Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(10):925-929
Placenta accreta spectrum (PAS) is a cause of massive obstetric hemorrhage and maternal mortality. The application of family-centered delivery techniques (FCDTs) during surgery to treat this disease is infrequent. We evaluate the implementation of FCDTs during PAS surgeries.
This was a prospective, descriptive study that included PAS patients undergoing surgical management over a 12-month period. The patients were divided according to whether FCDTs were applied (group 1) or not (group 2), and the clinical outcomes were measured. In addition, hospital anesthesiologists were surveyed to evaluate their opinions regarding the implementation of FCDTs during the surgical management of PAS.
Thirteen patients with PAS were included. The implementation of FCDTs during birth was possible in 53.8% of the patients. The presence of a companion during surgery and skin-to-skin contact did not hinder interdisciplinary management in any case.
Implementation of FCDTs during PAS care is possible in selected patients at centers with experience in managing this disease.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2020;42(8):448-453
To analyze the rates of cesarean delivery longitudinally in a university hospital using the Robson classification.
Data related to births performed between 2014 and 2018 and recorded in the Maternal and Neonatal Health Information System (Sistema de Informações em Saúde Materna e Neonatal, SISMATER, in Portuguese) were analyzed using the Robson classification. As an aid, we used articles published in the last five years that approach the same topic in other Brazilian maternity hospitals; they were retrieved from the LILACS, MEDLINE, CINAHL, Scopus, Web of Science and Cochrane Library databases.
There was little variation in the total rate of cesarean sections in the period; however, the profile of each group changed over the years. It was possible to verify a significant reduction in the participation of groups of pregnant women with lower risk and an increase in high-risk pregnancies, attributable to the decrease in beds in the institution, with a greater transfer of patients. In addition, there was a reduction in cesarean sections among the lower-risk groups,while the rate among the higher-risk groups remained stable.
The use of the Robson classification to stratify cesarean deliveries contributes to a better analysis of the indications for cesarean delivery, enabling the establishment of strategies to reduce the rates, generating a positive impact on hospital management and quality of care.