CONTEXT AND OBJECTIVE: Even if precursor lesions of cervical cancer are properly treated, there is a risk of persistence or recurrence. The aim here was to quantify the risks of persistence of high-grade intraepithelial squamous lesions, one and two years after cervical electrosurgical excisional treatment with positive margins. CONCLUSÃO: Esta metanálise confirma a importância de margem comprometida como indicador de tratamento incompleto no primeiro ano e ressalta a necessidade de uma adequada escolha da técnica eletrocirúr-gica em função da localização e extensão da doença e um acompanhamento adequado dessas pacientes.

Introduction: The pre and post-HIV test counseling is recommended by the Ministry of Health, and is a tool for reflection and joint decision-making. Objectives: To determine the proportion of women receiving counseling for submission to the HIV rapid test and to assess factors associated to not receiving counseling for this test. Method: A cross-sectional study was conducted in five "Baby-Friendly Hospitals" from the High Risk Pregnancy System in Rio de Janeiro City, Southeast Brazil. The study population were 955 rooming-in parturients, undergoing the HIV rapid test, between September 11 th and December 11 th , 2006. Semi-standardized questionnaires were applied to the mothers, and data were also obtained from laboratory and health archives. Binomial regression was performed in order to analyze the variables associated with non-counseling. Results: Were submitted to the HIV rapid test 28.5% of the parturients, and only 26.9% of them were counseled. Factors associated with non-counseling were: maternal education below 8 years of school (PR = 1.36; 95% CI: 1.15-1.62), 0 to 3 prenatal visits (RP = 0.73; IC 95%: 0.59-0.90) and hospitals with less than 50% of the parturients submitted to the HIV rapid test (PR = 1.65; 95% CI: 1.40-1.96). Conclusion: Socially underprivileged women were not a target of counseling, and only the low number of prenatal visits proved to be a protective factor against non-counseling. Counseling was seldom practiced for HIV rapid testing, indicating that this test has been performed without the consent of women, in an imperative way.

breastfeeding, anthropometric measurements, social and family information. The proportion of breastfeeding during follow-up was calculated. Survival analysis was conducted to estimate breastfeeding duration. In total, 242 of the 258 infants (93.7%) returned to follow-up; 170 (69.9%) at 6 months and 139 (57.2%) at 12 months (adjusted age). A history of miscarriages (27.5%), stillbirths (11.7%), neonatal deaths (9.5%) and preterm births (21.1%) was noted in 65.5% of women. At hospital discharge: 5.5% received exclusive breastfeeding, 65.8% breastfeeding and formula, 28.6% formula. At month 1, 81.3% received breastfeeding, decreasing to 68.5% at month 2, 62.4% at month 3, 48.1% at month 4 and 22.4% at month 6 (adjusted age). The median of breastfeeding duration was 4 months. Breastfeeding occurred up to four months adjusted age in almost half of the population. Despite the need to improve these rates, the results could reflect the profile of the Child-Friendly Hospital Initiative Unit. Maintaining breastfeeding amongst preterm infants following hospital discharge is still a challenge, for both mothers and health professionals.

ABSTRACT

OBJECTIVE: To analyze mortality and associated factors in a series of gastroschisis at birth in the state of Rio de Janeiro in a 10-year period (2005 to 2014). METHOD: A retrospective cohort study, which related the databases of the Live Births Information System and the Mortality Information System by probabilistic linkage. Final database was constructed in two stages: preparation of the two initial databases and establishment of relationships between them. RESULTS: Preterm newborns and those with low birthweight had higher risk of death, with statistical significance (p = 0.03 and p = 0.006, respectively). Regarding place of birth, although death frequency was higher in maternity units than in general hospitals (p = 0.04; OR = 0.5; 95%CI 0.3–1.0), it was observed that a unit characterized as a general hospital had a high birth frequency (61.2%). Furthermore, the comparative analysis of the risk of death between this unit and others showed a 7.5 higher risk of death in general hospitals and 3.2 higher in maternity units, with statistical significance (p < 0.001). Moreover, births in level II intensive care units had 3.9 times more risk of death compared with level III (p < 0.001). CONCLUSION: This study foments the discussion of two possible strategies in the treatment of gastroschisis in newborns. First, the centralization of care in tertiary units, enabling malformation care to be analyzed in a more detailed and standardized manner. Second, and perhaps more feasible, the elaboration of clinical guidelines to standardize immediate care for gastroschisis in babies born outside tertiary centers, as well as the standardization of their transportation until arrival at the tertiary center.