Analgesia neuroaxial durante o trabalho de parto: seus efeitos sobre os desfechos maternos e neonatais
Autor(a) principal: | |
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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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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 |
status_str |
publishedVersion |
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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http://www.repositorio.ufc.br/handle/riufc/52749 |
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Universidade Federal do Ceará (UFC) |
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UFC |
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