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      Vivências psíquicas de mulheres com pré-eclâmpsia: um estudo qualitativo Translated title: Psychic experiences of women with preeclampsia: a qualitative study Translated title: Experiencias psíquicas de mujeres con pre-eclampsia: un estudio cualitativo

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          Abstract

          As síndromes hipertensivas são as complicações mais frequentes na gestação constituindo, no Brasil, como primeira causa de mortalidade materna. A presente pesquisa objetivou investigar a vivência da gravidez e a constituição da relação afetiva mãe-bebê em grávidas com diagnóstico de pré-eclâmpsia. Participaram do estudo nove gestantes, acompanhadas em um ambulatório de gravidez de risco ou internadas em uma Unidade Materno-Infantil de um município do interior paulista. Foram realizadas entrevistas semiestruturadas, com posterior análise de conteúdo temática. Os quatro temas identificados nas entrevistas foram: os sentimentos frente à descoberta da gravidez; expectativas: da ambivalência ao vínculo mãe-bebê; maternidade e maternagem: crise vital ou risco?; e a hipertensão na gestação: perspectivas psicossomáticas e repercussões emocionais da doença. O desejo da maternidade foi manifesto, apesar do risco, com uma representação mental do bebê e expectativas de superação da insegurança relacionada ao desempenho do papel materno.

          Translated abstract

          Hypertensive disorders are the most common complications during pregnancy constituting, in Brazil, the first leading cause of maternal mortality. This study investigated the experience of pregnancy and the constitution of the mother-baby affective relationship in pregnant women diagnosed with preeclampsia. The study included nine pregnant women cared for at a Maternal-Infant Unity in an inner city in São Paulo state. Semi-structured interviews were conducted, with thematic content analysis. The four themes identified in the interviews were the following: feelings related to the discovery of the pregnancy; expectations: from the ambivalence to the mother-baby bond; motherhood and mothering: vital crisis or risk?; and hypertension during pregnancy: psychosomatic perspectives and emotional effects of the disease. The desire of motherhood was manifested, despite the risk, with a mental representation of the baby and expectations of overcoming insecurity related to the maternal role.

          Translated abstract

          Los síndromes hipertensivas son las complicaciones más frecuentes en la gestación constituyendo, en Brasil, como primera causa de mortalidad materna. La pesquisa ha objetivado investigar la experiencia del embarazo y la constitución de la relación afectiva madre- bebé en embarazadas con diagnóstico de pre-eclampsia. Han participado del estudio nueve gestantes, acompañadas en ambulatorio para embarazos de riesgo o hospitalizadas en Unidad Materno-Infantil de una ciudad en el interior paulista. Se realizaron entrevistas semiestructuradas, con posterior análisis del contenido temático. Los cuatro temas identificados en las entrevistas han sido: los sentimientos delante del descubrimiento del embarazo; expectativas de la ambivalencia al vínculo madre-niño; la maternidad y "maternagem": ¿crisis vital o riesgo? Y la hipertensión en el embarazo: perspectivas psicosomáticas y repercusiones emocionales de la enfermedad. El deseo de la maternidad ha sido manifestado, no obstante al riesgo, con una representación mental del bebé y expectativas de superación de la inseguridad relacionada al desempeño de la función materna.

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          The Burden of Eclampsia: Results from a Multicenter Study on Surveillance of Severe Maternal Morbidity in Brazil

          Objective Maternal mortality (MM) is a core indicator of disparities in women’s rights. The study of Near Miss cases is strategic to identifying the breakdowns in obstetrical care. In absolute numbers, both MM and occurrence of eclampsia are rare events. We aim to assess the obstetric care indicators and main predictors for severe maternal outcome from eclampsia (SMO: maternal death plus maternal near miss). Methods Secondary analysis of a multicenter, cross-sectional study, including 27 centers from all geographic regions of Brazil, from 2009 to 2010. 426 cases of eclampsia were identified and classified according to the outcomes: SMO and non-SMO. We classified facilities as coming from low- and high-income regions and calculated the WHO’s obstetric health indicators. SPSS and Stata softwares were used to calculate the prevalence ratios (PR) and respective 95% confidence interval (CI) to assess maternal characteristics, clinical and obstetrical history, and access to health services as predictors for SMO, subsequently correlating them with the corresponding perinatal outcomes, also applying multiple regression analysis (adjusted for cluster effect). Results Prevalence of and mortality indexes for eclampsia in higher and lower income regions were 0.2%/0.8% and 8.1%/22%, respectively. Difficulties in access to health care showed that ICU admission (adjPR 3.61; 95% CI 1.77–7.35) and inadequate monitoring (adjPR 2.31; 95% CI 1.48–3.59) were associated with SMO. Conclusions Morbidity and mortality associated with eclampsia were high in Brazil, especially in lower income regions. Promoting quality maternal health care and improving the availability of obstetric emergency care are essential actions to relieve the burden of eclampsia.
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            Prenatal depression in women hospitalized for obstetric risk.

            Little is known about depression during pregnancy in women with high maternal or fetal risk, as this population is often excluded from research samples. The aim of this study was to evaluate depressive symptoms and known risk factors for depression in a group of women hospitalized with severe obstetric risk.
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              A literature update on maternal-fetal attachment

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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                rpsaude
                Revista Psicologia e Saúde
                Rev. Psicol. Saúde
                Universidade Católica Dom Bosco, Programa de Mestrado e Doutorado em Psicologia (Campo Grande, MS, Brazil )
                2177-093X
                August 2019
                : 11
                : 2
                : 115-127
                Affiliations
                [1] orgnameFAMEMA danimassihpio@ 123456hotmail.com
                [2] orgnameUNESP peracoli@ 123456fmb.unesp.br
                [3] orgnameFaculdade de Medicina de Marília orgdiv1Cursos de Medicina e de Enfermagem roselivb@ 123456uol.com.br
                Article
                S2177-093X2019000200009
                10.20435/pssa.v11i2.648
                f66d09eb-6f42-42c9-b3df-5a5afe0a387c

                http://creativecommons.org/licenses/by/4.0/

                History
                : 11 December 2018
                : 26 November 2018
                : 08 November 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 13
                Product

                SciELO Periódicos Eletrônicos em Psicologia

                Categories
                Artigos

                gravidez de alto risco,pré-eclâmpsia,pregnancy high-risk,pre-eclampsia,psychology medical,embarazo de alto riesgo,preeclampsia,psicología médica,psicologia médica

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