Análise do perfil dos óbitos maternos de uma maternidade no Nordeste do Brasil

Abstract

The loss of a woman in the pregnancy-puerperal period is an event that ends, in a tragic way, the natural process of reproduction. For the World Health Organization, Maternal Death is defined as the death of a woman during pregnancy or within a period up to 42 days after its termination, regardless of the duration or location of the pregnancy, due to any cause related or aggravated by pregnancy or With respect to it, except for incidental or consequential causes. The study aimed to know the sociodemographic, obstetric and clinical profile of the maternal deaths of a public maternity hospital in northeastern Brazil. It is a descriptive, documentary research of a quantitative nature developed in the Maternity School Assis Chateaubriand. Data collection was performed during the month of August 2016, from the medical records of patients who died at the Maternal Intensive Care Unit (ICU) of the institution from January 2010 to December 2015. The sample consisted of 47 (55.3%), unmarried (40.4%), with a grade of schooling between complete / incomplete elementary school (48.9%). The results indicated a higher number of "domestic" women (34%), from the interior (61.7%) and brown women (59.6%). Prevalence of women with two to three previous pregnancies (36.2%), one previous birth (31.9%), and no history of abortions (68.1%). Records of prenatal follow-up were found in 36.2% of the medical records, with a greater number of women having had between one and five visits. There were records of pathological obstetric antecedents, with a higher number of pregnancy steatotic liver (4.3%). The most recurrent clinical history was heart disease (6.4%). Infection (36.2%), haemorrhage (25.5%) and Hellp syndrome (19.1%) were the most frequent risk factor in preterm gestation (14.9%), 1%). The mean systolic blood pressure at admission was 109.1 mmHg, Diastolic Blood Pressure 64.9 mmHg; Mean capillary glycemia was 152 mg / dL. During ICU admission, 70.2% of the women had blood counts and electrolytes. Regarding the urine summary, 25.5% performed this test, with signs of urinary infection in 83.3%. In the urine culture test, performed in 27.7% of the women, 76.9% identified colony forming units. Hemotherapy was indicated in 76.6% of the cases, with red blood cell transfusion (70.2%). In the majority of cases, the outcome of pregnancy was cesarean section surgery (58.7%), which occurred in the maternity ward (67.6%), indicated mainly by Specific Hypertensive Disease of Pregnancy / Eclampsia (26%). 96.7% of deliveries / abortions were followed up by an obstetrician. The prevalent death moment was the puerperium (76.6%), with cause related to infection (27.7%). 97.9% of the cases were classified as maternal deaths due to direct obstetric causes (59.6%) and were declared (87.2%). It is concluded that the profile indicates a woman with low socioeconomic level, gynecological-obstetric profile evidencing risks during pregnancy and admission to the ICU in a severe setting. It is understood that a considerable part of the deaths resulted from avoidable causes, through adequate prenatal care and assistance. There were flaws in the records regarding relevant information, indicating the need to better fill these data.