Repercussões maternas e fetais da analgesia obstétrica: uma revisão integrativa

Filho, Edson Diniz Sarmento; Amaral, Hudson Rodrigo Macendo; Silva, Diana Matos; Barbosa, Thiago Luis Andrade; Gomes, Ludmila Mourão Xavier

doi:10.15446/av.enferm.v33n2.52176

Cited by 4 publications

(10 citation statements)

References 33 publications

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“…It was verified the higher probability of first--minute Apgar score <7, but there was no significant difference in the fifth minute. This finding corroborates the literature, which confirms that pharmacological obstetric analgesia does not imply an increased risk for neonatal scores lower than 7 in the fifth minute of life (9,(16)(17) .…”

Section: Discussionsupporting

confidence: 92%

Pharmacological obstetric analgesia: a study of obstetric and neonatal outcomes

Fernandes¹,

Damasceno²,

Herculano³

et al. 2017

Rev Rene

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Objective: to investigate the association between pharmacological obstetric analgesia and obstetric and neonatal outcomes. Methods: it was a retrospective case-control study conducted with 393 pregnant women comprising 131 cases of pharmacological obstetric analgesia and 262 controls that did not perform this procedure. The sociodemographic and obstetric profile, the circumstances of parturient admission, obstetrical decisions, and obstetric and neonatal outcomes were investigated. Results: pregnant women submitted to pharmacological analgesia during labor presented an increased risk for the use of exogenous oxytocin (p<0.001), episiotomy (p=0.001), Kristeller maneuver (p=0.036), and forceps (p=0.004). Conclusion: pharmacological analgesia does not increase the risk of spontaneous perineal tear, abdominal delivery, and hospitalization in neonatal unit. Nevertheless, it influences the increased risk of synthetic oxytocin use, Kristeller maneuver, episiotomy, forceps, and the occurrence of lower first-minute Apgar scores.

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Section: Discussionsupporting

confidence: 92%

Pharmacological obstetric analgesia: a study of obstetric and neonatal outcomes

Fernandes¹,

Damasceno²,

Herculano³

et al. 2017

Rev Rene

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“…In this context, obstetric analgesia has made great strides and, in recent years, more and more women have opted for using it for labor pain relief (10)(11) . Among the types of analgesia, the epidural provides more effective pain relief and greater maternal satisfaction; in addition, women remain involved, preventing hyperventilation and reducing maternal stress (12) .…”

Section: Introductionmentioning

confidence: 99%

“…Among the types of analgesia, the epidural provides more effective pain relief and greater maternal satisfaction; in addition, women remain involved, preventing hyperventilation and reducing maternal stress (12) . The ideal epidural method should be the one with the least adverse effect on the fetus and the newborn (10) . However, a previous study investigated the relationship between labor analgesia and delivery outcomes and found that the use of pharmacological analgesia in labor was associated with an increased risk of instrumental vaginal delivery (13) .…”

Section: Introductionmentioning

confidence: 99%

“…A recent integrative review has shown that studies on obstetric analgesia, maternal and fetal outcomes in Brazil have increased (10) . However, the association between the use of analgesia and neonatal outcomes is still controversial (10,14) . In addition, most of the studies compare different types of analgesia, and only few compare the use and non-use of analgesia.…”

Section: Introductionmentioning

confidence: 99%

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Obstetric analgesia in labor and its association with neonatal outcomes

et al. 2020

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Objetive: To investigate the association between analgesia during labor and occurrence of neonatal outcomes. Method: Retrospective cohort study with medical records of 850 parturient. The exposure variable of interest was receiving pharmacological analgesia during labor and neonatal outcomes were: one- and five-minute Apgar, resuscitation maneuvers and referral of the newborn to Neonatal ICU. A logistic regression was carried out to obtain Odds Ratios and 95% confidence interval, with adjustment for confounding factors. Results: Among the women studied, 35% received analgesia and this use was associated with a greater chance of neonatal outcomes such as one-minute Apgar < 7 (p <0.0001), resuscitation maneuvers (p <0.001) and referral to the Neonatal ICU (p = 0.004), mostly were among low-risk pregnant women, even after adjustments. Conclusion: The use of pharmacological analgesia during labor is associated with one-minute Apgar < 7, resuscitation maneuvers and referral to the Neonatal ICU.

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“…Depending on the tolerability to anesthetic block and the dose applied, the pregnant woman may have clinical repercussions, the most common of which are nausea, vomiting, pruritus, and hypotension 6 . The latter, due to its effect in reducing uterine perfusion, may result in lower oxygen supply for the fetus.…”

Section: Introductionmentioning

confidence: 99%

Análise do resultado obstétrico de partos submetidos a anestesia de condução e das repercussões neonatais imediatas

Gontijo

Araújo

Reis

2020

Rev. Med. (São Paulo)

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Introdução: A anestesia é um recurso importante no alívio da dor durante o trabalho de parto (TP). Não é um procedimento isento de riscos e sua utilização envolve decisão com base nas condições clínicas e obstétricas, desejo da mulher e disponibilidade do procedimento. O objetivo deste estudo foi analisar a associação entre essa intervenção com a ocorrência de parto operatório e baixo escore de Apgar. Método: Estudo retrospectivo de base de dados hospitalar contendo 5.282 parturientes com gestação única, de feto em apresentação cefálica nascido vivo e sem malformação, entre os 8.591 nascimentos ocorridos no período de 2014 a 2017, na maternidade do Hospital das Clínicas da UFMG. Desfechos de interesse foram comparados entre partos conduzidos com ou sem anestesia, através de testes de associação. Resultados: A ocorrência de anestesia de condução de TP foi de 29,9%, sendo mais frequente entre adolescentes (33,3% versus 29,1%; p = 0,008), nulíparas (39,7% versus 21,6%; p<0,001), naquelas com parto induzido (40,6% versus 26,5%; p<0,001), portadoras de cardiopatias (53,5% versus 29,6%; p<0,001) e parturientes cujos recém-nascidos pesaram 2500 g ou mais ao nascer (31,3% versus 19,7%; p<0,001). Houve associação entre anestesia e aumento do uso de fórceps (15,7% versus 1,8%; p<0,001) e de vacum extrator (2,0% versus 0,6%; p < 0,001), porém ocorreu redução das taxas de cesariana (7,3% versus 12,9%; p<0,001). O uso da anestesia associou-se à maior ocorrência de Apgar de 1o minuto < 7 (p<0,001), mas não alterou o de 5o (p=0,243). A nuliparidade parece ter influência sobre a ocorrência de parto cesariano (8,6% versus 5,2%; p = 0,013) e uso de fórceps (19,4% versus 9,8%; p<0.001). Conclusão: O uso de anestesia de condução no parto associou-se ao parto vaginal operatório, e à menor taxa de cesariana, sem impacto no Apgar de 5o minuto.

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Repercussões maternas e fetais da analgesia obstétrica: uma revisão integrativa

Cited by 4 publications

References 33 publications

Pharmacological obstetric analgesia: a study of obstetric and neonatal outcomes

Pharmacological obstetric analgesia: a study of obstetric and neonatal outcomes

Obstetric analgesia in labor and its association with neonatal outcomes

Análise do resultado obstétrico de partos submetidos a anestesia de condução e das repercussões neonatais imediatas

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