Analysis of obstetrical deliveries under conduction anesthesia and immediate neonatal repercussion
DOI:
https://doi.org/10.11606/issn.1679-9836.v99i5p448-455Keywords:
Pregnant women, Hospitals, maternity, Anesthesia, Labor, obstetricAbstract
Introduction: Anesthesia is an important resource for pain relief during labor. It is not a risk-free procedure and its use involves decision-making based on clinical and obstetric conditions, woman’s desire and availability of the procedure. This study aimed to analyze the association between this intervention and the occurrence of operative delivery and low Apgar score. Method: Retrospective study of a hospital database containing 5,282 parturients with single gestation of a fetus with cephalic presentation born alive and without malformation, among the 8,591 births that occurred from 2014 to 2017, in the Clinical Hospital’s Maternity of UFMG. Outcomes of interest were compared between deliveries conducted with or without anesthesia by association tests. Results: The occurrence of labor conduction anesthesia was 29.9%, being more frequent among adolescents (33.3% versus 29.1%; p = 0.008), nulliparous (39.7% versus 21.6%; p<0.001), those with induced delivery (40.6% versus 26.5%; p<0.001), patients with heart disease (53.5% versus 29.6%; p<0.001) and parturients whose babies weighed 2500 g or more at birth (31.3% versus 19.7%; p<0.001). There was an association between anesthesia and increased use of forceps (15.7% versus 1.8%; p<0.001) and vacuum extractor (2.0% versus 0.6%; p<0.001), however, there was a reduction in the occurrence of cesarean section (7.3% versus 12.9%; p<0.001). Anesthesia was associated with a higher occurrence of 1st minute Apgar <7 (p<0.001), but did not change the 5th Apgar score (p = 0.243). Nulliparity seems to influence the occurrence of cesarean delivery (8.6% versus 5.2%; p = 0.013) and forceps use (19.4% versus 9.8%; p<0.001). Conclusion: The use of labor conduction anesthesia was associated with operative vaginal delivery, the lowest cesarean section rate, with no impact on the 5th minute Apgar score.
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