Hidroterapia e bola suíça no trabalho de parto: ensaio clínico randomizado

Abstract

Objective: To understand the influence of a warm bath and perineal exercise with the Swiss ball, in an isolated and combined manner, on the progression of labor. Methods: Randomized and controlled clinical trial, conducted from 2013 to 2014 in two public hospitals, with 128 women hospitalized for labor and delivery. The randomization allocated 44 parturients into the warm bath group, 45 into the Swiss ball group, and 39 into the warm bath with Swiss ball group. Results: The study showed a statistically significant increase in the frequency of uterine contractions with the isolated technique (p = 0.025) and associated Swiss ball use (p <0.001), and a significant increase in fetal heart rate with isolated and associated warm bath use (p <0.001). Conclusion: The association of the warm bath and Swiss ball was more effective for the progression of labor and vaginal delivery outcome when compared to the isolated use. ResumoObjetivo: Conhecer a influência do banho quente e exercício perineal com bola suíça, de forma isolada e combinada, sobre a progressão do trabalho de parto. Métodos: Ensaio clínico randomizado e controlado, realizado em dois hospitais públicos, no período de 2013 a 2014 com 128 mulheres internadas para assistência ao parto. A randomização aleatória alocou 44 parturientes no Grupo Banho Quente, 45 no Grupo Bola Suíça e 39 no Grupo Banho Quente e Bola Suíça associados. Resultados: A pesquisa mostrou aumento estatisticamente significante na frequência da contração uterina com uso isolado (p=0,025) e associado da bola suíça (p<0,001), um aumento também significante na frequência cardíaca fetal com uso isolado e associado do banho quente (p< 0,001). Conclusão: Associação do banho quente e bola suíça foi mais efetiva para a progressão do trabalho de parto e desfecho para o parto normal quando comparado com o seu uso isolado.Brazilian Clinical Trials Registry -Registro Brasileiro de Ensaios Clínicos (REBEC): RBR-84xprt

Obstetric practices performed by nurse-midwives of a hospital natural birth center

“…18 In addition, these practices and the freedom of position and movement during the labor, present in 83.0% of the records, are associated with relaxation, reduction in the number of interventions and reduction of the duration of the labor. [19][20][21][22] The partograph was used by 98.3% of the nurses, emphasizing its importance in the prevention of complications, interventions and surgical deliveries, as directed by the Guidelines for Natural Childbirth Care of the MH 23 , an important document that seeks to qualify childbirth care in Brazil through the use of evidencebased practices.…”

Use of the shower aspersion combined with the swiss ball as a method of pain relief in the active labor stage

“…Taavoni et al 19 Randomized and controlled study Barbieri et al 20 Experimental clinical trial or randomized and blind intervention Henrique et al 21 Randomized and controlled clinical trial…”

“…For the elaboration of this category, 2 articles were selected 20,21 . The mother`s cervical dilation can be used as an indicator of pain intensity, guiding the use of relief techniques.…”

“…Now, the swiss ball works on the perineal region, reducing the pelvic discomfort and the need for analgesia. The association of warm shower and the swiss ball during the first period of labor shows greater effectiveness in promoting comfort and consequent pain relief 21 . An experimental, blind and randomized clinical trial was conducted in an intra-hospital normal labor center of the Unified Health System (SUS), in the city of São Paulo.…”

“…when the ball was used isolated, to 216.85min. with the combined interventions, also leading to a higher incidence of normal labor when compared to the isolated use of therapies 21 .…”