Mortalidade materna : realidade que se faz conhecer lentamente

Abstract

The present study was the theme guiding thread maternal mortality, especially as regards the structure of the Epidemiological Surveillance in order to analyze its implementation process in the state of Ceará with their respective municipalities. It was based on analysis of 1072 maternal deaths occurring in the period 1991 to 2001. Deaths from 1991 to 1992 were from the death certificates in the Mortality Information System with a recognized underreporting. In the period 1993 to 1997, we used the confidential records of maternal death, complementing the information from hospital archives, home interviews and health professionals was carried out using the analysis of the State Committee for the Prevention of Maternal Mortality. From 1997 to 2001, we had the opportunity to deepen the analysis because it has computerized data through the EPI INFO and be feasible to investigate the following variables: maternal mortality ratio, ratio of specific mortality from direct obstetric causes, obstetric factors that caused the maternal death, personal factors, socio-economic, maternal health care and information system. From 1991 to 1996, the maternal mortality ratios presented in a clear rising trend, ranging from 22.8 per 100,000 live births to 95.1 per 100,000 live births, respectively. This upward trend was explained by the significant improvement of the death records. In the last two years, a reduction in maternal mortality to a level of 76.0 per 100,000 live births. This index considered quite high but showing a sharp decline, mainly due to the reduction of deaths from direct obstetric causes, which had decreased 34.7% from 1998 to 2001. Among the personal factors and socio-economic impacts of pregnant women that resulted in death, poor education, low family income, age between 20 and 29, understood as ideal for reproduction, a higher percentage of these concentrated. The factors of poor care and inadequate along with the socioeconomic conditions were associated with deaths, almost like that determinando.O study demonstrated that the development of selective action in primary and tertiary care has unquestionably contributed to the reduction maternal mortality observed. Despite these advances also identified a motley cast of interventions needs to remain and set of recommendations for the state Department of Health after experiencing maternal mortality, through state policies appropriate and timely.