Use of uterotonics in the third stage of labor in a maternity in the mata mineira area
DOI:
https://doi.org/10.5935/1415.2762.20200081Keywords:
Labor, Obstetric, Labor Stage, Third, Delivery, Obstetric, Nursing CareAbstract
Objective: to evaluate the use of uterotonics in primiparous parturient during the third period of labor, according to the route of birth and associated care factors, in a maternity hospital in a municipality in the Zona da Mata Mineira. Method: cross-sectional, descriptive, and analytical study with 222 women. Data collection took place through interviews. The descriptive analysis was performed using
relative and absolute frequencies. Pearson's chi-square test was used to identify statistical differences related to the use of uterotonics, in view of sociodemographic characteristics and obstetric care. Poisson regression models were used to
estimate the crude and adjusted prevalence ratios. Result: more than 80% of the puerperal women received uterotonic regardless of the route of administration. After adjusting for sociodemographic characteristics, it was identified that: not being in labor during hospitalization; having had a normal birth; breastfeed in the delivery room; having a companion in the delivery room; having skin to skin contact; and receiving a massage to extract the placenta were conditions associated with the use of intramuscular uterotonics. It was evidenced that: having been submitted to cesarean section; not breastfeeding in the delivery room; not receiving skin-toskin contact; and not being subjected to massage to extract the placenta were associated with intravenous use. Conclusion: it was concluded that factors of obstetric care are associated with the application of uterotonic in primiparous parturient during the
third period of labor, regardless of the route of administration, and that its use is a measure performed for the management of the third period of labor.
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Leão MRC, Riesco MLG, Schneck CA, Angelo M. Reflexões sobre o excesso de cesarianas no Brasil e a autonomia das mulheres. Ciênc Saúde Colet. 2013[citado em 2019 nov. 15];18(8):2395-400. Disponível em: http://www.scielo.br/pdf/csc/v18n8/24.pdf
Ministério da Saúde (BR). Secretaria de Ciência, Tecnologia e Insumos Estratégicos.-Diretrizes nacionais de assistência ao parto normal. Brasília: Ministério da Saúde; 2017. Disponível em: http://conitec.gov.br/images/Relatorios/2017/Relatorio_DiretrizesNacionais_PartoNormal_versao-final.pdf
Organização Pan-Americana de Saúde (OPAS). Folha informativa - Mortalidade materna. 2018[citado em 2019 nov. 15]. Disponível em: https://www.paho.org/bra/index.php?option=_comcontent&view=article&id=5741:folha-informativamortalidade-materna&Itemid=820
Begley CM, Gyte GM, Devane D, McGuire W, Weeks A, Biesty LM. Active versus expectante management for women in the thirty stage of labour. Cochrane Data base Syst Rev. 2019 Fev[citado em 2019 nov. 15];2(2):CD007412. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372362/pdf/CD007412.pdf
Salati JA, Leathersich SJ, Williams MJ, Cuthbert A, Tolosa JE. Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database Syst Rev. 2019[citado em 2019 nov. 15];4(4):CD001808. Disponível em: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001808.pub3/epdf/full
Ministério da Saúde (BR). Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Diretrizes nacionais de assistência ao parto normal. Brasília: Ministério da Saúde; 2016[citado em 2019 nov. 15]. Disponível em: http://conitec.gov.br/images/Relatorios/2016/Relatorio_Diretriz_PartoNormal_Recomendacao.pdf
Ruiz MT. Análise da perda hemática durante o processo de parturição[tese]. Ribeirão Preto: USP; 2012[citado em 2019 nov. 15]. Disponível em: https://www.teses.usp.br/teses/disponiveis/22/22133/tde-16012013-095258/publico/MARIANATORREGLOSARUIZ.PDF
Parry SWR, Gallos ID, Williams HM, Widmer M, Angolkar M, Tobias A, et al . First-line uterotonics for treating postpartum haemorrhage: a systematic review and network meta-analysis. Cochrane Database Syst Rev. 2017[citado em 2019 nov. 15];8:CD012754. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483493/pdf/CD012754.pdf
Committee on Practice Bulletins-Obstetrics. Practice bulletin n. 183:postpartum hemorrhage. Obstet Gynecol. 2017[citado em 2019 nov. 15];130(4):e168-86. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28937571/
World Health Organization (WHO). Recommendations intrapartum care for a positive childbirth experience. Geneva: WHO; 2018[citado em 2019 nov. 15]. Disponível em: https://apps.who.int/iris/bitstream/handle/10665/260178/9789241550215-eng.pdf;jsessionid=A2CEC6F80D1913FBCC15D9EA75014813?sequence=1
Organização Pan-Americana da Saúde (OPAS). Recomendações assistenciais para prevenção, diagnóstico e tratamento da hemorragia obstétrica. Brasília: OPAS; 2018[citado em 2019 nov. 15]. Disponível em: https://iris.paho.org/bitstream/handle/10665.2/34879/9788579671241-por.pdf?sequence=1&isAllowed=y
Coutinho LMS, Scazufca M, Menezes PR. Métodos para estimar razão de prevalência em estudos de corte transversal. Rev Saúde Pública. 2008[citado em 2019 nov. 15];42(6):992-8. Disponível em: https://www.scielo.br/scielo.php?pid=S0034-89102008000600003&script=sci_abstract&tlng=pt
Souza ML, Laurenti R, Knobel R, Monticelli M, Bruggemann OM, Drake E. Mortalidade materna por hemorragia no Brasil. Rev Latino-Am Enferm. 2013[citado em 2019 nov. 15];21(3):[08 telas]. Disponível em: http://www.scielo.br/pdf/rlae/v21n3/pt_0104-1169-rlae-21-03-0711.pdf
Neri-Mejía M, Pedraza-Avilés AG. Tratamiento activo del tercer periodo del trabajo de parto: três esquemas de oxitocina. Ginecol Obstet Mex. 2016[citado em 2019 nov. 15];84(5):306-13. Disponível em: https://www.medigraphic.com/pdfs/ginobsmex/gom-2016/gom165f.pdf
Adnan N, Boland F, Murphy DJ. Intramuscular oxytocin versus intravenous oxytocin to prevent postpartum haemorrhage at vaginal delivery (LabOR trial): study protocol for a randomised controlled trial. Trials. 2017[citado em 2019 nov. 15];18(1):541. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688658/pdf/13063_2017_Article2269.pdf
Gallos ID, Williams HM, Price MJ, Merriel A, Gee H, Lissauer D, et al . Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev. 2018[citado em 2019 nov. 15];4(4):CD011689. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494487/pdf/CD011689.pdf
Chawla D, Khatri R, Khatuja R, Gupta V, Agrawal R. A comparative study of various uterotonics in active management of third stage of labour. PARIPEX Indian J Research. 2018[citado em 2019 nov. 15];7(4):15-8. Disponível em: https://www.worldwidejournals.com/paripex/fileview/April_2018_1523281221_36.pdf
Jin XH, Li D, Li X. Carbetocin vs oxytocin for prevention of postpartum hemorrhage after vaginal delivery: a meta-analysis. Medicine (Baltimore). 2019[citado em 2019 nov. 15];98(47):e17911. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31764790/
Hardegg JJL, Brunner M, Ries JJ, Felten VS, Heugel C, Lapaire O, et al. Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome. Arch Gynecol Obstet. 2016[citado em 2019 nov. 15];293(6):1219-25. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863908/pdf/404_2015_Article3916.pdf
Oladapo OT, Okusanya BO, Abalos E. Intramuscular versus intravenous prophylactic oxytocin for the third stage of labour. Cochrane Database Syst Rev. 2018[citado em 2019 nov. 15];9(9):CD009332. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513632/pdf/CD009332.pdf
Vilchez G, Patel N, Maulik D. Postpartum haemorrhage refractory to uterotonics. BJOG. 2020[citado em 2019 nov. 15];127:635. Disponível em: https://obgyn.onlinelibrary.wiley.com/action/showCitFormats?doi=10.1111%2F1471-0528.16077
Saxton A, Fahy K, Rolfe M, Skinner V, Hastie C. Does skin-to-skin contact and breast feeding at birth affect the rate of primary postpartum haemorrhage: results of a cohort study. Midwifery. 2015[citado em 2020 fev. 12];31(11):1110-7. Disponível em: http://dx.doi.org/10.1016/j.midw.2015.07.008
Abedi P, Jahanfar S, Namvar F, Lee J. Breastfeeding or nipple stimulation for reducing postpartum haemorrhage in the third stage of labour. Cochrane Database Syst Rev. 2016[citado em 2020 fev. 12];(1):CD010845. Disponível em: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010845.pub2/epdf/full
Saccone G, Caissutti C, Ciardulli A, Abdel-Allem H, Hofmeyr GF, Berghella V. Uterine massage as part of active management of the third stage of labour for preventing postpartum haemorrhage during vaginal delivery: a systematic review and metaanalysis of randomised trials. BJOG. 2018[citado em 2020 fev. 12];125(7):778-81. Disponível em: https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.14923
Rangel RCT, Souza ML, Bentes CML, Souza ACRH, Leitão MNC, Lynn FA. Tecnologias de cuidado para prevenção e controle da hemorragia no terceiro estágio do parto: revisão sistemática Rev Latino-Am Enferm. 2019[citado em 2020 fev. 12];27:e3165. Disponível em: http://www.scielo.br/pdf/rlae/v27/0104-1169-rlae27-e3165.pdf
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