ABSTRACT
Trata-se de estudo descritivo quantitativo que objetivou conhecer as atividades realizadas pelos acompanhantes de mulheres em trabalho de parto e a avaliação deles em relação à experiência vivenciada. Foi realizado no Centro de Parto Normal (CPN) do Hospital Geral de Itapecerica da Serra (HGIS) do qual participaram 56 acompanhantes. A atividade mais freqüentemente realizada pelos acompanhantes no decorrer do acompanhamento do parto foi permanecer ao lado das parturientes oferecendo-lhes suporte físico e emocional, e todos avaliaram positivamente a experiência. Concluiu-se que a inserção do acompanhante ativo no parto deve ser incentivada e institucionalizada nos serviços de assistência ao parto
It is a quantitative descriptive study with the aim of to know the activities developed by the companions of women during the childbirth and their evaluation in relation to the experience of accompaniment. The research was developed at the birth center of Hospital Geral de Itapecerica da Serra (HGIS) and 56 companions have participated in the study. The activity more frequently realized by the companions during the process was to stay with the women offering them physical and emotional support and all companions have evaluated positively their experience. The authors concluded that the insertion of active accompaniment must be incentivated and institutionalized at birth care services
Se trata de un estudio descriptivo cuantitativo que tuvo como objetivo conocer las actividades de los acompañantes de mujeres en trabajo de parto y la evaluación realizadas por ellos, en relación a la experiencia vivenciada. Fue desarrollado en el Centro de Parto Normal (CPN) del Hospital General de Itapecerica da Serra (HGIS) del cual participaron 56 acompañantes. La actividad que com más frecuencia realizan los acompañaIt is a quantitative descriptive study with the aim of to know the activities developed by the companions of women during the childbirth and their evaluation in relation to the experience of accompaniment. The research was developed at the birth center of Hospital Geral de Itapecerica da Serra (HGIS) and 56 companions have participated in the study. The activity more frequently realized by the companions during the process was to stay with the women offering them physical and emotional support and all companions have evaluated positively their experience. The authors concluded that the insertion of active accompaniment must be incentivated and institutionalized at birth care services.ntes, en el transcurso del acompañamiento del parto, fue permanecer a lado de las parturientas ofreciéndoles soporte físico y emocional, habiendo evaluado positivamente la experiencia. Se concluye que la inserción del acompañante activo en el parto debe ser incentivado e institucionalizado en los servicios de asistencia ao parto
Subject(s)
Humans , Labor, Obstetric , Medical Chaperones , PerceptionABSTRACT
O trauma perineal é ocorrência freqüente no parto normal e no caso de episiotomia e rotura perineal de segundo grau exige reparo com sutura para promover a hemostasia e cicatrização, prevenindo a infecção e dor local. Os objetivos foram caracterizar o processo de cicatrização do trauma perineal no parto normal durante o puerpério, relacionado-o com a técnica de sutura convencional e experimental; identificar a freqüência e magnitude da dor perineal referida por puérperas submetidas à sutura do trauma perineal, relacionando-as com a técnica de sutura utilizadas, a paridade e o tipo de trauma. Trata-se de uma pesquisa experimental, controlada, randomizada, longitudinal, de tipo ensaio clínico, com abordagem quantitativa. Foi realizada no Centro de Parto Normal do Hospital Geral de Itapecerica da Serra, instituição pública do Estado de São Paulo, gerenciada por uma organização social de saúde. Fizeram parte da amostra 61 puérperas, que tiveram parto normal com episiotomia ou rotura perineal de segundo grau assistido por enfermeiras obstétricas. As puérperas foram submetidas à sutura perineal com o fio sintético poliglactina 910 de rápida absorção, sendo distribuídas no Grupo 1 - técnica convencional de sutura perineal, 30 puérperas e Grupo 2 - técnica experimental de sutura perineal, 31 puérperas - e avaliadas em quatro etapas, durante o puerpério. Os resultados mostraram que a cicatrização perineal ocorreu por primeira intenção, sem complicações em ambos os grupos; quanto à dor perineal espontânea, houve aumento significativo de freqüência entre o período de Grenberg e quatro dias após o parto, com redução também significativa quarenta e um dias após o parto; a freqüência de dor perineal à palpação foi significativamente menor no Grupo 2, quando avaliada quatro dia após o parto; não houve diferença significativa para a dispareunia entre as mulheres dos dois grupos que haviam retomado a atividade sexual; a dor ) perineal associada a sentar, andar, urinar e evacuar estava ausente em todas as mulheres do Grupo 2, na última avaliação. Não houve diferença significativa na freqüência de dor em relação à paridade. Na comparação entre o tipo de trauma perineal, a dor espontânea no período de Greenberg e a dor à palpação quatro dias após o parto foram significativamente mais freqüentes nas puérperas com episiotomia. Os análgésicos para alívio da dor perineal foram utilizados pelas puérperas de ambos os grupos, sem diferença significativa, ocorrendo um aumento na freqüência de mulheres que consumiram o medicamento entre quatro e quarenta e um dias após o parto. O trauma perineal, em especial a episiotomia, é responsável pela morbidade materna relaciona à dor no puerpério e, ainda que seja importante o aprimoramento de fios e técnicas de sutura, a prevenção de roturas e o uso restrito da episiotomia são imprescindíveis.
Perineal trauma is a frequent event in normal birth and, when an episiotomy or second-degree perineal rupture occurs, requires repair with suture in order to promote haemostasis and healing, preventing an infection and local pain. The objective of this study was to compare the effects of two different techniques of repair on the healing process of perineal trauma in normal birth during the immediate postpartum period. We identified the frequency and magnitude of perineal pain as referred to by women in the puerperium who were submitted to suture of perineal trauma, relating these results to the use of conventional or experimental techniques of repair, parity and kind of trauma. This was a longitudinal, experimental, randomly controlled trial, of the clinical essay type. It was undertaken at the Normal Birth Center of the Itapecerica da Serra General Hospital, a public institution of the State of São Paulo, administered by a social health organization. The sample for this study consisted of 61 women in the immediate postpartum period who had normal birth with episiotomies or second-degree perineal tears and who were being assisted by nurse-midwives. The study subjects, submitted to perineal repair using absorbable 910 polyglactine sutures, were distributed in two groups: the 30 women in Group 1 were submitted to the conventional technique, i.e interrupted transcutaneous sutures, and the 31 women in Group 2 were submitted to the experimental technique of repair of perineal trauma, i.e. continuous subcuticular suture. Both groups were evalueted in four different moments during the puerperium. The results indicates that perienal healing occured at first intention, without complications in both groups. There was a significant increase in spontaneous perineal pain between the fourth stage of labor and the fourth day after birth as well as a significant decrease in spontaneous perineal pain forty-one days after birth in both groups. Perineal pain in response to palpation was significantly less frequent among women in Group 2 then in Group 1 when both were evaluated four days after birth. There was no significant difference between women from both groups who had resumed sexual intercourse with respect to dsypareunia. At the final assessment, fort-one days after birth, perineal pain associated with sitting, walking, urinating and evacuating was absent among all women in Group 2. There was no significant difference as to the frequency of pain according to parity. Spontaneous pain in the fourth stage of labor and in response to palpitation four days after birth was more frequent among women with episiotomies than amongst those who had second-degree perineal ruptures. Women in both groups employed the use of analgesics for relief from perineal pain, without significant differences between them. There was an increase in the frequency of women from both groups who recurred to the consumption of analgesics for this purpose between the fourth and forty-first days after childbirth. Perineal trauma, particularly episiotomy, is responsible for maternal morbidity related to pain in the puerperium and, although the improvement of suture material and techniques of repair is important, the prevention of perineal tears and restrictive employment of episiotomies are indispensable.