O desenvolvimento da taquipnéia transitória do recém-nascido e desconforto respiratório precoce: associação à via de parto
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Data
2010
Autores
Minozzi, Andrea Simões [UNIFESP]
Orientadores
Scudeller, Tânia Terezinha [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
Título da Revista
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Título de Volume
Resumo
Introdução: Um dos distúrbios respiratórios mais frequentes do período neonatal é a
Taquipnéia Transitória do Recém-nascido (TTRN) e o Desconforto Respiratório Precoce
(DRP). Acredita-se que um dos principais fatores de risco para esses distúrbios seja a via de
parto, indicando o parto cesáreo como possível causador dessa morbidade perinatal pela.
ausência de compressão do canal de parto no tórax do feto e consequente acúmulo de
líquido pulmonar no neonato. Objetivo: Correlacionar o desenvolvimento da TTRN e DRP
com a via de parto. Desenho do estudo: Tratou-se de um estudo clínico observacional com
descrição retrospectiva de casos e amostra constituída de 412 neonatos, sendo que 206
nascidos de cesárea (PC) e 206 de parto vaginal (PV), na maternidade da Irmandade da
Santa Casa de Santos. Entre os grupos (PC x PV) foram comparadas a idade gestacional
do parto (IG), índice de Apgar de primeiro e quinto minuto, peso do neonato, freqüência
respiratória (FR), necessidade de oxigenoterapia, ventilação mecânica invasiva (VMI) ou
não-invasiva (VMNI), internação na Unidade de Terapia Intensiva Neonatal (UTIN), e
presença de DRP e/ou TTRN. As médias foram avaliadas pelo teste Mann-Whitney e as
proporções, pelo teste do qui-quadrado (X
2
), com p< 0,05. Resultados: Na amostra
estudada encontrou-se 26,41% de ocorrência de DRP ou TTRN sem diferença significativa
entre as vias de parto. As variáveis de Apgar de 5
0 minuto, IG, VMI, VMNI e Oxigenoterapia,
foram estatisticamente iguais entre os grupos PC e PV. No entanto, os valores médios do
peso dos neonatos foi significativamente menor nos nascidos de PV enquanto que a média
do Apgar de 1
o minuto foi maior nesse mesmo grupo (p=0,004). Os neonatos que
apresentaram DRP/TTRN, nascidos por PC demonstraram FR maior quando comparados
ao grupo PV. Conclusão: O PC não foi precursor de DRP/TTRN, como também não
apresentou relação causal com o uso de oxigenioterapia, VMI, VMNI e internação em UTIN.
O PV favoreceu melhor vitalidade neonatal e valores de peso de recém-nascidos (RN)
menores, comparados ao PC. A cesárea foi fator determinante nos índices de FR neonatal
mais elevados, em RN diagnosticados com DRP ou TTRN, sugerindo maior sofrimento
neonatal. Não há critérios estabelecidos para uso de oxigenioterapia, confirmado pela
freqüência significativa desta intervenção terapêutica mesmo em recém-nascidos saudáveis
(80,42%)
Introduction: One of the most common respiratory disorders of the neonatal period is Transient Tachypnea of the Newborn (TTRN) and Early Respiratory Distress (ERD). It is believed that one of the major risk factors for these disorders is the mode of delivery, cesarean section as indicating the likely cause of perinatal morbidity by no compression of the birth canal into the chest of the fetus and consequent accumulation of fluid in the newborn lung. Objective: To correlate the development of TTRN DRP and the route of delivery. Study Design: This was an observational clinical study with retrospective case description and a sample of 412 newborns, with 206 born in cesarean section (CP) and 206 delivered vaginally (PV), the maternity of the Brotherhood of Santa Casa de Santos. Between groups (CP x PV) were compared to gestational age at delivery (GA), Apgar score of the first and fifth minutes, birth weights, respiratory rate (RR), need for oxygen therapy, invasive mechanical ventilation (IMV) or not -invasive (NIMV), admission to the Neonatal Intensive Care Unit (NICU), and presence of ERD and / or TTRN. The means were evaluated by the Mann-Whitney Test and proportions by Chi-Square (X2), p<0,05. Results: In this sample met 26.41% of the occurrence of DRP or TTRN no significant difference between the means of delivery. The variables of Apgar Score of fifty minute , GA, IMV, NIMV and Oxygen were statistically identical between the groups PC and PV. However, the mean weight of neonates was significantly lower in infants of PV while the mean Apgar at first minute was higher in this same group (p = 0.004). Newborns who had TTRN/ERD, born by cesarean section demonstrate raised RR when compared to PV. Conclusion: The SC was not a precursor of DRP / TTRN, but also showed no causal relationship to oxygen therapy, VMI, NIV and hospitalization in the NICU. The PV favored better neonatal vitality and weight values of newborns lower compared to the SC. Cesarean section was an important factor in rates of neonatal RR higher in infants diagnosed with ERD or TTRN, suggesting greater neonatal suffering. There are no established criteria for oxygen therapy, confirmed by the significant frequency of this therapeutic intervention even in healthy newborns (80.42%)
Introduction: One of the most common respiratory disorders of the neonatal period is Transient Tachypnea of the Newborn (TTRN) and Early Respiratory Distress (ERD). It is believed that one of the major risk factors for these disorders is the mode of delivery, cesarean section as indicating the likely cause of perinatal morbidity by no compression of the birth canal into the chest of the fetus and consequent accumulation of fluid in the newborn lung. Objective: To correlate the development of TTRN DRP and the route of delivery. Study Design: This was an observational clinical study with retrospective case description and a sample of 412 newborns, with 206 born in cesarean section (CP) and 206 delivered vaginally (PV), the maternity of the Brotherhood of Santa Casa de Santos. Between groups (CP x PV) were compared to gestational age at delivery (GA), Apgar score of the first and fifth minutes, birth weights, respiratory rate (RR), need for oxygen therapy, invasive mechanical ventilation (IMV) or not -invasive (NIMV), admission to the Neonatal Intensive Care Unit (NICU), and presence of ERD and / or TTRN. The means were evaluated by the Mann-Whitney Test and proportions by Chi-Square (X2), p<0,05. Results: In this sample met 26.41% of the occurrence of DRP or TTRN no significant difference between the means of delivery. The variables of Apgar Score of fifty minute , GA, IMV, NIMV and Oxygen were statistically identical between the groups PC and PV. However, the mean weight of neonates was significantly lower in infants of PV while the mean Apgar at first minute was higher in this same group (p = 0.004). Newborns who had TTRN/ERD, born by cesarean section demonstrate raised RR when compared to PV. Conclusion: The SC was not a precursor of DRP / TTRN, but also showed no causal relationship to oxygen therapy, VMI, NIV and hospitalization in the NICU. The PV favored better neonatal vitality and weight values of newborns lower compared to the SC. Cesarean section was an important factor in rates of neonatal RR higher in infants diagnosed with ERD or TTRN, suggesting greater neonatal suffering. There are no established criteria for oxygen therapy, confirmed by the significant frequency of this therapeutic intervention even in healthy newborns (80.42%)
Descrição
Citação
MINOZZI, Andrea Simões. O desenvolvimento da taquipnéia transitória do recém-nascido e desconforto respiratório precoce: associação à via de parto. 2010. 41 f. Trabalho de conclusão de curso de graduação (Fisioterapia) - Instituto de Saúde e Sociedade (ISS), Universidade Federal de São Paulo (UNIFESP), Santos, 2010.