The decision of what kind of labor that should be held is intermittently generating a great debate in Brazil. The growth in the number of cesarean sections has raised worries in some of the involved sectors of the soc...The decision of what kind of labor that should be held is intermittently generating a great debate in Brazil. The growth in the number of cesarean sections has raised worries in some of the involved sectors of the society. It was proposed to investigate the factors which lead the women to take this decision, trying to understand the principle involved. A bibliographic review about the subject was made. The research happened in the town of Formiga, where some data were collected in two hospitals—public and private —about the number of labors during two months. Subsequently, the obstetricians and a group of pregnant women were submitted to a questionnaire, the answers were compiled and transformed into graphs which were analyzed. Finally, the data were compared with the related literature. The number of cesarean sections in the town was above the standard recommended. According to the obstetricians, the main reason would be the preference of the pregnant women, fact which was not confirmed by them, that discrepancy was confirmed by the literature. The level of information about the clinical indications for the type of labor was considered satisfactory by the doctors and the pregnant women, data contestable by the academics. The fear and the pain were identified by obstetricians and pregnant women as a predominant factor for the preference of cesarean sections, provided that, according to the literature, shows the precariousness of information for pregnant women about the normal birth. Another important data is that the doctors can have an important role in the kind of labor to be made. According to the obstetricians, their role would be very limited, but according to some pregnant women, they did trust in the doctors which should be the ideal labor for them. The analysis of most of the data collected shows a discrepancy between the information of pregnant women and obstetricians. Both sides involved in the issue do not admit as responsible for the elevate number of cesarean sections, so, some new approaches are needed for analysis. This analysis and diagnosis indicate the next step of the research: the supervision of the pregnant women, since the beginning of the gestation until the birth, trying to figure out the real factors which lead them to decide what kind of delivery should be taken.展开更多
妊娠期自发性腹腔内出血(spontaneous hemoperitoneum in pregnancy,SHiP)是一种严重的妊娠并发症,临床罕见且表现缺乏特异性,与子宫内膜异位症密切相关,会增加母胎不良结局的发生率。报告1例SHiP患者经手术救治,母胎平安的病例。该患...妊娠期自发性腹腔内出血(spontaneous hemoperitoneum in pregnancy,SHiP)是一种严重的妊娠并发症,临床罕见且表现缺乏特异性,与子宫内膜异位症密切相关,会增加母胎不良结局的发生率。报告1例SHiP患者经手术救治,母胎平安的病例。该患者30岁,初产妇,既往有子宫内膜异位症病史,本次妊娠前4个月因双侧卵巢子宫内膜异位囊肿破裂行腹腔镜手术。于妊娠39+2周因持续下腹疼痛半小时入院,考虑有胎儿窘迫、胎盘早剥可能,行紧急剖宫产,术中见腹腔内出血1200 mL,娩出一女婴,1 min Apgar评分10分,胎盘未见早剥征象。盆腔探查见子宫右后壁中下段一新生静脉血管自发性破裂,伴活动性出血,局部予缝合止血。因此,临床上对于SHiP应及时发现、快速诊断,选择合适的干预措施,有助于改善母胎妊娠结局。展开更多
文摘The decision of what kind of labor that should be held is intermittently generating a great debate in Brazil. The growth in the number of cesarean sections has raised worries in some of the involved sectors of the society. It was proposed to investigate the factors which lead the women to take this decision, trying to understand the principle involved. A bibliographic review about the subject was made. The research happened in the town of Formiga, where some data were collected in two hospitals—public and private —about the number of labors during two months. Subsequently, the obstetricians and a group of pregnant women were submitted to a questionnaire, the answers were compiled and transformed into graphs which were analyzed. Finally, the data were compared with the related literature. The number of cesarean sections in the town was above the standard recommended. According to the obstetricians, the main reason would be the preference of the pregnant women, fact which was not confirmed by them, that discrepancy was confirmed by the literature. The level of information about the clinical indications for the type of labor was considered satisfactory by the doctors and the pregnant women, data contestable by the academics. The fear and the pain were identified by obstetricians and pregnant women as a predominant factor for the preference of cesarean sections, provided that, according to the literature, shows the precariousness of information for pregnant women about the normal birth. Another important data is that the doctors can have an important role in the kind of labor to be made. According to the obstetricians, their role would be very limited, but according to some pregnant women, they did trust in the doctors which should be the ideal labor for them. The analysis of most of the data collected shows a discrepancy between the information of pregnant women and obstetricians. Both sides involved in the issue do not admit as responsible for the elevate number of cesarean sections, so, some new approaches are needed for analysis. This analysis and diagnosis indicate the next step of the research: the supervision of the pregnant women, since the beginning of the gestation until the birth, trying to figure out the real factors which lead them to decide what kind of delivery should be taken.
文摘妊娠期自发性腹腔内出血(spontaneous hemoperitoneum in pregnancy,SHiP)是一种严重的妊娠并发症,临床罕见且表现缺乏特异性,与子宫内膜异位症密切相关,会增加母胎不良结局的发生率。报告1例SHiP患者经手术救治,母胎平安的病例。该患者30岁,初产妇,既往有子宫内膜异位症病史,本次妊娠前4个月因双侧卵巢子宫内膜异位囊肿破裂行腹腔镜手术。于妊娠39+2周因持续下腹疼痛半小时入院,考虑有胎儿窘迫、胎盘早剥可能,行紧急剖宫产,术中见腹腔内出血1200 mL,娩出一女婴,1 min Apgar评分10分,胎盘未见早剥征象。盆腔探查见子宫右后壁中下段一新生静脉血管自发性破裂,伴活动性出血,局部予缝合止血。因此,临床上对于SHiP应及时发现、快速诊断,选择合适的干预措施,有助于改善母胎妊娠结局。
