Práticas obstétricas e desfechos perineais: análise da assistência ao parto

Abstract

The normal birth process involves systemic actions that encompass cascades of hormones and neurotransmitters triggering labor. It is facilitated by the use of appropriate obstetric practices, consisting of care technologies coupled with maternal-fetal assistance, providing effectiveness and comfort beyond the physical aspect while preventing negative outcomes from the birthing process. This study aimed to describe obstetric practices and perineal outcomes during delivery assistance in a standard-risk maternity ward. It was a descriptive, exploratory, observational study with a quantitative approach conducted at Maternity Nossa Senhora da Guia, involving 136 postpartum women. Data collection utilized a structured form filled during interviews, comprising maternal, fetal, and obstetric assistance variables. The collection took place from November 2022 to April 2023, approved by the Ethics Committee in accordance with National Health Council Resolutions 466/2012, 510/2016, and 580/2018. The study described the provision of Non-Pharmacological Methods for Pain Relief (NMPR) in 52.95% of labors, with no induction in 92.66%, and no partogram used in 94.86% of cases. Vaginal exams ranged from 1 to 7, Kristeller maneuver was performed in 8.09% of occasions, 35.3% had no perineal outcome recorded, and perineal laceration with and without information on the degree was identified in 22.8% of cases. The research revealed limited use of good obstetric practices during labor/delivery and a lack of records regarding postpartum conditions. Therefore, there is an inferred need to encourage and support the use of recommended obstetric practices based on available scientific evidence for both professionals and service users, aiming for increased adherence and improved assistance quality, as well as better perineal outcomes and higher maternal satisfaction levels with labor/delivery.