Parto e nascimento com ocitocina sintética: uso ou abuso?

Abstract

INTRODUCTION: Routine administration of oxytocin during labor is classified as an unnecessary, inappropriate or dangerous practice. Its use can lead to fetal death, postpartum haemorrhage, and contribute to the development of emotional disorders of the puerperium and cognitive deficits in childhood. However, even in the face of the evidence, it is observed its indiscriminate use. OBJECTIVES: To know the magnitude of oxytocin use during labor in pregnant women at usual risk and their associated factors. METHODOLOGY: A hospitalbased sectional study using data from the survey "Born in Belo Horizonte: Birth and Birth Survey". From the sample of 1088 women, after exclusion of those admitted for elective cesarean section or who presented complications during pregnancy, 389 puerperae were included in the analysis. In order to estimate the associations between the use of oxytocin and characteristics of puerperal and services, univariate analysis was used. To evaluate the relationship between one or more variables, an adjusted model was submitted to multivariate analysis. RESULTS: The prevalence of oxytocin use was 47.8%. For women who started prenatal late or who had uterine scarring, oxytocin infusion rates were significantly lower (p <0.001). Being admitted with six or more centimeters of dilatation and presenting three to four contractions in 10 minutes was related to decreased use of oxytocin. It was observed that puerperae submitted to interventions, mainly Kristeller's maneuver and analgesia, presented greater use of oxytocin. The predominant birth route was vaginal (92.1%), but it was not influenced by the use of oxytocin. There was one intrapartum fetal death, two early neonatal deaths and the permanence of a newborn hospitalized after the 27th day of life, in all cases the use of oxytocin was present. There was a greater use of oxytocin in physician-assisted deliveries according to productivity. On the other hand, being assisted by a nurse proved to be a protective factor. FINAL CONSIDERATIONS: The use of oxytocin appears to be a common practice. Its high prevalence, as well as the concomitant presence of other interventions, can be considered a reflection of the validity of the hegemonic medical model as the guiding pillar of obstetric care in the evaluated services.