores. As lesões estavam constituídas por pápulas eritematosas que confluíam até formar placas. Foi diagnosticada com erupção polimórfica da gravidez e recebeu anti-histamínicos, conseguindo a resolução da patologia. Discussão. A erupção polimórfica da gravidez é uma doença inflamatória benigna da pele. Começa com o aparecimento de pápulas pruriginosas que confluem até formar placas eritematosas, que aparecem primeiro no abdômen com exceção da área umbilical e geralmente parte das estrias e se espalham para as extremidades. O tratamento consiste no uso de emolientes e anti-histamínicos para o controle das lesões e o prurido. Conclusão. Ainda seja uma patologia benigna e autolimitada, é importante acertar o diagnóstico e iniciar o tratamento médico adequado, uma vez que sintomas como o prurido podem gerar arranhões que tendem a se infectar e comprometer o estado de saúde das pacientes. Cómo citar: Picón-Jaimes YA, Orozco-Chinome JE, Mejía-Antolínez LA, Garcés-Salamanca CT. Erupción polimorfa durante el puerperio inmediato. MedUNAB. 2019;22(1):64-70. doi:10.29375/01237047.3461

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BACKGROUND: Maternal mortality in Liberia is one of the highest in Sub-Saharan Africa. Post-partum family planning (PPFP) can reduce the risk of maternal mortality by preventing unwanted and closely spaced pregnancies. Yet, the uptake of PPFP is low in Liberia. OBJECTIVE: We investigated the barriers to acceptance of PPFP use among women in Montserrado County, Liberia. MATERIALS AND METHODS: A cross-sectional facility-based survey was conducted using a multistage sampling technique to select 378 women within 12 months' post-partum period. RESULTS: About half of our respondents were <25 years (52.9%), 24.1% were married, 66.4% had at least secondary education and 92.1% were Christians. The most commonly reported barriers were the fear of side effects (22.0%) and the post-partum abstinence (22.2%). Binary logistic regression analysis showed that being within the early post-partum period, i.e., within the first 6 months (adjusted odds ratio [AOR] = 0.23, 95% confidence interval [CI] [0.09-0.60] and lack of access to PPFP [AOR = 0.22, 95% CI [0.09-0.52]). Importantly, women who were married [AOR = 1.686, 95% CI (0.65, 4.36)] and those who were aware of PPFP [AOR 3.69, 95% CI (1.224, 11.096)] increased the likelihood of using PPFP. CONCLUSION: Important barriers to the utilisation of PPFP in Liberia were being within early post-partum period, lack of access and awareness of PPFP including myths and misconception. Therefore, health communication targeting mothers for PPFP at every contact with maternal and childcare services should be encouraged.

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