A Influência da fisioterapia nos desfechos maternos de mulheres induzidas por misoprostol

Abstract

It is known that the vaginal delivery method is the form of delivery that brings more advantages to the mother-baby binomial, however, in Brazil, a very high number of surgical deliveries is still observed. Therefore, one of the methods used by health professionals is the induction of labor, the most commonly used inducer in hospitals in the country being the drug misoprostol vaginally and, after the beginning of induction, the pregnant woman can move and walk. Therefore, the physical therapist plays a fundamental role in helping to increase the number of vaginal deliveries, as it aims to keep the pregnant woman active and stimulate her body awareness. Therefore, the study aims to evaluate the influence of physical therapy on maternal outcomes in women induced by misoprostol. This is an analytical, experimental, pragmatic clinical trial type study. The collection was carried out at the Maternity Hospital of the Lauro Wanderley University Hospital of the Federal University of Paraíba (HULW), located in the city of João Pessoa - PB. The study had as inclusion criteria pregnant women aged 18 years or older; misoprostol-induced labor (25mcg, vaginally); single pregnancy; live fetus; cervical dilatation greater than or equal to 5 cm at the beginning of the intervention and as exclusion criteria maternal physical and/or mental disability; fetal malformation; women in the expulsive period of labor. Data were processed in the Statistical Package for the Social Sciences SPSS database, version 20.0, attributing a significance level of 95% (p>0.05). The sample consisted of 32 induced pregnant women, 16 of whom were participants in the study group and 16 in the control group who did not receive assistance from the physical therapist. The vaginal delivery route in the EG was 93.8% and in the CG it was 56.2% (p=0.016). The total labor time of women who underwent vaginal delivery was 6h31min ± 3h31min for the EG and 4h28min ± 1h31min for the CG (p=0.032). Of the women who had vaginal delivery, the age group with the highest prevalence of the EG was 22 and 26 years old and for the CG it was 18 and 22 years old or 30 to 34 years old. All women in the EG with an overweight BMI progressed to vaginal delivery, while in the CG 85.7% were overweight and underwent surgical delivery. Regarding parity, the multiparous women in the EG, none of them progressed to surgical delivery, while 42.9% of the multiparous women in the CG had this type of delivery. The use of oxytocin was verified in 31.25% of the sample, of which 60.0% (6) were from the EG and 40.0% (4) from the CG. The episiotomy procedure was performed in two women who belonged to the CG. Perineal laceration occurred in both groups, being higher in women in the EG (73.3%), in which second-degree laceration was more prevalent (45.5%), compared to the CG (55.6%). in which the first degree was more incident (60.0%). The study in question showed that kinesiotherapy associated with labor induction by the drug misoprostol promoted a greater number of vaginal deliveries compared to those who only had induced labor. In addition, it was possible to perceive that all overweight women in the EG progressed to vaginal delivery, as well as all multiparous women in the same group had the same delivery method. In view of the above, it was possible to perceive the importance of the presence of the physical therapist both in the country's maternity hospitals and during the prenatal care of these pregnant women.