Fatores maternos e neonatais associados à ocorrência de laceração no parto normal

Abstract

The perineum is an important structure during pregnancy, being this type of control at the time. Traumas that are not appropriate are called perineal lacerations. These lacerations can be triggered spontaneously or purposely, the latter being by episiotomy. Perineal laceration can be classified as: grade I (affecting the skin and mucosa), grade II (reaching the muscle and sphincter of the anus) and grade IV (involving the sphincter of the anus). exposure of the anal epithelium). The objective of this study was to analyze the maternal and neonatal factors and their association in their absence and degree of spontaneous perineal laceration. Crosssectional descriptive study and quantitative approach. Data obtained in the month of March 2017 at the Maternity School Assis Chateaubriand (MEAC). The data were collected through a structured form aimed at the puerperal women. The data of the instrument were compiled and stolen with the aid of the Statistical Package for Social Sciences (SPSS) statistical program, version 20.0. Assuring the right of the participants, a survey was guided by Resolution No. 466/12 of the National Health Council. Analyzing the profile of women, 13 to 24 years (37.7%), followed by 25 to 34 years (35.7%). The majority (61%) had more than 9 years of study, 56.6% of the puerperas had an income greater than 937 reais and 57.6% worked in the home. Regarding the characteristics of the NBs, 55% were males, 58.9% had apgar 9. When the variables were related, it was observed that, among the 12 to 18 year olds, there was laceration between 70% of births, 19 to 24 occurred in 69.6% of the cases. Among the women with nine years or less of study, the majority (59.6%) were victims of perineal injury, the level of schooling greater than nine years obtained a greater recurrence of lacerations, but with an even greater percentage: 69, 6%. Analyzing the obstetric profile, 76.9% of the primiparous women had perineal laceration, the secondary or multiparous, in turn, obtained 52.9%. When analyzing the value of Apgar in the fifth minute, we found that 100% of the women with apgar NN 7 maintained intact perineum, apgar 8 resulted in 90% laceration with 10% integrity, apgar 9 resulted in 64.4% of perineal injury and with 35.6% integrity and apgar 10 resulted in 50% injury and 50% integrity. Thus, regarding the risk factors that can lead to perineal laceration, we have that, on the obstetric profile, parity and amount of pregnancies are factors related to the occurrence of perineal laceration, that is, primiparous or primigravida women have a greater risk of interfering with perineal integrity, which is explained by the low elasticity of the region in women who have never given birth. In factors related to the newborn, the study showed that the apgar is directly related, the higher the value, the greater the chances of laceration.