Mortalidade materna relacionada à doença hipertensiva especifica da gestação (DHGE) em uma maternidade no Pará

Guerreiro, Diana Damasceno; Borges, William Dias; Nunes, Heliana Helena de Moura; Silva, Silvia Cristina Santos; Maciel, Juliana de Paula

doi:10.5902/2179769213159

Cited by 10 publications

(10 citation statements)

References 5 publications

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“…Esse número representa um declínio de 47% em relação aos níveis encontrados em 1990, mas está distante da 5ª meta dos Objetivos de Desenvolvimento do Milênio de redução de 75% das mortes maternas até 2015. A maioria dessas mortes está concentrada nos países em desenvolvimento e é decorrente da falta de acesso a cuidados de rotina adequados e cuidados de emergência quando necessários 2,3 . Em se tratando de mortalidade materna (MM), a qual é definida como "o óbito de mulheres durante a gravidez, parto ou puerpério, resultante de complicações surgidas ou agravadas no período, ou por medidas tomadas em relação a essas", no âmbito brasileiro, embora haja controvérsias, a estatística sobre esse dado epidemiológico apresenta-se estimada em torno de 73 mortes para cada 100 mil nascidos vivos; no entanto, os dados ainda se mostram pouco disponíveis sobre a situação da MM 3,4 .…”

Section: Introductionunclassified

Fatores determinantes do near miss materno em uma unidade de terapia intensiva obstétrica

Souza¹,

Souza²,

Gonçalves³

2015

Rev. Bras. Ginecol. Obstet.

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ResumoOBJETIVO: Avaliar os fatores determinantes da morbimortalidade em unidade de terapia intensiva obstétrica de um hospital universitário. MÉTODOS: Estudo observacional de corte transversal com 492 gestantes ou puérperas. Foram selecionadas pacientes internadas na unidade de terapia intensiva obstétrica no período de um ano, sendo informadas sobre as propostas do estudo e realizada aplicação do questionário. A análise foi feita através do Microsoft Excel 2013 e GraphPad Prism 6. Foram empregados testes do χ 2 para verificar associação entre os fatores de risco para morbimortalidade materna grave. RESULTADOS: Foram encontrados como riscos relativos significativamente elevados para desenvolvimento de near miss quando comparada à morbidade materna grave, a raça não branca (OR=2,5; RP=2,3); pacientes casadas (OR=7,9; RP=7,1), escolaridade até 2º grau incompleto (OR=3,1; RP=2,8), procedente do interior (OR=4,6; RP=4,0), renda familiar menor que 1 salário mínimo (OR=7,0; RP=5,5), distúrbios hipertensivos gestacionais (OR=16,3; RP=13,2), realização do pré-natal (OR=5,0; RP=4,2) e a via de parto cesárea (OR=39,2; RP=31,2). CONCLUSÕES: Questões socioeconômicas, clínicas e assistenciais mostraram-se relacionados à prevalência de near miss, revelando a importância de intervenções amplas para melhorar esses indicadores. Reforça-se a importância da realização de pré-natal para identificação de riscos potenciais, garantia de um suporte nutricional à gestante, tratamento de doenças e estabelecimento de programa de imunização materna, assim como uma melhor assistência no que tange aos aspectos clínicos das pacientes, objetivando diminuir o risco obstétrico e neonatal. Abstract PURPOSE:To evaluate the risk factors for morbidity and mortality in an obstetric intensive care unit at a university hospital. METHODS: Observational cross-sectional study with 492 pregnant/puerperal women. Patients were admitted to the obstetric intensive care unit over a period of one year, being informed about the proposals of the study and a questionnaire was applied. The analysis was performed using Microsoft Excel 2013 and GraphPad Prism 6. To evaluate risk factors, χ 2 tests were used. RESULTS: The main risk factors to near miss were: non-white race (OR=2.5; PR=2.3); marital status (married women) (OR=7.9; PR=7.1), schooling (primary) (OR=3.1; PR=2.8), being from the countryside (OR=4.6; PR=4.0), low income (OR=70; PR=5.5), gestational hypertensive disorders (OR=16.3; PR=13.2), receiving prenatal care (OR=5.0; PR=4.254) and C-section before labor (OR=39.2; PR=31.2). CONCLUSIONS: The prevalence of near miss was associated with socioeconomic/clinical factors and care issues, revealing the importance of interventions to improve these indicators. Additionally, we suggest a better curriculum insertion of this subject in the discipline of the medical course due to the importance of avoiding the near miss using adequate medical education. The importance of correct prenatal care is emphasized in order to identify potential risks, to provide nutritional ...

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Section: Introductionunclassified

Fatores determinantes do near miss materno em uma unidade de terapia intensiva obstétrica

Souza¹,

Souza²,

Gonçalves³

2015

Rev. Bras. Ginecol. Obstet.

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“…In the present study, 38.3% of the patients indicated hypertension as a diagnosis of admission to the ICU. In a systematic review of the literature during 1990-2008, the hypertensive syndrome was found to be the most prevalent in a specific obstetric cause for hospitalization (5,14) Hypertensive gestational syndromes including chronic hypertension and the entire spectrum of preeclampsia, complicated about 7% of the pregnancies. Moreover, deaths related to this clinical condition have been constantly reported, often ranging from 1 to 24% (15).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Mortality of Obstetric Patients Admitted to a Tertiary Intensive Care Unit in the Brazilian Northeast

Barbosa

Lima

Aguiar

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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Objectives: This study aimed to analyze the determinants of hospitalization and death in an intensive care unit (ICU) between pregnant and postpartum women. Materials and Methods: This is a quantitative and retrospective documentary research performed at Dr. César Cals Hospital. Data was collected through the analysis of charts obtained from puerperal or pregnant women admitted to the ICU. Results: Regarding the type of delivery, 41 (73.2%) women had a cesarean section (CS) and, considering the outcome, the majority of the patients (51%) were discharged from the hospi-tal. Comparing the admission diagnosis and the outcome, it was revealed that many patients presented more than one diagnosis at the admission, the highest rate of which was the hyper-tensive disorders of pregnancy (HDP) and complications comprising of 23 (38.3%) patients out of which 4 of them died. Sepsis was the second cause of hospitalization including 17 (28.3%) patients. In addition, 11 (18.3%) patients had hemorrhaged. Moreover, there were 2 death reports related to fulminant hepatitis. Conclusions: It is expected that the results of the present study contribute to the extension of the professionals’ knowledge on the subject, collaborating to prevent hospitalization and death of these patients.

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“…The Hypertensive Disease Specific of Pregnancy is the most important clinical entity of the current obstetrics, a view that is based in the relatively high incidence, in ignorance of its true etiology and in the still present high maternal and fetal mortality, reflecting the innocuousness of therapeutic resources (11) . According to data found, there was decrease in cases where pregnant women develop Hypertensive Disease Specific of Pregnancy after the implementation of the program, but they still remain high.…”

Section: Discussionmentioning

confidence: 99%

Impact of deployment of “Stork Network” in hospitalizations in the Neonatal Intensive Care Unit

Andrade¹,

Manzotti²,

Gouveia³

et al. 2016

Rev Rene

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Objective: to assess the impact of the deployment of "Stork Network" (Rede Cegonha) in hospitalizations in the Neonatal Intensive Care Unit. Methods: a retrospective cross-sectional study with 283 medical records of newborns hospitalized in neonatal intensive care unit before and after the implementation of Stork Network, correlating data from pregnant women with the babies' conditions. Results: after the implementation of Stork Network, the percentage of pregnant women who performed six or more visits to the hospital increased 6.5% and the diagnosis of hypertensive disorders of pregnancy reduced 10.8%. It was also noted reduction of one week in the mean gestational age of babies and 14.4% reduction in the percentage of babies weighing ≥2500 grams. The number of deaths during hospitalization increased from 2.4% to 14.5%. Conclusion: the goal of performing screening and monitoring of risk pregnancies was reached, however, the reduction of neonatal mortality rate is still challenging.

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Mortalidade materna relacionada à doença hipertensiva especifica da gestação (DHGE) em uma maternidade no Pará

Cited by 10 publications

References 5 publications

Fatores determinantes do near miss materno em uma unidade de terapia intensiva obstétrica

Fatores determinantes do near miss materno em uma unidade de terapia intensiva obstétrica

Clinical Characteristics and Mortality of Obstetric Patients Admitted to a Tertiary Intensive Care Unit in the Brazilian Northeast

Impact of deployment of “Stork Network” in hospitalizations in the Neonatal Intensive Care Unit

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