{"id":1634,"date":"2024-02-29T10:39:31","date_gmt":"2024-02-29T13:39:31","guid":{"rendered":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/?page_id=1634"},"modified":"2024-07-10T23:10:39","modified_gmt":"2024-07-11T02:10:39","slug":"pagina-12-seguimento-laboritorial","status":"publish","type":"page","link":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/pagina-12-seguimento-laboritorial","title":{"rendered":"P\u00e1gina 12 – Seguimento Laboritorial"},"content":{"rendered":"\t\t
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SEGUIMENTO LABORATORIAL E OBST\u00c9TRICO GVHIV<\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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A <\/span>abordagem laboratorial<\/b> no in\u00edcio do acompanhamento <\/span>cl\u00ednico-obst\u00e9trico<\/b> de gestantes vivendo com HIV tem como objetivo <\/span>avaliar a condi\u00e7\u00e3o geral de sa\u00fade<\/b> da mulher e i<\/span>dentificar o status da infec\u00e7\u00e3o<\/b> pelo HIV (situa\u00e7\u00e3o imunol\u00f3gica e virol\u00f3gica inicial), a <\/span>presen\u00e7a de comorbidades<\/b> e a exist\u00eancia de <\/span>fatores que possam interferir<\/b> na evolu\u00e7\u00e3o da gravidez.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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O n\u00edvel da CV-HIV<\/span> \u00e9 um dos fatores <\/span>mais importantes associados ao risco de transmiss\u00e3o vertical<\/span> do HIV e auxilia no seguimento <\/span>e na defini\u00e7\u00e3o da via de parto<\/span>.\u00a0<\/span><\/p>

\u00a0<\/p>

– <\/span>Indica\u00e7\u00e3o da via de parto em gestantes vivendo com HIV\/aids<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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<\/span><\/span><\/span><\/span>Vale refor\u00e7ar a recomenda\u00e7\u00e3o de que o parto vaginal \u00e9 a <\/span>via de escolha <\/span>nas gestantes com CV-HIV menor que 1.000 c\u00f3pias\/mL a partir da 34\u00aa semana.\u00a0<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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\u00a0<\/p>

Se n\u00e3o houver indica\u00e7\u00e3o obst\u00e9trica, n\u00e3o se recomenda realizar cesariana eletiva em gestante com CV-HIV abaixo de 1.000 c\u00f3pias\/mL para prevenir TV-HIV.<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Fluxograma quanto \u00e0s situa\u00e7\u00f5es para administra\u00e7\u00e3o de AZT endovenoso profil\u00e1tico para gestante durante o parto<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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PCDT-TV p\u00e1g 108 - BRASIL- DCCI\/SVS\/MS.<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\u00a0<\/p>

Cuidados espec\u00edficos durante o parto vaginal e cesariana em gestantes vivendo\u00a0 com HIV\/AIDS<\/span><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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CUIDADOS ESPEC\u00cdFICOS DURANTE O PARTO VAGINAL<\/b><\/span><\/td><\/tr>
Assim como na gesta\u00e7\u00e3o, <\/span>est\u00e3o contra indicados todos os procedimentos invasivos durante o trabalho de parto<\/span> (amniocentese, cordocentese, amniotomia precoce e monitoriza\u00e7\u00e3o fetal invasiva durante o trabalho de parto). <\/span><\/span><\/td><\/tr>
O parto instrumentalizado deve ser evitado<\/span>;<\/span><\/span><\/td><\/tr>
Para o monitoramento do trabalho de parto, deve-se <\/span>evitar toques desnecess\u00e1rios e repetidos (usar o partograma). <\/span><\/span><\/td><\/tr>
Em condi\u00e7\u00f5es e indica\u00e7\u00e3o para o parto vaginal , <\/span>iniciar o AZT\u00a0 endovenoso logo que a parturiente chegar ao servi\u00e7o em trabalho de parto<\/span>, conforme o protocolo ,e <\/span>manter a infus\u00e3o at\u00e9 a ligadura do cord\u00e3o umbilical<\/span>.<\/span><\/span><\/td><\/tr>
Diante da integridade da bolsa amni\u00f3tica, a progress\u00e3o normal do trabalho de parto \u00e9 prefer\u00edvel \u00e0 sua indu\u00e7\u00e3o.<\/span><\/span><\/td><\/tr>
Evitar que as parturientes permane\u00e7am com bolsa rota por tempo prolongado,<\/span> visto que a taxa de TV aumenta progressivamente ap\u00f3s 4 (quatro) horas de bolsa rota.<\/span><\/span><\/td><\/tr>
A amniotomia artificial deve ser evitada.<\/span><\/span><\/td><\/tr>
A ligadura do cord\u00e3o umbilical deve ser imediata \u00e0 expuls\u00e3o do feto<\/span>, n\u00e3o devendo ser executada, sob nenhuma hip\u00f3tese, a ordenha do cord\u00e3o.<\/span><\/span><\/td><\/tr>

A episiotomia s\u00f3 ser\u00e1 realizada ap\u00f3s avalia\u00e7\u00e3o cautelosa de sua necessidade.\u00a0<\/span><\/p>

Sendo realizada, dever\u00e1 ser protegida por compressas umedecidas com degermante (o mesmo utilizado para degermar a vagina e o per\u00edneo durante o parto). Manter a episiotomia coberta pela compressa umedecida.<\/span><\/p><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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CUIDADOS ESPEC\u00cdFICOS DURANTE A CESARIANA ELETIVA<\/strong><\/td><\/tr>
A ces\u00e1rea eletiva deve ser realizada a partir da 38\u00aa semana de gesta\u00e7\u00e3o<\/b>, a fim de evitar a prematuridade, o trabalho de parto e a RPM.<\/td><\/tr>
Caso a <\/span>gestante que tenha indica\u00e7\u00e3o para a ces\u00e1rea eletiva<\/strong> inicie o <\/span>trabalho de parto antes da data prevista<\/strong> para a cirurgia e chegue \u00e0 maternidade com <\/span>dilata\u00e7\u00e3o cervical m\u00ednima <\/strong>(menor que 4cm), o obstetra deve iniciar a infus\u00e3o <\/span>endovenosa do AZT <\/strong>e realizar a <\/span>ces\u00e1rea, se poss\u00edvel, ap\u00f3s tr\u00eas horas de infus\u00e3o<\/strong>.<\/span><\/td><\/tr>
\u00a0Sempre que poss\u00edvel, proceder ao parto empelicado<\/b>.<\/td><\/tr>
Ligar o cord\u00e3o umbilical imediatamente ap\u00f3s a retirada do RN e n\u00e3o realizar ordenha do cord\u00e3o. <\/span><\/td><\/tr>
Realizar a c<\/span>ompleta hemostasia<\/strong> de todos os vasos da parede abdominal e a troca das compressas ou campos secund\u00e1rios antes de executar a histerotomia, minimizando o contato posterior do RN com sangue materno.<\/span><\/td><\/tr>
Utilizar antibi\u00f3tico profil\u00e1tico <\/strong>tanto na ces\u00e1rea eletiva quanto na de urg\u00eancia: dose \u00fanica EV de 2g de cefazolina.<\/span><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t<\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\tP\u00e1gina Inicial<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t<\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\tDiagn\u00f3stico<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t<\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\tTratamento<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\tSeguimento<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t<\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\tTabela de Siglas e Abreviaturas<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\"\"\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

SEGUIMENTO LABORATORIAL E OBST\u00c9TRICO GVHIV A abordagem laboratorial no in\u00edcio do acompanhamento cl\u00ednico-obst\u00e9trico de gestantes vivendo com HIV tem como objetivo avaliar a condi\u00e7\u00e3o geral de sa\u00fade da mulher e identificar o status da infec\u00e7\u00e3o pelo HIV (situa\u00e7\u00e3o imunol\u00f3gica e virol\u00f3gica inicial), a presen\u00e7a de comorbidades e a exist\u00eancia de fatores que possam interferir na […]<\/p>\n","protected":false},"author":6761,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[92],"tags":[],"class_list":["post-1634","page","type-page","status-publish","hentry","category-hiv-novo"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/pages\/1634","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/users\/6761"}],"replies":[{"embeddable":true,"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/comments?post=1634"}],"version-history":[{"count":0,"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/pages\/1634\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/media?parent=1634"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/categories?post=1634"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.ufsm.br\/pet\/ciencia-da-computacao\/wp-json\/wp\/v2\/tags?post=1634"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}