Atuação fisioterapêutica nas disfunções do assoalho pélvico decorrentes da episiotomia em adolescentes primíparas.
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Data
2021-12-01
Tipo de documento
Monografia
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
SANTANA, Ketilen Ritiele Oliveira Souza
Orientador
CARVALHO, Fábio Luiz Oliveira
Coorientador
Resumo
A gestação e o parto são um momento único na vida da mulher, o qual traz consigo mudanças no aspecto social, psicológico e fisiológico. Ademais, as gestantes adolescentes tendem a sofrer muito mais com as intercorrências obstétricas durante seu primeiro parto, pois possuem mais chances de trabalho de parto prolongado e realização da episiotomia, a qual é uma incisão que pode ser feita com bisturi ou tesoura cirúrgica, para alargar a abertura da vulva e tornar o processo do parto mais suave. No entanto, embora a episiotomia seja uma pequena incisão, ainda é uma incisão cirúrgica e, como em qualquer tipo de cirurgia, há riscos e benefícios que devem ser levados em consideração antes da decisão de realizá-la. A pesquisa tem como objetivo geral discutir sobre as disfunções na musculatura do assoalho pélvico em primigestas adolescentes decorrentes do procedimento de episiotomia, e como objetivos específicos descrever as técnicas e os recursos utilizados dentro da fisioterapia para tratar tais disfunções e alterações físicas e funcionais, assim como explanar sobre a anatomia pélvica e o processo de gestação enfrentados por essas gestantes. Portanto, a presente pesquisa trata de uma revisão integrativa e, para a realização deste estudo, foram utilizados os seguintes descritores: “primíparas”, “adolescentes”, “episiotomia”, “disfunções do assoalho pélvico” e “atuação fisioterapêutica”, em idiomas como português e inglês. A monografia foi realizada entre os meses de agosto e novembro de 2021, visto que, nesse período, foi realizada uma pesquisa sistemática diante do tema do trabalho. Foram utilizados estudos publicados entre os anos de 2011 e 2021, mas com predominância de utilização de estudos do ano de 2017 a 2021, em bases de dados como: LILACS, MEDLINE/PubMed e SciELO. Por conseguinte, a episiotomia pode desencadear Disfunções do Assoalho Pélvico (DAP), incluindo Incontinência Urinária (IU), Incontinência Anal (IA), Prolapso de Órgão Pélvico (POP), Disfunção Sexual (DS) e dor pélvica, necessitando de avaliação pélvica e intervenção fisioterapêutica. Dito isso, é possível observar que o trauma obstétrico do períneo devido à episiotomia é uma ocorrência frequente no parto vaginal, podendo impactar significativamente na qualidade de vida das mulheres adolescentes. Dessa maneira, visando atenuar a gravidade das DAP, a fisioterapia pélvica, com a utilização dos recursos da cinesioterapia e dos dispositivos auxiliares, é de grande importância no tratamento das musculaturas que foram atingidas pela episiotomia, a fim de trazer melhorias na funcionalidade pélvica e melhorar a qualidade de vida dessas pacientes, assim como, conscientizá-las sobre as potencialidades do seu corpo durante o trabalho de parto.
Pregnancy and childbirth are a unique moment in a woman’s life, which bring changes in the social, psychological and physiological aspects. Furthermore, pregnant teenagers tend to suffer much more from obstetric complications during their first birth, as they have more chances of prolonged labor and episiotomy, which is an incision that can be made with a scalpel or surgical scissors, to enlarge opening the vulva and making the birth process smoother. However, although an episiotomy is a small incision, it is still a surgical incision and, as with any type of surgery, there are risks and benefits that must be taken into account before deciding to perform it. The research has as a general objective to discuss the dysfunctions in the pelvic floor musculature in primiparous teenagers resulting from the episiotomy procedure, and as specific objectives to describe the techniques and resources used within physiotherapy to treat such dysfunctions and physical and functional changes, as well as to explain about the pelvic anatomy and the pregnancy process faced by these pregnant women. Therefore, this research is an integrative review and, for this study, the following descriptors were used: ‘primiparas’, ‘adolescents’, ‘episiotomy’, ‘pelvic floor dysfunctions’ and ‘physiotherapeutic performance’, in languages such as Portuguese and English. The monograph was carried out between the months of August and November 2021, since, during this period, systematic research was done about the theme of the work. Studies published between 2011 and 2021 were used, but with a predominance of studies from 2017 to 2021, in databases such as: LILACS, MEDLINE/PubMed and SciELO. Therefore, episiotomy can trigger Pelvic Floor Dysfunctions (PFD), including Urinary Incontinence (UI), Anal Incontinence (AI), Pelvic Organ Prolapse (POP), Sexual Dysfunction (SD) and pelvic pain, requiring pelvic evaluation and physiotherapy intervention. That said, it is possible to observe that obstetric trauma to the perineum due to episiotomy is a frequent occurrence in vaginal birth and can significantly impact the adolescent women’s quality of life. Thus, aiming to alleviate the severity of PFD, pelvic physiotherapy, with the use of kinesiotherapy resources and auxiliary devices, is of great importance in the treatment of muscles that were affected by episiotomy, in order to improve pelvic functionality and to improve these patients’ quality of life, as well as to make them aware of the potential of their bodies during birth labor.
Pregnancy and childbirth are a unique moment in a woman’s life, which bring changes in the social, psychological and physiological aspects. Furthermore, pregnant teenagers tend to suffer much more from obstetric complications during their first birth, as they have more chances of prolonged labor and episiotomy, which is an incision that can be made with a scalpel or surgical scissors, to enlarge opening the vulva and making the birth process smoother. However, although an episiotomy is a small incision, it is still a surgical incision and, as with any type of surgery, there are risks and benefits that must be taken into account before deciding to perform it. The research has as a general objective to discuss the dysfunctions in the pelvic floor musculature in primiparous teenagers resulting from the episiotomy procedure, and as specific objectives to describe the techniques and resources used within physiotherapy to treat such dysfunctions and physical and functional changes, as well as to explain about the pelvic anatomy and the pregnancy process faced by these pregnant women. Therefore, this research is an integrative review and, for this study, the following descriptors were used: ‘primiparas’, ‘adolescents’, ‘episiotomy’, ‘pelvic floor dysfunctions’ and ‘physiotherapeutic performance’, in languages such as Portuguese and English. The monograph was carried out between the months of August and November 2021, since, during this period, systematic research was done about the theme of the work. Studies published between 2011 and 2021 were used, but with a predominance of studies from 2017 to 2021, in databases such as: LILACS, MEDLINE/PubMed and SciELO. Therefore, episiotomy can trigger Pelvic Floor Dysfunctions (PFD), including Urinary Incontinence (UI), Anal Incontinence (AI), Pelvic Organ Prolapse (POP), Sexual Dysfunction (SD) and pelvic pain, requiring pelvic evaluation and physiotherapy intervention. That said, it is possible to observe that obstetric trauma to the perineum due to episiotomy is a frequent occurrence in vaginal birth and can significantly impact the adolescent women’s quality of life. Thus, aiming to alleviate the severity of PFD, pelvic physiotherapy, with the use of kinesiotherapy resources and auxiliary devices, is of great importance in the treatment of muscles that were affected by episiotomy, in order to improve pelvic functionality and to improve these patients’ quality of life, as well as to make them aware of the potential of their bodies during birth labor.
Palavras-chave
Gestação na adolescência, Episiotomia, Disfunções pélvicas, Atuação fisioterapêutica