Objectives: to describe the perineal outcomes of women who had delivered in water and out of water. Methods: a cross-sectional and quantitative study developed in a public hospital in Setúbal, Portugal. The population was of women who participated in the "Water Birth Project" in the period from 2011 to 2014, which gave birth in water and out of water. 104 women were selected according to established inclusion criteria. The groups were compared according to the following variables: demographics, obstetric information, delivery care and perineal outcomes. The data were analyzed in the Stata(r) software, with descriptive and bivariate statistics (chi-square and Fisher's test). Results: the medical records of 73 women who gave birth in water and 31 women who gave birth out of water were studied. Water deliveries were significantly associated with fewer perineal lacerations, lower rates of episiotomy, and shorter delivery time. Conclusions: the results of the study suggest that childbirth in water has a protective effect against severe third or fourth degree perineal tears, during fetal expulsion in water.
Este estudo tem como objetivo conhecer as experiências de enfermeiras da Atenção Primária de Saúde (APS) na assistência pré-natal de adolescentes. Tratou-se de uma pesquisa qualitativa usando entrevistas semiestruturadas com 19 enfermeiras atuantes na APS no atendimento pré-natal de adolescentes, analisadas segundo a Análise de Conteúdo Temática de Bardin. Foram identificadas três subcategorias pertencentes à categoria “Atendimento de pré-natal”: Atenção pré-natal às adolescentes; Enfoque de risco biológico versus risco social; e, Aspectos prioritários para assistência pré-natal. A adolescente não recebe atenção pré-natal específica e direcionada. Há necessidade de mais tempo de consulta, incluindo: acolhimento diferenciado, estimulo a criação do vínculo e de melhoria da qualidade das informações às adolescentes, bem como, medidas para evitar o abandono do pré-natal. As dificuldades citadas foram a adesão ao pré-natal, a falta de diálogo profissional–adolescente, e as situações vividas por essas adolescentes, além das dificuldades sociais.
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