Desfechos maternos e neonatais na admissão precoce para o parto de risco habitual

Abstract

There is a difficulty for professionals in detecting the phases of the first period of labor (PT), and, consequently, in diagnosing the appropriate time for hospitalization, since the beginning of the active phase defines the opportune moment for the admission of the pregnant woman for delivery. This can be explained by the existence of different concepts in the research literature, which leads to a greater number of early admissions. The time of hospital admission can be an important predictor of intervention during labor and delivery throughout the evolution of this process. The study aimed to describe the sociodemographic, obstetric and maternal and neonatal outcomes of pregnant women at usual risk with early admission. This is a descriptive cross-sectional study with low-risk pregnant women admitted to the Normal Birth Center (CO) from January to May 2021 in a maternity hospital located in the Northwest Region of Goiânia, Goiás. Data were collected from electronic medical records, manually recorded in a specific form prepared for the purposes of this research. The variables were related to socioeconomic, obstetric and neonatal data, submitted to descriptive statistics. A separation was performed between nulliparous and non-nulliparous pregnant women and the grouping of hospitalization conditions due to uterine dilation: 0-3 cm (without hospitalization recommendations in the literature); 4-5 cm (according to the Ministry of Health) and 6-10 cm according to the recommendations established by the World Health Organization (WHO). The parturients were young, aged between 20 and 35 years (74%), mostly non-white (69.6%), with low education (70.7%) and 49.3% without a partner. 44.7% nulliparous and 55.3% non-nulliparous and 31.1% had less than six prenatal care. Intravenous infusion of oxytocin occurred in 23.1% among nulliparous women and 10.9% among non-nulliparous women. Amniotomy was performed in 16.1% of nulliparous women and 10.0% of non-nulliparous women, and among those hospitalized with an intact bag, this intervention occurred in 74.6%. 19.1% of nulliparous women underwent cesarean section and 7.9% of non-nulliparous women; 1% of nulliparous women and 2.1% of non-nulliparous women had maternal complications. Among the nulliparous, 12.1% of the neonates and among the non-nulliparous 10% of the newborns were referred to neonatology. In interventions related to the use of oxytocin and performance of amniotomy and in view of the unfavorable maternal and neonatal outcomes related to the cesarean delivery, Apgar < 7 in the 1st minute and referrals of the NB to neonatology, the subgroups with the highest frequencies were those hospitalized with less of 6 cm of cervical dilatation. The relevance of the international recommendation of the World Health Organization regarding the concepts of active phase and consequent hospitalization criterion is observed