Resumen Introducción. La ganadería con bovinos criollos se práctica en espacios rurales con características difíciles para el manejo de las especies. Objetivo. Describir el sistema productivo y los factores socioculturales y técnico-económicos que afectan la producción del bovino criollo de Nunkiní (Bos taurus). Materiales y métodos. El estudio se realizó entre noviembre del 2020 a octubre del 2021, en nueve unidades de producción pecuarias de Nunkiní en el municipio de Calkiní, Campeche, México. La información se obtuvo de una cédula de entrevista con variables de estudio sociales, culturales, técnicas y económicas, aplicada a productores seleccionados. Los datos se analizaron mediante estadística descriptiva y ANDEVA. Resultados. La crianza del ganado la realizaron hombres (100 %), con edad promedio de 58,44 años. Los años de experiencia promedio fueron de 34, 61. Los productores jóvenes tuvieron mayor escolaridad y menor experiencia, y se encargaron de las unidades de producción de mayor nivel tecnológico. El tamaño de la unidad de producción pecuaria varió de cinco a veintidós bovinos (media de 14). El manejo alimenticio tuvo un esquema de trashumancia, donde de mayo a diciembre estuvieron libres en tierras ejidales y de enero a abril se manejaron semiestabulados, con pastoreo en potreros cultivados y suplementados con residuos agrícolas. Con el manejo zootécnico implementado por los productores, se obtuvo un promedio de 83 % de preñez. El producto principal comercializado fue carne fresca en cortes y venta directa al consumidor, con un precio promedio de 2,675 USD$/kg. Conclusión. Es un sistema tradicional extensivo que aprovecha el uso común de los agostaderos. Con productores de experiencia, pero de edad avanzada, de pequeña inversión y le sirve para fortalecer su economía familiar. Dicha actividad se ve amenazada por la falta de revalorización del bovino criollo y la introducción de razas exóticas en la zona para maximizar la producción.

Abstract Introduction. Livestock farming with Creole cattle is practiced in rural areas with challenging characteristics for species management. Objective. To describe the production system and the socio-cultural and technical-economic factors affecting the production of Nunkiní Creole cattle (Bos taurus). Materials and methods. The study was conducted from November 2020 to October 2021 in nine livestock production units of Nunkiní, Calkiní municipality, Campeche, Mexico. Information was obtained from an interview form with social, cultural, technical, and economic study variables, applied to selected producers. Data were analyzed using descriptive statistics and ANOVA. Results. Livestock farming was carried out by men (100 %), with an average age of 58.44 years. The average years of experience were 34.61. Younger producers had higher levels of education and less experience, and were responsible for the production units of higher technological levels. The size of the livestock production unit ranged from five to twenty-two cattle (average of 14). Feeding management followed a transhumance scheme, with cattle being free-ranging on ejido lands and from May to December and semi-stabled from January to April, grazing on cultivated pastures and supplemented with agricultural residues. With the zootechnical management implemented by the producers, an average pregnancy rate of 83 % was achieved. The main product marketed was fresh meat in cuts and direct sale to consumers, with an average price of 2.675 USD$/kg. Conclusion. It is traditional extensive system that takes advantage of the common use of grasslands. It involves experienced but older producers, with small investments, and serves to strengthen their family economy. This activity is threatened by the lack of revaluation of Creole cattle and the introduction of exotic breeds in the area to maximize production.

Abstract It is known that neuronal maturation after birth lasts approximately twenty years and requires a large amount of energy. If a pregnancy occurs before maturation, the energy must be distributed between the mother and the offspring, having an effect on the anatomical and functional processes of the brain. Therefore, the electrical activity of the frontal cortex was compared, as well as the performance of its functions and maternal care in adolescents and young people (less than six months after giving birth). The NEUROPSI test (attention and coding) and a maternal care instrument were applied to primiparous adolescents and young people; electroencephalographic recordings were performed on a sample of this population. Significant differences are observed in the coding and attention processes (F= 4.5, α= 0.03*; F= 79.7, α= 0.00**), and a significant correlation between attention and maternal care (health and affection categories) as well as health care coding. The electrical activity of the frontal lobe was slower in primiparous adolescents as well as maternal care behaviors. The above is related to delay in the neuronal maturation of adolescent mothers.

Resumen Se sabe que la maduración neuronal tras el nacimiento dura aproximadamente veinte años y necesita gran cantidad de energía. Si ocurre un embarazo antes de la maduración, la energía debe repartirse entre la madre y la cría, teniendo efecto en los procesos anatómicos y funcionales del cerebro. Por ello, se comparó la actividad eléctrica de la corteza frontal, así como el desempeño de sus funciones y cuidados maternales en adolescentes y jóvenes (con menos de seis meses posteriores al parto). Se aplicó el test NEUROPSI (atención y codificación) y un instrumento de cuidados maternales a primíparas adolescentes y jóvenes; a una muestra de esta población se les realizó registros electroencefalográficos. Se observan diferencias significativas en los procesos de codificación y atención (F= 4.5, α= 0.03*; F=79.7, α= 0.00**), y una correlación significativa entre la atención y el cuidado maternal (categorías de salud y cariño), así como de la codificación sobre el cuidado de la salud. La actividad eléctrica del lóbulo frontal fue más lenta en las adolescentes primíparas, así como las conductas de cuidado maternal. Lo anterior se relaciona con una menor maduración neuronal de madres adolescentes.

Abstract Introduction: México has a high rate of teenage pregnancy, which symbolizes a risk to the health and socio-economic development of this group. The prevention of a second pregnancy at this stage is relevant to improve quality of life. Objective: To explore the social representations of prenatal contraceptive counseling based on the experiences and expectations of pregnant adolescents and health providers in a second level care hospital. Methodology: Qualitative study based on Serge Moscovici’s Social Representations Theory with ten primiparous adolescents in any quarter of pregnancy and seven health providers, adolescents without pregnancy condition were excluded. We used semi-structured interviews recorded and analyzed in their integrity through fluctuating reading by two researchers, the discourse of the proposed thematic axes was contrasted. Integrity, confidentiality, and autonomy were respected. Results: The realities represented by adolescents showed a need for knowledge, values, respect, kindness, and patience. Providers evoked paternalistic counseling, but with recognition of focused counseling and reproductive rights. Conclusion: More participants stated that the ideal time to receive counseling is during pregnancy, since pregnant adolescents expressed the need to receive information and have more time lapse between their pregnancies. The expectations of the Prenatal Contraceptive Counseling (CAP by its acronym in Spanish) differed in terms of values to give rise to a paternalistic attitude on the part of the health provider and the preference of adolescents for counseling based on respect, honesty, and trust, among others.

Abstrato Introdução: O México tem um alto índice de gravidez na adolescência, o que simboliza um risco para a saúde e o desenvolvimento socioeconômico desse grupo. A prevenção de uma segunda gravidez nesta fase é relevante para melhorar sua qualidade de vida. Objetivo: Explorar as representações sociais do aconselhamento contraceptivo pré-natal a partir das experiências e expectativas de gestantes adolescentes e profissionais de saúde em um segundo nível de atenção hospitalar. Metodologia: Estudo qualitativo baseado na Teoria das Representações Sociais de Serge Moscovici com dez adolescentes primíparas em qualquer trimestre da gravidez e sete profissionais de saúde; foram excluídas as adolescentes sem condições de gravidez. Foram utilizadas entrevistas semiestruturadas gravadas e analisadas em sua integridade por meio da leitura flutuante de dois pesquisadores, contrastando o discurso dos eixos temáticos propostos. Integridade, confidencialidade e autonomia foram respeitadas. Resultados: As realidades representadas pelos adolescentes mostraram necessidade de conhecimento, valores, respeito, gentileza e paciência. Os prestadores evocaram aconselhamento paternalista, más com reconhecimento de aconselhamento focado e direitos reprodutivos. Conclusão: Um número maior de participantes afirmou que o momento ideal para receber aconselhamento é durante a gravidez, pois as adolescentes grávidas expressaram a necessidade de receber informações e de ter mais tempo entre as gestações. As expectativas da aconselhamento contraceptivo pré-natal (CAP, na sigla em espanhol) diferiram quanto aos valores para dar lugar a uma atitude paternalista por parte do provedor de saúde e a preferência das adolescentes por uma assessoria baseada no respeito, honestidade, confiança, entre outros

Resumen Introducción: México presenta una tasa elevada de embarazo adolescente lo que simboliza un riesgo a la salud y desarrollo socioeconómico de este grupo. La prevención de un segundo embarazo en esta etapa es relevante para mejorar su calidad de vida. Objetivo: Explorar las representaciones sociales de la consejería anticonceptiva prenatal a partir de las experiencias y expectativas de adolescentes gestantes y proveedores de salud en un hospital de segundo nivel de atención. Metodología: Estudio cualitativo basado en la Teoría de las Representaciones Sociales de Serge Moscovici con diez adolescentes primíparas en cualquier trimestre de embarazo y siete proveedores de salud, se excluyeron adolescentes sin condición de embarazo. Se utilizó entrevista semiestructurada grabadas y analizadas en su integridad mediante lectura fluctuante realizada por dos investigadores, se contrastó el discurso de los ejes temáticos propuesto. Se respetó la integridad, confidencialidad y autonomía. Resultados: Las realidades representadas por las adolescentes mostraron necesidad de conocimientos, valores, respeto, amabilidad y paciencia. Los proveedores evocaron una consejería paternalista, pero con reconocimiento de una consejería focalizada y derechos reproductivos. Conclusión: Las experiencias similares de los participantes fueron que el momento ideal para recibir la consejería es durante el embarazo, en virtud de que las adolescentes embarazadas manifestaron necesidad de recibir información y espaciar sus embarazos. Las expectativas de la consejería anticonceptiva prenatal difirieron en los valores para dar lugar a una actitud paternalista por parte del proveedor de salud y la preferencia de las adolescentes por una consejería basada en el respeto, honestidad, confianza, entre otros.

Abstract Introduction: Almost 800 female deaths occur daily due to preventable causes associated with complications during or after pregnancy or childbirth, equivalent to two maternal deaths per minute. Objective: To develop a nursing care process for a pregnant woman who suffered from hyperthyroidism using diagnostic taxonomies, results and nursing interventions with a focus on Orem's theory. Methodology: Case study of a pregnant woman treated in a second level care hospital, the Orem assessment guide was used, developing the stages: assessment, diagnosis, planning, execution and evaluation, individualized care plans were designed and executed. Privacy was protected by omitting identity, respecting the rights and well-being of the participant. Results: The risk conditioning factor that compromised the health of the mother-child binomial gave way to care planning aimed at the process of ineffective motherhood and ineffective self-management of health, establishing interventions such as high-risk pregnancy care and teaching the process of illness and prescribed medications, an improvement was obtained in the patient's health status, which allowed her discharge and adequate management of the high-risk pregnancy. Conclusion: The nursing care process exposed the context in which the pregnant woman with known uncontrolled pathology is admitted, which compromised maternal-fetal well-being. Nursing education is required to promote preconception maternal health for future pregnancies.

Abstrato Introdução: Quase 800 mortes femininas ocorrem diariamente por causas evitáveis associadas a complicações durante ou após a gravidez ou o parto, o equivalente a duas mortes maternas por minuto. Objetivo: Desenvolver um processo de cuidado de enfermagem a uma gestante portadora de hipertireoidismo utilizando taxonomias diagnósticas, resultados e intervenções de enfermagem com enfoque na teoria de Orem. Metodologia: Estudo de caso de uma gestante atendida em um hospital de atenção secundária, utilizou-se o guia de avaliação de Orem, desenvolvendo as etapas: avaliação, diagnóstico, planejamento, execução e avaliação, foram desenhados e executados planos de cuidados individualizados. A privacidade foi protegida pela omissão da identidade, respeitando os direitos e o bem-estar do participante. Resultados: O fator condicionante de risco que comprometia a saúde do binômio mãe-filho deu lugar ao planejamento do cuidado voltado ao processo de maternidade ineficaz e à autogestão ineficaz da saúde, estabelecendo intervenções como o cuidado à gravidez de alto risco e ensinando o processo e medicamentos prescritos, houve uma melhora no estado de saúde da paciente, o que permitiu sua alta e o gerenciamento adequado da gravidez de alto risco. Conclusão: O processo de cuidado de enfermagem expôs o contexto em que a gestante com patologia conhecida não controlada é internada, o que compromete o bem-estar materno-fetal. A educação em enfermagem é necessária para promover a saúde materna pré-concepcional em futuras gestações.

Resumen Introducción: Casi 800 muertes de mujeres en forma diaria ocurren por causas prevenibles asociadas a complicaciones durante o después del embarazo o el parto, equivaliendo dos muertes maternas por minuto. Objetivo: Desarrollar un proceso de atención de enfermería a gestante que cursó con hipertiroidismo empleando las taxonomías diagnósticas, resultados e intervenciones de enfermería con enfoque de la teoría de Orem. Metodología: Estudio de caso a mujer gestante atendida en hospital de segundo nivel de atención, se empleó la guía de valoración de Orem desarrollando las etapas: valoración, diagnóstico, planeación, ejecución y evaluación, se diseñaron y ejecutaron planes de cuidados individualizados. Se protegió la privacidad omitiendo identidad, respetando los derechos y bienestar de la participante. Resultados: El factor condicionante de riesgo que comprometía la salud del binomio madre-hijo, dio paso a la planificación del cuidado encaminado al proceso de maternidad ineficaz y autogestión ineficaz de la salud, estableciendo intervenciones como cuidados del embarazo de alto riesgo y enseñanza del proceso de enfermedad y medicamentos prescritos, se obtuvo mejora en el estado de salud de la paciente, lo que permitió su alta y un adecuado manejo del embarazo de alto riesgo. Conclusión: El proceso de atención de enfermería expuso el contexto en el que ingresa la mujer gestante con patología conocida no controlada, lo que comprometía el bienestar materno-fetal. Se requiere educación por parte de enfermería para fomentar la salud materna preconcepcional para futuros embarazos.

Resumen La seguridad de los psicofármacos durante el embarazo es un tema crucial en la práctica clínica. En esta revisión, se hace un breve recorrido sobre los cambios en el embarazo que impactan en la farmacodinamia de los medicamentos, además, se analizan los principales grupos farmacológicos en psiquiatría y sus efectos durante el embarazo. Se identifican tres períodos críticos durante el embarazo. El período de las primeras dos semanas se asocia con un mayor riesgo de aborto espontáneo. El período de la segunda a la décima semana es el más riesgoso, ya que pueden ocurrir alteraciones teratogénicas que afectan el desarrollo fetal. El período posterior a la décima semana se caracteriza por alteraciones en el crecimiento y desarrollo funcional del feto, pero suelen ser menos graves. Los antidepresivos, especialmente los inhibidores selectivos de la receptación de serotonina (ISRS) y los antipsicóticos de segunda generación se consideran los más seguros, pero estos últimos pueden estar asociados con síndrome metabólico, cardiopatías congénitas y trastornos del neurodesarrollo. El litio se ha asociado con efectos teratogénicos y malformaciones cardíacas, mientras que el valproato está relacionado con defectos congénitos importantes. Las benzodiacepinas pueden tener efectos tóxicos y causar síndrome de abstinencia en el recién nacido. La seguridad de los psicofármacos durante el embarazo requiere una evaluación individualizada de los beneficios y riesgos. Aunque algunos grupos de psicofármacos se consideran relativamente seguros, es necesario tener precaución y considerar las posibles complicaciones asociadas con su uso durante el embarazo.

Abstract: The safety of psychoactive drugs during pregnancy is a crucial issue in clinical practice. In this review, a brief overview of the changes in pregnancy that impact the pharmacodynamics of drugs is made; in addition, the main pharmacological groups in psychiatry and their effects during pregnancy are analyzed. Three critical periods during pregnancy are identified. The period of the first two weeks is associated with an increased risk of miscarriage. The period from the second to the tenth week is the most at risk , since teratogenic effects that affect fetal development can take place. The period after the tenth week is characterized by alterations in fetal growth and functional development , however ,less severe defects. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), and second-generation antipsychotics are considered the safest, but the latter may be associated with metabolic syndrome, congenital heart disease, and neurodevelopmental disorders. Lithium has been associated with teratogenic effects and cardiac malformations, while valproate is associated with major birth defects. Benzodiazepines can have toxic effects and cause Neonatal Withdrawal Syndrome . The safety of psychotropic drugs during pregnancy requires an individualized assesment of the benefits and risks. Although some groups of psychiatric drugs are considered relatively safe, caution is needed when considering the potential complications associated with their use during pregnancy.

Resumen Antecedentes: la histerectomía en bloque es un procedimiento controvertido y con poca literatura actualizada. Se define como la extirpación del útero grávido con su contenido gestacional in situ, las indicaciones para la realización de esta cirugía son los procesos neoplásicos (como la causa más frecuente( procesos sépticos, enfermedad trofoblástica y hemorragia secundaria a inserción placentaria anómala. Caso clínico: paciente de 45 años con embarazo de 8 semanas y 5 días, según la fecha de última regla, con miomatosis uterina gigante asociada con tromboembolismo pulmonar, quien decide la interrupción voluntaria del embarazo y realizarse la histerectomía en bloque. Conclusiones: la histerectomía en bloque es una cirugía poco realizada en la actualidad, sin embargo, este abordaje quirúrgico es una opción segura y efectiva para la interrupción voluntaria del embarazo, y no se debe descartar entre las alternativas de tratamiento quirúrgico, siempre individualizando cada paciente.

ABSTRACT BACKGROUND: En bloc hysterectomy is defined as the removal of the pregnant uterus with its gestational content in situ. The indications for performing this en bloc surgery are neoplastic processes, as the most frequent cause; septic processes, trophoblastic disease and hemorrhage secondary to abnormal placental insertion, however, it is a controversial procedure, and with little updated literature. CLINICAL CASE: 45-year-old patient with a pregnancy of 8 weeks and 5 days, with giant uterine myomatosis associated with pulmonary thromboembolism who decided to voluntarily terminate the pregnancy, and it was decided to perform en bloc hysterectomy. CONCLUSIONS: En bloc hysterectomy is a surgery rarely performed at present, however, this surgical approach is a safe and effective option for the voluntary termination of pregnancy, and it should not be ruled out among the surgical treatment alternatives, always individualizing each patient.

A gravidez na adolescência é um problema significativo de saúde pública no Brasil, contribuindo para altas taxas de morbimortalidade entre mulheres jovens. Durante a gestação, muitas adolescentes abandonam a escola e o trabalho, o que resulta em menor qualificação e maior vulnerabilidade ao mercado de trabalho informal. Além disso, as adolescentes grávidas enfrentam riscos elevados de complicações gestacionais e desafios emocionais, como ansiedade e depressão. A pandemia exacerbou essas vulnerabilidades, especialmente em relação ao abuso doméstico, devido ao isolamento social. Este estudo justifica-se pela necessidade de compreender o perfil demográfico e as características das parturientes adolescentes no Ceará entre 2020 e 2022, oferecendo subsídios para políticas públicas que visem melhorar a qualidade de vida dessas jovens e de seus filhos. Todos os dados foram analisados utilizando R. Durante o período analisado, foram registrados 331.924 nascimentos vivos no Ceará, dos quais 21.667 (6,53%) eram de mães com idade igual ou inferior a 17 anos. A idade média das mães adolescentes foi de 15,93 ± 1,11 anos, enquanto a média para as mães adultas foi de 28,00 ± 6,21 anos, evidenciando uma diferença estatisticamente significativa (Teste-t de Student, P < 0,05). A análise também revelou uma diferença significativa entre a idade dos pais de crianças nascidas de mães adolescentes (22,25 ± 5,72 anos) em comparação à idade dos pais de crianças nascidas de mães adultas (32,45 ± 7,81 anos) (Figura 3, Teste-T, P < 0,05). No que se refere à etnia, adolescentes indígenas representaram 9,95% dos casos de gravidez, seguidas pelas adolescentes pardas (7,26%) e pretas (5,9%). A menor proporção foi observada entre adolescentes brancas (4,43%). Não houve diferença estatisticamente significativa entre os grupos indígenas, pardas, pretas e a população amarela. Quanto ao estado civil, 71% das adolescentes se declararam solteiras. A análise educacional demonstrou uma tendência significativa de gravidez entre adolescentes com Ensino Fundamental II incompleto, completo, ou Ensino Médio incompleto, indicando que essas jovens ainda estavam em fase de conclusão desses ciclos escolares. Não foi observada uma relação significativa entre a redução da idade materna e a diminuição do escore APGAR em recém-nascidos (APGAR = 0,014 × “IDADE DA MÃE” + 8,5; P < 0,05, R² = 0,0004). Além disso, não houve diferença significativa na proporção de anomalias congênitas entre os nascimentos de mães adolescentes e adultas.

El embarazo en la adolescencia es un problema significativo de salud pública en Brasil, que contribuye a altas tasas de morbimortalidad entre las mujeres jóvenes. Durante el embarazo, muchas adolescentes abandonan la escuela y el trabajo, lo que resulta en menor calificación y mayor vulnerabilidad en el mercado laboral informal. Además, las adolescentes embarazadas enfrentan mayores riesgos de complicaciones gestacionales y desafíos emocionales, como ansiedad y depresión. La pandemia exacerbó estas vulnerabilidades, especialmente en relación con el abuso doméstico, debido al aislamiento social. Este estudio se justifica por la necesidad de comprender el perfil demográfico y las características de las madres adolescentes en Ceará entre 2020 y 2022, ofreciendo apoyo para políticas públicas que busquen mejorar la calidad de vida de estas jóvenes y sus hijos. Todos los datos fueron analizados utilizando R. Durante el período analizado, se registraron 331.924 nacimientos vivos en Ceará, de los cuales 21.667 (6,53%) eran de madres de 17 años o menos. La edad promedio de las madres adolescentes fue de 15,93 ± 1,11 años, mientras que la media para las madres adultas fue de 28,00 ± 6,21 años, evidenciando una diferencia estadísticamente significativa (Prueba t de Student, P < 0,05). El análisis también reveló una diferencia significativa entre la edad de los padres de niños nacidos de madres adolescentes (22,25 ± 5,72 años) en comparación con la edad de los padres de niños nacidos de madres adultas (32,45 ± 7,81 años) (Prueba de Wilcoxon, P < 0,05). En cuanto a la etnia, las adolescentes indígenas representaron el 9,95% de los casos de embarazo, seguidas por las adolescentes mestizas (7,26%) y negras (5,9%). La menor proporción se observó entre las adolescentes blancas (4,43%). No hubo diferencia estadísticamente significativa entre los grupos indígenas, mestizas, negras y la población amarilla. En cuanto al estado civil, el 71% de las adolescentes se declararon solteras. El análisis educativo demostró una tendencia significativa de embarazo entre adolescentes con secundaria incompleta o completa, o educación media incompleta, lo que indica que estas jóvenes aún estaban en proceso de completar estos niveles educativos. No se observó una relación significativa entre la disminución de la edad materna y la reducción de la puntuación APGAR en los recién nacidos (APGAR = 0,014 × "EDAD DE LA MADRE" + 8,5; P < 0,05, R² = 0,0004). Además, no hubo diferencia significativa en la proporción de anomalías congénitas entre los nacimientos de madres adolescentes y adultas.

Adolescent pregnancy is a significant public health issue in Brazil, contributing to high morbidity and mortality rates among young women. During pregnancy, many adolescents drop out of school and work, leading to lower qualifications and increased vulnerability to the informal labor market. Moreover, pregnant adolescents face higher risks of gestational complications and emotional challenges, such as anxiety and depression. The pandemic exacerbated these vulnerabilities, particularly concerning domestic abuse, due to social isolation. This study is justified by the need to understand the demographic profile and characteristics of adolescent mothers in Ceará between 2020 and 2022, providing support for public policies aimed at improving the quality of life for these young women and their children. All data were analyzed using R. During the analyzed period, 331,924 live births were recorded in Ceará, of which 21,667 (6.53%) were from mothers aged 17 years or younger. The average age of adolescent mothers was 15.93 ± 1.11 years, while the average for adult mothers was 28.00 ± 6.21 years, showing a statistically significant difference (Student's t-test, P < 0.05). The analysis also revealed a significant difference between the age of fathers of children born to adolescent mothers (22.25 ± 5.72 years) compared to the age of fathers of children born to adult mothers (32.45 ± 7.81 years) (Wicoxon test, P < 0.05). Regarding ethnicity, indigenous adolescents accounted for 9.95% of pregnancy cases, followed by brown (7.26%) and black (5.9%) adolescents. The lowest proportion was observed among white adolescents (4.43%). There was no statistically significant difference among indigenous, mixed-race, black, and yellow populations. Concerning marital status, 71% of adolescents declared themselves single. Educational analysis showed a significant trend of pregnancy among adolescents with incomplete or complete middle school or incomplete high school education, indicating that these young women were still in the process of completing these educational levels. There was no significant relationship between decreasing maternal age and a reduction in newborns' APGAR scores (APGAR = 0.014 × "MOTHER'S AGE" + 8.5; P < 0.05, R² = 0.0004). Additionally, there was no significant difference in the proportion of congenital anomalies between births of adolescent and adult mothers.

ABSTRACT Introduction Obstructive azoospermia occurs when there is a blockage in the male reproductive tract, leading to a complete absence of sperm in the ejaculate. It constitutes around 40% of all cases of azoospermia (1, 2). Blockages in the male reproductive tract can arise from either congenital or acquired factors, affecting various segments such as the epididymis, vas deferens, and ejaculatory ducts (3). Examples of congenital causes encompass conditions like congenital bilateral absence of the vas deferens and unexplained epididymal blockages (4). Acquired instances of obstructive azoospermia may result from factors like vasectomy, infections, trauma, or unintentional injuries caused by medical procedures (5). This complex condition affecting male fertility, presents two main treatment options: microsurgical reconstruction and surgical extraction of sperm followed by in vitro fertilization (IVF). Microsurgical reconstruction proves to be the most cost-effective option for treating obstructive azoospermia when compared with assisted reproductive techniques (6, 7). However, success rates of reconstruction defined by patency are as high as 99% for vasovasostomy (VV) but decline to around 65% if vasoepididymostomy (VE) is required (8, 9). Thus, continued refinement in technique is necessary in order to attempt to improve patency for patients undergoing VE. In this video, we show a comprehensive demonstration of microsurgical VE, highlighting the innovative epididymal occlusion stitch. The goal of this innovative surgical technique is to improve outcomes for VE. Materials and Methods The patient is a 39-year-old male diagnosed with obstructive azoospermia who presents for surgical reconstruction via VE. His partner is a 37-years-old female with regular menstrual cycles. The comprehensive clinical data encompasses a range of factors, including FSH levels, results from semen analysis, and outcomes from testicular sperm aspiration. This thorough exploration aims to provide a thorough understanding of our innovative surgical technique and its application in addressing complex cases of obstructive azoospermia. Results The procedure was started on the right, the vas deferens was identified and transected. The abdominal side of the vas was intubated and a vasogram performed, there was no obstruction. There was no fluid visible from the testicular side of the vas for analysis, thus we proceeded with VE. Upon inspection of the epididymis dilated tubules were identified. After selecting a tubule for VE, two 10-0 nylon sutures were placed, and it was incised. Upon inspection of the fluid motile sperm was identified. After VE, we performed a novel epididymal occlusion stitch technique. This was completed distal to the anastomosis by placing a 7-0 prolene through the tunica of the epididymis from the medial to lateral side. This stitch was then tightened down with the goal to largely occlude the epididymis so that sperm will preferentially travel through the anastomosis. The steps were then repeated on the left. At 3-month follow up, the patient had no change in testicular size as compared with preoperative size (18cc), he had no testicular or incisional discomfort, and on semen analysis he had presence of motile sperm. After 3 months post-surgery, the patient had motile sperm seen on semen analysis. Discussion The introduction of a novel epididymal occlusion stitch demonstrates a targeted strategy to enhance the success of microscopic VE. Encouragingly, a 3-month post-surgery follow-up reveals the presence of motile sperm, reinforcing the potential efficacy of our approach. This is promising given the historical lower patency, delayed time to patency, and higher delayed failure rates that patients who require VE experience (10). In total, 40% of all azoospermia cases can be attributed to obstruction. The conventional treatments for obstructive azoospermia involve microsurgical reconstruction and surgical sperm retrieval followed by IVF. While microsurgical reconstruction has proven to be economically viable, the quest for enhanced success rates has led to the exploration of innovative techniques. Historically, the evolution of VV and VE procedures, initially performed in the early 20th century, laid the foundation for contemporary microsurgical approaches (11). Notably, the microscopic VV demonstrated significant improvements in patency rates and natural pregnancy likelihood, as evidenced by the seminal Vasovastomy Study Group study in 1991 (8). In contemporary literature, success rates particularly for VE remain unchanged for the past three decades since the original published success rates by the Vasectomy Reversal Study Group (12). VE is associated with a longer time to patency as well with patients taking 2.8 to 6.6 months to have sperm return to ejaculate as compared to 1.7 to 4.3 months for those undergoing VV. Additionally, of those patients who successfully have sperm return to the ejaculate after VE up to 50% will have delayed failure compared to 12% for those undergoing VV who are patent. Finally, of those who experience delayed failure after undergoing VE it usually occurs earlier with studies reporting as early as 6 months post-operatively (20). Given the lack of improvement and significantly worsened outcomes with VE further surgical refinement is a constant goal for surgeons performing this procedure. Conclusion: In conclusion, this video is both a demonstration and a call to action for commitment to surgical innovation. We aim to raise the bar in VE success rates, ultimately bringing tangible benefits to patients and contributing to the ongoing evolution of reproductive medicine. The novel epididymal occlusion stitch emerges as a beacon of progress, promising not only enhanced safety but also potential reductions in patency time. Surgical excellence and methodological refinement, as exemplified in this video, lay the foundation for a future where male reproductive surgery continues to break new ground. 40 1, 1 (1 2. 2 . 2) 3. (3) 4. 4 (4) vasectomy infections trauma 5. 5 (5) fertility options IVF (IVF) costeffective cost effective 6, (6 7. 7 7) However 99 (VV 65 (VE 8, 8 (8 9. 9 9) Thus 39yearold yearold 39 year old 37yearsold yearsold 37 years cycles levels aspiration right transected obstruction 100 10 0 10- placed incised 70 7- left 3month month 18cc, 18cc cc , (18cc) discomfort postsurgery, postsurgery post surgery, Encouragingly followup approach 10. (10) total viable Historically th century 11. 11 (11) Notably likelihood 199 8. (8) literature 12. 12 (12) 28 66 6. 17 1. 43 Additionally 50 patent Finally postoperatively operatively 20. 20 (20) Conclusion conclusion innovation medicine progress ground ( (3 (4 (5 (IVF (18cc (10 (11 19 (12 (20 (2

Abstract Objective: To study the association between placental efficiency with anthropometry and nutritional phenotypes in full-term newborns from a birth cohort. Method: This was a secondary cross-sectional analysis of data obtained in a cohort study (Brazilian RibeirãoPreto and São Luís Birth Cohort Studies - BRISA), whose deliveries were performed between 2010 and 2011. Standardized questionnaires were applied to mothers, and placentas and newborns were evaluated shortly after delivery. Placental efficiency was assessed using the ratio between birth weight and placental weight (BW/PW ratio); values below the lower quartile (25th percentile for gestational age) were considered to have low placental efficiency. Newborn phenotypes were small and large for gestational age, stunted and wasted, evaluated using the INTERGROWTH-21 growth standard. To identify the confounding variables theoretical model was constructed using Directed Acyclic Graphs, and unadjusted and adjusted logistic regression were performed. Placental measurements were obtained blindly from pregnancy and delivery data. Results: 723 mother-placenta-child triads were studied. 3.2 % of newborns were small-for-gestational-age (SGA), 6.5 %large-for-gestational-age (LGA), 5.7 %had stunting, and 0.27 % wasting. A significantly higher risk was found between low placental efficiency and SGA (OR 2.82;95 % CI 1.05-7.57), stunting (OR 2.23; 95 % CI 1.07-4.65), and wasting (OR 8.22; 95 % CI 1.96-34.37). No relationship was found between LGA and placental efficiency. Conclusions: Low placental efficiency was associated with increased risk for small-for-gestational-age, stunting, and wasting. Placental morphometry can provide valuable information on intrauterine conditions and neonatal health, helping to identify newborns at higher risk of future comorbidities. Objective fullterm full term Method crosssectional cross sectional Brazilian BRISA, BRISA , BRISA) 201 2011 mothers BW/PW BWPW BW PW ratio) 25th th age wasted INTERGROWTH21 INTERGROWTH 21 INTERGROWTH-2 standard Graphs Results 72 motherplacentachild mother placenta child studied 32 3 2 3. smallforgestationalage SGA, (SGA) 65 6 5 6. %largeforgestationalage largeforgestationalage %large LGA, (LGA) 57 7 5. had 027 0 27 0.2 OR 2.8295 28295 2.82 82 2.82;9 1.057.57, 105757 1.05 7.57 1 05 1.05-7.57) 2.23 223 23 9 1.074.65, 107465 1.07 4.65 07 4 1.07-4.65) 8.22 822 8 22 1.9634.37. 1963437 1.96 34.37 . 96 34 37 1.96-34.37) Conclusions smallforgestationalage, health comorbidities 20 INTERGROWTH2 INTERGROWTH- (SGA (LGA 02 0. 8295 2.829 2829 282 2.8 2.82; 057 1.057.57 10575 105 1.0 757 7.5 1.05-7.57 2.2 074 1.074.65 10746 107 465 4.6 1.07-4.65 8.2 9634 1.9634.37 196343 196 1.9 3437 34.3 1.96-34.37 829 28 2. 1.057.5 1057 10 1. 75 7. 1.05-7.5 1.074.6 1074 46 4. 1.07-4.6 8. 963 1.9634.3 19634 19 343 34. 1.96-34.3 1.057. 1.05-7. 1.074. 1.07-4. 1.9634. 1963 1.96-34. 1.057 1.05-7 1.074 1.07-4 1.9634 1.96-34 1.05- 1.07- 1.963 1.96-3 1.96-

ABSTRACT The present research study addressed the issue of the inclusion of pregnant adolescents in Physical Education classes, focused on improving the physical health and well-being of the mother and fetus during pregnancy. The main objective of the work was to propose a program of physical activities adapted for the inclusion of pregnant students in the Physical Education class, in the “Pichincha” Fiscal Educational Unit. A methodology with a qualitative approach was proposed, scientific observation, interview, survey and documentary review were used as empirical methods that facilitated the identification of the problem in the initial part until the proposal of adapted physical exercises was carried out, in its final stage. It concludes with the application and execution of adapted physical activities, and improvements are obtained in cardiovascular health, strengthening of muscles and joints, control of weight gain, reduction of the risk of pregnancy complications and improvement of well-being. emotional. These results were compared with research by other authors that corroborate that implementing adapted physical activities contributes to improving the health of both the mother and the fetus.

RESUMO A presente pesquisa abordou a questão da inclusão de adolescentes grávidas nas aulas de Educação Física, com foco na melhoria da saúde física e do bem-estar da mãe e do feto durante a gravidez. O objetivo principal do trabalho foi propor um programa de atividades físicas adaptado para a inclusão de estudantes grávidas na aula de Educação Física, na unidade educacional fiscal “Pichincha”. Foi proposta uma metodologia com abordagem qualitativa, foram utilizados observação científica, entrevista, levantamento e revisão documental como métodos empíricos que facilitaram a identificação do problema na parte inicial até a realização da proposta de exercícios físicos adaptados, em sua etapa final. . Conclui com a aplicação e execução de atividades físicas adaptadas, obtendo-se melhorias na saúde cardiovascular, fortalecimento de músculos e articulações, controle do ganho de peso, redução do risco de complicações na gravidez e melhora do bem-estar emocional. Esses resultados foram comparados com pesquisas de outros autores que corroboram que a implementação de atividades físicas adaptadas contribui para melhorar a saúde da mãe e do feto.

RESUMEN El presente estudio investigativo abordó el tema de la inclusión de las gestantes adolescentes en las clases de Educación Física, enfocado al mejoramiento de la salud física y el bienestar de la madre y el feto durante el embarazo. El objetivo principal del trabajo fue proponer un programa de actividades físicas adaptadas para la inclusión de estudiantes en estado de gestación en la clase de Educación Física, en la Unidad educativa fiscal “Pichincha”. Se planteó una metodología con enfoque cualitativo, se utilizaron como métodos empíricos la observación científica, la entrevista, la encuesta y la revisión documental que facilitaron la identificación del problema en la parte inicial hasta la realización de la propuesta de ejercicios físicos adaptados, en su etapa final. Se concluye con la aplicación y ejecución de actividades físicas adaptadas, y se obtienen mejoras en la salud cardiovascular, el fortalecimiento de los músculos y las articulaciones, el control del aumento de peso, la reducción del riesgo de complicaciones del embarazo y la mejora del bienestar emocional. Estos resultados fueron comparados con investigaciones de otros autores que corroboran que implementar actividades físicas adaptadas contribuye al mejoramiento de la salud, tanto de la madre como del feto.

Resumen El embarazo ectópico se considera un problema de salud pública a nivel mundial, se hizo una investigación con el objetivo de establecer los fundamentos acerca del embarazo ectópico y las políticas de salud que se requieren para su mitigación. Esta revisión bibliográfica integrativa incluyó diversos textos, artículos, materiales impresos y digitales relacionados con el embarazo ectópico, consultando además en las bases de datos y directorios: SciELO, LILACS, Latindex, Medline; el proceso se realizó mediante el uso de palabras clave en español, quedando seleccionados 18 artículos publicados entre 1990 y 2023. Desde un enfoque histórico social del embarazo ectópico, se determinó que de la toma de decisiones clínicas oportunas, depende el diagnóstico temprano de esa patología; así como de la identificación de factores de riesgo y la actuación pertinente en consecuencia.

Abstract Ectopic pregnancy is considered a public health problem worldwide. This research aimed to establish the foundations of ectopic pregnancy and the health policies required for its mitigation. This bibliographic review included various texts, articles, printed and digital materials related to ectopic pregnancy, consulting databases and directories such as SciELO, LILACS, Latindex, and Medline; through the use of keywords in Spanish, 18 articles published between 1990 and 2023 were selected. Based on a social-historical approach to ectopic pregnancy, it was determined that timely clinical decision-making depends on the early diagnosis of this pathology, the identification of risk factors, and the relevant action accordingly.

RESUMEN Introducción: Las patologías tiroideas se encuentran entre los trastornos endocrinológicos más frecuentes reportados durante el embarazo, en parte debido a los cambios fisiológicos que ocurren generalmente en el primer trimestre y que puede llevar a la pérdida de este. Objetivo: El objetivo fue determinar la prevalencia de hipotiroidismo en mujeres con diagnóstico de aborto espontaneo en el Hospital Distrital de Presidente Franco durante el periodo 2019 a 2021. Materiales y Métodos: Estudio observacional, descriptivo, retrospectivo de corte transversal con muestreo no probabilístico de casos consecutivos, se estudiaron a todas las mujeres que tuvieron aborto espontáneo en el hospital distrital de presidente franco durante los años 2019 a 2021. Se utilizo el software estadístico Stata®12.0 para los cálculos estadísticos. Resultados: Se estudiaron a 432 mujeres que tuvieron abortos espontáneos. En dicho periodo se registró una prevalencia de 3,9%, la mayoría con hipotiroidismo subclínico con un 3,4%. El 52,9% en las edades comprendidas entre 20 a 35 años, 52,9% presentaron unión libre y 47% escolaridad primaria. El 52,9% proceden de zonas urbanas. Conclusión: Se determinó que aquellas perdidas de embarazo relacionado a hipotiroidismo corresponden con mayor frecuencia a Alto Paraná comparado con otra región de nuestro país y a nivel internacional. Además, se encontró el hipotiroidismo subclínico con mayormente en adultos jóvenes, con nivel de escolaridad primaria, la mayoría proveniente de zona rural.

ABSTRACT Introduction: Thyroid pathologies are among the most common endocrinological disorders reported during pregnancy, partly due to the physiological changes that typically occur in the first trimester, which can lead to pregnancy loss. Objective: determine the prevalence of hypothyroidism in women diagnosed with spontaneous abortion at the Hospital Distrital de Presidente Franco from 2019 to 2021. Materials and Methods: This observational, descriptive, retrospective, cross-sectional study utilized non-probabilistic sampling of consecutive cases, examining all women who experienced spontaneous abortion at the Hospital Distrital de Presidente Franco during the years 2019 to 2021. Stata®12.0 statistical software was employed for statistical calculations. Results: A total of 432 women who had miscarriages were analyzed. During this period, a prevalence of 3.9% was recorded, with most cases being subclinical hypothyroidism (3.4%). Among these, 52.9% of the 20-35 age group were in a common-law union, and 47% had completed primary school. Additionally, 52.9% were from urban areas. Conclusion: Those pregnancy losses related to hypothyroidism were determined to correspond more frequently in Alto Paraná compared to other regions of our country and internationally. Also, subclinical hypothyroidism was found in young adults, with primary schooling, most of them coming from rural areas.

Resumen En este artículo se analiza el Programa de Retención Escolar de Alumnas/os Madres, Padres y Embarazadas que funciona en la Ciudad de Buenos Aires (Argentina) desde 1999. Específicamente, se indaga en el período comprendido entre 2001 y 2008, cuando se formalizó en un programa de la Secretaría de Educación de la Ciudad. Desde un enfoque cualitativo y a partir de un estudio en casos, se analizan las potencialidades, las limitaciones, los desafíos y los alcances que tuvo, en este período en particular, para garantizar el derecho a la educación.

Abstract This article analyzes the School Retention Program for Pregnant and Parenting Students that has been operating in the City of Buenos Aires (Argentina) since 1999. Specifically, it investigates the period 2001-2008, when it was formalized as a Buenos Aires Secretary of Education program. Following a qualitative approach and on the basis of case studies, we analize the potentialities, limitations, challenges and effects of this particular period to guarantee the right to education.

ABSTRACT Introduction/framework/objectives The legislation gives the possibility for pregnant women with jobs where there are night shifts, to avoid doing them during this stage. However, sometimes the workers themselves question whether this has concrete scientific validity and what this could entail for themselves and their descendants. Not being a topic with much published literature, this review allows to consult a summary of the most up-to-date records at this level, in order to make assertive and scientific decisions regarding conditioning, as well as whether these should be mandatory or optional. Methodology This is a Bibliographic Review, initiated through a search carried out in May 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Content Night shifts during pregnancy may be associated with greater family-work conflict, tiredness and sleep disturbance; as well as cancers, weight gain, diabetes, high blood pressure and other cardiovascular diseases; in addition to preterm delivery, low birth weight and congenital anomalies. Discussion and Conclusions Night shifts during pregnancy, especially if numerous and/or consecutive, seem to allow for some alterations, whose pathophysiology is reasonably explained/theorized. However, the probability and eventual severity of these issues must be considered by the pregnant woman herself, so that she (duly informed with regard to current medical knowledge on the subject) choose whether she wishes to continue to do some night shifts and, if so, how; since anxiety and disruption of routines can also be harmful, especially on an emotional and/or economic level (more prominently in companies where the pregnant woman has empathy with the tasks, the work team and/or I have a shared transport). It should be decided on a case-by-case basis, as a team, taking into account pregnant´s opinion. It would be interesting for professionals working in a hospital environment, in an institution that has Obstetric service, to focus a little on the topic, portraying the national reality and publishing their research in a magazine in the area, to disseminate knowledge. and national level, with international extrapolation.

RESUMO Introdução/enquadramento/objetivos A legislação consagra a possibilidade de as grávidas com postos de trabalho em que existam turnos noturnos, os evitem durante esta etapa. Contudo, por vezes, as próprias trabalhadoras questionam a validade científica concreta dessa medida e o que isso poderá acarretar para si e para a descendência. Não sendo um tema com muita bibliografia publicada, esta revisão permite consultar uma síntese do que mais atualizado se registou a este nível, de forma a se tomarem decisões assertivas e científicas em relação a condicionamentos, bem como se estes devem ser obrigatórios ou opcionais. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em maio de 2023, nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo Os turnos noturnos durante a gravidez poderão associar-se a maior conflito família-trabalho, cansaço e perturbação do sono; bem como cancros, aumento de peso, diabetes, hipertensão arterial e outras doenças cardiovasculares; para além de parto pré-termo, baixo peso ao nascer e anomalias congénitas. Discussão e Conclusões Os turnos noturnos durante a gravidez, sobretudo se numerosos e/ou seguidos, parecem possibilitar algumas alterações, cuja fisiopatologia se encontra razoavelmente explicitada/teorizada. Contudo, a probabilidade e eventual gravidade dessas questões devem ser ponderadas pela própria grávida (devidamente informada relativamente aos conhecimentos médicos atuais), para que possa optar se deseja continuar a fazer alguns turnos noturnos e, em caso positivo, de que forma; uma vez que a ansiedade e perturbação de rotinas pode ser também perniciosa, sobretudo a nível emocional e/ou económico (com maior destaque em empresas onde a grávida tenha empatia com as tarefas e com a equipa de trabalho e/ou tenha meio de transporte partilhado). Caberá decidir caso a caso, em equipa, considerando a opinião da própria. Seria aliciante que profissionais a exercer em ambiente hospitalar, em instituição que tenha serviço de Obstetrícia, se debruçassem um pouco sobre o tema, retratando a realidade nacional e publicando a sua investigação em revista da área, para difusão de conhecimentos e nível nacional, com extrapolação internacional.

Abstract Background: Kidney transplantation (KT) improves quality of life, including fertility recovery. Objective: to describe outcomes of post-KT pregnancy and long-term patient and graft survival compared to a matched control group of female KT recipients who did not conceive. Methods: retrospective single-center case-control study with female KT recipients from 1977 to 2016, followed-up until 2019. Results: there were 1,253 female KT patients of childbearing age in the study period: 78 (6.2%) pregnant women (cases), with a total of 97 gestations. The median time from KT to conception was 53.0 (21.5 – 91.0) months. Abortion rate was 41% (spontaneous 21.6%, therapeutic 19.6%), preterm delivery, 32%, and at term delivery, 24%. Pre-eclampsia (PE) occurred in 42% of pregnancies that reached at least 20 weeks. The presence of 2 or more risk factors for poor pregnancy outcomes was significantly associated with abortions [OR 3.33 (95%CI 1.43 – 7.75), p = 0.007] and with kidney graft loss in 2 years. The matched control group of 78 female KT patients was comparable on baseline creatinine [1.2 (1.0 – 1.5) mg/dL in both groups, p = 0.95] and urine protein-to-creatinine ratio (UPCR) [0.27 (0.15 – 0.44) vs. 0.24 (0.02 – 0.30), p = 0.06]. Graft survival was higher in cases than in controls in 5 years (85.6% vs 71.5%, p = 0.012) and 10 years (71.9% vs 55.0%, p = 0.012) of follow-up. Conclusion: pregnancy can be successful after KT, but there are high rates of abortions and preterm deliveries. Pre-conception counseling is necessary, and should include ethical aspects. Background (KT life recovery Objective postKT post longterm long conceive Methods singlecenter single center casecontrol case 197 2016 followedup followed up 2019 Results 1253 1 253 1,25 period 7 6.2% 62 6 (6.2% cases, , (cases) 9 gestations 530 53 0 53. 21.5 215 21 (21. 91.0 910 91 months 41 spontaneous 216 21.6% 19.6%, 196 19.6% 19 19.6%) delivery 32 32% 24 24% Preeclampsia Pre eclampsia PE (PE 42 weeks OR 333 3 33 3.3 95%CI 95CI CI 95 143 43 1.4 7.75, 775 7.75 75 7.75) 0.007 0007 007 1.2 12 [1. 1.0 (1. 1.5 15 mgdL mg dL groups 0.95 095 proteintocreatinine protein UPCR (UPCR 0.27 027 27 [0.2 0.15 015 (0.1 0.44 044 44 024 0.2 0.02 002 02 (0.0 0.30, 030 0.30 30 0.30) 0.06. 006 0.06 . 06 0.06] 85.6% 856 85 (85.6 715 71 71.5% 0.012 0012 012 71.9% 719 (71.9 550 55 55.0% followup. followup follow up. follow-up Conclusion deliveries Preconception necessary aspects 201 125 25 1,2 6.2 (6.2 (cases 21. (21 91. 4 21.6 19.6 3. 14 1. 77 7.7 0.00 000 00 [1 (1 0.9 09 [0. 0.1 01 (0. 0.4 04 0. 0.0 03 0.3 85.6 8 (85. 71.5 0.01 001 71.9 (71. 55.0 1, 6. (6. (2 19. 7. [ ( [0 (0 85. (85 71. (71 55. (6 (8 (7

Resumo Histórico: Transplante renal (TR) melhora qualidade de vida, incluindo recuperação da fertilidade. Objetivo: descrever desfechos gestacionais pós-TR e sobrevida de longo prazo da paciente e do enxerto renal comparada a um grupo controle pareado de receptoras de TR que não conceberam. Métodos: estudo retrospectivo caso-controle com receptoras de TR de 1977 a 2016, acompanhadas até 2019. Resultados: foram identificadas 1.253 receptoras de TR em idade fértil no período do estudo: 78 (6,2%) gestantes (casos), total de 97 gestações. Tempo mediano entre TR até concepção foi 53,0 (21,5 – 91,0) meses. Taxa de aborto foi 41% (espontâneo 21,6%, terapêutico 19,6%), parto prematuro, 32%, e a termo, 24%. Pré-eclâmpsia (PE) ocorreu em 42% das gestações que alcançaram pelo menos 20 semanas. Presença de 2 ou mais fatores de risco para desfechos gestacionais desfavoráveis foi significativamente associada a abortos [OR 3,33 (IC95% 1,43 – 7,75), p = 0,007] e perda de enxerto renal em 2 anos. O grupo controle de 78 mulheres com TR foi comparável na creatinina basal [1,2 (1,0 – 1,5) mg/dL nos dois grupos, p = 0,95] e na relação proteína/creatinina urinária (RPCU) [0,27 (0,15 – 0,44) vs. 0,24 (0,02 – 0,30), p = 0,06]. Sobrevida do enxerto foi maior nos casos que nos controles em 5 anos (85,6% vs. 71,5%, p = 0,012) e 10 anos (71,9% vs. 55,0%, p = 0,012) de acompanhamento. Conclusão: a gestação pode ser bem-sucedida após TR, mas existem altas taxas de abortos e partos prematuros. Aconselhamento pré-concepção é necessário e deve incluir aspectos éticos. Histórico (TR vida fertilidade Objetivo pósTR pós conceberam Métodos casocontrole caso 197 2016 2019 Resultados 1253 1 253 1.25 7 6,2% 62 6 (6,2% casos, , (casos) 9 530 53 0 53, 21,5 215 21 (21, 91,0 910 91 meses 41 espontâneo 216 21,6% 19,6%, 196 19,6% 19 19,6%) prematuro 32 32% termo 24 24% Préeclâmpsia Pré eclâmpsia PE (PE 42 semanas OR 333 3 33 3,3 IC95% IC95 IC (IC95 143 43 1,4 7,75, 775 7,75 75 7,75) 0,007 0007 007 1,2 12 [1, 1,0 (1, 1,5 15 mgdL mg dL grupos 0,95 095 95 proteínacreatinina proteína RPCU (RPCU 0,27 027 27 [0,2 0,15 015 (0,1 0,44 044 44 vs 024 0,2 0,02 002 02 (0,0 0,30, 030 0,30 30 0,30) 0,06. 006 0,06 . 06 0,06] 85,6% 856 85 (85,6 715 71 71,5% 0,012 0012 012 71,9% 719 (71,9 550 55 55,0% acompanhamento Conclusão bemsucedida bem sucedida prematuros préconcepção pré éticos 201 125 25 1.2 6,2 (6,2 (casos 21, (21 91, 4 21,6 19,6 3, IC9 (IC9 14 1, 77 7,7 0,00 000 00 [1 (1 0,9 09 [0, 0,1 01 (0, 0,4 04 0, 0,0 03 0,3 85,6 8 (85, 71,5 0,01 001 71,9 (71, 55,0 1. 6, (6, (2 19, (IC 7, [ ( [0 (0 85, (85 71, (71 55, (6 (8 (7