Julio Elito Jr.

By Julio Elito Junior

Part of the book: Ectopic Pregnancy

By Julio Elito Júnior, Eduardo Félix Martins Santana and Gustavo Nardini Cecchino

Part of the book: Contemporary Gynecologic Practice

By Julio Elito Jr

Part of the book: Non-tubal Ectopic Pregnancy

By Julio Elito Jr and Micheli Goldani Shuai

The use of corticosteroids is one of the most important therapies used in prenatal care to improve the outcomes of the newborn by reducing the rates of respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis and contribute to the survival of extreme preterm infants. In addition to steroids, the use of magnesium sulfate protects the newborn from cerebral palsy in cases of extreme preterm births. All of these conditions increase perinatal morbidity/mortality and are related to potentially serious illness in the newborn requiring care in neonatal intensive units. The use of corticosteroids and magnesium sulfate are measured to prevent unfavorable outcomes of premature newborns admitted to a neonatal intensive care unit. The incidence of twin pregnancy is only 3% of all live births, however, it accounts for 15% of extreme preterm births less than 32 weeks. Women with multiple pregnancies are six times more likely to terminate the pregnancy before term compared to single pregnancies. The determination of the use of corticosteroids in multiple pregnancies remains conflicting due to the scarcity of studies related to this group. Therefore, this chapter aims to evaluate the effectiveness of the use of corticosteroids in twin pregnancies in early and late preterm, evaluating its outcome in respiratory morbidity and metabolic aspects of the newborn.

Part of the book: Topics on Critical Issues in Neonatal Care

By Julio Elito Jr.

Part of the book: Current Challenges in Childbirth

By Julio Elito Jr. and Jorge Francisco Kuhn dos Santos

Childbirth is one of the most important moments in life. Delivery assistance is a major challenge today. Safety in childbirth care to avoid maternal-fetal morbidity and mortality is especially important. It is vital to avoid, on the one hand, the excess of medicalization with early and unnecessary interventions and, on the other hand, the lack of care that can lead to a delay in decision-making. In this delicate balance, it is also important to consider the expectation of the parturient with her desires related to how the birth she idealized will happen. Respecting her wishes without putting the maternal-fetal unity at risk is a great challenge for the obstetrician. It is important to avoid interventions as fundal pressure, routine episiotomy and the excess of unnecessary caesarean section. Cultural, socio-economical aspects and choosing the delivery mode are part of a big puzzle. This chapter aims to assess the best childbirth care among the scientific evidence and will cover the following topics: first stage of labor (differentiating latent from active phase), progression of the first and second stages of labor, pain relief during labor, prevention of postpartum hemorrhage, care of the newborn, and the puerperal woman.

Part of the book: Current Challenges in Childbirth