Características clínicas das parturientes e perfil da assistência ao parto em uma instituição hospitalar do Rio Grande do Sul
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Data
2024-02
Autores
Orientador
Laste, Gabriela
Banca
Lohmann, Paula Michele
Bucker, Joana
Moretto, Virgínia Leismann
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Introdução: Apesar dos esforços, a assistência ao parto ainda está muito distante do modelo recomendado, a autonomia da mulher durante o trabalho de parto não é respeitada e práticas inapropriadas à saúde materna e neonatal, ainda podem acontecer habitualmente. As Recomendações da OMS definem um conjunto de intervenções para que o processo de parto seja seguro e também uma experiência positiva para as mulheres e suas famílias. Um novo modelo de assistência ao parto adaptável ao contexto de cada país, as recomendações visam à economia de custos substanciais através da redução de intervenções desnecessárias durante o trabalho de parto. Objetivo: Investigar as características clínicas das mulheres grávidas, e perfil da assistência ao parto em uma Instituição Hospitalar de médio porte. Procedimentos metodológicos: Tratou-se de estudo quantitativo transversal retrospectivo, descritivo e documental em 1485 prontuários que foram analisados, dos anos de 2019 a 2021 realizado em uma Instituição hospitalar do Rio Grande do Sul. Sendo avaliado as variáveis sobre os cuidados recomendados e não recomendados, na assistência ao parto normal segundo as Recomendações da Organização Mundial da Saúde publicadas em 2018 acerca dos cuidados intraparto. Os resultados foram analisados utilizando estatística descritiva, com a apresentação das frequências absolutas e percentuais para as variáveis em estudo. As análises foram realizadas através do software Jamovi, versão 2.3.21. Resultados: a maioria das mulheres do estudo encontrava-se com idade média de 28,1 anos, variando entre 18 anos até 46 anos, os dados sociodemográficos, apontaram uma predominância de 80,9% parturientes com etnia branca, negra 9,6% e parda 9,3%, multigestas 61,3% sendo a maior porcentagem de risco habitual. Identificou-se a prevalência de boas práticas: contato pele a pele imediato (65,8%), amamentação em sala de parto (64,6%), medidas não farmacológicas para alívio da dor (50,8%), presença do acompanhante (96,4%). Quanto às práticas intervencionistas, identificou-se: indução por infusão de ocitocina (32,4%), uso do misoprostol (14,5%), realização de amniotomia (15,6%) e episiotomia (11,4%). Conclusão: Apesar do avanço nas práticas recomendadas baseadas em evidências científicas buscadas e oportunizadas, ainda existem altas taxas de cesarianas e práticas intervencionistas durante o trabalho de parto e parto. As características das parturientes encontradas neste estudo demonstraram que ainda existem barreiras de medo da dor do trabalho de parto e receios que devem ser trabalhadas e, ofertando esses novos conhecimentos desde o pré- natal para a melhoria da fidelização da assistência intra parto e no parto.
Introduction: Despite the efforts, childbirth care is still far from the recommended model, women's autonomy during labor is not respected, and practices that are harmful to maternal and neonatal health can still happen habitually. The WHO Recommendations define a set of interventions so that the childbirth process is safe and also a positive experience for women and their families. A new model of childbirth care, adaptable to the context of each country, the recommendations aim to achieve substantial cost savings by reducing unnecessary interventions during labor. Objective: To investigate the clinical characteristics of pregnant women and the profile of childbirth care in a medium-sized hospital. Methodological procedures: This was a descriptive, and documental, retrospective cross-sectional quantitative study of 1485 medical records that were analyzed from 2019 to 2021 in a hospital institution in Rio Grande do Sul. The variables on recommended and non-recommended care in normal childbirth care were evaluated according to the World Health Organization Recommendations published in 2018 on intrapartum care. The results were analyzed using descriptive statistics, with the presentation of absolute and percentage frequencies for the variables under study. The analyses were performed using the Jamovi software, version 2.3.21. Results: most of the women in the study had a mean age of 28.1 years, ranging from 18 years to 46 years, the sociodemographic data showed a predominance of 80.9% parturients of white, 9.6% of black, and 9.3% of brown ethnicity, and 61.3% multigestous being the highest percentage of usual risk. The prevalence of good practices was identified: immediate skin-to-skin contact (65.8%), breastfeeding in the delivery room (64.6%), non-pharmacological measures for pain relief (50.8%), and presence of a companion (96.4%). Regarding interventional practices, the following were identified: induction by oxytocin infusion (32.4%), use of misoprostol (14.5%), amniotomy (15.6%), and episiotomy (11.4%). Conclusion: Despite advances in recommended practices based on scientific evidence sought and provided, there are still high rates of cesarean sections and interventional practices during labor and delivery. The parturient characteristics found in this study demonstrated that there are still barriers of fear of labor pain and concerns that must be worked on, and offering this new knowledge from prenatal care to improve the loyalty to intrapartum and childbirth care.
Introduction: Despite the efforts, childbirth care is still far from the recommended model, women's autonomy during labor is not respected, and practices that are harmful to maternal and neonatal health can still happen habitually. The WHO Recommendations define a set of interventions so that the childbirth process is safe and also a positive experience for women and their families. A new model of childbirth care, adaptable to the context of each country, the recommendations aim to achieve substantial cost savings by reducing unnecessary interventions during labor. Objective: To investigate the clinical characteristics of pregnant women and the profile of childbirth care in a medium-sized hospital. Methodological procedures: This was a descriptive, and documental, retrospective cross-sectional quantitative study of 1485 medical records that were analyzed from 2019 to 2021 in a hospital institution in Rio Grande do Sul. The variables on recommended and non-recommended care in normal childbirth care were evaluated according to the World Health Organization Recommendations published in 2018 on intrapartum care. The results were analyzed using descriptive statistics, with the presentation of absolute and percentage frequencies for the variables under study. The analyses were performed using the Jamovi software, version 2.3.21. Results: most of the women in the study had a mean age of 28.1 years, ranging from 18 years to 46 years, the sociodemographic data showed a predominance of 80.9% parturients of white, 9.6% of black, and 9.3% of brown ethnicity, and 61.3% multigestous being the highest percentage of usual risk. The prevalence of good practices was identified: immediate skin-to-skin contact (65.8%), breastfeeding in the delivery room (64.6%), non-pharmacological measures for pain relief (50.8%), and presence of a companion (96.4%). Regarding interventional practices, the following were identified: induction by oxytocin infusion (32.4%), use of misoprostol (14.5%), amniotomy (15.6%), and episiotomy (11.4%). Conclusion: Despite advances in recommended practices based on scientific evidence sought and provided, there are still high rates of cesarean sections and interventional practices during labor and delivery. The parturient characteristics found in this study demonstrated that there are still barriers of fear of labor pain and concerns that must be worked on, and offering this new knowledge from prenatal care to improve the loyalty to intrapartum and childbirth care.
Descrição
Palavras-chave
Parto normal; Cesariana; Gestante; Características clínicas; Assistência; Segurança; Normal delivery; Cesarean; Pregnant; Clinical features; Assistance; Safety
Citação
FALLER, Gabriela Da Silva Garcia. CARACTERÍSTICAS CLÍNICAS DAS PARTURIENTES E PERFIL DA ASSISTÊNCIA AO PARTO EM UMA INSTITUIÇÃO HOSPITALAR DO RIO GRANDE DO SUL. 2024. Dissertação (Mestrado) – Curso de Ciências Médicas, Universidade do Vale do Taquari - Univates, Lajeado, 29 fev. 2024. Disponível em: http://hdl.handle.net/10737/4366.