Análise da indicação da cesariana na pespectiva das puérperas e dos critérios clínicos prescritos para sua realização

Abstract

The cesarean birth was conceived to reduce risks and complications to the pair mother/baby during pregnancy and birth label on situations in which vaginal birth is unfavorable. The goal of this work was to evaluate the indication of cesarean in the perspective of the puerperae and the clinical criteria to its execution. A quantitative study, of transversal cut realized in the Public Maternity Hospital Dona Regina Siqueira Campos, Palmas-TO. The population was composed of 239 puerperae. The data gathering was executed through surveys and documental analysis, through queries on medical records. The puerperae were 26,5±6,53 years old, 98(43%) had concluded high school education and 112(46,9%), were in stable union with a partner. Regarding the obstetric data, 88,5% had 3 previous gestations and 45 of them abortion, they presented 38,5± 3,86 weeks of gestational age, 238 (99,6%) did prenatal, being 210(88,2%) of them accompanied in public health system, they had 9,44±5,24 medical appointments and 33(35,5%) had arterial hypertension and a gestational intercurrence. Concerning the guidance received on the prenatal on giving birth, 55% states not having received orientation, among the puerperae that received guidance, 31(29%), states having received information on the benefits of normal birth, 18(17%), received information on the difference of normal and cesarean birth, 13 (12%) puerperae were informed about the birth signs, other 13(13%) , still on prenatal, were informed that their births would be cesarean and to 07(7%) received information on what activities should be performed in order to facilitate birth. About the cesarean indication register in medical record, it was observed that 3 indications reported were not on agreement with scientific evidence about cesarean indication, being them: women’s lack of cooperation, urinary tract infection and tubectomy. Regarding information received on the motivation that took them to submit themselves to a cesarean, 201 of the interviewed, states having received explanations and that these happened mostly (90%) before birth, the most related were categorized on the followings indications: progression dystonia (34%), arterial hypertension (21%), cephalon pelvic disproportion (21%), fetal suffering (18%), poor fetal positioning (12%) and previous cesarean (7%). About the cesarean indications reported by the puerperae being consistent with the ones registered on medical records, 60 (25%) of the interviews done were not possible to compare the indication register of the medical record to the reports of the puerperae, among the bought interviews, 139 (58%) the information obtained was in accordance to the clinical criteria report, and on 40 (17%) were distinct. Therefore, as cesarean indication in the puerperae perspective is evaluated and the clinical criteria to its execution, it was verified that a great part of the interviews the obtained information was in accordance to the clinical criteria, however in some of them they were distinct, sometimes not being adequate not even to the obstetric record of the patient.