Utilização da linha púrpura como método diagnóstico da dilatação cervical e altura da apresentação fetal em gestantes em trabalho de parto

• Autor(a) principal: Nunes, Rodrigo Dias
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Universitário da Ânima (RUNA)
• Texto Completo: https://repositorio.animaeducacao.com.br/handle/ANIMA/3023
• topic: Trabalho de parto; Dilatação cervical; Apresentação fetal; Diagnóstico

Background: The vaginal exam is the main choice for monitoring labor, and may be associated to complications when performed excessively. The purple line has been described as an alternative method for this follow-up. Objective: To determine if the purple line can be used to estimate the progression of labor. Method: This is a prospective cohort study associated with analysis of accuracy, involving 220 patients, from August 2016 to May 2017. The patients were submitted to the observation and measurement of the purple line at the time of the vaginal exam. The associations between population characteristics and the appearance of the purple line in the sacral region, with significance level p <0.05, were studied through Poisson regression. The presence of the purple line was evaluated in relation to the evolution of labor. Pearson's correlation analysis and accuracy tests were performed between the measurements of the purple line and the cervical dilatation and the height of the fetal presentation. Results: There were 708 evaluations of the line, being present in 490 opportunities, among 189 patients, with incidence of 85.91% (CI 95% 81.30; 90.52). The purple line showed a 1.12 times higher incidence (CI 95% 1.02; 1.23) in white women (p=0.023), and 1.15 times higher (1.01; 1.32) in patients with premature rupture of membranes (p=0.042). The presence of the purple line increased 1.85 times (CI 95% 1.29; 2.67) the incidence of vaginal delivery (p < 0.001). There was positive correlation between line size and cervical dilation (r=0,893) and fetal height (r=0,681), with mean diagnostic accuracy of 23.05% and 8.21%, respectively. Conclusions: The purple line had a higher incidence in white women and in those with premature rupture of membranes, besides that, its presence increased the incidence of an adequate evolution of labor. The line presented a positive correlation with the parameters of labor progression, but it could not be used, routinely, to replace the vaginal exam, due to its low accuracy.