The challenge of the reference and counter-reference system in the prenatal assistance to pregnant women with infectious diseases

Abstract

The objective of this study was to determine the prevalence of infectious diseases, such as syphilis, acquired immune deficiency syndrome (AIDS) and hepatitis B and C, in pregnant women who undertook their prenatal care in thirteen basic health units (BHU) in São Paulo city. The efficiency of the reference and counter-reference system in such prenatal infectious diseases was evaluated considering the medical recordings of the final result of the pregnancy and the vertical transmission rates of these diseases. It consists of an epidemiologic study whose observations were based on the notes of the prenatal medical and nurse records of pregnant women who had infectious diseases susceptible to vertical transmission and final infectious status registers of their concepts. Women's syphilis prevalence was 0.86%, HIV and Hepatitis B was 0.22% and Hepatitis C was 0.36%. It's possible to conclude that there is no register of the reference and counter-reference system of these infectious diseases analyzed at the thirteen basic health units of the south-east region of São Paulo city evaluated in 2005. This lack of register makes it impossible to know the preventive measures taken and the vertical transmission rates. Making the professionals and the Health Coordination authorities aware of the importance of the dynamic of the prenatal attendance is necessary.

The Nursing Care with the Oral Health of Pregnant Women: A Qualitative Study

“…After all, the failure of the counter-reference interrupts the care during the pregnancy-puerperal period, because the service loses contact with the pregnant woman, who, in turn, lacks the necessary attention. Some authors reported that one of the main problems for real optimization of the system is the lack of written records coming from reference services [21]. On the other hand, effective practice results in faster care, avoids repeated actions at different levels of care, and minimizes the risk of gaps [21].…”

“…Some authors reported that one of the main problems for real optimization of the system is the lack of written records coming from reference services [21]. On the other hand, effective practice results in faster care, avoids repeated actions at different levels of care, and minimizes the risk of gaps [21].…”

HIV Vertical Transmission: Why is it Still Happening in Brazil?

“…The way the health system is organized does not inform the maternity hospital about the current HIV pregnant women and the mental health is not prepared to support the pregnant woman who is drug addicted. All of this reflects the neglect of antenatal HIV screening, difficulty in assisting, counseling and making laboratory diagnoses, pregnant women's poor adherence to prenatal and/or delayed diagnosis not to mention the low quality of prenatal care [11][12][13][14][15][16][17][18].…”

Congenital syphilis: injury panorama at a teaching Hospital

“…Irregular and infrequent condom use, low education, multiple sexual partners and little involvement with the preventive aspects also associate with the occurrence of syphilis [8].…”