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Mobilização e posições verticalizadas no trabalho de parto
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O entendimento dos desfechos associados a cada posição de trabalho de parto e mobilização é cada vez mais importante. Os objetivos deste trabalho são rever quais as vantagens e limitações da mobilização e das posições verticalizadas durante o trabalho de parto; avaliar a experiência e o nível de informação das grávidas e de profissionais de saúde sobre o tema. A metodologia utilizada foi a revisão narrativa de artigos científicos e a aplicação de formulários online: um dirigido às mulheres com partos entre 2000 e 2022 e outro dirigido a médicos especialistas, médicos internos e enfermeiros especialistas em saúde materna e obstétrica, divulgado nas redes sociais e via email, respetivamente. Neste estudo, 17 de 64 (26,6%) das respostas são profissionais de saúde são do Centro Hospitalar Lisboa Norte – Hospital Santa Maria, onde 37 de 64 (57,8%) de profissionais consideram que mais de 6 grávidas conseguiram mobilizar durante o primeiro período do trabalho de parto e 17 de 64 (26,6%) consideram que 6 a 9 grávidas em cada 10 puderam realizar posições verticais no parto. Dos 64 profissionais de saúde participantes, 26 (40,6%) consideram-se bem informados sobre a temática. Como obstáculo, 44 de 64 profissionais apontaram a falta de formação dos mesmos (68,8%); e 19 de 64 (29,7%) apontaram a ausência de recursos físicos. Dos 71% de mulheres que tiveram trabalhos de parto durante os quais desejaram manter a mobilidade e/ou estar em posição vertical durante o parto, esse desejo não foi possível em 49,3%, dos quais 28,9% por motivos médicos. São necessários mais estudos sobre a mobilização e posições verticalizadas no trabalho de parto, o desenvolvimento de métodos complementares de imagem para estudo e formações para avaliar riscos e benefícios.
Understanding the outcomes associated with each position of labor and mobilization is increasingly important. The goals of this work are to review the advantages and limitations of mobilization and vertical positions during labor; evaluate the experience and level of information of pregnant women and health professionals on the subject. The methodology used was the narrative review of scientific articles and the application of online forms: one aimed at women with deliveries between 2000 and 2022, shared on social networks; another aimed at specialist physicians, internal physicians and specialist nurses in maternal and obstetric health, shared via email and social networks. In this study, 17 out of the 64 (26.6%) health professionals' responses are from Centro Hospitalar Lisboa Norte – Hospital Santa Maria, where 37 out of 64 (57.8%) professionals consider that more than 6 pregnant women out of 10 were able to mobilize during the first stage of labor and 17 out of 64 (26.6%) consider that 6 to 9 pregnant women out of 10 were able to perform vertical positions during childbirth. 26 health professionals out of 64 (40.6%) consider themselves well informed on the subject. As an obstacle, it is pointed out the lack of training of health professionals in 44 out of 64 (68.8%); and in 19 out of 64 (29.7%) the absence of physical resources. Of the 71% of mothers who wanted to move and/or be in an upright position during childbirth, this desire was denied to 49.3%, of which 28.9% were for medical reasons. More studies are needed on mobilization and upright positions in labor, the development of complementary imaging methods for study, and training to assess risks and benefits.
Understanding the outcomes associated with each position of labor and mobilization is increasingly important. The goals of this work are to review the advantages and limitations of mobilization and vertical positions during labor; evaluate the experience and level of information of pregnant women and health professionals on the subject. The methodology used was the narrative review of scientific articles and the application of online forms: one aimed at women with deliveries between 2000 and 2022, shared on social networks; another aimed at specialist physicians, internal physicians and specialist nurses in maternal and obstetric health, shared via email and social networks. In this study, 17 out of the 64 (26.6%) health professionals' responses are from Centro Hospitalar Lisboa Norte – Hospital Santa Maria, where 37 out of 64 (57.8%) professionals consider that more than 6 pregnant women out of 10 were able to mobilize during the first stage of labor and 17 out of 64 (26.6%) consider that 6 to 9 pregnant women out of 10 were able to perform vertical positions during childbirth. 26 health professionals out of 64 (40.6%) consider themselves well informed on the subject. As an obstacle, it is pointed out the lack of training of health professionals in 44 out of 64 (68.8%); and in 19 out of 64 (29.7%) the absence of physical resources. Of the 71% of mothers who wanted to move and/or be in an upright position during childbirth, this desire was denied to 49.3%, of which 28.9% were for medical reasons. More studies are needed on mobilization and upright positions in labor, the development of complementary imaging methods for study, and training to assess risks and benefits.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Grávidas Profissionais de saúde Trabalho de parto Mobilização Verticalização Obstetrícia