Maternal Death and Potential Years of Life Lost(PYLL)in Santa Catarina,Brazil,in 2000 and 2014

Introduction: Indicators of maternal health are often used to evaluate the social development and overall health of a population, as well as the accessibility of health services. Among these indicators, the Potential Years of Life Lost, which is associated with maternal deaths, is useful for the definition of priorities, monitoring, evaluation, and intervention, identifying the highest risk groups. Objective: To analyze the Potential Years of Life Lost by maternal death in Santa Catarina in 2000 and 2014. Method: An Ecological study with exploratory spatial analysis was conducted with data obtained from the Information System on Mortality and Live Births. Results: In the Information System, 35 maternal deaths in the year 2000 were identified and 24 in 2014. The total estimated years of life lost were 845 years in 2000 and 780 years in 2014, dominated by direct obstetric causes. In 2000, women who died lost, on average, 39.8 years of life;and 41.5 years in 2014. Conclusion: The spatial pattern observed in 2000 highlights areas of high risk in different regions of Santa Catarina. The greatest loss of years occurred in younger women, confirming the need to prevent and control maternal mortality and review strategies for compliance with public policies in the State.

Prevention and Control of Postpartum Hemorrhage: Validation of Rangel’s Technology for Huambo, Angola

In the immediate postpartum period, women need to be observed by the obstetric nurse so that measures can be taken to prevent hemorrhages and reduce its complications. Most maternal deaths from hemorrhage are preventable with support measures for clinical practice, such as: guiding protocols, training of professionals, organization and management of health services and provision of adequate conditions for the parturition process. Objective: To validate Rangel’s instrument with its application in the Maternity Ward of the General Hospital of Huambo, Angola. Methodology: This is a descriptive study with a quantitative approach. This is the sixth stage, called pre-test, of the Translation and Cultural Adaptation process. This instrument was sent for evaluation by the validators using the electronic data collection form named Google forms, with a seven-point Likert-type scale (from 7—totally agree to 1—totally disagree). The analysis was performed with the Cronbach’s Alpha coefficient index (>0.91) and the Content Validity Index (CVI > 0.98). Results: Of the 10 items of evaluation criteria of the instrument analyzed by the 20 validators, 100% of them obtained a Cronbach’s Alpha index rating of 0.91: clarity;coherence;scientific writing;relevance;sequence;uniqueness and updating. Coverage, item criticality and objectivity reached a Cronbach’s Alpha of 0.95. The Content Validity Index was 0.95 for coverage, coherence, item criticality, scientific writing, relevance and updating. Conclusion: Rangel’s instrument for nursing care aimed at preventing and controlling hemorrhage in the third period of birth, translated into Angolan Portuguese and validated by nurses, through the statistical results obtained in the validation, was considered reliable and necessary for clinical nursing practice in Huambo, Angola. .

Postpartum Hemorrhage: A Technical Essay

Background: Postpartum hemorrhage is one of the main causes of maternal mortality, mainly in underdeveloped countries. Deaths are mostly preventable, and are related to socioeconomic development, organization of health services and professional training. Objective: To systematize alerts for the prevention of postpartum hemorrhage. Method: This is a technical essay developed from reflections on previously produced and published texts about maternal mortality and has hemorrhage as the focus of this study. Results: It presents the concept, classification of hemorrhage, risk factors and their classification, prevention strategies, universal recommendations, pharmacological and non-pharmacological interventions when hemorrhage already exists, bleeding assessment techniques;clinical evaluation, by laboratory examination and by shock index. Conclusions: Hemorrhage is a preventable cause of maternal death through the accomplishment of multiple care. Hospital care must be conducted by qualified professionals and in adequate numbers. The risk diagnosis must be carried out during prenatal care with the recording of clinical data accessible in the health care network. All references studied are not specific to nursing, as hemorrhage prevention requires multidisciplinary action.

Nurse Care and Comfort in the Puerperium of Girls/Women: Protocol for a Scoping Review

Purpose: Carrying out a scoping review to fill gaps in current knowledge regarding comfort needs in the care provided by nurses to girls/women who experience puerperium. Methods: The procedures guided by the Joanna Briggs Institute will be applied. The searches will be carried out in the Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Nursing Database, Scientific Electronic Library databases. Studies which are available in full and published in English, Spanish or Portuguese will be selected. There will be no restrictions to the study design or time frame. Two reviewers will independently screen all citations with the aid of software. The degree of agreement between the researchers will be verified by statistics that measure reliability. Through narrative descriptions, charts, and tables, we will present the results obtained. Data analysis will involve descriptive statistics, and qualitative evaluation. We will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist to review and write this review. Conclusion: We will summarize the main information available in the literature on the subject, aiming to obtain an overview of the practices employed, and the gaps present in knowledge that require greater attention from the scientific community.

The Contribution of Technological Approaches in Reducing Maternal Mortality: An Integrative Review

Aim: To analyze the role of available health technologies and techniques in reducing the number of women dying during pregnancy and childbirth. Background: Health condition of women during pregnancy and childbirth is very sensitive. During this period, proper and timely care plays an important role in reducing maternal mortality. Design: Whitte more and Knal’s framework for integrative reviews was followed in the review. PUBMED/MEDLINE, CINHAL and COCHRANE were searched for published studies between 2008 and 2015. Studies included were systematic reviews, randomized control trials, prospective cohort study, literature review and descriptive studies. Methods: 28 articles were selected to be included in the review. An integrative review approach was followed to analyze data and draw conclusions. Screening of titles and abstracts along with data extraction was completed by two authors independently. Study quality is not reported because of the methodological difficulties. Data synthesis consists of writing descriptive summaries and thematic analysis of the key findings in the included articles. Results: The included studies were based on health technologies and techniques including different devices and tools, medication and drugs, massage techniques, immersion in water, intervention radiology, simulations and training for the health professional. Conclusion: There are numerous health technologies and techniques which are relatively simple to develop, effective to use and safe to apply with no adverse effects. These include simulations and training programs, educational and awareness programs, decision support tools and information systems. Besides these, there are technologies and techniques which show promising results with no or very little adverse effects. These include Active management of the third stage of labour, use of magnesium sulphate, uterine balloon tamponade, wearable cardiac defibrillator and non-pneumatic anti-shock garment. The government, hospitals and care providers should make policies to develop and implement such type of technologies and techniques.

Prevention of Pre-Eclampsia and Eclampsia. A Systematic Review

Every pregnant woman needs continuous, timely and supportive care throughout during pregnancy for safe motherhood. The objective of this study was to analyze and evaluate the available medications and techniques for the prevention and treatment of pre-eclampsia and eclampsia. The standard methodology of systematic review without meta-analysis was followed and only RCTs and systematic reviews were included in the review. Three electronic data sources (PubMed/Medline, CINAHL, and Cochrane) were searched for studies, published between 1986 and 2016 on the prevention and control of pre-eclampsia and eclampsia. 47 studies were finally included in the review, of which 18 were systematic reviews and 29 were RCTs. Technologies and techniques used in the included studies for the prevention and control of pre-eclampsia and eclampsia are Magnesium Sulphate, Aspirin, Antioxidant (Vitamin C, E and Lycopene), Calcium supplementation, Chinese Herbal Medicine, physical activities, Nitric Oxide, Marine Food Oils, Low Salt Diet, Garlic, Plasma Volume Expansion, Low-dose Dopamine, Progesterone, Smoking, and Diuretics. Magnesium sulfate appears to be the most effective treatment which reduces the risk of eclampsia by more than 50%. However, its best dose and route are still controversial and need further research. The knowledge and experience of nurses in properly using the protocols and evidence-based interventions are necessary for the wellbeing of pregnant women.