Banca de QUALIFICAÇÃO: JORDÂNIA ABREU LIMA DE MELO

Uma banca de QUALIFICAÇÃO de MESTRADO foi cadastrada pelo programa.
STUDENT : JORDÂNIA ABREU LIMA DE MELO
DATE: 03/11/2020
TIME: 10:00
LOCAL: Será realizada por parecer
TITLE:

RESPIRATORY ORIENTATIONS DURING THE EXPULSIVE PERIOD AND ITS IMPACT ON THE PELVIC FLOOR: A CROSS-STUDY STUDY

KEY WORDS:

Keywords: Labor and Delivery. Lacerations. Pelvic floor. Physiotherapy techniques.

PAGES: 24
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Introduction: Perineal trauma can happen during vaginal delivery due to spontaneous perineal lacerations or episiotomy. Preventing the occurrence of perineal trauma favors the health of women in the postpartum period. Among the intrapartum physiotherapeutic techniques in low-risk obstetric care aimed at perineal protection, the stimulation of ambulation, the adoption of vertical postures and breathing exercises stand out. However, it is still necessary to conduct studies that investigate whether intrapartum physical therapy assistance can interfere in outcomes related to labor and delivery, such as perineal trauma. Objective: To verify the relationship between intrapartum physical therapy and perineal trauma, as well as obstetric and neonatal variables. Methods: Cross-sectional analytical observational study, carried out at the Ana Bezerra University Hospital (HUAB), Santa Cruz, Rio Grande do Norte, Brazil. A survey and analysis of data on parturient women aged between 18 and 40 years, primiparous and multiparous, with a single fetus and gestational age between 37 and 42 weeks of gestation was carried out. The dependent variable of the study was perineal trauma (episiotomy and spontaneous perineal lacerations), the independent variables were: intrapartum physiotherapeutic interventions (squatting position, use of the stool, squat, anterior trunk inclination, use of the Swiss ball, bipedestation, sedestation, walking, massage, warm bath, diaphragmatic breathing, pelvic mobility, compress, penumbra, music therapy, use of the bow and breathing guidelines in the expulsive period), obstetric, sociodemographic and neonatal variables.  A bivariate analysis (Chi-square test) was performed between the dependent variable and the independent ones. Binary Logistic Regression was applied to verify whether the independent variables were predictors of perineal trauma (outcome variable). A significance level of p <0.05 was adopted. Results: Data were collected from 171 women, with a mean age of 26.04 (± 5.68) years, with an average gestational age of 39.30 (± 1.26) weeks, 56.1% were multiparous, 77,8% demonstrated some type of perineal trauma, of these, spontaneous perineal lacerations (64.9%), grade 1 type (35.1%), prevailed. As for the integrity of the perineum, 22.2% had an intact perineum and 12.9% received an episiotomy. 67.3% of women were accompanied by physical therapists during labor. There was a significant association between the variables respiratory orientations during the expulsive period (p = 0.026), previous pregnancies (p = 0.001) and number of vaginal deliveries (p = 0.001). In the multivariate analysis, it was observed that there was a decrease in perineal trauma in 59.8% (OR: 0.402 95% CI: 0.164; 0.982) of women who received respiratory guidance in the expulsive period. Whereas, women with up to two vaginal deliveries (VD) are 5.38 (OR: 5.380 95% CI: 1.817; 15.926) times more likely to have perineal trauma when compared to those with more than two VD. Conclusion: The physiotherapeutic intervention in assisting the expulsive period of labor pointed to a positive effect on the pelvic floor of low-risk or usual-risk pregnant women.

BANKING MEMBERS:
Presidente - 1242804 - ADRIANA GOMES MAGALHAES
Interna - 1892581 - GRASIELA NASCIMENTO CORREIA
Externa ao Programa - 192.359.018-98 - PATRICIA DRIUSSO