Perfil epidemiológico da mortalidade materna no Estado do Ceará com ênfase aos óbitos ocorridos na Maternidade-Escola Assis Chateaubriand-UFC : 2000 2003

Abstract

Analyse the profile of maternal mortality in Ceará from 2000 to 2003 and, particularly, in Maternidade Escola Assis Chateaubriand (MEAC) – Universidade Federal do Ceará (UFC). Casuistry and Methodology: A retrospective study of 465 maternal death cases was made and 36 clinical records of the MEAC were investigated. As statistic methods were used the requirement: the Linear Association Test, the Qui-Square of Pearson Test, and the Logistic Regression Test. The Maternal Mortality Ratio was computed per 100.000 NV. Results: The study of the diversity at the Secretaria Estadual de Saúde (SESA): the largest Razão da Mortalidade Materna (RMM) happened in the year 2002: 88.7/100.000 NV, and the second largest in 2003: 78.1/100.000 NV. In analysed period, the direct obstetric causes fell from 78.6% to 59.1%, while the indirect grew from 21.4% to 40.9%. When the relation of the direct and indirect obstetrics causes was analysed, it was identified a Logistic Regression proportionally decreasing whereas the following years, if the measures of the considered period keep the same. It was not identified significative association in the analytical tests applied stated by the observed data in other diversities. According to age the largest percentage was between 20 and 24 years old (18.3%). As stated by place: 352 cases (76.2%) occurred in hospital, 69 (14.9%) at home, and in other places 41 (8.9%). According to antenatal care, what calls more attention are the 96 cases (32.8%) with less than four antenatal cares. In relation to the kind of delivery: 180 cases (51.3%) vaginal and 171 cases (48.7%) caesarean. In the revision of the clinical records of the MEAC, the incident of the cases of maternal deaths by direct obstetrics, with 29 events, shows the eclampsia with occurence in 11 of the cases (30.5%); the RMM varied between 86.4 and 220.8/100.000 NV; and the hospital stay time showed 12 cases with ≤ 1 day (33.3%). Conclusions: The direct obstetrics causes were the principal responsible for the maternal mortalities, decreasing during the period. Through the statistical analysis, according we may conclude, in the case that the adopted steps on the above period endure the same, it is expected annually a reduction. In the study made by SESA, the RMM varied on an average of 80.6/100,000 NV, while in the study of the clinical records of the MEAC, it was increased, showing a maximum value in the year 2003 of 220.8/100,000 NV.