Desfechos maternos perinatais da assistência da enfermagem obstétrica com a conduta hands off: um estudo de corte transversal

Abstract

The process of institutionalization of childbirth and birth brought important advances and improvements for the care of women and the newborn, but it was accompanied by a set of standardized and interventionist obstetric practices routinely used to characterize the technical model. During the evolution and development of obstetric care, the female perineum gained visibility, often becoming a surgical site. From the 1980s onwards, in response to the unfavorable results of this model, the humanization movement of childbirth emerged, which, in addition to the respectful and welcoming assistance, proposed an attention based on scientific evidence, being highlighted by WHO and MS obstetric nurse as a component of Humanization. In view of the function of the perineal body, its importance for adjacent structures and the awareness of morbidity after trauma, the maintenance of anatomical integrity is fundamental for the proper functioning and quality of life of the woman and therefore different perineal techniques and interventions are being used and studied aiming the maintenance of the local integrity and minimizing lacerations of greater gravity. The objective of this study was to analyze the perinatal maternal outcome of care for women by obstetric nurses with the use of the hands off procedure. A cross-sectional study was conducted, including 608 women who had their deliveries attended by obstetric nurses with the use of hands off as perineal protection conduit. Sociodemographic and obstetric clinical characteristics were evaluated. The data were collected from electronic medical records and records books of the nursing team. Statistical analysis was performed using the Pearson χ2 test and the logistic regression model. It was observed that there was a prevalence of low-severity perineal outcomes in 96.5% of cases of low-severity (1st degree or integral perineum), showing an increased chance of perineal correction in primiparous women and when weight was greater than or equal to 3500g. However, considering the results of this investigation, it is believed that expectant management for perineal protection, hands off, can be considered within the good practices to assist women in the process of parturition, considering that this conduct promotes benefits related to maternal outcomes without compromising perinatal outcomes.