Maternal Results From Planned Home Births Assisted by Nurses From the Hanami Team in the South of Brazil, 2002-2012

Abstract

Method: this transversal study It includes home and hospital births (212). Descriptive analysis was undertaken, with CI 95%, using the SAS/9.1.3 software.Results: the rate of amniotomy was 9.9% (CI 95% 5.9-13.9), of episiotomy was 0.5% (CI 95% 0.5-1.5), the amniotic fluid remained clear in 95.2% , there was no change in fetal heartbeat in 94.3% ). The vaginal tears perineal trauma were exclusively of first degree (64.7%; CI 95% 57.8-71.6) and second degree (7.0%; CI 95% 3.4-10.8), it being the case that almost half did not need suturing (46.8%; CI 95% 41.1-52.6). The rate of transfer to hospital was 7.4%, all these cases occurring during labor (CI 95% 3.8 -11.0). The rate of cesareans in the sample was 9.9%. Método: estudo transversal. Foram incluídos os partos ocorridos no domicílio e no hospital (212), no referido período. Foi realizada análise descritiva com IC a 95%, no SAS/9.1.3. Conclusions RESULTADOS MATERNOS DOS PARTOS DOMICILIARES PLANEJADOS ASSISTIDOS POR ENFERMEIRAS DA EQUIPE HANAMI NO SUL DOResultados: a taxa de amniotomia foi 9,9% (IC 95% 5,9-13,9), de episiotomia 0,5% (IC95% 0,5-1,5), o líquido amniótico permaneceu claro em 95,2% (IC95% 92,4-98), não houve alteração dos batimentos cardíacos fetais em 94,3% (IC95% 92-96,6). As lacerações vaginais foram exclusivamente de primeiro grau (64,7%; IC95% 57,8-71,6) e de segundo grau (7,0%; IC95% 3,4-10,8), sendo que praticamente a metade não necessitou de sutura (46,8%; IC95% 41,1-52,6). A taxa de transferência foi de 7,4%, sendo todas durante o trabalho de parto (IC95% 3,8-11,0). A taxa de cesárea da amostra foi 9,9%.Conclusão: as mulheres assistidas no domicílio são submetidas a poucas intervenções. As intercorrências e transferências obstétricas são baixas. Método: estudio transversal. Fueron inclusos partos en domicilio y en hospital (212). El análisis descriptivo fue realizado en SAS/9.1.3., con IC 95%. DESCRITORES:Resultados: la tasa de amniotomía fue 9,9% (IC 95% 5,9-13,9), de episiotomía 0,5% (IC95% 0,5-1,5), el líquido amniótico permaneció claro en 95,2% (IC 95% 92,4 a 98), no hubo alteración en la frecuencia cardíaca fetal en 94,3% 6). Laceraciones vaginales fueron de primer grado (64,7%; IC 95%: 57,8 a 71,6) y de segundo (7,0%; IC 95% 3.4 a 10.8), y casi la mitad no necesitó sutura (46,8%; IC 95%: 41,1-52,6). La tasa de transferencia fue de 7,4% (IC 95%: 3,8 a 11,0). La tasa de cesáreas en la muestra fue de 9,9%.Conclusión: las mujeres que reciben asistencia en el domicilio son sometidas a pocas intervenciones, complicaciones obstétricas y las transferencias son bajas.DESCRIPTORES: Parto domiciliário. Parto normal. Parto humanizado. Nacimiento a término. Enfermería obstétrica.

Obstetric practices in planned home births assisted in Brazil

“…The women who chose a PHB had a high level of education, a result similar to other Brazilian studies (8)(9)(10)(11)(12) . However, they were younger when compared to those of international studies (1)(2)(3)(13)(14) .…”

“…The fact that women are younger can be explained by the study population, made up mainly of primiparous women, similar to other studies conducted in Brazil (8)(9)(10)(11)(12) . It is emphasized that this is virtually the only data that differs from most international studies, since multiparous women are the ones that opt more for the PHB (1-4,13-14,18) .…”

“…However, most patients of VBC have low levels of education (15)(16)(17) . Women assisted at home showed high compliance with prenatal care, which was also observed in a study carried out in a VBC (15) and at home (10) .…”

“…Care practices developed in the home environment are described in some quantitative studies that analyzed small samples (from 70 to 212 women) (8)(9)(10) . These studies revealed lower rates of interventions, such as amniotomy and episiotomy, when compared to hospital rates, and there is a greater adoption of good practices, such as freedom of deambulation, movement and eating, participation of partners, skin-to-skin contact, breastfeeding stimulation, freedom of choice on the type of position at delivery, and high rates of vaginal delivery after cesarean sections.…”

Prática De Episiotomia Entre Residentes Em Enfermagem Obstétrica

“…Um estudo realizado em Santa Catarina em 2017, com uma população de 187 parturientes de risco habitual, que demonstrou os resultados maternos de partos domiciliares, apresentou uma taxa de episiotomia inferior ao que foi encontrada no presente estudo. Houve apenas uma episiotomia, representando 0,5% do total de partos assistidos, 27,3% períneo íntegro e 72,2% de lacerações perineais, sendo que destas 72,1% foram de primeiro grau, 7,9% de segundo grau e não houve lacerações de terceiro e quarto grau (15) .…”