Análise da hemorragia no parto vaginal pelos índices de eritrócitos e hematócrito

Abstract

Objective: To analyze hemorrhage at vaginal delivery using hemoglobin and hematocrit indices. Methods: This was a cross-sectional study of 328 vaginal deliveries divided into spontaneous delivery with or without episiotomy and forceps delivery. The sample was randomly stratified by type of vaginal delivery. Data were collected at admission for delivery, hospital discharge and postpartum return visit. Results: There were 122 (37.2%) deliveries without episiotomy, 147 (44.8%) with episiotomy, and 59 (18.0%) with forceps delivery and episiotomy. Hemoglobin values between admission for delivery and discharge ranged from -5.9 g/dl to 0.7 g/dl. Hemoglobin reduction was significantly higher in women having forceps delivery than in those with spontaneous deliveries, with and without episiotomy (p=0.0133 and p<0.0001, respectively). Hemorrhage was greater in the forceps delivery group than in the other groups. Conclusion: The analysis of hemorrhage at vaginal delivery by using hemoglobin and hematocrit indices showed variation among the three types of vaginal delivery studied. There was greater hemorrhage with forceps delivery and less hemorrhage with spontaneous delivery. In women with forceps delivery, postpartum indices were lower than those at hospital admission. ResumoObjetivo: Analisar a hemorragia no parto vaginal através dos índices de eritrócitos e hematócrito. Métodos: Estudo transversal realizado em 328 partos vaginais divididos em: espontâneo, com e sem episiotomia, e parto fórceps. A amostragem foi aleatória estratificada por tipo de parto vaginal. Os dados foram coletados na internação para o parto, na alta hospitalar e no retorno puerperal. Resultados: Foram estudados 122 (37,2%) partos sem episiotomia, 147 (44,8%) com episiotomia e 59 (18,0%) com uso de fórceps e episiotomia. O valor individual de hemoglobina, entre a internação para o parto e a alta hospitalar variou de -5,9 g/dl a 0,7 g/dl.A redução da hemoglobina foi significativamente maior no parto fórceps comparado aos partos espontâneos, com e sem episiotomia, p=0,0133 e p<0,0001, respectivamente. No parto fórceps a hemorragia é maior quando comparada aos outros tipos de parto Conclusão: A análise da hemorragia no parto vaginal através dos índices de eritrócitos e hematócrito evidenciou que há variação nos três tipos de parto vaginal estudados, sendo a hemorragia maior no parto fórceps e menor no parto vaginal espontâneo. No puerpério, nos casos de partos fórceps estes índices mantiveram-se inferiores aos da internação.

Per-Partum Anaemia and Missed Post-Partum Haemorrhage in Low Resources Settings

“…We think that it should be systematically adopted, to improve the recognition and early management of post-partum blood loss in low income environment and as such avoid severe PPH. Spontaneous delivery with episiotomy/perineal tear and forceps delivery can also cause a greater blood loss [37]. These relationships were not investigated in this work.…”

Avaliação da assistência de enfermagem na hemorragia pós-parto

“…It was thus evidenced that professionals should have knowledge of the main causes of PPH, which is a determining factor for fast, efficient and resolutive assistance, thus reducing possible complications of the condition that leads many women to death. [3][4][5] It was also observed that most of the professionals had less than five years in the service and, although almost all of the interviewees were specialists in the areas of Gynecology/Obstetrics, more than half said they had never had contact with patients in the PPH, a determining factor for the quality of service. It is understood that clinical practice is the main responsible for the accumulation of knowledge and skills and such qualification does not necessarily come with the length of service in a given sector, nor with age, but with clinical experience with certain situations.…”

“…3 It is stated by some authors that, during vaginal delivery, several factors may be associated with PPH, including the third prolonged delivery period, the impediment of falling fetal presentation, episiotomy, macrosomia, use of forceps and extractor vacuum, induction and conduction of labor, previous postpartum hemorrhage and nulliparity. [3][4] By the fifth goal of the Millennium Development Goals, the World Health Organization (WHO), to the reduction of ¾ of maternal mortality in the period 1990-2015, and in order for this objective to be achieved, a reduction in maternal mortality due to PPH should occur. It is reaffirmed by the WHO that, in order to achieve this goal, it will be necessary for all to be prepared, skilled and with a careful improvement in the health of women through strategic policies and programs that ensure effective interventions for women reduction of PPH.…”

“…Data from the Mortality and Live Births Information System of the Brazilian Ministry of Health identified that PPH corresponded to 40.8% of obstetric hemorrhages. [2][3][4][5][6] It is understood, based on the high maternal morbimortality index associated with PPH, that it is imperative to know the main nursing behaviors used to control this obstetric complication. The nurse, as responsible for the care of the woman, must be endowed with technical and scientific knowledge about obstetric complications and, thus, offer to the puerpera effective Nursing interventions for the reestablishment of wellbeing and the control of the postpartum hemorrhage.…”

Polímeros Empregados Em Período De Pandemia Sars-Cov-2 a Importância Dos Polímeros Durante a Pandemia De Covid-19

“…A placenta prévia pode ter como consequência o acretismo placentário, caracterizado pela invasão excessiva do trofoblasto no miométrio, com risco de hemorragia intraparto e uso de terapêutica transfusional (GIELCHINSKY et al, 2002;PEREIRA;CAMPOS, 2013). da placenta e como última alternativa a histerectomia (MORAES et al, 2009;QUIÑONES et al, 2010).…”