Análise dos grupos de pacientes submetidas a parto cesáreo na Maternidade do Hospital das Clínicas da Faculdade de Medicina de Botucatu a partir de uma classificação de Robson modificada
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2020-02-28
Autores
Ikeda, Ligia Mitie
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Universidade Estadual Paulista (Unesp)
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Introdução: A classificação de Robson tem sido utilizada para avaliação das taxas de cesáreas no mundo. Recomenda-se que cada localidade adapte a classificação original de acordo com suas necessidades. Objetivos: Analisar os casos de cesáreas realizadas na Maternidade do Hospital das Clínicas da Faculdade de Medicina de Botucatu utilizando uma classificação baseada nos 10 grupos de Robson, modificada a partir da inclusão de subgrupos e analisar os resultados a partir das recomendações estabelecidas pela Organização Mundial da Saúde. Métodos: Foi um estudo prospectivo com pacientes admitidas para assistência ao parto, no período de 01 de junho 2018 e 31 de maio de 2019. Uma planilha foi desenhada para a coleta dos dados e a classificação dos grupos foi elaborada a partir da classificação de Robson, modificada pela inclusão de subgrupos com métodos de indução e momento da indicação da cesárea. Resultados: Foram analisados 1823 partos, sendo 810 (44%) cesáreos. Houve 35,6% de primigestas, 19,5% de uma cesárea prévia e 15,4% de prematuros. O grupo 5, com maior número, teve 435 pacientes (23,8%), seguido do grupo 3, 422 (23,1%) e do grupo 1, 316 (17,3%). O grupo 5 teve maior número de cesáreas, 305 (37,6%). O grupo 2 teve 128 (15,8%). As iterativas totalizaram 19%. Indução do trabalho de parto teve 55,0% de sucesso. Entre pacientes com comorbidades, 60,5% tiveram cesárea. Comorbidades obstétricas mais frequentes foram: pré-eclâmpsia (12,7%), diabetes gestacional (8,4%) e restrição de crescimento fetal (5,7%). Dentre os diagnósticos clínicos, hipertensão arterial crônica (7,1%) e obesidade (4%). As cesáreas por impossibilidade de garantir a vitalidade fetal compreenderam 18,9%. Cesáreas a pedido constituíram 14,1%. Conclusão: Como primeira análise baseada na classificação de Robson, ela permitiu ampliar nossa visão quanto aos casos de partos cesáreos em geral e quanto àqueles relacionados à indução do trabalho de parto nesta maternidade.
Introduction: Robson classification has been used to assess cesarean section rates worldwide. It is recommended that each location adapts the original classification according to their needs. Objectives: To analyze the cases of cesarean sections performed at the Maternity from the Clinics Hospital from Medical School of Botucatu using a classification based on Robson's 10 groups, modified from the inclusion of subgroups, and to analyze the results from the recommendations established by the World Health Organization. Methods: This was a prospective study with patients admitted for childbirth assistance from June 1, 2018 to May 31, 2019. A spreadsheet was designed for data collection and the classification of groups was elaborated from the classification of Robson, modified by the inclusion of subgroups with methods of induction and the moment of cesarean section indication. Results: 1,823 births were analyzed, 810 (44%) of which were cesarean. There were 35.6% of primiparous women, 19.5% of women with previous cesarean section and 15.4% of premature babies. Group 5, with the largest number, had 435 patients (23.8%), followed by group 3, 422 (23.1%) and group 1, 316 (17.3%). Group 5 had the highest number of cesarean sections, 305 (37.6%). Group 2 had 128 (15.8%). Women with two or more previous cesarean sections totaled 19%. Labor induction was 55.0% successful. Among patients with comorbidities, 60.5% had cesarean sections. Most frequent obstetric comorbidities were: pre-eclampsia (12.7%), gestational diabetes (8.4%) and fetal growth restriction (5.7%). Among the clinical diagnoses, chronic arterial hypertension (7.1%) and obesity (4%). Cesarean sections due to the impossibility of guaranteeing fetal vitality comprised 18.9%. Cesarean sections on maternal request constituted 14.1%. Conclusion: As a first analysis based on Robson's classification, it allowed us to enhance our view regarding cases of cesarean deliveries in general and those related to the induction of labor in this maternity hospital.
Introduction: Robson classification has been used to assess cesarean section rates worldwide. It is recommended that each location adapts the original classification according to their needs. Objectives: To analyze the cases of cesarean sections performed at the Maternity from the Clinics Hospital from Medical School of Botucatu using a classification based on Robson's 10 groups, modified from the inclusion of subgroups, and to analyze the results from the recommendations established by the World Health Organization. Methods: This was a prospective study with patients admitted for childbirth assistance from June 1, 2018 to May 31, 2019. A spreadsheet was designed for data collection and the classification of groups was elaborated from the classification of Robson, modified by the inclusion of subgroups with methods of induction and the moment of cesarean section indication. Results: 1,823 births were analyzed, 810 (44%) of which were cesarean. There were 35.6% of primiparous women, 19.5% of women with previous cesarean section and 15.4% of premature babies. Group 5, with the largest number, had 435 patients (23.8%), followed by group 3, 422 (23.1%) and group 1, 316 (17.3%). Group 5 had the highest number of cesarean sections, 305 (37.6%). Group 2 had 128 (15.8%). Women with two or more previous cesarean sections totaled 19%. Labor induction was 55.0% successful. Among patients with comorbidities, 60.5% had cesarean sections. Most frequent obstetric comorbidities were: pre-eclampsia (12.7%), gestational diabetes (8.4%) and fetal growth restriction (5.7%). Among the clinical diagnoses, chronic arterial hypertension (7.1%) and obesity (4%). Cesarean sections due to the impossibility of guaranteeing fetal vitality comprised 18.9%. Cesarean sections on maternal request constituted 14.1%. Conclusion: As a first analysis based on Robson's classification, it allowed us to enhance our view regarding cases of cesarean deliveries in general and those related to the induction of labor in this maternity hospital.
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Cesáreas, Classificação de Robson, Robson 10 Group Classification System, Robson classification