Non-pharmacological therapies applied in pregnancy and labor: an integrative review

Biana, Camilla Benigno; Cecagno, Diana; Porto, Adrize Rutz; Cecagno, Susana; Marques, Vanessa de Araújo; Soares, Marilú Corrêa

doi:10.1590/s1980-220x2019019703681

Cited by 19 publications

(14 citation statements)

References 47 publications

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“…Senses of Birth (SoB) is a health education intervention in Brazil that seeks to minimize unnecessary medicalization for women during childbirth by offering information on evidence-based practices (EBP) ( 50 ). A recent integrative review has listed studies on non-pharmacological therapies with immediate effects in labor, such as massage, hot baths, Swiss ball, breathing techniques, and supportive care ( 51 ). Rates of hydrotherapy use differ widely from country to country ( 4 , 52 ).…”

Section: Discussionmentioning

confidence: 99%

Quantitative cardiac autonomic outcomes of hydrotherapy in women during the first stage of labor

Dias

Cardoso²,

Ghimouz³

et al. 2023

Front. Med.

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IntroductionMost hydrotherapy studies during childbirth report findings related to pain using a widespread set of subjective measures. In this study, ECG biomarkers as quantitative cardiac autonomic outcomes were used to assess the effects of warm shower hydrotherapy on laboring women during the first stage of labor.MethodsThis was a prospective single-blind cohort study on stage I delivering women. Their cardiac autonomic function was assessed using heart rate variability (HRV) measures during a deep breathing test using point-of-care testing comprised of an HRV scanner system with wireless ECG enabling real-time data analysis and visualization. Labor pain and anxiety were assessed using the Visual Analog Scale for Pain (VASP) and the Beck Anxiety Inventory (BAI). A total of 105 pregnant women in the first stage of labor who received warm shower hydrotherapy, intravenous analgesia (scopolamine + sodium dipyrone), or spinal anesthetic (bupivacaine + morphine) were enrolled.ResultsIn women during the first stage of labor, parasympathetic modulation reflected through RMSSD (root mean square of successive RR interval differences) was significantly reduced by hydrotherapy and intravenous analgesia (before vs. after mean rank diff. 35.73 and 65.93, respectively, p < 0.05). Overall HRV (SDNN, standard deviation of RR intervals) was significantly decreased only by intravenous analgesia (before vs. after mean rank diff. 65.43, p < 0.001). Mean heart rate was significantly increased by intravenous analgesia, while spinal anesthesia reduced it, and hydrotherapy did not alter it (before vs. after mean rank diff. –49.35*, 70.38*, –24.20NS, respectively, *p < 0.05, NS not significant).ConclusionThis study demonstrates that warm shower therapy may impact the sympathovagal balance via parasympathetic withdrawal in women during the initial stage of labor. The findings of this study provide quantitative support for using warm shower hydrotherapy during labor via point-of-care testing. The dependability of hydrotherapy as a non-pharmacological treatment is linked to the completion of more clinical research demonstrating quantitative evidence via outcome biomarkers to support indications on stress and birth progress.

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Section: Discussionmentioning

confidence: 99%

Quantitative cardiac autonomic outcomes of hydrotherapy in women during the first stage of labor

Dias

Cardoso²,

Ghimouz³

et al. 2023

Front. Med.

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“…The perception of maternal fatigue is high as a result of intensified uterine contractions, leg cramps, and respiratory and digestive diseases, in addition to the excessive use of synthetic oxytocin and unsupervised exercise 1,4 . Lack of energy supply through feeding during childbirth, dehydration, ketoacidosis, and psychological and situational factors can also increase maternal fatigue during labor 1,2. Among the non-pharmacological methods to reduce the perception of maternal fatigue during labor, breathing exercises, the use of the Swiss Ball, massage, and thermotherapy stand out 6,7 . As maternal fatigue is more pronounced during the second period of labor, is not recommended directed pushing it increases the risk of the use of pharmacological analgesia and cesarean 8 .…”

Section: Introductionmentioning

confidence: 99%

Assessment of responsiveness and minimum important difference of the Maternal perception of Childbirth Fatigue Questionnaire (MCFQ)

2022

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Introduction: The assessment of responsiveness and the Minimum Clinically Important Difference (MCID) is the basis for validating the Maternal perception of Childbirth Fatigue Questionnaire (MCFQ). Objective: To assess the responsiveness and determine the value of the MCID for the MCFQ. Methods: This is an observational study, conducted at HC-UFPE with 50 parturients in active labor. The MCFQ was applied in two moments: in the initial evaluation (EV1), performed at the beginning of labor between 4-6 cm of uterine dilation, and final (EV2), six hours after the first evaluation. Responsiveness was determined by calculating the effect size (ES), and standardized response mean (SRM), considering that values of 0.2, 0.5, and 0.8 points represent respectively small, moderate, or large values of responsiveness. The ability to detect change through the questionnaire was also assessed by the t-test. The level of significance adopted for this analysis was p less than 0.05. The MCID was verified based on the calculation of the standard error of measurement (SEM) index. Results: The MCFQ showed values of 0.4 and 0.6 for ES and SEM respectively and a p-value <0.001, thus showing a good capacity for change. The value of the MCID for this population was seven points. Conclusion: MCFQ presents a potentially significant change with a value of the MCID of seven points after six hours of active labor.

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“…A primeira fase é a dilatação do colo uterino, que se subdivide em fase latente, na qual o tempo de trabalho de parto varia de 6,0 a 7,5 horas em primíparas e de 4,5 a 5,5 horas em multíparas e, fase ativa, na qual o tempo pode variar entre 3,7 a 8,4 horas, sendo finalizado ao atingir os 10 cm de dilatação ou ao iniciar o processo expulsivo do trabalho de parto (Abalos et al, 2020). A posição adotada pela parturiente pode interferir na duração do parto, sendo a posição vertical considerada fator importante na redução do tempo do primeiro estágio do trabalho de parto (Biana et al, 2021).…”

Section: Introductionunclassified

“…Esta é utilizada para mobilidade pélvica e posicionamento, podendo, além de controlar os sintomas álgicos, reduzir a duração do trabalho de parto e promover autoconfiança materna. Os recursos não farmacológicos oferecem suporte à gestante no manejo, diminuição da dor e autocontrole no processo de parto além do cuidado padrão, ou seja, trazem uma combinação de técnicas físicas e psicológicas de apoio ao parto, gerando satisfação da parturiente (Biana et al, 2021). Nos últimos 30 anos, várias estratégias foram desenvolvidas no Brasil com a finalidade de melhorar a assistência no parto, reduzir o número de cesarianas e a morbimortalidade materna e fetal.…”

Section: Introductionunclassified

O uso da bola de nascimento como recurso fisioterapêutico diminui a dor e a duração do trabalho de parto?

Mendes

Silva²,

Teixeira³

et al. 2022

RSD

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Introdução: A dor do parto é uma experiência vivenciada pela maioria das parturientes. Recursos não farmacológicos podem ser usados para reduzir o quadro álgico, a duração e o risco de sofrimento materno e fetal no parto. O objetivo deste estudo foi avaliar os efeitos do uso da bola de nascimento na redução da dor e duração do trabalho de parto. Métodos: Trata-se de uma revisão sistemática, realizada nas bases de dados PubMed, PEDro e SciELO em setembro/2022. Foram selecionados para a pesquisa apenas ensaios clínicos controlados randomizados. A pergunta de pesquisa foi: O uso da bola de nascimento como recurso fisioterapêutico diminui a dor e a duração do trabalho de parto? Resultados: Foram encontrados 17 estudos, sendo 6 incluídos. Dentre os estudos analisados, todos avaliaram o efeito do uso da bola de nascimento na redução da dor, observando diferença significativa, enquanto 5 analisaram seu efeito na redução da duração do trabalho de parto, apresentando resultados divergentes. Um dos estudos permitiu o uso da bola amendoim, uma alternativa em casos de anestesia peridural para posicionamento materno. A bola de parto é um dos recursos não farmacológicos de baixo custo utilizado no manejo da dor e duração do parto, apresentando segurança clínica, não interferindo em parâmetros maternos e fetais. Conclusão: Esta revisão permite concluir que a bola de nascimento é um recurso que apresenta resultados positivos na redução da dor durante o trabalho de parto, entretanto não há ainda um consenso na literatura a respeito do seu efeito na duração do parto.

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Non-pharmacological therapies applied in pregnancy and labor: an integrative review

Cited by 19 publications

References 47 publications

Quantitative cardiac autonomic outcomes of hydrotherapy in women during the first stage of labor

Quantitative cardiac autonomic outcomes of hydrotherapy in women during the first stage of labor

Assessment of responsiveness and minimum important difference of the Maternal perception of Childbirth Fatigue Questionnaire (MCFQ)

O uso da bola de nascimento como recurso fisioterapêutico diminui a dor e a duração do trabalho de parto?

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