Psychological pregnancy, also called pseudogenesis or pseudoseis, is a picture in which the woman has the same symptoms of pregnancy, although she is not pregnant. Thus, absence of menstruation, nausea, belly growth, and even darkening of the nipples, breast growth and milk production; may occur. This picture is usually related to the great fear of not becoming pregnant, or on the contrary: the extreme desire to be a mother. In many situations, it occurs when the woman faces successive attempts to get pregnant, but without success. Thus, it can somatize this desire, presenting an organic, behavioral and also of sensations, just as if it were pregnant.
Such a situation can be a great inconvenience for the woman, the supposed future father, family and friends; when they realize that it is not a real picture – especially if the woman refuses to accept reality. Thus, support and affection are paramount, especially the companion. It is also important to work with her the idea of consulting with a psychologist, as a way of not extending this pregnancy for a long time, under the risk of maintaining it until the moment of delivery, and can be a very traumatic and suffered situation . In addition, therapy may be important in ascertaining whether pseudo-cystic is related to some other psychological problem. In extreme cases, hormonal treatment may be necessary to induce menstruation and in situations that include other psychological disorders, such as depression, the use of other drugs may be necessary. The simplest way to detect it is through the HCG examination, since only truly pregnant women have a positive result. Psychological, sexual and social-environmental trauma can also be related to pseudogestation. Some experts further suggest that this condition may indicate polycystic ovarian syndrome, tumors or cancer of the uterus, and ovarian and hormonal disorders. The pregnancy is an extremely remarkable period and dreamed of a large number of women. There are nine months of anguish, doubts and also happiness and new discoveries. The gestation ends with the delivery, an extremely delicate moment characterized by the expulsion of the fetus and also the embryonic attachments.
The delivery, being the most important moment of all pregnancy, must be preceded by a very meticulous prenatal. Knowing the baby’s developmental conditions is essential to know how birth can be conducted. There are two main types of delivery: the normal one , in which we have the natural way of giving birth, and the cesarean section, where a cut is made in the abdomen for the withdrawal of the baby. The first type, despite being the healthiest mode of delivery for not involving surgical procedure, is not always the first option of the pregnant woman. This is due to the fact that, when scheduling the delivery, doctors and mothers ensure greater convenience, in addition to avoiding the long hours of waiting for a normal delivery. However, although it seems the most adequate way to perform the delivery, the scheduling of the cesarean section is discouraged by the World Health Organization (WHO), mainly because it often causes premature birth. It is estimated that 40% of all deliveries in our country are Caesarean. If we analyze only the private network, the cesarean section represents 80% of deliveries. It is important to note that the WHO recommends that cesarean sections should not represent more than 15% of birth forms in a country.
According to the WHO, cesarean section is an emergency surgery and should be treated as such , so it is unnecessary to perform this procedure when the pregnancy is not at risk or the woman does not present serious health problems. Several studies report that normal delivery is much safer than cesareans, which have a relatively high number of maternal and infant deaths. Among the main risks, we can mention the infections, hemorrhages and complications from anesthesia. In addition, children born with normal labor usually have fewer cases of respiratory, autoimmune and even obesity. However, it is not always possible to perform a normal delivery, at which time a surgical intervention is necessary. Among the main problems that may indicate a cesarean section, we can highlight the baby “seated”, placenta previa, rupture uterine and early detachment of the placenta. A childbirth model that is gaining momentum throughout the world is the humanized one . This type of delivery makes the time of birth as welcoming as possible, allowing the woman to choose the position at the time of delivery and the people who will be with her at that time. In addition, the minimum possible medical intervention is prioritized. Through this way of giving birth, the mother’s first contact with the newborn occurs more quickly.
In humanized childbirth, the presence of the doula, a person responsible for indicating ways to alleviate pain, is also common, as well as ensuring greater emotional support for the pregnant woman and the father of the child. Although the presence of this person is very important for some pregnant women, it is not all maternities that allow them to enter. Another important point about humanized childbirth concerns the presence of doctors. This measure is necessary, although there are few interventions, to guarantee a safe and uncomplicated delivery for the mother. Childbirth is a special moment in the life of a couple and therefore must be carried out respecting the needs and wants of each individual. Listening to the mother at this time ensures that experience is as traumatic as possible and that is why there is a growing demand for humanized deliveries. With the texts that are set out below, you will know a little more about births, when each type should be performed and why caesarean is still indicated, despite its risks. You will also know the different positions of labor and places that guarantee a less painful experience, such as water birth .
Gestational trophoblastic neoplasia
Gestational trophoblastic neoplasia represents a group of gestational trophoblastic diseases that have malignant potential. The trophoblastic neoplasia (NTG) is a group of gestational trophoblastic diseases include malignant potential. Among these diseases, we highlight the hydatidiform mole persistent, invasive hydatidiform mole, choriocarcinoma and trophoblastic tumor of the placental bed. The cure rate of these diseases is high and can reach up to 100% in cases where they are discovered early. Normally, NTG is preceded by a molar pregnancy, however, term pregnancy, abortion, and ectopic pregnancy can also cause it. The normal after any pregnancy is that the levels of hCG begin to decline, but in some cases, this level is maintained by the persistent growth of trophoblastic tissue. When hCG levels continue to increase after a pregnancy, it is a sign that the patient has NTG. It is worth mentioning that the trophoblastic tumor of the placental bed has different characteristics from the other NTG types. This relatively rare form has low hCG levels and its main symptom is postpartum genital hemorrhage. After the identification of a NTG, a series of analyzes is necessary to know the stage in which the disease is and to evaluate the risks. X-ray examinations, ultrasonography, CT scans and magnetic resonance imaging are performed.
The four stages of the disease are described below:
– Stage I – Disease is only in the womb;
– Stage II – Disease is located in the uterus and genitals;
– Stage III – Disease has metastases in the lung and may or may not involve the genitals;
– Stage IV – Presents other sites with metastasis, often reaching the liver and brain.
Previously, gestational trophoblastic neoplasms were treated with surgery to remove the uterine matrix, but the risks of death were very large. Nowadays, most NTGs are treated with chemotherapy , which is able to cure a large number of patients. This can be done through only one drug or with combinations, in which case it is called polychemotherapy. The choice of one or more drugs will depend on the stage of the disease and its risks. In the case of trophoblastic tumor of the placenta, chemotherapy with a single drug does not solve the problem. It is recommended, in this case, the hysterectomy (removal of the uterus) associated with polychemotherapy.
During treatment of NTG, it is important to evaluate hCG to see if levels are declining. Chemotherapy is performed until hCG is denatured and dosages are made for 1 year after the end of treatment. Therefore, it is important that during this time the woman does not become pregnant in any hypothesis, as this will influence the results of the dosage. A new pregnancy is only allowed after a year of denial . It is not possible to predict how many chemotherapies the woman will have to perform until complete cure, since each organism responds differently to therapy. This also holds true for side effects, which are felt differently by each woman. Among the most commonly reported effects are fatigue, nausea, skin blemishes and eye irritation. Remember that NTGs have a high cure rate and that many women can get pregnant normally after treatment with chemotherapy. Therefore, do not worry too much, follow your doctor’s recommendations correctly and wait for remission of the disease.
Microcephaly is an abnormality in which the child has a lower head circumference than other children of the same age. The microcephaly is a problem in that there is a reduction in head circumference, which is well below the population mean for age and sex determined. Usually are included in this diagnosis newborns with perimeter of the head less than 33 centimeters. Microcephaly may be present at birth ( congenital microcephaly ) or develop during the first years of life ( postnatal microcephaly ). The child with the anomaly may have normal weight and length or have the whole body below average for their age. When only the skull is out of normal patterns, microcephaly is called disproportionate. When, in addition to the skull, the length and weight are also below normal, we say that it is a proportional microcephaly.
→ Causes of Microcephaly
Microcephaly occurs as a consequence of genetic problems and also of other external factors. Perinatal hypoxia (decreased oxygen supplied to the fetus), exposure of the fetus to radiation, use of drugs, alcohol consumption, intrauterine malnutrition, and diseases such as maternal phenylketonuria, rubella , cytomegalovirus infection, toxoplasmosis , among others.
→ Effects of microcephaly for the baby
Microcephaly affects the normal development of the brain, but severity is related to the cause of the abnormality. Some children will have normal intelligence; others, however, may present with mental retardation and developmental delays. It is estimated that 90% of cases of microcephaly cause some degree of delay . In addition, some affected children may have problems such as motor complications, speech difficulties and seizures.
→ State of emergency in public health in 2015
In November 2015, Brazil declared a State of Emergency in Public Health after the diagnosis of 141 cases of microcephaly in Pernambuco in less than a year. These numbers are 10 times higher than those recorded in the previous year. The Ministry of Health, after several analyzes, found that there is a direct relationship between Zika and the development of microcephaly. This theory was raised because some of the mother reported the onset of body spots, itching, and fever during gestation, symptoms suggestive of zika virus infection. After the discovery, it was recommended that pregnant women take extra care and protect themselves from the Aedesaegypti mosquito , using repellents and long-sleeved clothing and pants.