RESUMO
INTRODUCTION: The type of perineal repair can have significant long-term effects on various functions in a woman's postpartum life. The aim was to compare urinary incontinence (UI), women's satisfaction, pelvic floor muscle strength (PFMS), and sexual function according to the type of perineal repair (surgical glue or suture thread) during the first eight months after normal childbirth. METHODS: A controlled randomized clinical trial of 133 primiparous women undergoing perineal repair during birth with surgical glue or sutures, evaluated during labor and monitored up to 8 months postpartum, from March 2017 to September 2018, in the city in São Paulo, Bazil. Descriptive and inferential analyses were carried out. RESULTS: A total of 133 women were included in the study, 111 (83.5%) were assessed between 10 to 20 days postpartum, 121 (91.0%) between 50 to 70 days, and 54 (40.6%) between 6 to 8 months. There were no significant differences for UI concerning the type of repair; however, there was a significant difference concerning the postpartum period (p=0.031), with a higher prevalence at two months. Most women reported satisfaction, with the highest levels reported two months after birth (p=0.019). For PFMS, the mean of the glue and suture groups were 32.4 cmH2O and 27.4 cmH2O, but not significant. Women in the glue group showed higher mean values in all sexual function domains but without significance. CONCLUSIONS: Surgical glue showed good aesthetic and functional results in the perineum at eight months postpartum.
RESUMO
INTRODUCTION: The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at São Bernardo Hospital. METHODS: A form containing information on the obstetric history of the parturient, the type of immersion, and the labour and birth follow-up was used by midwives to collect the data. BACKGROUND: The Apgar score (at 1min after birth) used in this study, called Aqua Apgar, was adapted by Cornelia Enning. RESULTS: The mean water immersion time was 1h and 46min and had an influence on the duration of labour (mean 5h and 37min), with a statistically significant difference (P=0.004). There was a decreased cervical dilatation time and a shorter duration of the expulsion phase. In the immersion scenario, 30% of the women did not undergo any examination to assess the length of the cervix, and 57.8% presented intact perennial areas or first-degree tears. As for neonatal outcomes, during maternal immersion, 97% maintained normal fetal heart rates (between 110 and 160 beats per minute) and Aqua Apgar was higher than 7, both in the first minute (mean of 9.4) and in the fifth minute of life (mean of 9.9). CONCLUSION: These safety outcomes, based on sound scientific evidence, should increasingly support and inform clinical decisions and increase the number of waterbirths in health facilities. The results of this study align with growing evidence that suggests waterbirth is a safe delivery option and therefore should be offered to women.
