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Fundamento: El puerperio es el periodo de tiempo que comienza en la finalización del parto hasta las seis semanas posparto; durante el cual, es necesario brindar atención conforme a los principios bioéticos inscritos en la normativa de salud vigente en el Ecuador. Objetivo: Analizar las percepciones que tienen las mujeres puérperas sobre la aplicación de los 4 principios bioéticos durante la atención en salud. Metodología: El estudio es de tipo descriptivo con enfoque cualitativo. Los datos corresponden a 10 mujeres puérperas mayores de edad, atendidas en el Hospital Gineco Obstétrico Pediátrico de Nueva Aurora "Luz Elena Arizmendi" de la ciudad de Quito, que respondieron a una entrevista sobre los principios bioéticos aplicados en la atención recibida. Se realizaron análisis de contenido a través del software ATLAS TI versión 23. Resultados: Se obtuvo una percepción positiva de las mujeres puérperas acerca de la aplicación del principio de justicia. Por otra parte, se evidencian dificultades en el de autonomía, sobre todo en la comprensión de la información brindada a la paciente acerca de los procedimientos durante el parto y puerperio, además de coacciones por parte del personal sanitario. Se percibe el consentimiento informado como un mero trámite administrativo. El principio de beneficencia se lo asume como parte de la vocación del personal y la no maleficencia genera malestar si no va acompañado de información clara y oportuna. Conclusiones: Los principios bioéticos son transversales en la normativa de salud vigente, pero sobresale el de justicia en la atención a mujeres puérperas.

Background: The puerperium is the period of time beginning at the end of labor until six postpartum weeks; during which it is necessary to provide attention in accordance with the bioethical principles included in the current health guidelines in Ecuador. Objective: To analyze the perceptions that postpartum women have about the 4 bioethical principles application during health care. Methodology: The study type is descriptive with a qualitative approach. The data correspond to 10 adult postpartum women assisted at the Nueva Aurora "Luz Elena Arizmendi" Pediatric Obstetric and Gynecological Pediatric Hospital in the Quito city, who responded to an interview about the bioethical principles applied in the received care. Content analysis was conducted through ATLAS TI version 23 software. Results: A positive perception was obtained from postpartum women concerning the application of the Justice principle. Furthermore, difficulties are evident in the Autonomy section, mainly in the comprehension of the information provided to the patient about the procedures during the labor and puerperium, as well as coercion by health personnel. Informed consent is perceived as a mere administrative formality. The Beneficence principle is assumed as part of the vocation of the personnel and Non-maleficence generates discomfort if it is not accompanied by clear and opportune information. Conclusions: Bioethical principles are transversal in current health guidelines, but that of Justice stands out in the care of postpartum women.

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Este protocolo trata especificamente da utilização sistemática da Lista de Verificação para o Parto Seguro como uma estratégia voltada para a prevenção das principais causas de óbitos maternos, de natimortos por causas intraparto e de óbitos neonatais. O objetivo é assegurar que as equipes sigam de maneira consistente as etapas de segurança críticas de maneira a minimizar os riscos mais comuns e evitáveis que colocam em risco as vidas e o bem-estar da parturiente e do recém-nascido (ORGANIZAÇÃO MUNDIAL DA SAÚDE, 2009). (AU)

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Objetivo: Analisar a recorrência da violência obstétrica, elucidar a heterogeneidade deste tema, compreender o tratamento recebido pelas pacientes, e discorrer a visão da enfermagem frente à Violência obstétrica. Método: Metodologia descritiva; revisão bibliográfica a partir da plataforma Google Acadêmico, embasada em artigos publicados em bases científicas como SciELO, PubMed, Lilacs, etc., com abordagem qualitativa. Resultados: Trata-se de qualquer ato exercido por profissionais da saúde no que cerne ao corpo, aos processos reprodutivos e ao psicológico das mulheres, exprimido através de uma atenção desumanizada, abuso de ações intervencionistas, medicalização e a transformação patológica dos processos de parturição fisiológicos. Conclusão: Foi possível compreender que há necessidade da criação de leis rigorosas que concretizem o conceito de Violência obstétrica e puna os responsáveis por praticála, mais pesquisas e debates envolvendo este tema, orientações a respeito dos direitos das grávidas, parturientes e puérperas, fiscalização rotineira das instituições e a busca pela educação continuada.

Objective: Analyze the recurrence of Obstetric Violence, elucidate the heterogeneity of this theme, understand the treatment received by patients, and discuss the view of nursing in relation to Obstetric Violence. Method: Descriptive methodology; bibliographical review using the Google Academic platform, based on articles published in scientific databases such as SciELO, PubMed, Lilacs, etc., with a qualitative approach. Results: It is any act performed by health professionals regarding the body, reproductive and psychological processes of women, expressed through dehumanized care, abuse of interventionist actions, medicalization and the pathological transformation of physiological parturition processes. Conclusion: It was possible to understand that there is a need to create strict laws that implement the concept of Obstetric Violence and punish those responsible for practicing it, more research and debates involving this topic, guidance on the rights of pregnant women, parturients and postpartum women, inspection routine of institutions and the search for continuing education.

Objetivo: Analizar la recurrencia de la violencia obstétrica, dilucidar la heterogeneidad de este tema, comprender el trato recibido por los pacientes y discutir la visión de la enfermería en relación a la Violencia Obstétrica. Método: Metodología descriptiva; Revisión bibliográfica mediante la plataforma Google Academic, basada en artículos publicados en bases de datos científicos como SciELO, PubMed, Lilacs, etc., con un enfoque cualitativo. Resultados: Es todo acto realizado por profesionales de la salud en relación con los procesos corporales, reproductivos y psicológicos de la mujer, expresado a través de cuidados deshumanizados, abuso de acciones intervencionistas, medicalización y transformación patológica de los procesos fisiológicos del parto. Conclusión: Se pudo entender que existe la necesidad de crear leyes estrictas que implementen el concepto de violencia obstétrica y sancionen a los responsables de practicarlo, más investigaciones y debates en torno a este tema, orientaciones sobre los derechos de las mujeres embarazadas, parturientas y posparto. la mujer, la rutina de inspección de las instituciones y la búsqueda de la educación continua.

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Resumen: Introducción: La enfermedad tromboembólica venosa en el período grávido - puerperal es una de las primeras causas de morbi-mortalidad materna. No existe un consenso acerca de las directivas para su abordaje, por lo que el objetivo de esta investigación fue conocer cómo se desempeñan los Ginecólogos y Residentes de Ginecología del Uruguay, con respecto a distintos factores de riesgo, la indicación de tromboprofilaxis y las herramientas disponibles. Metodología: Se realizó de julio a octubre del 2020, un estudio observacional, descriptivo, transversal donde se incluyeron a Ginecólogos y Residentes de Ginecología del Uruguay, mediante una encuesta electrónica anónima a través de la plataforma Survey Monkey. Resultados: Se obtuvo un n de 159 encuestados. El 57,3% refirió pensar sistemáticamente en factores de riesgo para enfermedad tromboembólica venosa. Las guías más utilizadas para la clasificación del riesgo e indicación de tromboprofilaxis fueron la American College of Obstestricians and Gynecologists con un 81,0% y la Royal College of Obstestricians and Gynaecologists con un 13,0%. La herramienta terapéutica con mayor disponibilidad es la heparina de bajo peso molecular y la menos utilizada es la compresión neumática intermitente. Conclusiones: Existen inconsistencias entre la clasificación de riesgo e indicación de tromboprofilaxis en diferentes situaciones clínicas. Existe un porcentaje no despreciable de profesiones que no piensan sistemáticamente en factores de riesgo para eventos tromboembólicos durante el período grávido - puerperal.

Abstract: Introduction: One of the main causes of maternal morbity and mortality in the pregnant - puerperal period is venous thromboembolic disease. There is no consensus on the guidelines to address this illness. The main objective of this research was to know how Gynecologists and Gynecology Residents of Uruguay perform, in reference to considering potential risk factors, indication for thromboprophylaxis and the tools available. Methodology: An observational, descriptive, cross-sectional study carried out from July to October 2020, including Gynecologists and Gynecology Residents of Uruguay, through an anonymous online survey using the Survey Monkey platform. Results: A final n of 159 respondents was obtained. 57.3% of which referred to think systematically about risk factors for venous thromboembolic disease. The most popular guidelines for risk classification and indication of thromboprophylaxis were the American College of Obstestricians and Gynaecologists with 81.0% and the Royal College of Obstestricians and Gynaecologists with 13.0%. The most chosen therapeutic tool was low molecular weight heparin, and the least preferred one was intermittent pneumatic compression. Conclusions: There are incoherences between the risk classification and the actual indication of thromboprophylaxis in different clinical situations. There´s still a non-negligible percentage of professionals that do not systematically consider risk factors for thromboembolic events during the pregnant-puerperal period.

Resumo: Introdução: A doença tromboembólica venosa no período gestação - puerpério é uma das principais causasde morbidadee mortalidade materna. Nãohá consenso sobre as diretrizes para o seu abordagem, por issoo objetivo desta pesquisa foi saber como encarao os ginecologistas e os residentes em ginecologia do Uruguai, no que dizrespeito à fatores de risco, indicação de tromboprofilaxia e as ferramentas disponíveis. Metodologia: Estudo observacional, descritivo e transveral realizado de julho a outubro de 2020, que incluiu ginecologistas e residentes em ginecologia do Uruguai. Um levantamento eletrônico anónimo foi desenvuelto através da plataforma SurveyMonkey. Resultados: Foram estudados 159 entrevistados. 57,3% relataram pensarsobre fatores de risco para doença tromboembólica venosa. As diretrizesmais utilizadas para classificação de risco e indicação de tromboprofilaxia foram o American College of Obstestricians and Gynecologists com 81,0% e o Royal College of Obstestricians and Gynaecologists com 13,0%. A ferramenta mais selecionada é heparina de baixo peso molecular e a menos utilizada é a compressão pneumática intermitente. Conclusões: Há inconsistências entre a classificação de risco e a indicação de tromboprofilaxia em diferentes situações clínicas. Ainda há um numero consideravel de profisionais que não pensam sistematicamente em fatores de risco para eventos tromboembólicos durante o período gravidez - puerperal.

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RESUMO O objetivo do artigo foi analisar a influência do exercício físico durante a gestação, correlacionando a sua prática com o desfecho materno fetal. O estudo realizado foi de caráter observacional, descritivo, quantitativo e retrospectivo, com entrevistas realizadas com as puérperas primigestas internadas no serviço de pós-parto em uma maternidade pública de Joinville, SC. Os questionários perguntavam sobre informações prévias da puérpera, condições da gestação, exercícios físicos realizados durante a gestação e dados acerca do recém-nascido (RN). As puérperas foram divididas em dois grupos: ativo (n=110) e inativo (n=122), possibilitando, desta maneira, a análise dos diferentes desfechos entre os grupos. Evidenciou-se que o grupo ativo apresentou maiores chances de obter ganho de peso adequado durante a gestação (RC 1,556) e de realização de parto normal (RC 1,899). Em contrapartida, apresentou maiores chances de o RN ser pequeno para a idade gestacional (PIG) (RC 2,436), considerando o intervalo de confiança de 95%. Os dados do presente estudo sugerem que a atividade física durante o período gestacional traz benefícios tanto para a saúde materna quanto para o recém-nascido, desde que realizado de maneira programada, bem orientada e dentro de um limite de intensidade e duração.

ABSTRACT The aim of the article was to analyze the influence of physical exercise during pregnancy, correlating its practice with the fetal maternal outcome. The study was observational, descriptive, quantitative and retrospective, with interviews conducted with primiparous mothers who were in the postpartum service in a public maternity hospital in Joinville, SC. The questionnaires asked about previous information on the postpartum women, pregnancy conditions, physical exercises performed during pregnancy and data about the newborn (NB). The postpartum women were divided into two groups: active (n = 110) and inactive (n = 122), allowing the analysis of the different outcomes between the groups. It was shown that the active group was more likely to obtain adequate weight gain during pregnancy (OR 1,556) and normal delivery (OR 1,899). On the other hand, it was more likely that the newborn was small for gestational age (SGA) (OR 2,436), considering the 95% confidence interval. The data from the present study suggest that physical activity during pregnancy brings benefits to both maternal and newborn health, provided that it is performed in a regular, well-oriented manner and within a limit of intensity and duration.

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El término infección puerperal se utiliza para describir cualquier infección bacteriana del aparato genital después del parto. Durante gran parte del siglo XX las infecciones puerperales, la preeclampsia y la hemorragia obstétrica formaron parte de la tríada letal de mortalidad materna. La ecografía, la resonancia magnética y la tomografía axial computarizada son la triada de elección para el diagnóstico del abdomen agudo en el puerperio. El mismo resulta difícil debido a factores intrínsecos y es entonces, cuando el radiólogo adquiere un papel crucial. Se presentó un caso de una mujer de 30 años, con 8 días de habérsele practicado una cesárea con un puerperio inmediato normal. Posteriormente presentó dolor abdominal, fiebre, escalofríos y masa palpable en fosa iliaca izquierda. Se practicaron técnicas de imágenes se plantea una masa ovárica izquierda, se realizó laparotomía exploradora y se concluyó como absceso ovárico (AU).

The term puerperal infection is used to describe any bacterial infection of the genital tract after delivery. During much of the twentieth century puerperal infections, preeclampsia and obstetric hemorrhage were part of the lethal triad of maternal mortality. Ultrasonography, magnetic resonance imaging and computed tomography are the triad of choice for the diagnosis of acute abdomen in the puerperium, which is difficult due to intrinsic factors and it is when radiologist plays a vital role. The authors present the case of a woman, aged 30 years, at the 8th day after undergoing a cesarean section with a normal immediate puerperium, who later presented abdominal pain (AU).

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Introducción: El bajo peso al nacer constituye en todo el mundo y grupos de poblaciones el índice más importante para determinar las posibilidades que tiene el recién nacido de sobrevivir y tener un crecimiento sano. Objetivo: Identificar algunos factores de riesgo sociobiológicos asociados al bajo peso al nacer en el área de salud del Policlínico Docente 30 de Noviembre de Santiago de Cuba durante el 2016. Métodos: Se realizó un estudio analítico, de casos y controles. Se escogieron como controles a las 8 puérperas que aportaron igual cantidad de recién nacidos con bajo peso y como controles a 16 de las madres cuyo producto de la concepción tuvo un peso normal en igual período. Entre las variables analizadas figuraron: edad materna, antecedentes obstétricos desfavorables, enfermedades previas asociadas y propias del embarazo, edad gestacional en el momento del parto y estado nutricional. Resultados: En la serie predominaron las enfermedades previas y propias del embarazo, fundamentalmente la anemia y la infección vaginal; mientras que el parto pretérmino tuvo alta significación estadística. Conclusiones: Los factores de riesgos biológicos con mayor fuerza de asociación fueron la malnutrición por defecto durante la captación, las enfermedades previas y asociadas al embarazo; en tanto, entre los factores con significación estadística predominaron la prematuridad y el período intergenésico corto, no así los antecedentes obstétricos desfavorables. Existió correlación entre la edad gestacional, el bajo peso al nacer, la presencia de partos pretérminos y el crecimiento intrauterino retardado.

Introduction: Low birth weight constitutes in the entire world and populational groups the most important index to determine the possibilities that the newborn has to survive and to have a healthy growth. Objective: To identify some social and biological risk factors associated with low birth weight in the health area from 30 de Noviembre Teaching Polyclinic in Santiago de Cuba during 2016. Methods: An analytic study of cases and controls was carried out. The 8 postpartum women who contributed with the same quantity of underweight newborns and as controls 16 of the mothers whose product of the conception had a normal weight in same period were chosen. Among the analyzed variables there were: maternal age, unfavorable obstetric history, associated previous diseases and diseases characterizing pregnancy, gestational age at childbirth and nutritional state. Results: Previous diseases and diseases characterizing pregnancy, fundamentally anemia and vaginal infection prevailed in the series; while preterm childbirth had a high statistical significance. Conclusions: Biological risk factors with greater association force were malnutrition defect during registration, the previous diseases and those associated with pregnancy; as long as, among the factors with statistical significance prematurity and the short intergenesis prevailed, what did not occur with the unfavorable obstetric history. Correlation existed between gestational age, low birth weight, the presence of preterm childbirths and the slowed intra-uterine growth.

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Relato de caso: neste estudo, foi relatado um óbito por LV, ocorrido em uma puérpera, no município de Palmas, Tocantins, cuja enfermidade não foi identificada durante a gestação, tampouco no período em que permaneceu hospitalizada; evidenciados os fatores que contribuíram para a letalidade do caso; e discutidas as formas adequadas de manejo. Conclusão: por meio de investigação rigorosa nos registros clínicos, laboratoriais e informações junto à família, foi detectada ausência de informações nos prontuários médicos, falhas no monitoramento da paciente, dificuldades de reconhecer um quadro grave de LV em puérpera e, com isso, a necessidade de atualização dos profissionais de saúde com relação à análise clínica e laboratorial, a fim de que haja uma avaliação mais apurada dos sintomas, detecção precoce das complicações, diagnóstico rápido, tratamento adequado e evitar a ocorrência de óbitos.

Case report: In this study, a death due to LV occurred in a puerpera, in the municipality of Palmas, Tocantins, whose disease was not identified during pregnancy, nor during the period in which she was hospitalized evidenced the factors that contributed to the lethality of the case; and discussed the appropriate forms of management. Conclusion: A rigorous investigation in the clinical, laboratorial and family records revealed a lack of information in the medical records, failure to monitor the patient, difficulties in recognizing a severe VL in the puerperium, and with this, the need for updating of health professionals with respect to clinical and laboratory analysis, in order to have a more accurate evaluation of symptoms, early detection of complications, rapid diagnosis, adequate treatment and avoiding the occurrence of deaths.

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Introducción: La fascitis necrotizante es una infección progresiva poco común, con alta letalidad que puede afectar a cualquier parte del cuerpo, pero es más frecuente en las extremidades, en especial en las piernas, causada en su mayoría por una infección polimicrobiana y se caracteriza por afectar la fascia superficial, tejido subcutáneo, grasa subcutánea con nervios, arterias, venas y fascia profunda. Objetivo: Reportar el caso de una puérpera diagnosticada de fascitis necrotizante. Presentación de caso: Puérpera de 28 años de edad con antecedentes de obesidad e infección por VIH, ingresada en el Servicio de Obstetricia en un hospital de la República Sudafricana, por presentar fiebre, escalofríos y dolor en el abdomen. Se utilizó tratamiento endovenoso con antibióticos y tratamiento quirúrgico. Resultados: Evolución satisfactoria de la paciente sin secuelas. Conclusiones: El diagnóstico oportuno de esta patología permite un accionar temprano, con la consecuente sobrevida de los pacientes(AU)

Introduction: Necrotizing fasciitis is a very lethal uncommon progressive infection that can affect any part of the body, however it is more frequent in the limbs, especially the legs, caused mostly by a polymicrobial infection. It affects the superficial fascia, subcutaneous tissue, subcutaneous fat with nerves, arteries, veins and deep fascia. Objective: To report the case of a puerpera diagnosed with necrotizing fasciitis. Case presentation: A 28-year-old woman with a history of obesity and HIV infection, was admitted to the Obstetrics Service at a hospital in the Republic of South Africa. She had fever, chills and pain in the abdomen. Intravenous treatment with antibiotics and surgical treatment was used. Results: Satisfactory evolution of the patient with no sequelae. Conclusions: The opportune diagnosis of this pathology allows acting early, with the consequent survival of the patients(AU)

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Breastfeeding (BF) has presented, among other benefits, a reduction in infant mortality, a prevention of respiratory infections and a reduction in the risks of developing diseases. Therefore, the objectives of this study were to evaluate the knowledge and attitudes of puerperal in relation to BF in a university hospital, as well as the sources from which this information was obtained and the professional categories responsible for same. The work was carried out at the Hospital das Clinicas, Federal University of Uberlândia (HC-UFU). Structured interviews were conducted to obtain data for the evaluation of information and exercise of the BF practice with puerperal hospitalized in the accommodation complex, for mother and child, from July 1st to December 31st, 2010. Of the total of 907 women interviewed, 617 (68.0%) intended to BF for 12 months or more, 566 (62.4%) performed the BF within the first hour of birth, in 551 cases (60.8%) the decision to BF was taken by the woman before the current pregnancy and 828 (91.3%) received help in BF. Of the women who received help, 788 (95.1%) were assisted by professionals from the nursing team. It was shown that the majority of the puerperal intended to breast-feed for 12 months or more, considering that they also carried out BF in the first hour after child birth. The study also noted the importance of the nursing staff in taking care of the mother/child pair, promoting better interaction and acceptance of BF.

O aleitamento materno tem, dentre outros benefícios, a diminuição da morbimortalidade infantil, a prevenção de infecções respiratórias e a redução dos riscos de desenvolvimento de doenças, portanto, os objetivos deste estudo foram avaliar os saberes e atitudes de puérperas sobre aleitamento materno em um hospital universitário, bem como as fontes de obtenção e as categorias profissionais responsáveis por essas informações. O trabalho foi realizado no Hospital das Clínicas da Universidade Federal de Uberlândia (HC-UFU). Foram realizadas entrevistas estruturadas para obtenção de dados para avaliação de informações e exercício da prática do AM com puérperas internadas no alojamento conjunto, entre 1º de julho a 31 de dezembro de 2010. Do total de 907 entrevistadas, 617 (68,0%) das mulheres pretendiam amamentar por 12 meses ou mais, 566 (62,4%) das mulheres realizaram o AM já na primeira hora do nascimento, em 551 (60,8%) a decisão de amamentar foi tomada pela mulher antes da gravidez atual e 828 (91,3%) receberam ajuda no processo de amamentação. Das mulheres que receberam ajuda, 788 (95,1%) foram auxiliadas por profissionais da equipe de enfermagem. Foi demonstrado que a maioria das puérperas pretendia amamentar por 12 meses ou mais, tendo em vista que também realizaram o AM na primeira hora. Observou-se também a importância da equipe de enfermagem para com o cuidado do binômio mãe/filho, fazendo com que houvesse melhor interação e aceitação do AM

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Se realizó un estudio descriptivo y transversal de 21 puérperas cesareadas, con infección del sitio quirúrgico, ingresadas en el Hospital Ginecoobstétrico Dra. "Nelia Irma Delfín Ripoll" de Palma Soriano, provincia de Santiago de Cuba, desde octubre de 2014 hasta igual mes de 2015, a fin de caracterizarles según variables seleccionadas. En la serie predominaron el grupo etario de 20-29 años, la anemia (66,6 %) y la obesidad (42,8 %) como principales factores de riesgo, la cirugía urgente limpia contaminada (76,1 %), así como el Staphylococcus aureus y la Escherichia coli como los gérmenes más aislados; asimismo, se utilizaron combinaciones de antibióticos de primera línea con resultados favorables en todas las pacientes. Se concluye que la presencia de factores de riesgo y la identificación de bacterias como agentes causales importantes, exige mantener una vigilancia epidemiológica permanente para disminuir la infección en estas pacientes.

A descriptive and cross-sectional study of 21 newly-delivered woman undergoing cesarean section, with infection of the surgical place, admitted to Dr. "Nelia Irma Delfín Ripoll" Ginecoobstetric Hospital in Palma Soriano, Santiago de Cuba, was carried out from October, 2014 to the same month in 2015, in order to characterize them according to selected variables. In the series the 20-29 age group, anemia (66.6%) and obesity (42.8%) prevailed as main risk factors, the polluted clean urgent surgery (76.1%), as well as the Staphylococcus aureus and the Escherichia coli as the isolated germs; also, combinations of first line antibiotics were used with favorable results in all the patients. It was concluded that the presence of risk factors and the identification of bacterias as important causal agents, demands maintaining a permanent epidemiologic surveillance to diminish the infection in these patients.

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El consumo de sustancias ilícitas y de alcohol durante el embarazo constituye un problema de salud pública grave, que incide en el aumento de la morbi-mortalidad materno-fetal, el síndrome de abstinencia neonatal e institucionalización de los menores. El puerperio de estas mujeres presenta otros desafíos, siendo uno de ellos el control de su fertilidad posterior dado la menor adherencia al uso de métodos de anticoncepción (MAC) versus la población general. OBJETIVO: Conocer sobre la indicación de métodos anticonceptivos en puérperas con consumo problemático de drogas durante el embarazo, atendidas en el Hospital Dr.Gustavo Fricke, de Viña del Mar. MÉTODO: Se realizó un estudio observacional retrospectivo de los registros médicos de todas las pacientes con test de drogas positivo en orina de la Unidad de Puerperio del Servicio de Ginecología y Obstetricia cuyo parto ocurrió entre Junio del 2015 y Agosto del 2016...

The consumption of illicit substances and alcohol during pregnancy is a serious public health problem, given the increase in maternal-fetal morbidity and mortality, neonatal abstinence syndrome and institutionalization of minors. In turn, the postpartum period of these women presents other challenges, one of which is the control of their subsequent fertility given the lower adherence to the use of contraception methods (MAC) versus the general population. OBJECTIVE: Get to know the indication of contraceptive methods in postpartum women with problematic drug use during pregnancy, treated at the Dr. Gustavo Fricke Hospital, in Viña del Mar. METHOD: A retrospective observational study of the medical records of all patients with a positive urine drug test was performed at the Puerperium Unit of the Gynecology and Obstetrics Service whose delivery occurred between June 2015 and August 2016...

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Se realizó un estudio descriptivo y transversal, de casos y controles, en el Policlínico Docente "30 de Noviembre" de Santiago de Cuba, de enero de 2013 a igual mes del 2014, conformado por 20 puérperas pertenecientes al consultorio No. 29, en quienes se aplicó auriculoterapia para estimular la secreción láctea (grupo de estudio), e igual número de madres del consultorio homólogo No. 28, que no recibieron tratamiento (grupo de control), con vistas describir la práctica de la lactancia materna durante los primeros 6 meses de vida. En la serie, 40,0 % de las pacientes con auriculoterapia lactaron de forma exclusiva hasta los 6 meses y 25,0 % hasta los 5 meses, mientras que 40,0 % de las madres que no recibieron el tratamiento lo hicieron hasta los 4 meses y 35,0 % hasta los 3. Los niños del grupo de control presentaron, con mayor frecuencia, anemia (70,0 %), afecciones respiratorias (40,0 %) y enfermedades diarreicas (20,0 %), así como más ingresos hospitalarios (35,0 %). En el grupo de estudio 40,0 % de los lactantes presentó anemia, y se redujeron en 50 % las enfermedades y en 10 % los ingresos hospitalarios.

A descriptive and cross sectional, case - control study was carried out in "30 de Noviembre" Teaching Polyclinic in Santiago de Cuba, from January, 2013 to the same month of 2014, formed by 20 puerperas belonging to doctor´s office No. 29 in whom auriculotherapy was applied to stimulate breast secretion (study group), and the same number of mothers' from the homologous doctor´s office No. 28, who received no treatment (control group), with the aim of describing the practice of breast feeding during the first 6 months of life. In the series, 40.0% of the mothers with auriculotherapy nursed in an exclusive way up to 6 months and 25.0% up the 5 months, while 40.0% of mothers who had no treatment nursed up to 4 months, and 35.0% up to 3 months. The children from the control group had anemia (70.0%), breathing disorders (40.0%) and diarrheic diseases (20.0%) more frequently, as well as more hospital admissions (35.0%). In the study group 40.0% of the infants had anemia, diseases decreased in 50% and hospital admissions decreased in 10%.

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Todo recém-nascido tem seus direitos regulamentados na Lei 8.069/90 – Estatuto da Criança e do Adolescente – ECA; dentre os direitos arrolados neste documento encontra-se o relacionado à saúde que é estendido ao nascituro. Na realidade vivenciada pelo Serviço Social no Alojamento Conjunto do HCM observamos que a gestante com dependência química, inserida no sistema capitalista vigente, além de possuir seus direitos violados pelo Estado, a partir do momento que não adere ao pré-natal, também viola o direito do seu bebê, impedindo-o de ter acesso à saúde e demais políticas, cuja expressão da questão social torna-se latente. Assim, este trabalho apresenta a intervenção do(a) assistente social e as articulações com a rede de proteção ao atender recém-nascidos de puérperas em dependência química. Trata-se de estudo quanti-qualitativo com revisão literária e levantamento dos atendimentos realizados de março à agosto de 2014. Foram realizados 16 atendimentos, no qual 13 foram intervenções articuladas ao Conselho Tutelar e 3 com a Vara da Infância e Juventude. O(a) assistente social através do arsenal teórico-metodológico e técnico-operativo reúne elementos para uma análise de conjuntura que co-responsabilize o Estado no papel protetivo tanto do recém-nascido como da puérpera com dependência química, visto que ambos encontram-se desprotegidos socialmente. Ao realizar as atividades articuladas e coordenadas entre si e com a rede de proteção, o Serviço Social do HCM atua na perspectiva da garantia de direitos, o que exige competência ético-política, educação continuada e afinidade com as demais políticas que compõe o conceito ampliado de saúde (AU).

Every newborn has their rights regulated by Law 8.069/90 - Statute of the Child and Adolescent – ECA; among the rights enrolled in this document is the related to health that is extended to the unborn child. In reality experienced by the Social Work in HCM Bed Set observed that pregnant women with addiction, part of the current capitalist system, in addition to having their rights violated by the state, from the moment that does not adhere to prenatal care, also violates the right of your baby, preventing him from having access to health and other policies, whose expression of the social question becomes latent. This work presentes theintervention of Social Worker and the joints with the safety net to meet newborns of mothers in addiction. It is quantitative and qualitative study of the literature review and survey of attendances March to August 2014. Were held 16 sessions, in which 13 were interventions articuled the Guardian Council and 3 wiht the Children and Youth Court. The Social Worker through the theoretical-methodological and technical-operational arsenal brings together elements for a situation analysis that co-responsibility to tha State in protective role in both the newborn and the postpartum women with chemical dependency, since both are socially unprotected. When performing the articulated and coordinated activities between themselves and with the safety net, the Social HCM Service operates from the perspective of the guarantee of rights, which requires ethical-political competence, continuing education and affinity with the other policies that make up the broader concept health (AU).

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Objetivos: Determinar la regresión colposcópica de las lesiones cervicales intraepiteliales de alto grado en gestantes. Diseño: Estudio observacional descriptivo, transversal. Institución: Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Perú. Participantes: Gestantes con diagnóstico de lesión cervical intraepitelial de alto grado - LIEAG (NIC II, NIC III, cáncer in situ). Intervenciones: Se procedió a la búsqueda en el software de anatomía patológica sobre los resultados de Papanicolaou con informe citológico de LIEAG, desde el año 2004 hasta 2008. Principales medidas de resultados: Regresión colposcópica de lesiones de alto grado en mujeres puérperas. Resultados: La distribución de las LIEAG difirió estadísticamente entre la muestra de Papanicolaou y la colposcopia, pero en ambas se mantuvo el orden de NIC II, III y cáncer in situ. Según la colposcopia, en el preparto la LIEAG más frecuente fue NIC II (83,3%), seguida de NIC III y cáncer in situ (15% y 1,7%, respectivamente). En el control posparto, 38,3% presentó un estudio colposcópico normal y los casos que continuaban siendo patológicos (61,7%) mostraron mejoría hacia lesiones de riesgo bajo, como NIC I (26,7%). Solo en 35% persistieron las lesiones de riesgo alto (NIC II, III, cáncer in situ, con 25%, 6,7% y 3,3%, respectivamente). Estas modificaciones de las LIEAG en el posparto fueron estadísticamente significativas. El parto vía vaginal se relacionó con menor persistencia de lesiones de riesgo alto, a diferencia de la vía cesárea. Destacó la mejoría del estudio colposcópico en las pacientes de 36 a más años de edad, las que habían tenido una sola pareja y en quienes iniciaron las relaciones sexuales después de los 20 años. Conclusiones: La regresión espontánea de las lesiones cervicales de grado alto en el posparto ocurrió en 65%, más en quienes fueron atendidas de parto vaginal, quienes tenían 36 años o más, las monógamas y quienes iniciaron relaciones sexuales después de los 20 años.

Objectives: To determine high-grade intraepithelial cervical lesions colposcopic regression in pregnant women. Design: Cross-sectional observational study. Setting: Hospital Nacional Docente Madre Niño San Bartolome, Lima, Peru. Participants: Pregnant women with high grade intraepithelial cervical lesion diagnosis - HSIL (CIN II, CIN III, cancer in situ). Interventions: Results of HSIL in Papanicolaou cytology reports from 2004 until 2008 were searched in Pathology Service software. Main outcome measures: Colposcopic regression of high degree lesions in puerperal women. Results: HSIL distribution was statistically different between Papanicolaou and colposcopy reports but both maintained CIN II, CIN III and cancer in situ order. According to colposcopy HSIL was more frequent than CIN II (83.3%) and cancer in situ followed by CIN III and cancer in situ (15% and 1.7% respectively). In post partum control 38.3% had normal colposcopy and 61.7% of cases remained pathological but presented improvement to low-risk lesions such as CIN I (26.7%). Only 35% persisted as high-risk lesions (CIN II, CIN III, cancer in situ: 25%, 6.7% and 3.3% respectively). These post partum changes were statistically significant. Birth by vaginal delivery was related to lower persistence of high risk lesions in the post partum compared to birth by caesarean section. Thirty-six and older women showed improvement in the post partum as well as those having a single sexual partner and beginning sexual relations after age 20. Conclusions: Post partum spontaneous regression of high degree cervical lesions occurred in 65% of puerperal women, more in those with vaginal delivery, 36 year-old or older, history of one sexual partner and beginning sexual relations after age 20.

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Introducción: tanto las infecciones puerperales como las neonatales precoces reflejan probablemente los microorganismos que están presentes en la vagina en el período cercano al parto. Objetivo: establecer la relación entre los microorganismos identificados en las secreciones genitales de las gestantes a término y el desarrollo de sepsis neonatal y puerperal, así como vincular dichas complicaciones con los agentes diagnosticados. Métodos: se realizó un estudio longitudinal y prospectivo en los servicios de microbiología, obstetricia, perinatología y neonatología del Hospital General Docente "Dr. "Juan Bruno Zayas Alfonso", de Santiago de Cuba, desde julio de 2009 hasta marzo de 2010. Se identificaron microorganismos en 179 muestras cervicovaginales, las cuales fueron procesadas en el laboratorio de microbiología según las normas vigentes. Resultados: los microorganismos más identificados resultaron los géneros Mycoplasmas y Chlamydias (78,2 y 69,3%, respectivamente) y fueron los que con mayor frecuencia se asociaron. Un porcentaje elevado de las gestantes (67,0 %), tenía más de un agente en sus secreciones genitales. Después del parto hubo un hallazgo mayor de infecciones en el producto de la concepción (21,8 %) que en las puérperas (3,9%) y la mayoría de estas complicaciones se relacionaron con la presencia de 2 o más microorganismos. Conclusiones: las asociaciones de microorganismos patógenos o potencialmente patógenos en las secreciones genitales de embarazadas a término, aumentan el riesgo de complicaciones posnatales.

Introduction: both the puerperal infections and the early neonatal infections probably reflect the organisms which are present in the vagina in the period close to childbirth. Objective: to establish the relationship between the organisms identified in the genital secretions from the pregnant women at term and the development of neonatal and puerperal sepsis, as well as to link these complications with the diagnosed agents. Methods: a longitudinal and prospective study was carried out in the microbiology obstetrics, perinatology and neonatology services of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital, in Santiago de Cuba, from July, 2009 to March, 2010. Organisms were identified in 179 cervix and vaginal samples, which were processed in the microbiology laboratory according to the present norms. Results: the organisms mostly identified were the Mycoplasmas and Chlamydias (78.2 and 69.3 %, respectively) and were those most frequently associated. A high percentage of the pregnant women (67.0%) had more than an organism in their genital secretions. After the childbirth there was a higher finding of infections in the conceptus (21.8%) than in the puerperas (3.9%) and most of these complications were related to the presence of 2 or more organisms. Conclusions: the associations of pathogenic or potentially pathogenic microorganisms in the genital discharge of pregnant women at term, increase the risk of postnatal complications.

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En el período gravido - puerperal, la coagulación sanguínea sufre cambios que se impone conocer para interpretar correctamente esos trastornos cuando se presentan en esta etapa, teniendo en cuenta las posibles complicaciones y el peligro para la vida que pueden presentarse. El objetivo del presente artículo es proporcionar a los obstetras una revisión bibliográfica que les permita actualizarse acerca del tema y facilite su modo de actuación ante pacientes con coagulación intravascular diseminada. Se concluye que es preciso diagnosticar tempranamente el proceso en la fase bioquímica de bajo grado y aplicar en las féminas el tratamiento expedito de la enfermedad de base para eliminar las complicaciones o disminuir su ocurrencia.

In the period from pregnancy to puerperium, blood clotting suffers changes which are important to be known in order to interpret correctly those dysfunctions when they appear in this stage, keeping in mind the possible complications and the danger for life which can take place. The objective of the present work is to provide the obstetricians a literature review that allows them to be updated about the topic and facilitate their performance in case of patients with disseminated intravascular clotting. It is concluded that it is necessary to have an early diagnosis on the process during the low grade biochemical phase and to apply in these women the expedite treatment of the base disease to eliminate complications or to decrease their occurrence.

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Se efectuó un estudio descriptivo y transversal de 52 gestantes y puérperas, con diagnóstico de enfermedad tromboembólica venosa, que ingresaron en la Unidad de Cuidados Intensivos del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres de Santiago de Cuba, desde enero del 2007 hasta julio del 2009. En la serie predominaron las mujeres en edad fértil (tercera década de vida) y los siguientes factores de riesgo: reposo prolongado en cama y uso de anticonceptivos orales. La mencionada afección primó en forma de trombosis venosa, sobre todo en las grávidas en el tercer trimestre de embarazo y en las que se decidió realizar cesárea; a los efectos, entre las manifestaciones clínicas más comunes figuraron: dolor, taquicardia y edema, principalmente en la pierna izquierda. El diagnóstico definitivo se estableció fundamentalmente a través de la ecografía Doppler, el tratamiento aplicado en la mayoría de las afectadas se basó en la heparina de bajo peso molecular y las complicaciones más frecuentes, relacionadas con la anticoagulación, resultaron ser las hemorragias y las trombocitopenias.

A descriptive and cross-sectional study of 52 pregnant and puerpera women under a diagnosis of venous thromboembolic disease who were admitted at the Intensive Care Unit from Saturnino Lora Torres Provincial Teaching Clinical-Surgical Hospital in Santiago de Cuba was carried out from January, 2007 to July, 2009. Women in childbearing age (third life decade) and the following risk factors: prolonged bed rest and oral contraceptive use were predominant in the series. The aforementioned affection was relevant in its venous thrombosis form, mainly in the gravid in the third trimester of pregnancy and in those who underwent cesarean delivery. To all intents and purposes, pain, tachycardia, and edema, mostly in the left leg, were the most common clinical manifestations. The final diagnosis was made using Doppler scanning. The therapy applied to the majority of the affected women was based on underweighted molecular heparin. Hemorrages and thrombopenias, both related to anticoagulation, were the most frequent complications.

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O modelo assistencial vigente dispensado à mulher, em seu processo de ser mãe, caracteriza-se pela prioridade aos aspectos biológicos e desvios da normalidade clínica e obstétrica. Questionamos se essa maneira de assistir atende às demandas integrais da mulher que vivencia tal processo. Assim sendo, o objetivo do estudo foi compreender as percepções da mulher sobre a assistência de enfermagem que atende a suas demandas no processo de ser mãe. Aplicou-se a Técnica Projetiva de Desenho e Estória de Trinca, em que solicitou-se à participante do estudo que fizesse um desenho o qual retratasse a assistência recebida e contasse uma história sobre ele, a qual foi gravada e constituiu o material empírico desta pesquisa. As histórias foram organizadas, segundo o método de elaboração do Discurso do Sujeito Coletivo, e analisadas à luz do Modelo de Relacionamento Humano proposto por Hagerty, Linchar-Sauer, Patusky, e Bouwsema. Participaram 13 mães internadas no Instituto Fernandes Figueira - Fundação Osvaldo Cruz, no município do Rio de Janeiro. Da análise, apreenderam-se cinco Discursos do Sujeito Coletivo: 1. Sendo bem tratada. 2. Porque os profissionais tratam bem. 3. Sendo maltratada. 4. Porque os profissionais tratam mal. 5. Sentindo-se dependente. Por meio desses discursos, mostra-se a fragilidade e inconsistência de uma assistência à mulher, no seu processo de ser mãe, centrada em rotinas e perspectivas individuais dos profissionais. Nesse contexto, a mulher sente-se à mercê da boa vontade e da competência pessoal do profissional de estabelecer um relacionamento com ela, que permita a promoção de seu bem-estar. Dessa forma, dependendo dos profissionais com os quais interage, a mulher percebe-se em um cenário em que se alterna aos extremos de sentir-se bem tratada ou maltratada. Seus discursos denunciam a ausência de metas comuns e de um referencial que dê diretrizes para uma assistência e atuação profissional ) voltadas para a promoção da saúde materna e saúde infantil

The assistance model in force given to the woman in her process of being a mother is characterized by the priority of the biological aspects and diversions from the clinical and obstetric normality. We question if this way of assisting attends the integral demands of the woman that lives that process. Thus the objective of the study was to understand the woman's perceptions about the nursing assistance that assists their demands in the process of being a mother. The Projective Technique of Drawing and Story of Trine was applied and had requested to the participant of the study to do a drawing that to portray the assistance received and to tell a report about it, which was recorded. Those things have constituted the empiric material of this research. The reports were organized according to the method of elaboration of the Collective Subject's Speech and analyzed based on the Model of Human Relationship proposed by Hagerty, Lynch-Sauer, Patusky, and Bouwsema. Thirteen mothers interned at the Instituto Fernandes Figueira - Fundação Osvaldo Cruz, in Rio de Janeiro city, had taken part on this study. From the analysis, there were apprehended five Speeches of the Collective Subject: 1. Being well treated. 2. Why the professionals treat well. 3. Being badly treated. 4. Why the professionals mistreated. 5. Feeling dependent. Through those speeches, it is shown the fragility and inconsistency of assistance to the woman, in her process of being a mother, centered in individual routines and perspectives of the professionals. In that context, the woman feels at the mercy of the good will and of the personal competence from the professional to establish a relationship with her that allows the promotion of her well being. In that way, depending on the professionals with whom the woman interacts, she feels herself into a scenery which is altered to the extremely between feeling well treated or mistreated. Their speeches denounce the absence of common goals and of a reference that gives guidelines to a professional assistance and performance turned to the promotion of the maternal health

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