Evaluation of prenatal care according to indicators for the Prenatal and Birth Humanization Program

Abstract

Objectives: to evaluate prenatal care provided to low-risk pregnant women users of the Sistema Único de Saúde (SUS) (Public Health System) in the city of Joinville, SC. Methods: this is a cross-sectional observational study carried out from March 2018 to February 2019, through interview and analysis of the Pregnant Card of puerperal over 18 years old, from Joinville, who underwent prenatal care at SUS, excluding recent given up puerperal. Prenatal care was evaluated according to the recommended criteria by the Prenatal and Birth Humanization Program. Results: 683 mothers were interviewed. The criteria with the highest levels of adequacy were accessibility (99.6%), early initiation on prenatal care (92.7%) and 6 or more consultations (87.1%) and the criteria with the lowest rates of adequacy were the set of guidelines (17.7%) and the third and first trimester exams (42.5% and 63.5% respectively). Conclusion: it is concluded that the prenatal care provided by SUS in the city of Joinville, despite the almost universal accessibility, the early onset and the prevalence of puerperal women with more than 6 consultations, showed a sharp decline in the analysis of the recommended indicators.

Qualificação interprofissional da atenção pré-natal no contexto da atenção primária à saúde

“…A atenção pré-natal é um dos pilares do cuidado à gestante, cuja relevância para a redução da morbimortalidade materno infantil já se encontra pactuada. Estudos demonstram que a má qualidade da assistência pré-natal frequentemente resulta em repercussões negativas tanto no parto e nascimento quanto no puerpério e para o recém-nascido 1,2 .…”

Network care: relationship between prenatal care adequacy and hospital obstetric care in a cross-sectional study

“…National statistics reveal increased coverage in prenatal care, but also significant incidence figures of treatable and/or avoidable morbidities, a trend that has been observed for some years in the country and which is quite contradictory (2) . In fact, follow-up adequacy is related to the improvement of maternal and neonatal outcomes, both because of their role in injury prevention during gestational follow-up and the opportune referral to appropriate care services for obstetric complications, reflecting a great deal on the strengthening of health networks and reducing the overload of referral services (3)(4) .…”

Cuidado em rede: relação entre a adequação pré-natal e os atendimentos obstétricos hospitalares em um estudo transversal

“…As estatísticas nacionais revelam ampliação de cobertura no acompanhamento pré-natal, mas também números expressivos de incidência de morbidades tratáveis e/ou evitáveis, uma tendência que vem sendo observada há alguns anos no país e que é bastante contraditória (2) . De fato, a adequabilidade do acompanhamento está relacionada com a melhoria dos desfechos maternos e neonatais, tanto por seu papel na prevenção de agravos durante o acompanhamento gestacional quanto pelo encaminhamento oportuno a serviços de atendimento adequados às complicações obstétricas, refletindo sobremaneira no fortalecimento das redes de saúde e na redução da sobrecarga de serviços de referência (3)(4) .…”