Relação entre os fatores maternos, fetais e assistenciais e o desfecho laceração perineal no parto

Abstract

Introduction: This research aims to analyze the relationship between maternal, fetal and care factors and the outcome of perineal laceration during childbirth. Perineal laceration is characterized as a type of spontaneous trauma resulting from vaginal birth that occurs during the passage of the fetus through the vaginal canal and although its mechanism is spontaneous, some factors may favor its occurrence, and this has motivated studies by researchers in the area. health due to the clinical implications and morbidities associated with this condition. Objective: To analyze the relationship between maternal, fetal and care factors and the outcome of perineal laceration at birth. Method: This is a cross-sectional, descriptive study, with a quantitative approach, carried out through field research in four low-risk maternity hospitals in the capital of the State of Alagoas (Maceió), with postpartum women who received assistance during normal birth and who were hospitalized in respective maternity hospitals, as well as their medical records. Sampling was simple random probabilistic and collection was carried out from November 2022 to August 2023 using a structured form. For data analysis, the free software R (R version 4.2.2 (2022-10-31 ucrt)) was used using Central Tendency measures and the Shapiro-Wilk, Mann-Whitney, Chi-Square, Exact Tests Fisher test, Z test for equality of proportions and Kruskal Wallis, admitting two hypotheses and considering a statistically significant difference with a p-value ≤ 5%. This research was approved by the Research Ethics Committee of the Federal University of Alagoas (UFAL), under CAAE nº 58121222.3.0000.5013. Results: 344 forms were collected, and the analysis demonstrated that the majority are in the age group between 18 and 29 years old, do not work, have a monthly family income of one minimum wage, declare themselves mixed race, have completed high school and are married or in a stable union . The majority had a BMI >18.5kg/m² to 24.9kg/m², had one pregnancy, one birth and no abortion, an average gestational age of 39.27 weeks and an interpartum interval of 51.15 months. Regarding the characterization of labor and delivery assistance, the majority of women who had their labors induced received Misoprostol alone, gave birth in the lithotomy position, were assisted by doctors, had a companion present, used non-pharmacological methods for relief of pain and had their perineums intact. Fetal characteristics demonstrated that the average fetal weight was 3222.6 kilos, head circumference was 34.01 cm and somatic cap was 38 weeks. Regarding association analyses, parity was a protective factor, since women who did not have a laceration tend to have had more pregnancies, more births and more natural births. Conclusion: From the results of this study, a high prevalence of perineal lacerations can be evidenced, since more than half of the women in this study presented this outcome, however, the analyzes did not demonstrate a significant statistical association between maternal, fetal and care variables and the perineal laceration outcome, with the exception of the variables, gestational age and parity.