O uso da bola suíça na aceleração do trabalho de parto e parto: ensaio clínico randomizado

Abstract

Hospitalization and medicalization of health care contributed to the fact that women started giving birth in hospitals, no longer being the protagonist of their parturition process. Obstetrical best practices are beneficial procedures for attendance of labour and birth. Among obstetrical best practices, the most used non-pharmacological methods are the shower bath, ambulation, Swiss ball and birth stool. The application of Swiss ball in labour has the potential to relieve nervous tension. The pressure of the ball over perineum allows the pelvic girdle to be positioned forward to the spinal column, providing a better positioning for the fetus. The aim of this research was to evaluate the interference of Swiss ball use in the acceleration of labour in primiparous women. It is a randomized controlled clinical trial performed in the main maternity of habitual risk of Alagoas with a sample of 62 primiparous women, in the active phase of labour, integral bag of waters, gestational age between 37 to 41 weeks and 6 days. There was no statistically significant difference between the experimental and control groups in the variables, frequency and duration of uterine contractions, fetal decline and cervical erasure. However, the study showed a statistically significant difference about difference between the means of cervical dilation for the control group of 0,57 cm compared to experimental group in two first hours (p=0,008), as well as 0,8 cm for the control group when compared to the experimental group during the last two hours of study participation (p=0,026). About cervical dilatation velocity, control group presented a higher dilation in both times (p=0,003 and p=0,004), which evidenced that parturient of control group presented a higher dilatation velocity. Therefore, given the presented data, the use of Swiss ball does not interfere in the acceleration of labour and birth in primiparous women. And despite the progression of dilatation velocity of control group, it may be demonstrated that the total time of obstetric evaluation until the time of birth behaved similar. Therefore, the acceleration of labour comprises the progression of all the variables that act in a synchronized manner and determine its evolution.