Objective: Presenting methodology for transferring knowledge to improve maternal outcomes in natural delivery based on scientific evidence. Method: An intervention study conducted in the maternity hospital of Itapecerica da Serra, SP, with 50 puerperal women and 102 medical records from July to November 2014. The PACES tool from Joanna Briggs Institute, consisting of pre-clinical audit (phase 1), implementation of best practice (phase 2) and Follow-up Clinical Audit (phase 3) was used. Data were analyzed by comparing results of phases 1 and 3 with Fisher's exact test and a significance level of 5%. Results: The vertical position was adopted by the majority of puerperal women with statistical difference between phases 1 and 3. A significant increase in bathing/showering, walking and massages for pain relief was found from the medical records. No statistical difference was found in other practices and outcomes. Barriers and difficulties in the implementation of evidence-based practices have been identified. Variables were refined, techniques and data collection instruments were verified, and an intervention proposal was made. Conclusion: The study found possibilities for implementing a methodology of practices based on scientific evidence for assistance in natural delivery.
Objectives: to compare the pelvic floor muscle strength in primiparous women after normal
birth and cesarean section, related to the socio-demographic characteristics,
nutritional status, dyspareunia, urinary incontinence, perineal exercise in
pregnancy, perineal condition and weight of the newborn.Methods: this was a cross-sectional study conducted after 50 - 70 postpartum days, with 24
primiparous women who underwent cesarean delivery and 72 who had a normal birth.
The 9301 PeritronTM was used for analysis of muscle strength. The mean muscle
strength was compared between the groups by two-way analysis of variance. Results: the pelvic floor muscle strength was 24.0 cmH2O (±16.2) and 25.4 cmH2O (±14.7) in
postpartum primiparous women after normal birth and cesarean section,
respectively, with no significant difference. The muscular strength was greater in
postpartum women with ≥ 12 years of study (42.0 ±26.3 versus 14.6 ±7.7 cmH2O; p=
0.036) and in those who performed perineal exercises (42.6±25.4 11.8±4.9 vs.
cmH2O; p = 0.010), compared to caesarean. There was no difference in muscle
strength according to delivery type regarding nutritional status, dyspareunia,
urinary incontinence, perineal condition or newborn weight. Conclusion: pelvic floor muscle strength does not differ between primiparous women based on
the type of delivery. Postpartum women with normal births, with higher education
who performed perineal exercise during pregnancy showed greater muscle
strength.
OBJECTIVES: to analyze the Pelvic Floor Muscle Strength (PFMS) of pregnant women with one or
more vaginal or cesarean deliveries; to compare the PFMS of these with pregnant
women with the PFMS of primiparous women. METHODS: cross-sectional study with women up to 12 weeks pregnant, performed in
Itapecerica da Serra, São Paulo state, from December 2012 to May 2013. The sample
consisted of 110 pregnant women with one or more vaginal deliveries or cesarean
sections and 110 primigravidae. The PFMS was evaluated by perineometry
(Peritron(tm)) and vaginal digital palpation (modified Oxford scale). RESULTS: the average PFMS in pregnant women with a history of vaginal delivery or cesarean
section was 33.4 (SD=21.2) cmH2O. From the Oxford scale, 75.4% of the pregnant
women with previous vaginal or cesarean deliveries presented grade ≤ 2, and 5.5%
grade ≥ 4; among the primiparae, 39.9% presented grade ≤ 2, and 50.9% grade ≥ 4,
with a statistically significant difference (p<0.001). From the perineometry,
there was no statistically significant difference between the PFMS and age, type
of delivery, parity, body mass index, and genitourinary tract symptoms, however,
there was a statistically significant difference between the pregnant women with
and without a history of episiotomy (p=0.04). In the palpation, none of the
variables showed a statistically significant difference. CONCLUSION: pregnancy and childbirth can reduce the PFMS.
Freshwater stingray injuries, which should be considered occupational injuries, are common in the study area, especially in places like beaches or in the lakes that form during the dry season, when stingrays are routinely observed. A significant proportion of respondents was unaware of the correct first aid measures and had insufficient resources to treat the complications of these injuries in the locality where they reside. Interactive activities involving local residents - such as lectures and the distribution of simple pamphlets providing information about stingray injuries - are needed.
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