Resultados maternos e perinatais pós intervenções não farmacológicas para o alívio da dor e ansiedade no trabalho de parto : ensaio clínico, randomizado e controlado

• Autor(a) principal: Melo, Patricia de Souza [UNIFESP]
• Data de Publicação: 2017
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5323167; http://repositorio.unifesp.br/handle/11600/50444
• topic: Obstetric nursing; Labor pain; Clinical trial; Hydrotherapy; Enfermagem obstétrica; Dor do parto; Ensaio clínico; Hidroterapia

Objective: To analyze the clinical effects of nonpharmacological interventions – warm jet hydrotherapy bath and perineal exercises with the Swiss ball, and the combination of both for pain relief and anxiety during labor in mothers, fetuses and newborns. Method: This is a clinical, randomized and controlled trial. The study was carried out in two public institutions associated with the Brazilian Unified Health System (SUS), located in the city of São Paulo, Brazil. The population was comprised of mothers of common risk that attended the intrahospital labor center. The sample included 101 mothers. Results: Among them, 58.4% used a labor induction method – and oxytocin was the commonest (76.3%). The vaginal delivery occurred in 88.1% of the participants. The integrity of membranes was significant to determine the kind of delivery and fetal heart rate. Women with ruptured membranes had an increase of 5.5 times in the odds of having a C-section birth (p=0.040) and their fetuses presented a decrease of 4.6 bpm in comparison with the fetuses of mothers with integral amniotic membranes (p=0.043). There was an increase in the average of maternal respiratory rate (p=0.037) and dilation (p<0.001) after the intervention. We have noticed that the chances of C-section delivery decrease 86% after every contraction increase in the second moment of the assessment. There were no differences in means of systolic and diastolic pressures and pulse pressure were found in the three groups, before and after intervention. We found that warm shower modified delivery progression isolatedly (p=0.041) and combined (p=0.021), because there was an increase in the number of uterine contractions compared with the group that used pelvic floor exercises with the Swiss ball isolatedly. No statistically significant differences of means were found in fetal heart rate, transitory acceleration presence, variability or decelerations, as well in the Apgar index in the first and fifth minute of life. Conclusion: The use of interventions isolatedly or combined has showed to be safe, because they did not contribute to unfavorable maternal and perinatal outcomes; therefore, they should be recommended and incorporated into obstetric practices.