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Repercussões psíquicas da perda perinatal de um gêmeo: entre o luto e o investimento

Thu, 13 Mar 2025 00:00:00 GMT

Title: Repercussões psíquicas da perda perinatal de um gêmeo: entre o luto e o investimento Author(s)/Inventor(s): Oliveira, Daiana Gaignoux de Advisor: Rabello, Mariana Almeida Abstract: Multiple pregnancies demand restructurings at various levels, requiring the family to bond with two or more children and adapt to this new reality. Death in the perinatal period is especially delicate, given its unexpected and impactful nature, requiring care from health teams. The occurrence of the death of a twin in the perinatal period brings complex issues for the family, which finds itself facing the need to care for the surviving baby while grieving the loss of a child. Thereby, the objective was to analyze the psychic and emotional aspects of mothers and fathers who experienced perinatal losses in multiple pregnancies, with the survival of at least one of the babies. The research is a descriptive study with a qualitative approach. Psychological and multidisciplinary medical records of the patients were consulted, and the data were analyzed according to the thematic modality, as suggested by Minayo (2014). The analysis of the reports resulted in the following categories: Characteristics of multiple pregnancy; Aspects of loss during the gestational-puerperal cycle; Specificities of the grieving process; The role of the multidisciplinary team. Particular issues related to twinhood and to the period in which death occurred were highlighted. The intensity of the experience lived by the parents indicates the possibility of grief postponement in these cases, as well as possible difficulties in the initial relationship with the surviving baby. In this context, the approaches adopted by the multidisciplinary team are crucial in assisting the expression of suffering and bonding with the surviving child, ensuring that one process does not hinder the other. The importance of further studies on the subject is emphasized, especially concerning the grieving process of parents and the development of the surviving twin. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

Incluindo o psíquico em uma uti neonatal: quando o cuidado com o bebê prematuro se faz pela presença

Thu, 13 Mar 2025 00:00:00 GMT

Title: Incluindo o psíquico em uma uti neonatal: quando o cuidado com o bebê prematuro se faz pela presença Author(s)/Inventor(s): Perry, Cassia Patricia Barroso Advisor: Haddad , Camila Carpes Chafic Abstract: The Neonatal Intensive Care Unit (NICU) is considered a critical area, where patients who were born prematurely or with some serious condition are admitted. Born before the time, premature babies have specificities and cannot be observed as full-term newborns, thus, to improve their physical and mental development, it is important to intervene as early as possible. Taking that into consideration, this study aimed to understand which aspects should be observed in premature babies admitted to the NICU regarding their psychological development and which interventions become necessary, taking early intervention as a reference. A descriptive study, with qualitative approach, was carried out in a public maternity hospital with high fetal risk, in the city of Rio de Janeiro. Two focus groups were held with 8 professionals, one representative from each professional category working on the NICU. The data was analyzed through content analysis, in thematic modality, according to Gomes (2016). Three categories were identified and discussed: (1) Introducing the subject: the importance of communicating with the babies admitted to the NICU; (2) What’s already done that has an effect? Professionals' perception of the subjective impact of hospitalization on the development of babies and the early intervention that happens informally; and (3) Proposing new dialogues: the repercussions of the focus group on the reflection and practice of professionals. In the end, an instrument for assessing the psychological risk of premature babies admitted to a NICU was proposed, articulating what is exposed in the literature with the knowledge discussed in the focus groups. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

Adequação do ganho de peso gestacional de mulheres atendidas em maternidade do Rio de Janeiro: comparação entre as curvas brasileiras e a recomendação do instituto de medicina (IOM, 2009)

Tue, 11 Mar 2025 00:00:00 GMT

Title: Adequação do ganho de peso gestacional de mulheres atendidas em maternidade do Rio de Janeiro: comparação entre as curvas brasileiras e a recomendação do instituto de medicina (IOM, 2009) Author(s)/Inventor(s): Moraes, Mariana Campos de Advisor: Saunders, Cláudia Abstract: Introduction: Gestational weight gain (GWG) is physiological and necessary for fetal growth and development. Its monitoring regards an important part of prenatal care, since when inadequate, it is related to adverse perinatal outcomes. In 2021, the Brazilian Weight Gain Curves were developed based on this population. However, studies evaluating their performance are scarce. Objective: To analyze the adequacy of GWG of pregnant women, according to the Brazilian Weight Gain Curves. Methods: The study was designed as observational and cross-sectional, conducted in a public maternity hospital in the city of Rio de Janeiro. A total of 725 adult pregnant women (≥18 years old) with low- and high-risk pregnancies, with a single fetus, who received prenatal care and had anthropometric data available were evaluated. Sociodemographic data, current and previous clinical and obstetric history were analyzed from interviews conducted postpartum and data collection from medical records. The sample was divided into three groups: insufficient GWG, adequate GWG and excessive GWG, according to the Brazilian weight gain recommendation. The 9 Chi-square and Kruskal-Wallis tests were used to compare frequencies and medians, respectively, and Dunn's test to verify differences between groups, assuming statistical significance of p<0.05. Results: The prevalence of insufficient GWG was 25.8%, 21.1% for adequate GWG and 53.1% for excessive GWG. When compared with the adequacy assessed by the IOM (2009) method, there were lower prevalences of insufficient and adequate GWG and higher prevalences of excessive GWG (p<0.001). The modifiable factors related to GWG were pre-gestational BMI (p=0.001) and number of consultations with a nutritionist (p=0.008). The sensitivity of the Brazilian curves in relation to the IOM (2009) recommendation for excessive GWG was 100%, with specificity of 76.6%. For insufficient GWG, the sensitivity and specificity were 72.3% and 20%, respectively. Conclusion: The Brazilian curves have better sensitivity and specificity values for excessive GWG compared to insufficient GWG, using the IOM (2009) recommendation as the standard test. Research on gestational and neonatal outcomes in Brazilian pregnant women in relation to the recommendations of the Brazilian Weight Gain Curves is necessary to consolidate their use in this population. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização

As motivações para a solicitação pela cesárea numa maternidade do Rio de Janeiro

Mon, 10 Mar 2025 00:00:00 GMT

Title: As motivações para a solicitação pela cesárea numa maternidade do Rio de Janeiro Author(s)/Inventor(s): Marques, Gabriella Lima dos Santos Advisor: Leite, Helder Camilo Abstract: It is essential that health professionals seek to understand the motivations that lead patients to choose a cesarean section so that they can provide more effective counseling to help them make an informed decision. Objective: To understand the motivations of patients to request a cesarean section, without clinical indication, at the UFRJ Maternity School. Methodology: A descriptive exploratory study with a qualitative approach carried out at the UFRJ Maternity School. Data collection took place from February to July 2024 and was carried out in two stages, the first stage being a semi-structured interview and the second stage collecting information on the medical records about the sociodemographic and obstetric profile. The research population consisted of patients at the Maternity School who opted for a cesarean section. Data analysis was performed using Minayo's discourse analysis technique. Results and Discussion: Four categories of motivations for requesting a cesarean section emerged: Perception of delay in labor progression; Fear and pain; Experiences of previous births; and Maternal and fetal clinical and physical conditions. Most participants reported receiving more superficial guidance, which may have affected their ability to make an informed choice about the best route of delivery. Conclusion: It is essential that professionals invest more in guiding these women during prenatal care about vaginal and cesarean delivery and actively listening to their perceptions and experiences about vaginal delivery. Publisher: Universidade Federal do Rio de Janeiro Type: Trabalho de conclusão de especialização