O estudo da morbidade materna e do concepto em uma maternidade pública de João Pessoa, Paraíba

Abstract

É expressamente proibida a comercialização deste documento, tanto na sua forma impressa como eletrônica. Sua reprodução total ou parcial é permitida exclusivamente para fins acadêmicos e científicos, desde que na reprodução figure a identificação do autor, título, instituição e ano da tese/dissertação. Apoio Financeiro:Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) Bolsa de Doutorado GD/Programa de Pós-GraduaçãoAs teses escolares dedicam-se a pais, a parentes, a amigos. (Machado de Assis)A Nestor e Ruth (meus pais), por quem fui sempre Abençoada. Introduction -The study of maternal morbidity contributes to a better understanding of the maternal health scene in Brazil and to the fuller knowledge of obstetric problems that may lead (or not) to the hospitalization of pregnant women. Maternal morbidity data are vital for the administrators of public health policies, who need to know how many women are expected to need basic obstetric care so as to make pregnancy and delivery safer. Objectives -To study maternal morbidity and the conceptuses of puerperae in a public maternity hospital in João Pessoa, Paraíba, and identify women with a diagnosis considered potentially threatening and suggestive of being possible near misses. Method -This is a transverse study that is part of a larger project on maternal morbimortality. A sample of 414 puerperae was selected by a process of systematic random sampling, the data on whom were collected, prospectively, from September to November 2011, on the basis of clinical case notes and complementary interviews, at a public maternity hospital of reference in great demand in the municipality. Results -A total of 383 pregnancies which were carried through to delivery and 391 conceptuses were studied. There predominated, among the puerperas: the 20 -34 year age-group, of brown skin color, low level of schooling, low income and no formal professional occupation. Half of them underwent caesarian section and 17% of the new-born presented health problems. The following incidents were identified during labour: lacerations of the perineum, haematomas, traumatisms, haemorrhages and hypertensions. During the puerperium, hypertensive disorders, post-partum hemorrhage and other puerperal infections were noteworthy. The most frequent mention in the case notes of maternal causes was of hypertensive disturbances of pregnancy. Among the 64 diagnoses suggestive of nearmiss, are the hypertensive (58%) and the haemorrhagic syndromes (32.8%). In the comparative analysis of the groups of puerperae with morbidities suggestive of nearmiss, the following variables presented statistically significant differences (p<0.001): health problems during the previous and present pregnancy, hypertension, risk pregnancy and use of hypertensive medications. No statistical differences between the characteristics of the newborn and those of maternal morbidity (whether suggestive of near miss or not) were found. Conclusion -The study allowed the identification of maternal characteristics and the prevale...

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