A influência de métodos não farmacológicos na duração do parto: uma revisão sistemática

Gregolis, Thais Blaya Leite; Santos, Sabrina da Silva; Silva, Ilce Ferreira da; Bessa, Andréa Ramos da Silva

doi:10.1590/1413-81232024296.19032022

person Thais Blaya Leite Gregolis

Acquisition, analysis and interpretation of data · elaboration of the work · read the manuscript · interpreted the results · agreed on the final version · agreed to be responsible for all aspects of the work

schoolPrograma de Pós-Graduação em Saúde Coletiva, Universidade Federal do Acre. Distrito Industrial, Rio Branco-Ac. 69920-900 Rio Branco AC Brasil. thaisgregolis@hotmail.com

0000-0002-3799-4083

person Sabrina da Silva Santos

study design · acquisition, analysis, interpretation of data · elaboration of the work · review · read the manuscript · interpreted the results · agreed on the final version · agreed to be responsible for all aspects of the work

schoolPrograma de Pós-Graduação em Saúde Coletiva, Universidade Federal do Acre. Distrito Industrial, Rio Branco-Ac. 69920-900 Rio Branco AC Brasil. thaisgregolis@hotmail.comschoolDepartamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Segio Arouca, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil.

0000-0001-8327-3546

person Ilce Ferreira da Silva

study design · acquisition, analysis, interpretation of data · elaboration of the work · review · read the manuscript · interpreted the results · agreed on the final version · agreed to be responsible for all aspects of the work

schoolPrograma de Pós-Graduação em Saúde Coletiva, Universidade Federal do Acre. Distrito Industrial, Rio Branco-Ac. 69920-900 Rio Branco AC Brasil. thaisgregolis@hotmail.comschoolDepartamento de Epidemiologia e Métodos Quantitativos em Saúde, Escola Nacional de Saúde Pública Segio Arouca, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil.

0000-0002-7134-3030

person Andréa Ramos da Silva Bessa

study design · acquisition, analysis, interpretation of data · elaboration of the work · review · read the manuscript · interpreted the results · agreed on the final version · agreed to be responsible for all aspects of the work

schoolPrograma de Pós-Graduação em Saúde Coletiva, Universidade Federal do Acre. Distrito Industrial, Rio Branco-Ac. 69920-900 Rio Branco AC Brasil. thaisgregolis@hotmail.com

0000-0002-9553-9310

Chief editors:

Maria Cecília de Souza Minayo, Romeu Gomes, Antônio Augusto Moura da Silva

Study	Year	Country	Study design	Method assessed
Bomfim-Hyppólito, 1998¹⁶	1994	Brazil (Fortaleza)	Experimental	Semi-sitting position (60º trunk inclination) during expulsion stage
Eckert et al., 2001¹⁷	1995	Australia	Experimental	Immersion bath in first stage of labor.
Schröcksnadel et al., 2003¹⁸	1998	Austria	Case-control	Water birth.
Almeida et al., 2005¹⁹	2000	Brazil (Goiânia)	Experimental	Breathing techniques associated with relaxation techniques.
Bio et al., 2006⁷	2003	Brazil (São Paulo)	Experimental	Keep moving and switching to vertical positions during labor and delivery.
Silva and Oliveira, 2006²⁰	2002	Brazil (São Paulo)	Experimental	Immersion bath for 40-60 minutes.
Gaudernack et al., 2006²¹	2003	Norway	Experimental	Acupuncture.
Zanetti-Daellenbach et al., 2007²²	1998	Switzerland	Cohort	Water birth after immersion bath for time desired by parturient.
Mamede et al., 2007²³	2004	Brazil (São Paulo)	Quasi-experimental	Walking during active stage of labor.
Gau et al., 2011²⁴	2008	Taiwan	Experimental	Birth ball exercise.
Cortes et al., 2011²⁵	2011	UK	Population-based cohort	Water birth.
Gallo et al., 2013²⁶	2009	Brazil (Ribeirão Preto)	Experimental	Massage during dilation period and uterine contractions for 30 mins.
Liu et al., 2014²⁷	2009	China	Experimental	Immersion bath in active stage of labor.
Mafetoni and Shimo, 2015²⁸	2013	Brasil (Campinas)	Experimental	Acupressure at point BP6.
Desseauve et al., 2016²⁹	2015	France	Cross-sectional	Dorsal decubitus during labor and delivery, change in position during labor, dorsal decubitus in expulsion stage.
Vaziri et al., 2016³⁰	2014	Iran	Experimental	Spontaneous pushing in lateral position.
Koyucu and Demirci, 2017³¹	2013	Turkey	Experimental	Spontaneous pushing.
Cicek and Basar, 2017³²	2016	Turkey	Experimental	Lamaze breathing technique.
Makvandi et al., 2018³³	2016	Iran	Quasi-experimental	Combination of immersion bath, birth ball exercise, aromatherapy with lavender.
Gallo et al., 2018⁸	2011	Brazil (Ribeirão Preto)	Experimental	Pelvic movement exercises on Swiss ball, 40-min massage, 40-min hot/warm shower.
Ulfsdottir et al., 2018³⁴	2014	Sweden	Cohort	Water birth.
Maddady et al., 2018³⁵	2015	Iran	Experimental	Hot / warm shower.
Mafetoni et al., 2018³⁶	2015	Brazil (Campinas)	Experimental	Auriculotherapy.
Cavalcanti et al., 2019³⁷	2013	Brazil (São Paulo)	Experimental	Hot / warm shower and exercises with Swiss ball, alone and in combination.
Neiman et al., 2020³⁸	2016	USA	Cohort	Immersion bath and waterbirth.

Study	Intervention	Sample		Effect	Duration (minutes)		Statistics	Quality
		With NPMs	Without NPMs		With NPMs	Without NPMs
Hot/warm shower
Maddady et al., 2018³⁵	Hot / warm shower	50	49	Reduction	Active stage: 221.2	Active stage: 312.6	Mean Difference -110.7; 95%CI: 169.5; -51.8	Low risk of bias¹²
Immersion bath
Silva and Oliveira, 2006²⁰	Immersion bath for 40 to 60 minutes	54	54	No effect	6-10 cm dilation: 250.9	6-10 cm dilation: 260.4	p=0.89	Low risk of bias¹²
Neiman et al., 2020³⁸	Immersion bath	61	111	Nulliparous No effect Increase Multiparous No effect No effect	Nulliparous Active stage: 764.7 Expulsion stage: 88.4 Multiparous Active stage: 469.3 Expulsion stage: 20.6	Nulliparous Active stage: 757.8 Expulsion stage: 79.7 Multiparous Active stage: 401.9 Expulsion stage: 16.8	Nulliparous p=0.13 p=0.03 Multiparous p=0.59 p=0.08	Good quality¹⁴
Liu et al., 2014²⁷	Immersion bath in first stage of labor	33	47	No effect No effect	Active stage: 596.55 Expulsion stage: 58.79	Active stage: 552.30 Expulsion stage: 56.04	p=0.43 p=0.72	Some concerns¹³
Eckert et al., 2001¹⁷	Immersion bath in first stage of labor	137	137	No effect No effect	Active stage: 404.23 Expulsion stage: 64.94	Active stage: 407.21 Expulsion stage: 68.80	p=0.89 p=0.65	High risk of bias¹²
Walking
Mamede et al., 2007²³	Walking	75	-	Reduction	Active stage: 22; 10 and 6 minutes shorter for every 100 meters walked at 1^st, 2^nd or 3^rd hour, respectively	Linear regression		Low risk of bias¹³
Breathing techniques
Cicek and Basar, 2017³²	Lamaze breathing technique	35	35	Reduction Reduction No effect No effect	Latent stage: 403.71 Active stage: 174.00 Transition stage: 110.71 Expulsion stage: 19.11	Latent stage: 658.71 Active stage: 264.57 Transition stage: 101.42 Expulsion stage: 24.48	p<0.001 p=0.01 p=0.28 p=0.14	Some concerns¹²
Ball exercises
Gau et al., 2011²⁴	Birth ball exercises	48	39	Reduction No effect	Active stage: 380 Expulsion stage: 38.48	Active stage: 485.4 Expulsion stage: 41.3	p=0.04 p=0.59	Some concerns¹²
Massage
Gallo et al., 2013²⁶	30-min massage	23	23	Increase	Labor: 408	Labor: 342	Mean difference 1.1 hour; 95%CI: 0.2; 2.0	Low risk of bias¹²
Positions adopted by mother
Desseauve et al., 2016²⁹	Dorsal decubitus during labor	431	120	Reduction	Labor classified as ≥120 or <120 minutes	OR=2.2 95%CI: 1.2; 4.2		Good quality¹⁵
Dorsal decubitus during expulsion	303	144	Increase	Labor classified as ≥120 or <120 minutes		OR=0.1 95%CI: 0.0; 0.4
Bomfim-Hyppólito,1998¹⁶	Semi-sitting position (60º) in expulsion stage	127	121	No effect	Expulsion stage: 21.7	Expulsion stage: 25.1	p=0.06	High risk of bias¹²
Maternal mobility
Desseauve et al., 2016²⁹	Switching position during labor	411	140	Increase	Labor classified as ≥120 or <120 minutes	OR=0.2 95%CI: 0.1; 0.3		Good quality¹⁵
Acupuncture/Acupressure/Auriculotherapy
Gaudernack et al., 2006²¹	Acupuncture	43	48	Reduction	Active stage: 264	Active stage: 366	Mean Difference 1.7 hour; 95%CI: 0.2; 3.1	Low risk of bias¹²
Mafetoni and Shimo, 2015²⁸	Acupressure at point BP6	38	30	Reduction	628.10	913.10	p=0.004	Low risk of bias¹²
Mafetoni et al., 2018³⁶	Auriculotherapy	25	27	No effect	607.8	694.7	p=0.08	Low risk of bias¹²
Water birth
Schröcksnadel et al., 2003¹⁸	Water birth in District Hospital	47	265	Reduction	Expulsion stage: 15	Expulsion stage: 20	p=0.02	Good quality14
Schröcksnadel et al., 2003¹⁸	Water birth at University Hospital	218	265	No effect	Expulsion stage: 23	Expulsion stage: 20	Non-significant	Good quality14
Zanetti-Daellenbach et al., 2007²²	Water birth after immersion bath	89	146	No effect Reduction	Active stage: 330.5 Expulsion stage: 35.3	Active stage: 352.8 Expulsion stage: 49.1	Non-significant p<0.001	Good quality¹⁴
Cortes et al., 2011²⁵	Water birth	78	48	Reduction	Expulsion stage: 43	Expulsion stage: 57	p=0.01	Good quality¹⁴
Ulfsdottir et al., 2018³⁴	Water birth	306	306	Reduction	Expulsion stage: 21.6	Expulsion stage: 26.8	p=0.01	Good quality¹⁴
Neiman et al., 2020³⁸	Water birth	58	111	Nulliparous Reduction Multiparous No effect	Nulliparous Expulsion stage: 23.2 Multiparous Expulsion stage: 9.5	Nulliparous Expulsion stage: 79.7 Multiparous Expulsion stage: 16.8	Nulliparous p=0.03 Multiparous p=0.08	Good quality¹⁴
Pushing techniques in expulsion stage
Koyucu and Demirci, 2017³¹	Spontaneous pushing	40	40	Increase	Expulsion stage: 63.2	Expulsion stage: 46.6	p<0.001	Low risk of bias¹²
Vaziri et al., 2016³⁰	Spontaneous pushing in lateral position	35	34	Increase	Expulsion stage: 76.32	Expulsion stage: 64.56	p<0.001	Some concerns¹²
Techniques used in association
Almeida et al., 2005¹⁹	Breathing plus relaxation techniques	19	17	Increase No effect No effect	Latent stage: 145.26 Active stage: 173.68 Transition stage: 126.31	Latent stage: 84.70 Active stage: 151.76 Transition stage: 103.23	p=0.01 p=0.54 p=0.16	Some concerns¹²
Cavalcanti et al., 2019³⁷	Hot / warm shower plus birth ball exercises	39	44	No effect	From combined intervention to birth: 216.85	Hot shower to birth: 255.05	p=0.10	Low risk of bias¹²
Cavalcanti et al., 2019³⁷	Hot / warm shower plus birth ball exercises	39	45	No effect	From combined intervention to birth: 216.85	From birth ball exercises to birth: 288.41	p=0.10	Low risk of bias¹²
Gallo et al., 2018⁸	Ball exercises, lumbosacral massage plus warm/hot shower	40	40	No effect Reduction	Active stage: 373 Expulsion stage: 19	Active stage: 445 Expulsion stage: 37	95%CI: 148; 5 95%CI: 30; -5	Low risk of bias¹²
Makvandi et al., 2018³³	Immersion bath, birth ball exercise, aromatherapy with lavender and vertical positions during second stage of labor	77	77	Reduction No effect	Active stage: 210.02 Expulsion stage: 36.61	Active stage: 269.54 Expulsion stage: 43.08	p<0.001 p=0.08	Low risk of bias¹³
Bio et al., 2006⁷	Mobility and alternating vertical postures	50	50	Reduction	Active stage: 316	Active stage: 508	p<0.001	Some concerns¹²

[TFN1] Source: Authors.