Mortes de mulheres internadas para parto e por aborto e de seus conceptos em maternidades públicas

Abstract

The aim of this cross-sectional hospital-based study of 7,845 pregnancies was to analyze deaths of women hospitalized for childbirth and abortion, and fetal and neonatal deaths, in public hospitals in the cities of São Paulo, Rio de Janeiro and Niteroi (RJ), Brazil, in 2011. Outcomes of the pregnancies were: one maternal death, 498 abortions, 65 fetal deaths, 44 neonatal deaths and 7,291 infant survivors. Data were collected through interviews, medical records and the women's pregnancy records, and from the Mortality Information System (SIM). The study population was described and kappa coefficients of causes of death (from the SIM, and certified by research) and mortality health indicators were estimated. The maternal mortality ratio was 13.6 per 100,000 live births (LB), the fetal death rate was 8.8‰ births and the neonatal mortality rate was 6.0‰ LB. The drug most used to induce abortion was Misoprostol. The main causes of fetal and neonatal deaths were respiratory disorders and maternal factors. Congenital syphilis, diabetes and fetal death of unspecified cause were under-reported in the SIM. Kappa coefficients by chapter were 0.70 (neonatal deaths) and 0.54 (stillbirths). Good quality care in reproductive planning, prenatal care, during labor and at birth will result in prevention of deaths.

Neonatal Near Miss among Newborns of Women with Type 1 Diabetes Mellitus

“…Among the 7 newborns who died, most had a birth weight <1750 g, gestational age <33 weeks, and met pragmatic criteria for NNM. A recent study conducted in Brazil with a larger sample in the general population obtained similar results, with the main cause of neonatal deaths due to respiratory disorder, low birth weight, and premature birth [25]. T1DM might have anticipated resolution of pregnancies in a way that newborns died as a complication of prematurity.…”

Internações por "Outras gravidezes que terminam em aborto". CID 00-008 na região metropolitana de Porto Alegre

“…Devido ao ato ilegal do abortamento, os dados de abortos provocados foram subestimados, sendo classificados por diferentes maneiras de causas, ou seja, prejudicando também a avaliação da faixa etária. Além disso, foi concluído que apesar da obrigatoriedade de investigação das causas de óbito fetais e neonatais, apenas pouco mais da metade teria sido realizado 16 .…”

Aplicabilidade da Lista Brasileira de Causas de Mortes Evitáveis por intervenção do Sistema Único de Saúde, para análise de óbitos perinatais em municípios dos estados Rio de Janeiro e São Paulo, 2011*

“…Perinatal deaths were identified by following up on a hospital-based birth cohort (follow-up time for stillbirths equal to zero; follow-up time for live births equal to age at death), conducted in six SUS maternity hospitals with the highest frequency of live births -one in Niterói-RJ and one in the city of Rio de Janeiro (RJ Center); and four in São Paulo (SP Center) -, between September and November 2011. The underlying cause of perinatal deaths was checked in parallel by experienced researchers, so as to provide the information 13 and BAL application with greater reliability.…”

“…Death certificate data was complemented by checking underlying cause of death through the information collected. 13 The main questionnaire and the operational stages of the study were the same at the RJ Center and at the SP Center.…”