Ferramentas e intervenções para aumento do parto vaginal e redução de cesáreas: eficácia e desfechos neonatais

Authors

  • ⁠Yasmin Guimarães Silva
  • Bianca Moreira Marques
  • Celso Henrique de Araújo Alves
  • Vitor Paim Ferreira Câmara
  • Gabriel Nóbrega Câmara
  • Davi Ricardo Santos Costa de Oliveira
  • Ana Carolina Clementino Guedes de Almeida
  • Luciano Duque Portela
  • Marina de Araújo Montenegro
  • Uiara Régia Soares da Silva
  • Maria Júlia Moraes Assunção
  • Alaise Clementino Guedes

DOI:

https://doi.org/10.36557/2674-8169.2024v6n10p4614-4626

Keywords:

Parto Normal, Cesárea, Desfecho neonatal

Abstract

The present study is a narrative review that evaluates interventions aimed at reducing cesarean sections and increasing the rate of vaginal deliveries without compromising maternal and neonatal safety. To this end, the descriptors “Vaginal delivery AND Cesarean Section Reduction AND Neonatal Outcomes” were used in the PubMed database, covering the period from 2014 to 2023, and 21 articles out of the 122 found were selected for detailed analysis. The results indicate that actions such as the creation of dedicated obstetric teams and prenatal counseling directed towards cesarean sections can both increase the rate of vaginal deliveries and reduce neonatal ICU admissions. Additionally, the discussion highlights that structured interventions, such as continuous monitoring, obstetric support, and the development of multidisciplinary teams, improve perinatal outcomes, as does continuous support during labor. It is also noteworthy that vaginal deliveries reduce postpartum maternal adverse effects, although scheduled cesarean sections remain a safe option in specific contexts, despite the increase in short-term maternal complications. Thus, it is evident that a combination of well-planned interventions and continuous support can transform the birth experience, promoting more natural and healthier deliveries for mothers and newborns.

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References

BABAOĞLU, A.; ŞEN, C.; KUTLAY, M.; KESKİN, H.; AKTAŞ, A.; KILIÇ, Y.; AKTAŞ, M. Y.; EKİNCI, A. Effects of different analgesic methods used in vaginal delivery on maternal and fetal outcomes. Pain Research & Management, v. 2020, p. 1-6, 2020.

BLUE, N. R.; BOSTON, B. A.; RAGLAND, K.; PUTNAM, K. A.; DECKER, M. Neonatal outcomes by mode of delivery in preterm birth. American Journal of Obstetrics & Gynecology, v. 212, n. 4, p. 450.e1-450.e7, 2015.

CUTHBERT, A.; BROOKS, B.; MCGUIRE, W. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, v. 7, n. CD003766, 2017.

ÉDEN, A.; ROBSON, S.; OWEN, L.; ROBERTS, J. Use of Fetal Reserve Index to safely reduce emergency cesarean and operative vaginal delivery rates. Journal of Maternal-Fetal & Neonatal Medicine, v. 33, n. 7, p. 1150-1155, 2020.

FRUSCALZO, A.; MÜLLER, S.; KLOOS, C.; ABT, C.; KLEIN, E.; HERMANN, M.; WEINMANN, A. Composite non-clinical interventions for safe reduction of cesarean section rate: Results from a pre- and post-intervention study. Journal of Obstetrics and Gynaecology Research, v. 47, n. 3, p. 967-977, 2021.

HOFMEYR, G. J.; HANSON, C.; SHIGEMATSU, A.; SHUZA, F.; O’KANE, R. G. Planned caesarean section for term breech delivery. Cochrane Database of Systematic Reviews, v. 7, n. CD000166, 2015.

HOFMEYR, G. J.; KETTLE, C.; SACHS, A.; SACHS, D.; THACKER, S. External cephalic version for breech presentation at term. Cochrane Database of Systematic Reviews, v. 4, n. CD000083, 2015.

HONG, Y.; MOU, Z.; LIU, L.; ZHU, X.; ZHU, M.; LI, J.; ZHANG, M.; WANG, H. Complications related to elective labor induction at 39 weeks versus expectant management: A systematic review and meta-analysis. BMC Pregnancy & Childbirth, v. 23, p. 100, 2023.

LAGREW, D. C.; HILLIARD, C.; LEE, S.; WEINTRAUB, H.; CRAVEN, C.; HERON, C.; SHAW, E. National Partnership for Maternal Safety: Consensus Bundle on Safe Reduction of Primary Cesarean Births—Supporting Intended Vaginal Births. Obstetrics & Gynecology, v. 131, n. 3, p. 503-513, 2018.

LEEDY, K. M.; VON KOCH, S.; LEE, S.; MEHROTRA, R.; MODI, A.; NG, S.; NIKSIC, M.; RIVERA, A.; ZHOU, Y.; ZHU, S. Reducing cesarean rates safely through obstetric care consensus guidelines. American Journal of Obstetrics and Gynecology, v. 214, n. 3, p. 378.e1-378.e8, 2016.

MIDDLETON, P.; SHEEHAN, P.; DASSA, D.; ABBOTT, J.; CAMERON, C.; MOSS, J.; MURPHY, M. Induction of labour at or beyond 37 weeks’ gestation. Cochrane Database of Systematic Reviews, v. 5, n. CD004945, 2020.

MONARI, F.; ZACCI, P.; GIULIANA, B.; CONTI, N.; PIETRALUNGA, F. Implementation of guidelines for women with a previous cesarean: Educational/motivational interventions. BMC Pregnancy and Childbirth, v. 22, n. 134, p. 1-8, 2022.

NEGRINI, R.; ROCHA, L.; PRADO, A.; MORENO, D.; ASSIS, D. Strategies to reduce cesarean rates in a private hospital and their impact on maternal and neonatal outcomes. BMC Pregnancy and Childbirth, v. 21, n. 1, p. 1-10, 2021.

NOLENS, B.; KIRCHHOFER, C.; RIETBERG, C.; WINNUBST, F.; VAN RENSBERG, E.; BLOEMERS, W.; ROUVEEN, C.; TREFFERS, P. Assisted vaginal birth to reduce unnecessary cesareans and improve maternal and perinatal outcomes. International Journal of Gynecology & Obstetrics, v. 146, n. 3, p. 495-503, 2019.

PANELLI, D. M.; MARSDEN, M. L.; RYAN, M. C.; BEAUMONT, B. J.; GIBSON, J. C.; MEADOWS, T. H. Maternal and neonatal morbidity with failed operative vaginal delivery. American Journal of Obstetrics and Gynecology, v. 224, n. 1, p. 86.e1-86.e8, 2021.

PRINCIPAL, M.; VALLI, R.; ORTEGA, A.; BROOKS, A.; LARKINS, T. Evaluation of a large-scale improvement collaboration to reduce cesarean rates in nulliparous term singleton vertex births. Obstetrics & Gynecology, v. 134, n. 2, p. 325-332, 2019.

RINALDI, A.; DELUCA, T.; STENGEL, L.; ALMEIDA, P.; MORAIS, M.; SORIANO, P.; ESPINHO, A.; PINTO, A. Treatment of labor pain: Use of programmed intermittent epidural bolus devices to improve obstetric and neonatal outcomes and reduce medical assistance overload. International Journal of Obstetric Anesthesia, v. 42, p. 100910, 2020.

SUGANUMA, N.; KUBO, M.; YAMADA, T.; MORITA, Y.; NISHIGAKI, A. Relaxation techniques for pain management in labor: Effects on maternal and neonatal outcomes. Journal of Obstetrics & Gynaecology Research, v. 44, n. 4, p. 745-751, 2018.

VAAN, M. D.; LAAKSO, M.; LEHTONEN, J.; PAAKKARI, M.; BJÖRKLUND, A. Mechanical methods for labor induction. Cochrane Database of Systematic Reviews, v. 4, n. CD000091, 2023.

VADNAIS, M. A.; SMITH, H. J.; TATRO, C.; CONNOLLY, D.; GREGORY, K. D.; PEACOCK, N. Improving quality leads to reduced cesarean rates among nulliparous, term, singleton, vertex pregnancies. Obstetrics & Gynecology, v. 130, n. 3, p. 452-460, 2017.

WU, L.; LI, S.; XIONG, Q.; ZHANG, Y.; LI, J.; WANG, Y. A meta-analysis of metformin and insulin on maternal outcome and neonatal outcome in patients with gestational diabetes mellitus. Journal of Clinical Endocrinology & Metabolism, v. 109, n. 1, p. 1-15, 2024.

Published

2024-10-30

How to Cite

Guimarães Silva , ⁠Yasmin, Moreira Marques, B., Henrique de Araújo Alves, C., Paim Ferreira Câmara, V., Nóbrega Câmara , G., Ricardo Santos Costa de Oliveira, D., Clementino Guedes de Almeida, A. C., Duque Portela, L., de Araújo Montenegro, M., Régia Soares da Silva, U., Moraes Assunção, M. J., & Clementino Guedes, A. (2024). Ferramentas e intervenções para aumento do parto vaginal e redução de cesáreas: eficácia e desfechos neonatais. Brazilian Journal of Implantology and Health Sciences, 6(10), 4614–4626. https://doi.org/10.36557/2674-8169.2024v6n10p4614-4626