PRINCIPAIS DESFECHOS E ASPECTOS CLÍNICO-EPIDEMIOLÓGICOS DA INDUÇÃO DE TRABALHO DE PARTO

Abstract

Introduction: The application of nursing care requires knowledge that goes beyond the scientific, which sometimes promotes understanding between the physiological path of parturition and the necessary interventional practices. A substantial amount of healthy pregnant women at some stages are exposed to at least one clinical intervention during labor. Within this interventional range, one can mention labor induction, a procedure that consists in provoking effective uterine contractions prior to spontaneous labor. Objective: To analyze clinical, epidemiological, and sociodemographic aspects of pregnant women submitted to induction of labor in a public teaching hospital in Mato Grosso do Sul. Methods: The study was divided into two phases: first, it was performed a summarization of evidence that allowed pointing out the main obstetric and neonatal outcomes of induction of labor through the construction of an integrative literature review; subsequently, a research of cross-sectional design and quantitative approach was performed. The research was conducted in the joint housing of a Federal Public Teaching Hospital in Dourados - MS in the period from October 2022 to January 2023. Pregnant women aged 18 years or older, gestational age ranging from 37 weeks and 0 days to 42 weeks were included in the study. The sample was composed of 60 pregnant women. The data collection instrument was developed by the responsible researcher, based on the data collection protocol of the "Born in Brazil 2" project, developed by Fiocruz, under the authorization of the responsible author. This instrument was applied using the RedCap platform for data collection and management, through the collection of secondary fingers. The data were coded, quantified, and tabulated in Microsoft Excel Software spreadsheet, version 2019, and analyzed using descriptive statistics. The pregnant woman's acceptance was obtained by formally signing the Informed Consent Form. The research was approved by the Research Ethics Committee under opinion: 5,655,000/2022 on September 20, 2022. Results: There was a predominance of pregnant women self-declared as brown-skinned, with complete elementary education and single marital status. The main comorbidities identified were gestational diabetes mellitus, gestational hypertension, chronic hypertension, preeclampsia and hypothyroidism. The indications for labor induction for maternal causes were gestational diabetes mellitus, gestational hypertension as well as pre-eclampsia. Among fetal causes indicating induction of labor, intrauterine growth restriction and oligohydramnios were identified. Conclusion: Socioeconomic inequalities and limited access to quality prenatal care were reverberated due to exposure to the risks that induction presents. The main route of labor inductions was vaginal birth. The main findings on comorbidities present in pregnant women undergoing induction corroborate the findings on the main indications for labor induction, highlighted: gestational diabetes mellitus, chronic, gestational hypertension, and preeclampsia. In summary, intrauterine growth restriction and oligohydramnios were prevalent among fetal causes.