Parto normal depois de cesárea é opção sim!

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Cesárea

Novas diretrizes internacionais apontam que procedimento é seguro, mas ainda não vale para todos os casos

 

De acordo com novas diretrizes anunciadas pelo Colégio Americano de Ginecologistas e Obstetras – a sociedade americana de obstetrícia e ginecologia – mulheres que passaram por uma cesareana podem ser candidatas a partos normais em gestações futuras.
“Isso enfatiza mais uma vez que um trabalho de parto após uma cesareana é uma opção importante para a maioria das mulheres”, disse um dos autores das novas diretrizes, o Dr. Jeffrey Ecker, especialista em medicina materno-fetal do Massachusetts General Hospital de Boston.
Ter um parto normal após ter feito uma cesária é seguro para a maioria das mulheres
Foto: Getty Images
Alguns anos atrás, acreditava-se que uma vez que a mulher tivesse passado por uma cesareana, qualquer parto subseqüente deveria seguir o mesmo procedimento. Mas, com as mudanças em procedimentos cirúrgicos e crescentes evidências que sustentam a possibilidade de parto normal após cesárea, as atitudes começaram a mudar.
Nos anos 80 e 90, porém, com o aumento desse tipo de parto, também aumentaram as complicações relacionadas ao procedimento. Devido a preocupações em relação às complicações e possíveis conseqüências legais delas, o índice de partos vaginais após cesareanas caiu drasticamente de 28,3% em 1996 para 8,8% dos partos em 2006. Mas, os autores das diretrizes apontam que cesareanas sucessivas também têm um risco de complicações tanto para a mãe quanto para o bebê.
“Estudos mais recentes sustentam a idéia de que muitas mulheres podem ter partos normais bem-sucedidos depois de passarem por uma cesárea”, explicou o Dr. William Grobman, outro autor das novas diretrizes e professor associado de obstetrícia e ginecologia Escola de Medicine da Universidade Northwestern, em Chicago.
Em março, um comitê do Instituto Nacional de Saúde dos Estados Unidos chegou à mesma conclusão, afirmando que ter passado por uma cesareana no passado não obriga a mulher a seguir o mesmo procedimento em partos futuros.
As novas diretrizes recomendam que mulheres que passaram por uma cesárea com incisão uterina horizontal baixa (incisão transversal baixa) sejam orientadas a passar por parto vaginal se assim desejarem.
Segundo as novas diretrizes, entre 60% e 80% das mulheres que tentam parto normal após ter feito uma cesareana têm o parto bem-sucedido. Grobman afirmou que tais percentuais são baseados em números populacionais e que para algumas mulheres, estes índices podem ser ainda mais altos.
Publicadas na edição de agosto da revista especializada Obstetrics and Gynecology, as diretrizes apontam que também podem ser candidatas a parto normal após cesareana mulheres que já passaram por duas cesáreas usando a incisão transversal baixa e mulheres que passaram por uma cesárea com incisão transversal baixa e estão grávidas de gêmeos.
Algumas gestantes, no entanto, não são candidatas ao parto vagina após cesareana. Dentre elas estão aquelas que tiveram uma incisão uterina vertical ou complicações sérias na gestação, como placenta prévia, disse Grobman.
“Em vez de dar uma instrução do tipo ‘isso pode’ ou ‘isso não pode’, os médicos precisam oferecer informações sobre os possíveis benefícios e riscos, dando às mulheres a autonomia de tomar suas próprias decisões”.

Por Serena Gordon

Este artigo pertence ao http://gestavida.blogspot.com/
Plágio é crime e está previsto no artigo 184 do Código Penal.

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