Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado

Abstract

OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%), distócia (22,4%) e o sofrimento fetal agudo (18,2%), e no hospital privado foram cesárea iterativa (36%) e distócia (36%). As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.

Adolescent pregnancy: a comparative study between mothers who use public and private health systems

“…The type of birth to which the adolescents were submitted clearly shows this dichotomy. Studies (14)(15) show a high rate of c-sections in Brazil, mainly due to inadequate medical care, pregnant women's precarious education, causes of economic nature, among others.…”

“…This increase is progressive and exaggerated, and occurs especially among the socioeconomic favored classes, who attend private clinics and/or have health plans, while these indexes are lower among the economically less favored classes, whose deliveries mainly occur in public hospitals or teaching hospitals (14) . Table 3 It is important to appoint that the index of csections tolerated by the Ministry of Health is 15 to 20%, and that the current high rate of c-sections constitutes a public health problem, since it has led to higher rates of maternal and perinatal morbidity and mortality (16) .…”

Mulheres esterilizadas voluntariamente pelo sistema único de saúde em Ribeirão Preto - SP, segundo o tipo de parto

“…No Brasil, no entanto, o número de cesáreas cresce de modo desproporcional às referidas indicações, e se observa que há maior indicação de cesárea associada à categoria de internação hospitalar privada e pré-paga e ao aumento do padrão social das gestantes do que ao risco obstétrico propriamente dito (FABRI et al, 2002;FAÚNDES;CECATTI, 1993;HOPKINS, 2000;HOPKINS et al, 2005;MORAIS;GOLDENBERG, 2001;VILLAR et al, 2006;YAZLLE et al, 2001).…”

The multiple meanings of 'risk': views on the abortion of non-viable fetuses among Brazilian medical doctors and magistrates

“…Brazil has one of the world's highest rates of C-section births (WHO 1985, Víctora et al 2011 and prevalence is higher among private hospitals than the public health system (Faúndes & Cecatti 1991, Yazlle et al 2001Fabri et al 2002, Faúndes et al 2004, Haddad & Cecatti 2011 This suggests that the higher on the economic scale, the more autonomy the woman has for choosing this kind of procedure, even if it is more risky. C-sections are considered to involve risk, but risk is inherent to any pregnancy.…”

“…Women are not at risk of death and may take pregnancy to full term without harm to their 6 In their study of 86,120 births in the city of Ribeirão Preto (São Paulo State) between 1986 and 1995, Yazlle et al (2001) found the C-section rate to be 32.1% in public hospitals, and 81.8% in private hospitals. Fabri et al (2002) compared the rate of C-sections between one public and one private hospital located in the state of Minas Gerais in 1996, and found that C-sections accounted for 24.3% of births in the public hospital against 89.2% in the private hospital. Haddad and Cecatti (2011) found that the rate of C-sections in Brazil in 2006 was 30.1% in the public system versus 80.7% in private hospitals.…”