Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais

Detalhes bibliográficos
Autor(a) principal: Souza, Marcella Rocha Tavares de
Data de Publicação: 2020
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/52749
Resumo: The objective was to compare obstetric and neonatal outcomes among women who used and who did not use neuraxial analgesia during labor. This is a cross-sectional, comparative and retrospective study, carried out in July 2019 to February 2020, at Maternidade Escola Assis Chateaubriand. The inclusion criteria were: women who went into labor, with a live, single and full-term fetus between 37 and 41 weeks and 6 days, in cephalic presentation. The group with neuraxial analgesia met the following criteria: patient's request, active labor, good vitality assured by the obstetrician and absence of contraindications. Both groups were excluded: elective cesarean sections, fetal malformation and medical records with incomplete information. The sample size was calculated by estimating the difference of two proportions, group 1 referring to vaginal deliveries with analgesia (73%) and group 2 to vaginal deliveries without analgesia (83%), with 130 women for each group. Data collection took place through a structured instrument developed by the researcher and consisting of socioeconomic, obstetric and neonatal data. In the statistical analysis, Student's t test, Mann-Whitney U test, Pearson's chi-square test and Fisher's exact test were used. Statistical analyzes were performed using the IBM SPSS program. Most parturients in both groups were primiparous (103; 79.23% vs 94; 72.3%; p = 0.19). The group with analgesia had a high rate of oxytocin use (57; 43.8%; p <0.001), the most used technique was the epidural (76.9%), followed by the combined spinal-epidural (11.5%) and spinal anesthesia (10.8%). The duration of active labor in the group with analgesia was 392.12 minutes and in the group without analgesia, 260.68 minutes (p <0.001). In the group with analgesia, there was a higher rate of vaginal delivery (88; 67.7%), followed by cesarean delivery (41; 31.5%) and 1 forceps delivery (0.8%). There was a higher frequency of cesarean sections in women who gave birth under analgesia (41; 31.5% vs 5; 3.8%; p <0.001). Episiotomy was more prevalent in the group with analgesia (p = 0.03), with a rate of 7.9%. There was no statistical difference between the groups regarding APGAR in the 1st and 5th minutes. The parturients under analgesia gave birth to heavier babies (p = 0.007). Most of the NBs of women from both groups were referred to the rooming-in. It was concluded that in the group with analgesia there were more interventions during labor, with a higher rate of cesarean delivery, use of oxytocin, episiotomy and longer duration of active labor and expulsion period compared to the group without neuraxial analgesia.
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spelling Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonataisAnalgesia ObstétricaEnfermagem ObstétricaPromoção da SaúdeTrabalho de PartoThe objective was to compare obstetric and neonatal outcomes among women who used and who did not use neuraxial analgesia during labor. This is a cross-sectional, comparative and retrospective study, carried out in July 2019 to February 2020, at Maternidade Escola Assis Chateaubriand. The inclusion criteria were: women who went into labor, with a live, single and full-term fetus between 37 and 41 weeks and 6 days, in cephalic presentation. The group with neuraxial analgesia met the following criteria: patient's request, active labor, good vitality assured by the obstetrician and absence of contraindications. Both groups were excluded: elective cesarean sections, fetal malformation and medical records with incomplete information. The sample size was calculated by estimating the difference of two proportions, group 1 referring to vaginal deliveries with analgesia (73%) and group 2 to vaginal deliveries without analgesia (83%), with 130 women for each group. Data collection took place through a structured instrument developed by the researcher and consisting of socioeconomic, obstetric and neonatal data. In the statistical analysis, Student's t test, Mann-Whitney U test, Pearson's chi-square test and Fisher's exact test were used. Statistical analyzes were performed using the IBM SPSS program. Most parturients in both groups were primiparous (103; 79.23% vs 94; 72.3%; p = 0.19). The group with analgesia had a high rate of oxytocin use (57; 43.8%; p <0.001), the most used technique was the epidural (76.9%), followed by the combined spinal-epidural (11.5%) and spinal anesthesia (10.8%). The duration of active labor in the group with analgesia was 392.12 minutes and in the group without analgesia, 260.68 minutes (p <0.001). In the group with analgesia, there was a higher rate of vaginal delivery (88; 67.7%), followed by cesarean delivery (41; 31.5%) and 1 forceps delivery (0.8%). There was a higher frequency of cesarean sections in women who gave birth under analgesia (41; 31.5% vs 5; 3.8%; p <0.001). Episiotomy was more prevalent in the group with analgesia (p = 0.03), with a rate of 7.9%. There was no statistical difference between the groups regarding APGAR in the 1st and 5th minutes. The parturients under analgesia gave birth to heavier babies (p = 0.007). Most of the NBs of women from both groups were referred to the rooming-in. It was concluded that in the group with analgesia there were more interventions during labor, with a higher rate of cesarean delivery, use of oxytocin, episiotomy and longer duration of active labor and expulsion period compared to the group without neuraxial analgesia.Objetivou-se comparar os desfechos obstétricos e neonatais entre mulheres que utilizaram e que não utilizaram analgesia neuroaxial durante o trabalho de parto. Trata-se de um estudo transversal, comparativo e retrospectivo, realizado em julho de 2019 a fevereiro de 2020, na Maternidade Escola Assis Chateaubriand. Os critérios de inclusão foram: mulheres que entraram em trabalho de parto, com feto vivo, único e a termo entre 37 a 41 semanas e 6 dias, em apresentação cefálica. O grupo com analgesia neuroaxial atenderam aos seguintes critérios: solicitação da paciente, trabalho de parto ativo, boa vitalidade assegurada pelo obstetra e ausência de contraindicações. Foram excluídos para ambos os grupos: cesarianas eletivas, má formação fetal e prontuários com informações incompletas. Incluiu-se no grupo com analgesia as mulheres que a utilizaram em julho de 2019 a janeiro de 2020. O tamanho da amostra foi calculado com a Estimação da diferença de duas proporções, sendo 130 mulheres para cada grupo. A coleta de dados ocorreu através de um instrumento estruturado elaborado pela pesquisadora e constituído por dados socioeconômicos, obstétricos e neonatais. Na análise estatística, utilizou-se o teste t de student, teste U de Mann-Whitney, teste de qui-quadrado de Pearson e o teste exato de Fisher. As análises estatísticas foram realizadas com programa IBM SPSS. A maioria das parturientes de ambos os grupo eram primigestas e nulíparas. O grupo com analgesia teve alta taxa de uso de ocitocina (57; 43,8%), a técnica mais utilizada foi a epidural (76,9%), em seguida da combinada raquiperidural (11,5%) e a raquianestesia (10,8%). A duração do trabalho de parto ativo no grupo com analgesia foi de 392,12 minutos e no grupo sem analgesia de 260,68 minutos. O parto vaginal foi mais prevalente no grupo com analgesia (88; 67,7%), (41; 31,5%) de cesáreas e 1 parto fórceps (0,8%), ocorrendo maior taxa de cesáreas neste grupo. Houve aumento de episiotomia no grupo com analgesia (p=0,03), com taxa de 7,9%. Não houve diferença estatítica entre os grupos quanto ao APGAR no 1º e 5º minuto. O grupo das mulheres com analgesia pariram bebês mais pesados (p=0,007). A maioria dos RN foram encaminhados ao alojamento conjunto de ambos os grupos. O grupo com analgesia teve maior taxa de uso de ocitocina, de realização de episiotomia, prevalência de parto cesárea, maior duração do trabalho de parto ativo e do período expulsivo em comparação ao grupo sem analgesia neuroaxial.Damasceno, Ana Kelve de CastroSouza, Marcella Rocha Tavares de2020-07-03T19:05:21Z2020-07-03T19:05:21Z2020-03-16info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisapplication/pdfSOUZA, M. R.T. Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais. 2020. 10 f. Dissertação (Mestrado em Enfermagem) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2020. Disponível em: http://www.repositorio.ufc.br/handle/riufc/52749. Acesso em: 12/04/2022.http://www.repositorio.ufc.br/handle/riufc/52749porreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2022-04-12T17:39:45Zoai:repositorio.ufc.br:riufc/52749Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T18:36:05.125830Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
title Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
spellingShingle Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
Souza, Marcella Rocha Tavares de
Analgesia Obstétrica
Enfermagem Obstétrica
Promoção da Saúde
Trabalho de Parto
title_short Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
title_full Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
title_fullStr Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
title_full_unstemmed Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
title_sort Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
author Souza, Marcella Rocha Tavares de
author_facet Souza, Marcella Rocha Tavares de
author_role author
dc.contributor.none.fl_str_mv Damasceno, Ana Kelve de Castro
dc.contributor.author.fl_str_mv Souza, Marcella Rocha Tavares de
dc.subject.por.fl_str_mv Analgesia Obstétrica
Enfermagem Obstétrica
Promoção da Saúde
Trabalho de Parto
topic Analgesia Obstétrica
Enfermagem Obstétrica
Promoção da Saúde
Trabalho de Parto
description The objective was to compare obstetric and neonatal outcomes among women who used and who did not use neuraxial analgesia during labor. This is a cross-sectional, comparative and retrospective study, carried out in July 2019 to February 2020, at Maternidade Escola Assis Chateaubriand. The inclusion criteria were: women who went into labor, with a live, single and full-term fetus between 37 and 41 weeks and 6 days, in cephalic presentation. The group with neuraxial analgesia met the following criteria: patient's request, active labor, good vitality assured by the obstetrician and absence of contraindications. Both groups were excluded: elective cesarean sections, fetal malformation and medical records with incomplete information. The sample size was calculated by estimating the difference of two proportions, group 1 referring to vaginal deliveries with analgesia (73%) and group 2 to vaginal deliveries without analgesia (83%), with 130 women for each group. Data collection took place through a structured instrument developed by the researcher and consisting of socioeconomic, obstetric and neonatal data. In the statistical analysis, Student's t test, Mann-Whitney U test, Pearson's chi-square test and Fisher's exact test were used. Statistical analyzes were performed using the IBM SPSS program. Most parturients in both groups were primiparous (103; 79.23% vs 94; 72.3%; p = 0.19). The group with analgesia had a high rate of oxytocin use (57; 43.8%; p <0.001), the most used technique was the epidural (76.9%), followed by the combined spinal-epidural (11.5%) and spinal anesthesia (10.8%). The duration of active labor in the group with analgesia was 392.12 minutes and in the group without analgesia, 260.68 minutes (p <0.001). In the group with analgesia, there was a higher rate of vaginal delivery (88; 67.7%), followed by cesarean delivery (41; 31.5%) and 1 forceps delivery (0.8%). There was a higher frequency of cesarean sections in women who gave birth under analgesia (41; 31.5% vs 5; 3.8%; p <0.001). Episiotomy was more prevalent in the group with analgesia (p = 0.03), with a rate of 7.9%. There was no statistical difference between the groups regarding APGAR in the 1st and 5th minutes. The parturients under analgesia gave birth to heavier babies (p = 0.007). Most of the NBs of women from both groups were referred to the rooming-in. It was concluded that in the group with analgesia there were more interventions during labor, with a higher rate of cesarean delivery, use of oxytocin, episiotomy and longer duration of active labor and expulsion period compared to the group without neuraxial analgesia.
publishDate 2020
dc.date.none.fl_str_mv 2020-07-03T19:05:21Z
2020-07-03T19:05:21Z
2020-03-16
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
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dc.identifier.uri.fl_str_mv SOUZA, M. R.T. Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais. 2020. 10 f. Dissertação (Mestrado em Enfermagem) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2020. Disponível em: http://www.repositorio.ufc.br/handle/riufc/52749. Acesso em: 12/04/2022.
http://www.repositorio.ufc.br/handle/riufc/52749
identifier_str_mv SOUZA, M. R.T. Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais. 2020. 10 f. Dissertação (Mestrado em Enfermagem) - Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, 2020. Disponível em: http://www.repositorio.ufc.br/handle/riufc/52749. Acesso em: 12/04/2022.
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reponame_str Repositório Institucional da Universidade Federal do Ceará (UFC)
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