Julio Elito Júnior

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

By Lucas Almeida das Chagas, Rosângela Maria Lopes de Sousa, Rosiane Mattar, Julio Elito Júnior and Edward Araujo Júnior

Based on the understanding of the complexity of gestational diabetes mellitus (GDM) and the various factors associated with the disease’s onset, including the type of diet consumed, this chapter aims to assess the relationship between the role of diet and the risk of women developing GDM. GDM is defined as any degree of carbohydrate intolerance of varying severity, diagnosed for the first time during pregnancy, which does not meet the diagnostic criteria for pre-existing diabetes, and which may or may not persist after delivery. The etiology of this condition is not fully understood, but the diagnosis of GDM is fundamental to the prevention of complications for both mother and child. Currently, the gold standard for diagnosing GDM is the oral glucose tolerance test (OGTT), which should be performed between 24 and 28 weeks of pregnancy. Because of the high prevalence of GDM and its associated complications, it is imperative that pregnant women modify their eating habits and engage in regular physical activity to prevent the adverse effects of hyperglycemia. Lifestyle changes combined with dietary interventions such as the inclusion of fruits, vegetables, and complex carbohydrates rich in fiber should be followed to improve glycemic control and prevent the adverse effects of hyperglycemia during pregnancy.

Part of the book: Women's Health Updates