Percepção de fadiga e dor durante o trabalho de parto e os desfechos maternos e obstétricos
Data
2023-05-19
Autores
Mendes, Nathalia Antal 
Orientadores
Scudeller, Tânia Terezinha
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A dor durante o trabalho de parto (TP) é multifatorial e pode ser um fator decisivo para uma experiência negativa e nesse sentido incrementar ansiedade e fadiga da parturiente. A fadiga pode ser considerada física ou psicológica e faltam estudos para avaliação e demonstração de como ela pode afetar o processo de nascimento. Embora existam indicadores positivos com relação a métodos não farmacológicos para o controle da dor no TP, estudos que correlacionam as variáveis de percepção de dor e fadiga com desfechos maternos e obstétricos ainda são escassos. Objetivos: Avaliar o comportamento da dor e fadiga materna durante o TP; investigar a relação entre intensidade de dor e percepção de fadiga, relacionar o nível de atividade física com o índice de fadiga, verificar se o uso de ocitocina sintética pode influenciar na percepção de dor e fadiga, investigar o tempo do TP, avaliar a incidência de indução de TP e a ocorrência de parto vaginal e cesárea. Métodos: Estudo observacional com total de 49 mulheres de duas maternidades de São Paulo, que responderam a um questionário sociodemográfico, questionário sobre nível de atividade física realizado na última semana gestacional, Questionário de Percepção Materna de Fadiga no Trabalho de Parto (QMFP) e Escala Visual Analógica (EVA) em dois momentos da fase ativa do TP. Foram utilizados testes estatísticos Wilcoxon, Teste t, Tau de Kendall e Spearman para as devidas correlações. Em seguida realizada regressão linear múltipla para predizer a percepção de fadiga durante o trabalho de parto. Foi considerado um nível de significância de 5%. Resultados: Observou-se que as variáveis fadiga (p < .001) e dor (p < .001) possuem um comportamento progressivo durante o TP e estão correlacionadas, de modo que enquanto uma variável aumenta, a outra aumenta (5-7 cm p = 0.01 e 8-10 cm de dilatação p = 0.04). Em relação a correlação entre ocitocina e dor não houve diferença estatística significativa em ambos os momentos (p = 0.080 e p = 0.091). No modelo de regressão linear múltipla (R² = 0.25, p = 0.566), o tempo do TP não apresentou resultado estatisticamente significativo (p = 0.114), o uso de ocitocina foi estatisticamente significativo (p = 0.006) e a percepção de dor entre 8-10 cm foi estatisticamente significativa (p = 0.003). Conclusão: Dor e fadiga estão relacionadas e possuem um comportamento progressivo durante o TP; a prática de atividade física durante a última semana de gestação não alterou a percepção de fadiga materna ao longo do TP; uso de ocitocina sintética diminui a percepção de fadiga e não provoca aumento da dor; o tempo de duração do TP não influenciou a sensação e fadiga; a incidência de indução de TP está de acordo com a literatura, houve proporção adequada entre partos vaginais e cesáreas.
Introduction: Pain during labor is multifactorial and can be a decisive factor for a negative experience and in this sense increase anxiety and fatigue of the parturient. Fatigue can be considered physical or psychological and there is a lack of studies to evaluate and demonstrate how it can affect the birth process. Although there are positive indicators regarding non-pharmacological methods for pain control during labor, studies correlating variables of pain perception and fatigue with maternal and obstetric outcomes are still scarce. Objectives: To evaluate the behavior of maternal pain and fatigue during labor; to investigate the relationship between pain intensity and perception of fatigue; to relate the level of physical activity with the fatigue index; to verify if the use of synthetic oxytocin can influence the perception of pain and fatigue; to investigate the duration of labor; to evaluate the incidence of labor induction and the occurrence of vaginal delivery and cesarean section. Methods: Observational study with a total of 49 women from two maternity hospitals in São Paulo, who answered a sociodemographic questionnaire, questionnaire on physical activity level during the last gestational week, Questionnaire of Maternal Perception of Fatigue in Labor (QMFP) and Visual Analog Scale (VAS) in two moments of active phase of labor. Wilcoxon, t-test, Kendall's Tau, and Spearman's statistical tests were used for correlations. Then, multiple linear regression was performed to predict the perception of fatigue during labor. A significance level of 5% was considered. Results: It was observed that the variables fatigue (p < .001) and pain (p < .001) have a progressive behavior during labor and are correlated, so that while one variable increases, the other increases (5-7 cm p = 0.01 and 8-10 cm dilation p = 0.04). Regarding the correlation between oxytocin and pain there was no statistically significant difference at both time points (p = 0.080 and p = 0.091). In the multiple linear regression model (R² = 0.25, p = 0.566), the time was not statistically significant (p = 0.114), oxytocin use was statistically significant (p = 0.006), and pain perception between 8-10 cm was statistically significant (p = 0.003). Conclusion: Pain and fatigue are related and have a progressive behavior during labor; the practice of physical activity during the last week of pregnancy did not alter the perception of maternal fatigue during labor; the use of synthetic oxytocin decreased the perception of fatigue and did not increase pain; the duration of labor did not influence the perception of fatigue; the incidence of labor induction is in accordance with the literature, there was an adequate proportion between vaginal deliveries and cesarean sections.
Introduction: Pain during labor is multifactorial and can be a decisive factor for a negative experience and in this sense increase anxiety and fatigue of the parturient. Fatigue can be considered physical or psychological and there is a lack of studies to evaluate and demonstrate how it can affect the birth process. Although there are positive indicators regarding non-pharmacological methods for pain control during labor, studies correlating variables of pain perception and fatigue with maternal and obstetric outcomes are still scarce. Objectives: To evaluate the behavior of maternal pain and fatigue during labor; to investigate the relationship between pain intensity and perception of fatigue; to relate the level of physical activity with the fatigue index; to verify if the use of synthetic oxytocin can influence the perception of pain and fatigue; to investigate the duration of labor; to evaluate the incidence of labor induction and the occurrence of vaginal delivery and cesarean section. Methods: Observational study with a total of 49 women from two maternity hospitals in São Paulo, who answered a sociodemographic questionnaire, questionnaire on physical activity level during the last gestational week, Questionnaire of Maternal Perception of Fatigue in Labor (QMFP) and Visual Analog Scale (VAS) in two moments of active phase of labor. Wilcoxon, t-test, Kendall's Tau, and Spearman's statistical tests were used for correlations. Then, multiple linear regression was performed to predict the perception of fatigue during labor. A significance level of 5% was considered. Results: It was observed that the variables fatigue (p < .001) and pain (p < .001) have a progressive behavior during labor and are correlated, so that while one variable increases, the other increases (5-7 cm p = 0.01 and 8-10 cm dilation p = 0.04). Regarding the correlation between oxytocin and pain there was no statistically significant difference at both time points (p = 0.080 and p = 0.091). In the multiple linear regression model (R² = 0.25, p = 0.566), the time was not statistically significant (p = 0.114), oxytocin use was statistically significant (p = 0.006), and pain perception between 8-10 cm was statistically significant (p = 0.003). Conclusion: Pain and fatigue are related and have a progressive behavior during labor; the practice of physical activity during the last week of pregnancy did not alter the perception of maternal fatigue during labor; the use of synthetic oxytocin decreased the perception of fatigue and did not increase pain; the duration of labor did not influence the perception of fatigue; the incidence of labor induction is in accordance with the literature, there was an adequate proportion between vaginal deliveries and cesarean sections.
Descrição
Citação
MENDES, Nathalia Antal. Percepção de fadiga e dor durante o trabalho de parto e os desfechos maternos e obstétricos. 2023. 57 f. Dissertação (Mestrado Interdisciplinar em Ciências da Saúde) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2023.