These studies were conducted to define calf body shape, to test for relationships between calf shape and sire expected progeny differences for birth weight (BWTEPD) and first-calf calving ease (CEEPD) and to evaluate the efficacy of calf shape as a selection criterion for reduction of calving difficulty. Birth weight (BW), head circumference (HC), hip width (HW), shoulder width, body length (BL), cannon circumference (CC), cannon length (CL) and heart girth (HG) were measured at birth on 1,016 calves sired by Angus, Polled Hereford and Simmental bulls. In the Angus- and Polled Hereford-sired calves, sire effects were present for BW-adjusted residuals of CC. Additionally, HW, BL and HG residuals differed among half-sib groups for the Polled Hereford-sired calves. Thus, calf body measure differences independent of BW were in part attributable to sire. Multivariate factor analysis was used to identify underlying skeletal width and frame dimensions of calf shape in both breeds. After adjustment of body measures for differences in BW, a positive relationship of BWTEPD with HC and CC and a negative relationship between CEEPD and CC existed. Further adjustment for BWTEPD removed effects of CEEPD on CC. Thus, BWTEPD influenced calf shape independent of BW, but shape was not related to CEEPD independent of BWTEPD. Simmental bulls were divergently selected on CEEPD relative to BWTEPD so that body measures of calves from sires whose progeny tended to be born with more or with less dystocia than expected from BWTEPD could be obtained. Differences in CL and CC at constant BW were in part attributable to sire. Underlying shape factors were similar to those of the other breeds. Sire BWTEPD was positively related to CC and HC independent of BW. However, a relationship between body measures and CEEPD existed only at constant BW and BWTEPD. Calf shape independent of BW was also not different among calves born unassisted and assisted. Estimates of heritability, repeatability and birth to weaning relationships for each BW-residual body measure were generally not significant. Overall, sire BWTEPD was related to calf shape independent of BW. However, increases in skeletal dimensions were not related to either observed calving difficulty nor sire CEEPD independent of BW. Selection for reduced calving difficulty should not be based on calf body shape. / Ph. D.

L’étude du retentissement d’un xénobiotique en général ou d’un médicament en particulier sur la gestation humaine est difficile à appréhender. Elle doit prendre en compte des considérations éthiques, indispensables lors de toute recherche chez la femme enceinte, mais aussi pour le cas de l’induction de la parturition, de la complexité des mécanismes physiologiques impliqués. S’il existe un relatif consensus expérimental à partir de modèles animaux pour évaluer leur retentissement sur la fertilité et l’embryogenèse, il n’y a pas à ce jour d’attitude pour évaluer un risque induit d’un accouchement prématuré. Hors la naissance prématurée est la première cause de mortalité du nouveau-né et concerne quinze millions de naissances par an au niveau mondial. Les étiologies sont multiples : infectieuses dont VIH,grossesses multiples, addictions. La littérature récente fait part aussi de cette problématique pour certains médicaments indispensables comme les inhibiteurs de protéase chez les femmes enceintes infectées par le VIH. Nous avons réalisé trois études spécifiquement chez la femme enceinte : modulation du passage placentaire des inhibiteurs de protéase du VIH, modulation des hormones stéroïdiennes placentaires et materno-foetales par la mifépristone, variation des protéines sériques maternelles dans les jours précédents la parturition. C’est à l’issue de ces travaux que nous émettons plusieurs hypothèses sur l’incidence d’un médicament lors de la parturition humaine et les moyens envisagés pour l’étudier de manière la moins invasive possible. / Effects of a xenobiotic or drug on human gestation are difficult to approach. This is due tonecessary ethical considerations with regards to research on pregnant women as well as thecomplexity of physiological processes involved in the case of induced parturition. While thereis a relative experimental consensus with animal models to assess their impact on fertility andembryogenesis, there is currently no method to assess the risk of induced preterm labor.Preterm labor is the leading cause of newborn deaths at the rate fifteen million births per yearglobally. The etiologies are multiple: infectious including HIV, multiple pregnancies,addictions. Recent publications also discuss this issue in the context of necessary drugs suchas protease inhibitors for HIV infected pregnant women. We realised three studies specificallyin pregnant women: modulation of the placental transfer of protease inhibitors of the HIV,modulation of the feto-maternal and placental steroid hormones by mifepristone, and a studyabout variation of the maternal serum proteins in the previous days of the parturition. Also,regarding our studies and the literature, we make several hypotheses on possible interferencesbetween drugs and human parturition, disturb its signal, and methods proposed for its study ina minimally invasive manner.

Confirmatory factor analysis provided empirical support for the existence of the hypothesized constructs assessed by the CBSEI-C32. Doubly MANOVA indicated that the experimental group was significantly more likely than the control group to demonstrate higher self-efficacy for childbirth and lower perceived anxiety and pain in the early and middle phase of labour. The effects of the programe on anxiety and pain during labour differed according to different phase of labour. Independent samples t test also demonstrated a significantly higher level of coping behaviour performed by the experimental group as compared with the control group. (Abstract shortened by UMI.) / The aim of this study was to test the effectiveness of an educational intervention, based on Self-efficacy theory (Bandura, 1989); to promote women's self-efficacy for childbirth and their coping ability for reducing anxiety and pain during labour. The study consisted of two phases: the 1st phase was to establish the validity and reliability of the primary outcome measure of the phase 2 study: a short form of the Chinese version of the Childbirth Self-efficacy Inventory (CBSEI-C32). The confirmatory factor analysis (CFA) was used to establish the construct validity of the CBSEI-C32. In the 2nd phase, the focus was to test the effectiveness of educational intervention to promote women's self-efficacy for childbirth and their coping behaviour during labour. The researcher used an experimental design with random assignment of eligible participants into experimental (n = 54) or control (n = 62) group that completed one pre-test (baseline at 32--34 weeks of gestation) and three posttest surveys (post-intervention at 37 weeks of gestation and within 48 hours and 6 weeks after delivery). The experimental group received two 90-minute sessions of an educational program offered at 33--35 weeks of gestation based on Bandura's (1986) self-efficacy theory. The primary outcome measures were the two subscales of the CBSEI-C32: outcome expectancy (OE-16) and efficacy expectancy (EE-16). The secondary measures included psychological morbidity (GHQ12), pain and anxiety during labour (VAS) and performance of coping behaviour during labour (CCB). Physiological labour outcomes in terms of mode of delivery, length of labour, types of analgesia used, Apgar scores of newborn and neonatal admission were also extracted from the participants' medical record. / Ip Wan Yim. / "June 2005." / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3717. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 159-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

Thesis (M.S.)--Oregon State University, 2005. / Printout. Includes bibliographical references (85-92 leaves). Also available on the World Wide Web.

A quantitative competitive binding "triple sandwich" enzyme immunoassay was used to evaluate pathogen/class-specific antibody responses in Holstein-Friesian calves vaccinated against Clostridium perfringens B-toxin at various ages postpartum. Vaccination of dams at six weeks and again at two weeks prepartum increased pathogen-specific antibody levels in their colostrum and respective calf's serum. Calves initially vaccinated at three days produced both a primary and secondary pathogen-specific antibody response, whereas calves initially vaccinated at 12 and 21 days produced only secondary responses. Maternally-derived antibodies were found to suppress neonatal antibody production following primary immunization. They were also found to influence secondary humoral immune responses, although in a diminished capacity. Pathogen-specific IgG and IgM concentrations in dams' sera and colostra were found related to subsequent pathogen-specific IgG and IgM neonatal serum concentrations. Only pathogen-specific IgA in dams' colostra was correlated to neonatal levels, possibly owing to a different origin and role of this immunoglobulin class. All class-specific colostral immunoglobulin levels were related to subsequent neonatal concentrations. Based on results from this experiment, it is recommended that calves be vaccinated at three days postpartum with a booster administered at 63 days.

Introdução: o modelo predominante de assistência ao parto no Brasil caracteriza-se pelo uso abusivo ou inadequado de intervenções e cerceamento dos direitos da parturiente (restrição à presença de acompanhante de escolha da mulher, realização de amniotomia de rotina durante o trabalho de parto, posição litotômica de rotina, infusão intravenosa de ocitocina de rotina, puxo dirigido e pressão no fundo uterino da parturiente durante a expulsão fetal) em todos os períodos clínicos do parto. Sabe-se que esse modelo pode ser modificado com a adoção das boas práticas de assistência ao parto normal preconizadas pela Organização Mundial da Saúde. Embora as melhores práticas no parto e nascimento estejam fundamentadas em evidências científicas, faltam pesquisas sobre sua implementação na prática clínica. Objetivo geral: avaliar o impacto da implementação das práticas baseadas em evidências na assistência ao parto normal. Método: estudo de intervenção quase experimental, tipo antes e depois, baseado na metodologia de implementação de evidências científicas na prática clínica do Instituto Joanna Briggs. Foi conduzido no Hospital da Mulher Mãe Luzia, maternidade pública de referência para a assistência obstétrica em Macapá, Amapá. Foram entrevistados 42 profissionais (enfermeiros e médicos obstetras e residentes das duas categorias) e 280 mulheres atendidas no trabalho de parto e parto. Também foram analisados dados de 555 prontuários de puérperas. A pesquisa foi desenvolvida em três fases: auditoria de base (fase 1), intervenção educativa (fase 2) e auditoria pós-intervenção (fase 3). A intervenção educativa consistiu em um seminário denominado Seminário de práticas baseadas em evidências científicas na assistência ao parto normal, oferecido para os profissionais. A coleta de dados ocorreu entre julho de 2015 e março de 2016. Os achados foram analisados comparando-se os dados das fases 1 e 3, adotando-se o nível de significância de 5%. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da Universidade de São Paulo. Resultados: após a intervenção educativa, houve incremento de 8,3 p.p. na taxa de parto normal. Na entrevista com as mulheres, constatou-se aumento de 10,0 p.p. (p=0,002) da presença do acompanhante durante o trabalho de parto e de 31,4 p.p. (p<0,001) no uso da posição vertical ou cócoras. A realização de amniotomia foi reduzida em 16,8 p.p. (p=0,005), o uso de posição litotômica em 24,3 p.p. (p<0,001), a utilização de ocitocina em 17,1 p.p. (p=0,004), os puxos dirigidos em 29,3 p.p. (p<0,001) e a manobra de Kristeller em 10,7 p.p. (p=0,013). Na perspectiva dos profissionais, houve redução da prescrição ou administração de ocitocina de 29,6 p.p. (p=0,005). Na análise dos dados dos prontuários, observou-se redução significativa da taxa de amniotomia em 29,5 p.p. (p<0,001) e de posição litotômica em 1,5 p.p. (p=0,013), enquanto a taxa de posição vertical ou cócoras apresentou incremento de 2,2 p.p. (p=0,013). Conclusões: a intervenção educativa revelou impacto positivo na melhora da assistência à mulher durante o trabalho de parto e parto, com aumento da taxa de parto normal e, também, na visão das mulheres, que alegaram ter mais acompanhantes de sua escolha, poder adotar mais posições verticalizadas no período expulsivo, utilizar menos ocitocina, puxos dirigidos e manobra de Kristeller. Esses resultados conferem em parte com o dos profissionais, que citaram realizar menos orientação de puxos dirigidos e prescreverem menos ocitocina. Também coincidem parcialmente com as anotações dos prontuários, que incluem aumento das posições verticais e redução da posição litotômica e da prática de amniotomia. No entanto, verificou-se que os profissionais continuam empregando práticas como posição litotômica de rotina, puxos dirigidos e manobra de Kristeller, no período expulsivo. Conclui-se que houve um impacto positivo na proposta conduzida, mas mostra que o processo de implementação de evidências científicas na assistência ao parto normal adotado não foi capaz de obter sucesso completo na mudança das práticas obstétricas dos profissionais participantes. / Background: the predominant model of childbirth care in Brazil is characterized by abusive or inappropriate use of interventions and parturient\'s rights disrespect (such as restriction of presence of the chosen companion of the woman, routine amniotomy, routine lithotomy position, routine oxytocin intravenous infusion, directed pushing, and fundal pressure during second stage of labour) in all clinical periods of the childbirth. This model of care could be modified adopting good practices on maternal health recommended by World Health Organization. Despite the evidence-based best practices in childbirth, there is a lack of research on its implementation into clinical practice. Aim: to evaluate the impact of the implementation of evidence-based practices on normal birth. Method: before and after quasi-experimental study based on Joanna Briggs Institute Evidence Implementation method. It was conducted at Mãe Luzia Women\'s Hospital, a reference maternity hospital for maternity care in Macapá, Amapá, Brazil. Interview of 42 professionals (nurses, obstetricians and residents of both categories) and 280 women who were attended during labour and birth. Data from 555 puerperium records were also analysed. The research was developed in three phases: baseline audit (phase 1), educational intervention (phase 2) and post-intervention audit (phase 3).The educational intervention was a seminar named \"Scientific evidence-based practices on normal childbirth seminar\", attended by the professionals. Data were collected from July 2015 to March 2016. The findings were analysed comparing the data from phases 1 and 3, adopting a level of significance of 5%. There search was approved by the Research Ethics Committee from School of Nursing of University of Sao Paulo. Results: after the educational intervention, there was an increase of 8.3 p.p. in normal birth rate. According to the interviewed women, there was an increase of 10.0 p.p. (p = 0.002) in the presence of companion during labour and of 31.4 p.p. (p <0.001) in the adoption of vertical or squatting position to give birth. The amniotomy was reduced by 16.8 p.p. (p = 0.005), lithotomy position by 24.3 p.p. (p<0.001), oxytocin infusion by 17.1 p.p. (p = 0.004), directed pushing by 29.3 p.p. (p <0.001) and Kristeller maneuver by 10.7 p.p. (p = 0.013). In the professionals\' perspective, it was found a reduction in oxytocin prescription (29.6 p.p.; p = 0.005). In medical records data analysis there was a reduction on amniotomy rate (29.5 p.p.; p<0.001) and lithotomy position (1.5 p.p.; p = 0.013), while vertical or squatting position had increased in 2.2 p.p. (p = 0.013). Conclusions: the educational intervention showed a positive impact improving women´s care during labour and birth, increasing normal birth rate. Also in the women´s view, having more companions of their choice, they were able to adopt vertical positions in the second stage of labour and had less oxytocin infusion, directed pushing and Kristeller maneuver. These results confer in part with these of the interviews with professionals, who have cited performing less direct pushing and prescribed less oxytocin infusion. These results are also similar with the medical records, which include increase in the adoption of vertical positions and the reduction of lithotomic position and amniotomy. However, it was verified that professionals still practice lithotomic position, directed pushing and Kristeller maneuver in the second stage of labour. The educational intervention had a positive impact, but did not have complete success in changing professional practices.

Com o objetivo de avaliar as modificações morfo-funcionais que ocorrem durante a fase preparatória do parto de caprinos, 18 fêmeas da raça Saanen foram examinadas duas vezes ao dia nos últimos 20 dias de gestação e, ao final do experimento, foram agrupadas segundo o momento que antecedia o parto, da seguinte forma: 16, 8, 6, 4 ,3, 2, 1 ½ , 1, ½ dia antes do parto e imediatamente antes da parição. Também foram colhidas amostras de plasma sangüíneo e de soro lácteo para a dosagem de progesterona, estradiol e cortisol e dos teores lácteos de cálcio. Durante o exame clínico foram avaliados os seguintes parâmetros: temperatura corpórea; relaxamento e movimentação dos Ligamentos Sacro-Isquiáticos; distensão e plenitude da glândula mamária e dos tetos; aspecto da secreção láctea pré-colostral e concentração de cálcio nela presente; modificações da vulva e do fluxo vaginal e determinação dos teores plasmáticos de cortisol, progesterona e estradiol. Ocorreram graduais relaxamento e aumento da movimentação dos Ligamentos Sacro-Isquiáticos, observados com maior intensidade a partir de 24 horas antes da parição, com grau máximo observado no momento do parto. Associada ao relaxamento e movimentação dos ligamentos, ocorreu diminuição gradual na capacidade dos animais em movimentar a cauda. A glândula mamária e os tetos foram tornando-se cada vez mais distendidos e plenos de acordo com a proximidade do momento da parição, sendo que a presença de edema na glândula mamária foi esporádica. A freqüência de cabras cuja secreção láctea foi classificada como colostro aumentou com a aproximação do parto, assim como os teores de cálcio na secreção pré-colostral. Houve um aumento significativo do fluxo vaginal nos animais examinados imediatamente antes da parição. O perfil hormonal sofreu influência da fase preparatória do parto, sendo que ocorreu diminuição dos teores plasmáticos médios de progesterona e aumento dos teores de estradiol e cortisol à medida que a parição se aproximava. A temperatura corpórea, o tamanho e o edema de vulva, o grau de flexibilidade da base da cauda e a coloração da mucosa vaginal não sofreram influência da fase preparatóra do parto. / With the aim to evaluate the morpho-functional changes of the caprine\'s parturition preparatory phase, 18 Saanen does were examined twice a day within the 20 finishing days of gestation and at the end of the experiment they were grouped according to the moment that preceded the birth (16, 8, 6, 4, 3, 2, 1 ½, 1, ½ days before parturition and immediately before labor). There were also picked samples of sanguine plasma and milky serum for the progesterone, oestradiol and cortisol dosage and milky calcium determinations. During the clinical exam the following parameters were evaluated: corporal temperature; relaxation and movement of the Sacrosciatic Ligaments; movement and flexibility of the tail; distention and filling of the udder and teats; appearance of the pre-colostral milky secretion and its calcium concentration; modifications of the vulva and vaginal discharge and determination of the plasmatic values of progesterone, oestradiol and cortisol. Gradual relaxation and increase of movement of the Sacrosciatic Ligaments occurred, observed with larger intensity starting from 24 hours before parturition, with maximum degree observed in the moment of the birth. A gradual decrease in the animals\' capacity on tail movement was observed associated to the relaxation and movement of the Sacrosciatic Ligaments. The mammary gland and teats became more distended and full in agreement with the proximity of the moment of parturition and the edema presence in the mammary gland was sporadic. The frequency of goats whose milky secretion was classified as colostrum increased with the approach of the labor, as well as the calcium tenors in the pre-colostral secretion. There was a significant increase of the vaginal discharge in the animals examined immediately before parturition. The hormonal profile suffered influence of the preparatory phase of labor, occurring decrease of the medium plasmatic tenors of progesterone and increase of the oestradiol and cortisol tenors as the parturition approaches. The corporal temperature, the size and vulva edema, the degree of flexibility of the tail and the coloration of vaginal mucous membrane didn\'t suffer influence of the preparatory stage of labor.

Este estudo foi realizado na Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, com cento e oitenta e sete gestantes sem comorbidades, para conhecer o perfil nutricional de gestantes que receberam orientação dietética e avaliar o ganho ponderal materno total, o tipo de parto e os resultados perinatais. Foi realizada pesquisa retrospectiva e descritiva, por meio de consulta dos formulários de anamnese alimentar, dos bancos de dados clínicos e prontuários das pacientes. As gestantes foram classificadas de acordo com o IMC prégestacional: 23 (12,2%) eram de baixo peso (IMC < 19,8 kg/m2); 84 (45%), eutróficas (IMC de 19,8 a 26,0 kg/m2); 37 (19,8%), sobrepeso (IMC de 26,1 a 29,0 kg/m2) e 43 (23%), obesas (IMC > 29,0 kg/m2). No consumo energético, não se constatou diferença entre os grupos. A média de porcentagem de carboidratos, proteínas e lipídeos ingerida foi semelhante entre os grupos. Sobre o perfil da ingestão de micronutrientes, a de cálcio, vitamina A e vitamina C foi semelhante entre os grupos; a de ferro foi maior nas gestantes eutróficas quando comparadas às com sobrepeso e com obesidade (p<0,001); a de folatos foi maior nas gestantes eutróficas quando comparadas às obesas (p=0,002); a de fibras foi menor nas gestantes de baixo peso quando comparadas às eutróficas (p=0,042). O ganho de peso excessivo (acima do recomendado) foi significativamente maior (p=0,009) nas gestantes com sobrepeso e obesidade, porém o ganho ponderal materno médio foi significativamente menor nas obesas (p<0,001). Não foi observada diferença entre os grupos quanto à idade gestacional no parto e o tipo de parto. O peso dos recém-nascidos das gestantes de baixo peso apresentou média significativamente menor (p=0,005) que dos demais grupos. As gestantes com sobrepeso apresentaram maior porcentagem de recém-nascidos com mais de 4000g (p=0,037) que os demais grupos. A proporção de recém-nascidos grandes para a idade gestacional foi significativamente maior (p=0,006) nas gestantes com sobrepeso e com obesidade quando comparadas aos demais grupos. Os índices de Apgar não apresentaram diferença significativa entre os grupos. A indicação de cesárea por vício pélvico foi significativamente mais frequente em gestantes com baixo peso (p = 0,006) quando comparadas aos outros grupos / This study was carried out at Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, with one hundred eighty-seven pregnant women without comorbidities. This study aimed to know the nutrition profile of pregnant women who received dietary counseling and to evaluate the maternal total weight gain, type of delivery and perinatal outcome. A retrospective and descriptive research was carried out through consultation of forms of dietary anamnesis, the clinical databases and medical records. The women were classified according to pre-gestational body mass index (BMI): 23 (12.2%) were underweight (BMI < 19.8 kg/m2), 84 (45%) normal weight (BMI 19.8 to 26.0 kg/m2), 37 (19.8%) overweight (BMI 26.1 to 29.0 kg/m2) and 43 (% 23) obese (BMI > 29.0 kg/m2). No difference was observed in energy consumption between the groups. The averages percentage of carbohydrates, protein and lipid intake were similar between groups. Regarding the profile of micronutrient intake, calcium intake, vitamin A and vitamin C was similar between groups; iron intake was higher in normal weight pregnant women compared to overweight and obese (p<0.001); folate intake was higher in normal weight pregnant women compared to obese (p=0.002); fiber intake was lower in underweight pregnant women compared to normal weight (p=0.042). Excessive weight gain (above the recommended) was significantly higher (p=0.009) in pregnant women with overweight and obesity, however the mean of total maternal weight gain was significantly lower in obese women (p<0.001). No difference was observed between the groups regarding gestational age at delivery and mode of delivery. The weight of newborns of underweight pregnant women had a mean significantly lower (p=0.005) compared to other groups. The overweight pregnant women had a higher percentage of newborns with more than 4000g (p=0.037) compared to other groups. The proportion of newborns large for gestational age was significantly higher (p=0.006) in pregnant women with overweight and obesity compared to other groups. The Apgar scores did not differ significantly between groups. Indication of cesarean for contracted pelvis was significantly more frequent in underweight pregnant women (p=0.006) when compared to other groups

A atenção qualificada é o processo pelo qual uma mulher grávida e seu filho recebem os cuidados adequados, durante a gravidez, trabalho de parto, puerpério e período neonatal; sendo uma intervenção fundamental no sentido de que as gestações e partos sejam mais seguros, observando que apenas 53% das mulheres em países em desenvolvimento são atendidas no parto por pessoal qualificado. As evidências epidemiológicas mostram que existe uma relação entre a atenção qualificada ao parto e o declínio da mortalidade materna. Objetivos: Descrever a participação dos profissionais de enfermagem no processo de nascimento, identificando quais são os profissionais que atuam na assistência ao parto, qual a sua formação profissional e que ações são desenvolvidas pela equipe de enfermagem. Metodologia: Estudo descritivo com abordagem quantitativa, realizado em uma maternidade de um município de pequeno porte. A população estudada foi composta por 6 enfermeiros, 12 técnicos e 2 auxiliares de enfermagem. A coleta de dados ocorreu através de entrevistas semiestruturadas aos profissionais no próprio local de trabalho e observação não participante onde foram observados 10 admissões, 15 parturientes em trabalho de parto, 21 partos, destes 7 foram partos normais e 14 partos cesárea, e 21 pós parto imediato. Resultados: Perfil dos profissionais: maioria do sexo feminino (85%), idade média é de 33,2 anos, sendo que 45% casados, 35% solteiros. Os enfermeiros possuem no máximo 5 anos de formação profissional. As técnicas de enfermagem 8 (67%) são formadas a menos de 4 anos e as auxiliares de enfermagem, uma está formada há 1 ano e outra está formada há 7 anos. Trabalham na instituição em plantões de 12 horas, em torno de 48 horas semanais. Somente cinco (25%) dos profissionais entrevistados possuem outro emprego. Observou-se 60% (12) dos profissionais com menos de quatro anos na assistência. Nenhum recebeu treinamento ou capacitação específica para a assistência obstétrica. Os 20 profissionais afirmam não realizar parto nesta instituição. Os enfermeiros não assumem a realização do parto a não ser em situações emergenciais na ausência do médico. Conclusões: O processo de trabalho sobrecarrega o enfermeiro que deve se organizar para atuar na assistência obstétrica e também nas demais clínicas de internação hospitalar. Os partos são realizados pelos médicos obstetras e o parto cesárea ainda é predominante. As práticas baseadas em evidências científicas atualizadas precisam ser incentivadas. A educação continuada e a criação de protocolos assistenciais com padronização de um nível mínimo e essencial de competências em obstetrícia poderão ser estratégias para melhorar o desempenho dos profissionais que assistem no trabalho de parto e parto. Os administradores hospitalares precisam ser conscientizados de que a atenção obstétrica por pessoal qualificado é um investimento certo na qualidade da assistência da instituição e refletirá em inúmeros benefícios, contribuindo também com a redução das altas taxas de cesárea e com certeza prevenindo a mortalidade materna e perinatal. / The qualified attention is the process which a pregnant woman and her son receive the right cares, during the pregnancy, parturition work, woman pains and after birth period; being a fundamental intervention in the sense of pregnancies and parturitions are safer, observing that only 53% of women from countries in development are attended in the parturition by qualified people. The epidemiologic evidences show that theres a relation between the qualified attention to the birth and the decrease of the maternal mortality. Objetives: Describing the participation of the nursing professionals in the process of parturition, identifying what are the professionals that act in the assistance of parturition, what professional graduation is yours and what acts are developed by the nursing team. Methodology: Described study with quantity broaching, realized in a maternity of a small town. The population studied was formed by 6 nurses, 12 nursing technicians and 2 nursing auxiliaries. The collect of data happened beyond semi structure interviews to the professionals in their own place of work and not participating observation where it was observed 10 admissions, 15 pre parturitions, 21 parturitions, of what 7 were normal parturitions and 14 Caesarians, and 21 post parturitions immediately. Results: Professional profiles: the most from female sex (85%), average is 33,2 years old, being 45% married, 35% single. The nurses have at most 5 years of professional graduation. The nursing technicians 8 (67%) are less than 4 years and the nursing auxiliaries, one of them is graduated theres 1 year and the other one is graduated theres 7 years. They work in the institution in shifts of 12 hours, at about 48 hours a week. Only 5 (25%) of the interviewed professionals have another job. It was observed that 60% (12) of the professionals with less than 4 years in the assistance. None of them received training of specified capacitating to the obstetric assistance. The 20 professionals affirm not to realize parturition in that institution. The nurses dont assume the realization of parturition out emergency situations in the miss of a doctor. Conclusions: The work process overloads the nurse that must organize to act the obstetric assistance and also other more hospitalar internation clinics. The parturitions are realized by obstetrician doctors and Caesarian is predominant yet. The practices based in updating scientific evidences need to be incentived. The continue education and the creation of attendance protocols with standardization of a minimum and essential level of competences in obstetric will be able to be strategies to improve the performance of the professionals that assist in the parturition work and parturition. The hospital manages need to be awared that the obstetric attention by qualified people is a right investment in the quality of institution assistance and itll reflect in a lot of benefits, also contributing with the reduction of high taxes of Caesarian and certainly preventing the maternal and neonatal mortality.

Perdas embrionárias e alterações gestacionais são frequentemente observadas em prenhezes de embriões bovinos manipulados in vitro. Sabe-se que tais anormalidades são resultantes de alterações epigenéticas ocasionadas pela manipulação dos gametas e/ou do embrião durante as técnicas de reprodução assistida (ARTs), com destaque para as técnicas de fecundação in vitro (FIV) e da clonagem por transferência nuclear de células somáticas (SCNT). Tais alterações resultam em distúrbios no desenvolvimento do concepto em algum momento crítico entre a fertilização e o parto, fornecendo bons modelos de estudos sobre a fisiopatologia de perdas embrionárias e dos distúrbios de desenvolvimento. Caracterizam-se como momentos críticos após a transferência do embrião (TE) o desenvolvimento embrionário no útero, o reconhecimento materno da gestação, a placentação e o desenvolvimento da placenta e do feto, os quais tem de ser transpassados sem nenhuma falha, permitindo um desenvolvimento normal do concepto até o termo. Sendo assim, o presente trabalho abordou três fases distintas do amplo período gestacional em prenhezes por ARTs. O Estudo 1 foi realizado durante o período peri-reconhecimento materno da gestação e objetivou descrever a abundância de expressão de genes estimulados pelo interferon tau (ISGs) de células mononucleares do sangue periférico (PBMCs) maternas em gestações oriundas de ARTs no primeiro mês de gestação; o Estudo 2 compreendeu os primeiros 35 dias de gestação e objetivou descrever as mudanças morfológicas e vasculares do complexo útero-concepto-ovário e o estímulo à expressão de ISGs em PBMCs em gestações de conceptos clonados por SCNT com diferentes fenótipos de desenvolvimento, sendo esses denominados gestação anembrionada e CL persistente; e o Estudo 3 foi conduzido durante o período pré-parto e objetivou descrever as alterações na produção de esteroides sexuais e corticosteroides em gestações produzidas por ARTs. Três hipóteses foram testadas: (1) Gestações de conceptos clonados por SCNT apresentam uma baixa e mais tardia estimulação de ISGs em PBMCs maternas quando comparadas com gestações de conceptos produzidos por FIV e IA; (2) O concepto clonado por SCNT apresenta um menor estímulo sobre mudanças morfológicas e vasculares do complexo útero-ovário e ISGs em PBMCs maternas durante os primeiros 35 dias de gestação, quando comparado com conceptos oriundos de IA; e (3) Gestações de embriões oriundos de ARTs apresentam alterações na dinâmica esteroidogênica no pré-parto quando comparados com gestações de IA. No estudo 1 foram coletadas amostras de sangue de gestações produzidas por inseminação artificial (IA), FIV e clonagem por SCNT, nos dias 15, 18, 20, 22, 24, 26, 28 e 31 pós-ovulação e foi realizada mensuração da abundância de transcritos de ISGs (OAS1 e ISG15) em PBMCs maternas. No estudo 2, gestações produzidas por IA e clonagem por SCNT, foram submetidas a escaneamentos ultrassonográficos dos ovários, útero e concepto a cada 3 dias do dia 14 ao 35 (dia 0 = ovulação) e amostras de sangue foram coletadas nos dias 15, 18, 20, 22, 24, 26, 28 e 31 para mensuração da abundância de transcritos de ISGs (OAS1 e ISG15) em PBMCs maternas. No estudo 3, foram coletadas amostras de sangue no último mês em gestações naturais, oriundas de FIV e de clonagem por SCNT para análise hormonal de 10 esteroides utilizando o método de espectrometria de massas multi-hormonal de alta resolução LC-MS/MS. O primeiro estudo mostrou semelhanças na expressão de genes estimulados pelo IFNT em gestações oriundas de ARTs e produzidas por IA. Entretanto, a estimulação nas gestações oriundas de ARTs aparentou ser quatro dias mais prolongada, sugerindo uma maior funcionalidade do trofectoderma em conceptos oriundos de ARTs. O segundo estudo demonstrou um aumento na expressão de ISGs em PBMCs maternas tanto em gestações de conceptos normais quanto em anormais, justificando a manutenção da função luteal mesmo na ausência de detecção do concepto por ultrasonografia. No terceiro estudo, demonstrou-se alterações na esteroidogênese nas gestações de embriões FIV e clonados no último mês de gestação, sendo essas compatíveis com a hiperativação da enzima aromatase durante todo o último mês de gestações oriundas de FIV e hiperativação das enzimas P450C11 e P450C21 trinta dias antes do parto em gestações oriundas de clonagem por SCNT. O presente estudo concluiu que conceptos oriundos de FIV e clonagem por SCNT apresentam um prolongamento no estímulo de ISGs pelo IFNT, conceptos clonados anormalos apresentam estímulo de ISGs, o que justifica a manutenção da função luteal, e, por fim, a cascata esteroidonênica que culmina com o parto apresenta-se alterada em gestações oriundas de FIV e clonagem por SCNT. / Pregnancy losses and gestational abnormalities are frequently observed in pregnancies from in vitro produced embryos in bovines. It is known that these abnormalities are due to epigenetic changes from the manipulation of gametes and/or embryo during the use of assisted reproduction techniques (ARTs), especially for the in vitro fertilization (IFV) and cloning by somatic cells nuclear transfer (SCNT). These changes results in disturbances of conceptus development in any critical stage between the fertilization and parturition, which provides good models for the study of physiopathology of embryo losses and disturbances of development. Critical stages after the embryo transfer (ET) to the uterus are characterized as the maternal recognition of pregnancy, placentation, and fetal-placental development, which needs to be surpassed without failures, in order to develop a normal conceptus until term. Therefore, the present work approached three distinct phases of the wide gestational period in pregnancies from ARTs. The Study 1 was conducted during the maternal peri-recongnition of pregnancy period and aimed to describe the expression of interferon stimulated genes (ISGs) in maternal peripheral blood mononuclear cells (PBMCs) in pregnancies derived of ARTs; the Study 2 comprise the first 35 days of pregnancy and aimed to describe morphological and vascular changes of the complex uterus-ovaries-conceptus, as well as the expression of ISGs in maternal PBMCs in pregnancies of conceptus cloned by SCNT with different phenotypes of development, denominated as anembryonic gestation and persistent CL; the Study 3 was conducted during the pre-partum period and aimed to describe changes in the production of sexual steroids and corticosteroids during the last month of pregnancies derived of ARTs. Three hypothesis were tested: (1) Pregnancies of conceptus cloned by SCNT presented a decrease and delay in the stimulation of ISGs in maternal PBMCs when compared with conceptuses produced by IFV and AI; (2) Stimulus from the conceptus for changes in the morphology and vasculature of the the uterus-ovarian complex, detected by ultrasonography in B and Doppler modes, and the stimulation of ISGs in maternal PBMCs during the first 35 days of pregnancy of conceptus cloned by SCNT are less intense when compared with conceptus derived from AI; and (3) Pregnancies derived of ARTs present changes in the steroidogenic dynamics in the pre-partum, when compared with pregnancies derived from AI. In Study 1 blood samples were collected from pregnancies produced by AI, IVF, and cloning by SCNT, at days 15, 18, 20, 22, 24, 26, 28, and 31 post-ovulation for the measurement of abundance of transcripts of ISGs (OAS1 and ISG15) in maternal PBMCs. In Study 2, pregnancies derived of AI and cloning by SCNT, were submitted to ultrasonographic scans for the evaluation and description of morphological and vascular changes in ovaries, uterus, and conceptus every 3 days from day 14 to 35 (day 0 = ovulation) and blood samples were collected on days 15, 18, 20, 22, 24, 26, 28 e 31 for the measurement of the abundance of transcripts of ISGs (OAS1 and ISG15) in maternal PBMCs. In Study 3, blood samples were collected during the last month of pregnancies naturally conceived, derived of IVF, and cloned by SCNT for the analysis of 10 steroids using the method of mass spectrometry high resolution LC-MS/MS. The first study showed similarities in the ISGs expression stimulation in pregnancies derived of ARTs and AI. However, the stimulation in the ART derived pregnancies was apparently 4 days longer, suggesting a greater placental function in conceptus derived of ARTs. The second study showed an increase in ISG expression in both normal and abnormal conceptus development, which justifies the maintenance of CL in the absence of a conceptus structure detected by ultrasonography. In the third study, was detected changes in the steroidogenesis of pregnancies derived of IFV and cloning by SCNT during the last month of pregnancy, which are compatible with the hyperactivation of the aromatase enzyme during the last month of IFV derived pregnancies, and hyperactivation of the enzymes P450C11 and P450C21 thirty days before parturition in pregnancies derived of cloning by SCNT. The present study concludes that conceptus derived of IFV and cloning by SCNT present a prolonged stimulus of ISGs, cloned conceptus with anomalous development presents a stimulus of ISGs, which justifies the CL function maintenance, and, ultimately, the steroidogenic cascade that culminates with the term is altered in pregnancies derived from IFV and cloning by SCNT.