O presente trabalho teve como objetivo avaliar a influência da cesariana eletiva no eritrograma de bezerros neonatos da raça Nelore durante os primeiros trinta dias de vida. Os neonatos foram alocados em 3 grupos 8 bezerros obtidos por parto espontâneo (PE), 8 bezerros nascidos por cesariana, sem indução do parto (CSI) e 8 bezerros nascidos por cesariana, com indução do parto (CCI) pelo uso de 25 mg de Dexametasona, 24 horas antes do procedimento cirúrgico, pela via intramuscular. Os nascimentos ocorreram entre 282 e 292 dias de gestação. As amostras de sangue para a determinação do quadro eritrocitário foram colhidas por punção da veia jugular externa, utilizando-se Sistema Vacutainer®. A determinação do eritrograma foi realizada no contador automatizado BC-2800 Vet Mindray®. Os resultados obtidos evidenciam que a cesariana eletiva não influenciou o número de hemácias, das taxas de hemoglobina e nos valores do volume globular a crase sanguínea de bezerros na primeira semana de vida. Na primeira semana de vida observou-se, independentemente do grupo experimental uma diminuição no número de hemácias, das taxas de hemoglobina e nos valores do volume globular. Até os 5 dias de vida, os valores de Volume Corpuscular Médio (VCM) e de Hemoglobina Corpuscular Média (HCM) dos bezerros nascidos de partos espontâneos por via vaginal são estatisticamente menores do que os obtidos em bezerros nascidos de cesariana eletiva. A partir de 10 dias de vida observou-se, nos animais obtidos de parto espontâneo, uma rápida recuperação nos valores de hemácias, hemoglobina e volume globular, enquanto nos animais nascidos por cesariana (induzida e não induzida) não ocorria essa recuperação nas taxas de hemoglobina e nos valores do volume globular. Nos bezerros obtidos por cesariana observou-se que no período entre 10 e 30 dias de vida o Volume Corpuscular Médio (VCM) e a Hemoglobina Corpuscular Média (HCM) diminuíram, passando a apresentarem microcitose e hipocromia quando comparados com bezerros obtidos por parto espontâneo. Entre todos os grupos, os animais nascidos por cesariana sem indução apresentaram os valores com menor magnitude do início ao fim do período experimental. Os animais nascidos a termo demonstram uma capacidade de recuperação fisiológica mais apurada que dos animais nascidos por cesariana. / This study aimed to evaluate the influence of elective cesarean section in erythrogram of newborn calves of the Nellore breed for the first thirty days of life. Neonates were divided into 3 groups 8 calves obtained by spontaneous birth (PE), 8 calves born by caesarean section without labor induction (CSI) and 8 calves born by cesarean section with induction of labor (CCI) by the use of 25 mg of dexamethasone 24 hours before the surgical procedure, by the intra-muscular). Births occurred between 282 and 292 days of gestation. Blood samples for determining the erythrocyte frame were collected by puncture of the external jugular vein using Vacutainer ™ System. The determination of erythrocyte was performed in the automated counter BC-2800 Vet Mindray®. The results show that elective caesarean section did no affect the number of red blood cells, hemoglobin rates and values of the globular volume in the first week of life of calves. At this first week of life was observed, regardless of the experimental group a decrease in the number of red blood cells, hemoglobin rates and values of the globular volume. Until 5 days of age, the mean corpuscular volume values (MCV) and Mean Corpuscular Hemoglobin (MCH) of calves born from spontaneous vaginal deliveries are statistically lower than those obtained in calves born from elective cesarean section. From 10 days of life was observed in animals obtained by from spontaneous delivery, a quick recovery in the values of erythrocytes, hemoglobin and packed cell volume, whereas in animals born via caesarean section (induced and uninduced) did not occur such recovery in the rates of hemoglobin and packed cell volume values. In calves obtained by Caesarean section it was observed that in the period between 10 and 30 days of life Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin (MCH) decreased, submitting a microcytic hypochromic when compared with calves obtained by spontaneous delivery. Among all groups, animals born by caesarean section without induction showed the values with lower magnitude from beginning to end of the trial period. Animals born at term show a more accurate physiological recovery capability in comparingson with animals born by Caesarean section.

Introdução: considerando as altas taxas de cesariana e de morbidades relacionadas a este procedimento cirúrgico, especialmente no Brasil, considera-se relevante elucidar para além da perspectiva numérica como a cesariana acontece a partir do ponto de vista de mulheres que foram a ela submetidas. Objetivo: compreender a experiência da mulher primípara com a cesariana. Método: pesquisa qualitativa fundamentada na fenomenologia social de Alfred Schütz. Foram entrevistadas, em 2012, oito puérperas que tiveram seus partos em maternidades que atendem a convênios de saúde em Minas Gerais, Brasil. Os depoimentos foram obtidos a partir das seguintes questões norteadoras: como foi sua experiência com a cesariana? Considerando esta experiência, o que você espera para o próximo parto? Resultados: a mulher decide pela cesariana, por medo do parto vaginal visto como causador de dor e sofrimento. Sofre influências de pessoas próximas para optar pela cesariana. Mesmo decidida, refere medo em relação à cirurgia e à anestesia. Revela satisfação com a cesariana, embora aponte as limitações vivenciadas no pós-operatório, ressaltando a necessidade do suporte profissional para o cuidado do recém-nascido, especialmente quanto ao contato precoce mãe-filho e ao apoio para a amamentação. Caso engravide novamente, espera experienciar outra cesariana por medo do parto vaginal. Considerações Finais: os resultados apontam para a necessidade de atitudes profissionais que respondam à experiência e às expectativas da mulher submetida à cesariana. / Introduction: considering the high rates of caesarean and morbidities related to this surgical procedure, especially in Brazil, it is relevant to elucidate beyond the numeral perspective how the caesarian sections occur from the women\'s point of view who have been put through them. Objectives: to understand the primiparous women\'s experience of the caesarian. Method: a qualitative research based on the social phenomenology of Alfred Schütz. In 2012, eight puerperal women were interviewed. All of them have given birth in maternities which have health insurance in Minas Gerais, Brazil. The testimonies were obtained by asking the following questions: how was your experience of the caesarian? Considering this experience, what do you wish for the next childbirth? Results: most women prefer the caesarean section because they are afraid of the pain and sufferance from the vaginal parturition. They are influenced by close people to choose the caesarean. Even after the decision, they declare fear of the surgery as well as the anaesthesia. Satisfaction of the caesarean is revealed although the postoperative limitations are mentioned. Professional support is needed to care of the newborn, especially to promote the early mother-child contact and support the breast-feed. If there is a new pregnancy, women prefer to experience another caesarean since the fear of vaginal parturition. Final Considerations: the results point out that professional attitudes are necessary to respond to women\'s experience and expectations of the caesarean.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2014-09-03T10:17:49Z No. of bitstreams: 2 Tese Hugo Campos Oliveira Santos.pdf: 2080957 bytes, checksum: 336f5cb1ae89058f6495b2a2af051029 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-09-03T10:17:49Z (GMT). No. of bitstreams: 2 Tese Hugo Campos Oliveira Santos.pdf: 2080957 bytes, checksum: 336f5cb1ae89058f6495b2a2af051029 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2013-12-18 / Caesarean section is a surgical technique utilized to deliver the fetus from the uterus and an increase in this surgical procedure can be noted around the world. In Brazil, approximately 40% of total deliveries occur in this way, it is estimated that caesarean section corresponds to 80% of deliveries in private assistance between 2008 and 2012. Diabetes complicates gestation and pregnancy complicates diabetes, this combination increases the possibility of flawed scarring process, which may cause esthetic, psychological and clinical problems. The Low-Level Laser Therapy (LLLT) is an ally for the treatment of a number of wounds – accelerating cell metabolism and reducing inflammatory and infectious processes. The objective of this study was to evaluate the effects of AlGaInP LASER (660nm) treatment regarding wound healing quality and hypertrophic scar prevention in patients with gestational diabetes undergone caesarean section. The clinical study was performed at Hospital das Clínicas of the Federal University of Goiás, after Ethics Committee approval (CEP/HC.053/11). In the period between November (2011) and May (2013) 90 patients divided into 3 groups were assessed: Group A: LASER (3 Joules/cm2), Group B: LASER (6 Joules/cm2) and Group C (Control – no treatment). Caesarean incision was photographed in the periods: T1 (1day), T2 (2days), T3 (3days), T4 (15days) and T5 (30days). Photos were used in order to calculate mean area and standard deviation. The area of the photographs was analyzed and calculated in pixels with specific software (Software Image J – NIH/USA), measuring, thus, the wound contraction in percentage (%). The calculation was performed by the caesarean scar area reduction and the increase of incision contraction percentage (recovery) throughout the periods for each group. Contraction results (%) with regard to wound area were significant (p<0.05) for all groups studied, according to Kruskal Wallis’, Mann-Whitney’s and Wilcoxon’s tests. Groups treated with LASER (A and B) presented higher edge contraction, being 89% the scar reduction of Group A (p<0.001) and 81% of Group B (p<0.05), when compared to control group (73%). However, Group A demonstrated higher wounded area reduction when compared to group B, especially in the period between the 3rd and the 15th day from the postoperative (p<0.001). It was verified that the better performance of Low-power LASER (AlGaInP) occurred in the time reported in the literature as scarring process inflammatory stage (≤7days). Inflammatory process reduction may have contributed to reducing scarring time, increasing wound contraction percentage, benefitting, thus, the incision esthetic aspect throughout 30 days of treatment. During the study, occurrence of hypertrophic scars was not observed in any of the experimental groups in the period of 60days from the postoperative. / A cesárea é uma técnica cirúrgica utilizada para retirar o feto do útero, nota-se atualmente um aumento dessa cirurgia em todo o mundo. No Brasil, aproximadamente 40% do total de partos são realizados por essa via, estima-se que a cesariana corresponda a 80% dos partos na assistência privada entre 2008 a 2012 . O diabetes complica a gestação, e, a gravidez complica o diabetes, essa combinação aumenta as chances de falhas no processo de cicatrização, o que pode acarretar problemas estéticos, psicológicos e clínicos. O LASER de baixa potência (LBP) é um aliado para o tratamento de uma variedade de ferimentos – acelerando o metabolismo celular, reduzindo os processos inflamatório e infeccioso. Esse estudo tem por objetivo avaliar os efeitos da terapia a LASER AlGaInP (660nm) quanto à qualidade da cicatrização e da prevenção de cicatrizes hipertróficas em pacientes com diabetes gestacional submetidas à cirurgia cesárea. A pesquisa clínica foi realizada no Hospital das Clínicas da Universidade Federal de Goiás - UFG, após aprovação do Comitê de Ética (CEP/HC.053/11). Entre novembro de 2011 e maio de 2013 foram avaliadas 90 pacientes divididas em 3 grupos: Grupo A: LASER (3 Joules/cm2), Grupo B: LASER (6 Joules/cm2) e Grupo C (Controle - sem tratamento). A incisão cesárea foi fotografada nos tempos: T1 (1dia), T2 (2dias), T3 (3dias), T4 (15dias) e T5 (30dias). As fotos foram utilizadas para calcular a área média e o desvio padrão. A área das fotografias foi analisada e calculada em pixels por meio de programa específico (Software Image J – NIH/USA). Mensurando, assim, a contração da ferida em percentagem (%). O cálculo foi realizado por meio da redução da área da cicatriz cesárea e a percentagem de contração da incisão em decorrer do tempo para cada grupo. Os resultados da contração (%) em relação à área da ferida foram significativos (p<0,05) para todos os grupos estudados, conforme testes de Kruskal Wallis, Mann-Whitney e Wilcoxon. Os grupos tratados com LASER (A e B) tiveram maior contração das bordas, sendo de 89% de redução da cicatriz para o grupo A (p<0,001) e de 81% para o grupo B (p<0,05), quando comparados ao grupo controle (73%). Porém, o grupo A demonstrou maior redução da área da ferida, quando comparado ao grupo B, principalmente no período entre o 3º e 15º dias do pós-operatório (p<0,001). Verificou-se que a melhor atuação do LASER de baixa potência (AlGaInP) ocorreu no tempo relacionado na literatura como fase inflamatória do processo de cicatrização (≤ 7dias). A redução do processo inflamatório pode contribuir para reduzir o tempo de cicatrização, aumentando a percentagem de contração da ferida, favorecendo assim, o aspecto estético da incisão no decorrer de 30 dias de tratamento. Durante o estudo, não foi observado ocorrência de cicatrizes hipertróficas em nenhum dos grupos experimentais no período de até 60dias do pós-operatório.

This poststructuralist qualitative study explored the discourses constructing women’s choice for a caesarean section in the absence of clinical indications, in the talk and texts of women, midwives, an obstetrician, professional journals and the media publications. The study affirms inscriptions surrounding choice in childbirth are shaped discursively through a multiplicity of discourses underpinned by social and institutional practices. With advances in technology, childbearing women have a greater variety of options from which to choose. Controversial, is the option of a caesarean section, regardless of clinical need. The issue is depicted in both professional and popular discourse as contentious, complex and contradictory. Its momentum into the 21st century, as a new object of obstetric discourse, has been played out on a number of platforms. In this thesis I draw from the theoretical ideas of French philosopher Michel Foucault, to examine this complex debate. I argue there is a volatile moment in the history of childbirth in which an explosion of discourses have sculptured choice for a caesarean, in the absence of clinical indications, out of a repartee of autonomy, convenience, desire, fear and risk. In this precarious moment, new meanings joust with the old on a shifting terrain awash with rhetoric that co-opts, competes, and contradicts to bring about a caché of mutable ‘truths’. Whether caesarean, as an optional extra, can be explained in terms of a libertarian imperative, an embodiment of lifestyle, the satiation of desire, the attenuation of fear or the avoidance of risk, the democratisation of this choice has exposed a pathologising paradox, whereupon the normal emerges as the abnormal, and the abnormal emerges as the normal. The deconstruction of choice through a poststructuralist lens has enabled insight into how contradiction and contest befall the ‘order of things ’ and in so doing, provides new openings for contemplating the discursive positioning of women through the competing discourses of childbirth.

<p><strong>Syfte:</strong> Syftet med denna studie är att beskriva hur pappor upplever ett akut kejsarsnitt.</p><p><strong>Metod: </strong>Deskriptiv studie med kvalitativ design. Semi-strukturerade intervjuer genomfördes med tio pappor som varit med om ett akut kejsarsnitt.  </p><p><strong>Resultat: </strong>I studien framkom positiva upplevelser av akut kejsarsnitt så som ett bra bemötande av personalen och en känsla av att bli omhändertagen. Personalen uppfattades som proffsiga, trevliga och snälla. Det var framförallt efter det akuta kejsarsnittet som pappor upplevde en delaktighet då de själva fick ta hand om barnet. De såg då sin roll som betydelsefull. Pappans<em> </em>upplevelser av det akuta kejsarsnittet kan också<em> </em>vara kaotisk och traumatisk. Det fanns en önskan om psykologiskt stöd efter det akuta kejsarsnittet. Pappor upplevde att de inte kunde hjälpa till med så mycket praktiskt under själva kejsarsnittet utan de upplevde mer att de var ett mentalt stöd för mamman. Det fanns upplevelser av bristande information, både före, under och efter det akuta kejsarsnittet.</p><p><strong>Slutsats: </strong>Då det framkom i studien att det fanns en önskan om psykologiskt stöd bör det införas rutiner för att fånga upp dessa pappor och en möjlighet att erbjuda dem hjälp. Vad gäller information bör riktlinjer utformas för att pappor ska känna att de är väl informerade genom hela förloppet, informationen bör individanpassas. En informationsbroschyr om akut kejsarsnitt kan utformas och finnas tillgänglig på förlossningsavdelningar som ett led i informationsgivning.</p><p><strong>Nyckelord: </strong>Pappa, akut kejsarsnitt, upplevelser.</p>

Syfte: Syftet med denna studie är att beskriva hur pappor upplever ett akut kejsarsnitt. Metod: Deskriptiv studie med kvalitativ design. Semi-strukturerade intervjuer genomfördes med tio pappor som varit med om ett akut kejsarsnitt.   Resultat: I studien framkom positiva upplevelser av akut kejsarsnitt så som ett bra bemötande av personalen och en känsla av att bli omhändertagen. Personalen uppfattades som proffsiga, trevliga och snälla. Det var framförallt efter det akuta kejsarsnittet som pappor upplevde en delaktighet då de själva fick ta hand om barnet. De såg då sin roll som betydelsefull. Pappans upplevelser av det akuta kejsarsnittet kan också vara kaotisk och traumatisk. Det fanns en önskan om psykologiskt stöd efter det akuta kejsarsnittet. Pappor upplevde att de inte kunde hjälpa till med så mycket praktiskt under själva kejsarsnittet utan de upplevde mer att de var ett mentalt stöd för mamman. Det fanns upplevelser av bristande information, både före, under och efter det akuta kejsarsnittet. Slutsats: Då det framkom i studien att det fanns en önskan om psykologiskt stöd bör det införas rutiner för att fånga upp dessa pappor och en möjlighet att erbjuda dem hjälp. Vad gäller information bör riktlinjer utformas för att pappor ska känna att de är väl informerade genom hela förloppet, informationen bör individanpassas. En informationsbroschyr om akut kejsarsnitt kan utformas och finnas tillgänglig på förlossningsavdelningar som ett led i informationsgivning. Nyckelord: Pappa, akut kejsarsnitt, upplevelser.

Pappans närvaro under förlossning har ökat de senaste åren. Vid förlossning förväntas de spela en aktiv roll i form av stöd för kvinnan. Många män är inte beredda på att en normal förlossning hastigt kan behöva slutas med kejsarsnitt. Syftet med studien är att ta reda på och beskriva pappors upplevelser av akut kejsarsnitt. För att få fram pappors upplevelse användes en fenomenologisk forskningsmetod i form av kvalitativa forskningsintervjuer. Fem pappor deltog i studien. Data presenteras i fem kategorier; blivande pappors kunskap och förväntningar kring förlossning, att inte veta vad som händer, närvaro ger delaktighet, att bli lämnad ensam eller inte, med eller utan information samt efter operation. Resultatet visade att blivande pappors förväntningar kring förlossning är att det ska gå normalt till. Deras kunskap om akuta kejsarsnitt är liten och därmed känner de sig oförberedda inför händelsen. Om informationen från barnmorskan var bristande medförde det att pappan kände oro och att han inte var delaktig i processen. De pappor som får information känner sig mer trygga och får en mer positiv upplevelse. En sådan enkel handling som att informera om vad som sker kan ändra en hel syn på en upplevelse. / Fathers attendance during childbirth has increased during the years. They are expected to play an important role in supporting the woman during delivery. Many men are not aware that what seems to be a normal delivery suddenly can end with an emergency caesarean section. The aim of this study was to see/find out how prospective fathers experience the situation of emergency caesarean section. To study fathers experience of caesarean section we used a phenomenological research method. Five fathers participated in the study and data was obtained by qualitative research interviews. The data was analysed and divided into five categories: expectant fathers knowledge and expectations about giving birth, to not know what is happening, presence gives a feeling of participation, to be left alone or not with or without information and after the operation. Results of the study showed that prospective fathers´ birth expectations were that it will be a normal delivery. Their knowledge of emergency caesarean section is small and therefore they feel unprepared with the situation. Not receiving continuous information from the midwife makes the father worried and anxious and gives a negative feeling of the delivery. The fathers who received information during the process had a more positive feeling and a feeling of participation. A simple thing like getting information changes the way a person feels about a situation.

Today around 28 000 women originally from countries where FGM is practised, are living in Sweden. Many of them are at childbearing age which means that knowledge about FGM and its consequences is of outmost importance during delivery. The aim of this study is to describe current research on how to manage the delivery, regarding deinfibulation and the following stitching as well as the risk of complications when the labouring woman is mutilated. This review of literature is based on 12 scientific articles published between years 1989 – 2005. Five different databases have been searched with use of a large number of keywords.The review found that no scientific research has been carried out that describes how deinfibulation and following stitching should be managed when the woman is mutilated. All available articles within this area are referring to best practice only. The review also found that the conclusions of the studies are contradictory. The majority, however, show an increased frequency for prolonged labour that could be related to FGM. The three largest studies also show an increased rate of caesarean section among mutilated women. In the few studies that examine haemorrhage, the majorities show an increased tendency to bleed, that could be related to FGM. Several articles emphasize the importance of good routines for deinfibulation to reduce the risk for complications.In summary it can be established that due to methodological problems in many studies, no reliable conclusion can be made that the researched complications exists to a greater extent when the woman is mutilated

Förlossningsrädsla utgör en speciell utmaning för mödrahälsovården och förlossningsvården.En konsekvens av rädslan är att kvinnor allt oftare kräver kejsarsnitt utan medicinsk indikation. Syftet med denna studie var att belysa faktorer som ligger till grund för förlossningsrädsla samt att ta reda på hur omvårdnadspersonal kan ge stärkande omvårdnad till denna sårbara grupp. Metoden var en systematisk litteraturstudie som omfattade fjorton vetenskapliga artiklar. Materialet till litteraturstudien identifierades via datoriserad och manuell sökning i databaser och tidsskrifter på Högskolan Dalarnas bibliotek samt sjukhus biblioteket på Falu Lasarett. Sökningen gjordes i databaserna ELIN@dalarna, Pub Med, Swe Med, Libris och Google sholar. Sökord som användes var: Fear of childbirth. Resultatet visade att rädslans innehåll och natur hänger samman med kvinnans personliga förutsättningar samt den sociala situation hon lever i. En slutsats blev att många kvinnor behöver hjälp för sin oro inför förlossningen och många har i högre grad än andra väntande kvinnor haft besvär med psykisk ohälsa. En viktig förutsättning för ett optimalt och professionellt bemötande av den förlossningsrädda kvinnan är ett gott samarbete mellan hela vårdkedjan, så alla har samma synsätt. Genom att alla säger samma saker skapas en trygghet.

<p>Pappans närvaro under förlossning har ökat de senaste åren. Vid förlossning förväntas de spela en aktiv roll i form av stöd för kvinnan. Många män är inte beredda på att en normal förlossning hastigt kan behöva slutas med kejsarsnitt. Syftet med studien är att ta reda på och beskriva pappors upplevelser av akut kejsarsnitt. För att få fram pappors upplevelse användes en fenomenologisk forskningsmetod i form av kvalitativa forskningsintervjuer. Fem pappor deltog i studien. Data presenteras i fem kategorier; blivande pappors kunskap och förväntningar kring förlossning, att inte veta vad som händer, närvaro ger delaktighet, att bli lämnad ensam eller inte, med eller utan information samt efter operation. Resultatet visade att blivande pappors förväntningar kring förlossning är att det ska gå normalt till. Deras kunskap om akuta kejsarsnitt är liten och därmed känner de sig oförberedda inför händelsen. Om informationen från barnmorskan var bristande medförde det att pappan kände oro och att han inte var delaktig i processen. De pappor som får information känner sig mer trygga och får en mer positiv upplevelse. En sådan enkel handling som att informera om vad som sker kan ändra en hel syn på en upplevelse.</p> / <p>Fathers attendance during childbirth has increased during the years. They are expected to play an important role in supporting the woman during delivery. Many men are not aware that what seems to be a normal delivery suddenly can end with an emergency caesarean section. The aim of this study was to see/find out how prospective fathers experience the situation of emergency caesarean section. To study fathers experience of caesarean section we used a phenomenological research method. Five fathers participated in the study and data was obtained by qualitative research interviews. The data was analysed and divided into five categories: expectant fathers knowledge and expectations about giving birth, to not know what is happening, presence gives a feeling of participation, to be left alone or not with or without information and after the operation. Results of the study showed that prospective fathers´ birth expectations were that it will be a normal delivery. Their knowledge of emergency caesarean section is small and therefore they feel unprepared with the situation. Not receiving continuous information from the midwife makes the father worried and anxious and gives a negative feeling of the delivery. The fathers who received information during the process had a more positive feeling and a feeling of participation. A simple thing like getting information changes the way a person feels about a situation.</p>