Practices During Preparturition and Normal Delivery Care in a Maternity Hospital in Southern Brazil

Schneckenberg, Camila Rocha; Kluthcovsky, Ana Claudia Garabeli Cavalli; Ditzel, Ana Paula

doi:10.1590/1678-4324-2020190420

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Article - Human and Animal Health • Braz. arch. biol. technol. 63 • 2020 • https://doi.org/10.1590/1678-4324-2020190420 copy

Practices During Preparturition and Normal Delivery Care in a Maternity Hospital in Southern Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to evaluate the practices of hospital care during pré parturition and normal delivery in a maternity hospital in Southern Brazil. A cross-sectional and quantitative study performed with 82 postpartum women. Results were evaluated for the total number of postpartum women and in two groups according to hospital delivery time (≤ 8 and > 8 hours). Chi-square and Fisher Exact tests were used. with a significance level of 5%. Percentages of useful practices were: oral diet (23.2%), freedom of position and movement (90.2%), non-pharmacological methods to alleviate pain (64.6%), companion in prepartum (62.1%) and parturition (42.5%) and partogram (62.2%). Harmful practices: enema (3.7%), trichotomy (3.7%), lithotomy position (92.7%) and Kristeller maneuver (20.7%). Practices used inappropriately: amniotomy (4.9%), oxytocin (41.5%), analgesia (1.2%) and episiotomy (36.6%). The hospital labor time above 8 hours was associated with offering oral diet (p < 0.001), use of non-pharmacological methods for pain relief (p < 0.01), oxytocin infusion (p = 0.01) and episiotomy (p < 0.01). The delivery care with minimum intervention compatible with the recommendations is still a challenge.

Keywords:
obstetric labor; natural childbirth; health services research

Variables		n	%
Age in years
	Less than 20	9	11.0
	20 or above	73	89.0
Marital status
	Without a partner	11	13.4
	With a partner	71	86.6
Skin color
	Non-white	30	36.6
	white	52	63.4
Schooling
	Up to 8 years of study	35	42.7
	Over 8 years of study	47	57.3
Paid work
	No	45	54.9
	Yes	37	45.1
Monthly family income* per capita in reais^a
	Up to 880.00	71	87.7
	> 880.00	10	12.3
Prenatal consultations
	≤ 6	13	15.9
	7 or more	69	84.1
First pregnancy
	Yes	19	23.2
	No	63	76.8
Time of hospital labor
	< 8	52	63.4
	8 or more	30	36.6
Intercurrences in pregnancy
	Yes	14	17.1
	No	68	82.9
Gestational age
	< 37 weeks	3	3.7
	37 weeks or more	79	96.3
Birth weight in grams^b
	< 2,500	2	2.6
	2,500 to 3,999	71	91.0
	4,000 or more	5	6.4
Apgar in the first minute^c
	≤ 7	11	13.7
	8 or more	69	86.3
Apgar in the fifth minute^d
	≤ 7	1	1.3
	8 or more	78	98.7

Instituto de Tecnologia do Paraná - Tecpar Rua Prof. Algacyr Munhoz Mader, 3775 - CIC, 81350-010 Curitiba PR Brazil, Tel.: +55 41 3316-3052/3054, Fax: +55 41 3346-2872 - Curitiba - PR - Brazil
E-mail: babt@tecpar.br

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[1] *Correspondence: camila.crs@hotmail.com (C. R. S.); anafabio2009@gmail.com (A.C.G.C.K.); prof.go.anapaula@gmail.com (A. P. D).

Variables		Total			Time of hospital labor (hours)				p
		Total			Up to 8		More than 8
		n	%		n	%	n	%
Oral diet offered									<0,001*
	Yes	19	23.2		5	9.6	14	46.7
	No	63	76.8		47	90.4	16	53.3
Freedom of position and movement									0.25**
	Yes	74	90.2		45	86.5	29	96.7
	No	8	9.8		7	13.5	1	3.3
Non-pharmacological methods for pain relief									<0.01*
	Yes	53	64.6		25	48.1	28	93.3
	No	29	35.4		27	51.9	2	6.7
Presence of companion (prepartum)									0.11*
	Yes	51	62.1		29	44.2	22	73.3
	No	31	37.8		23	55.8	8	26.7
Presence of companion (labor)									0.10*
		Yes	34	41.5		18	34.6	16	53.3
		No	48	58.5		34	65.4	14	46.7
Use of partogram									0.43*
	Yes	51	62.2		34	65.4	17	56.7
	No	31	37.8		18	34.6	13	43.3

Variables		Total		Hospital labor time (hours)				p
		Total		Up to 8		More than 8
		n	%	n	%	n	%
Enema								1.00**
	Yes	3	3.7	2	3.8	1	96.7
	No	79	96.3	50	96.2	29	3.3
Trichotomy								0.55**
	Yes	3	3.7	1	1.9	2	6.7
	No	79	96.3	51	98.1	28	93.3
Lithotomy position during delivery								0.66**
	Yes	76	92.7	49	94.2	27	90.0
	No	6	7.3	3	5.8	3	10.0
Kristeller maneuver								0.12*
	Yes	17	20.7	8	15.4	9	30.0
	No	65	79.3	44	84.6	21	70.0

Variables		Total		Admission time until delivery (hours)				p
		Total		Up to 8		More than 8
		n	%	n	%	n	%
Amniotomy								1.00**
	Yes	4	4.9	3	5.8	1	3.3
	No	78	95.1	49	94.2	29	96.7
Oxytocin infusion								0.01*
	Yes	34	41.5	16	30.8	18	60.0
	No	48	58.5	36	69.2	12	40.0
Analgesia								0.37**
	Yes	1	1.2	0	0.0	1	3.3
	No	81	98.8	52	100.0	29	96.7
Episiotomy								<0.01*
	Yes	30	36.6	12	23.1	18	60.0
	No	52	63.4	40	76.9	12	40.0