Perfil das gestantes de alto risco hospitalizadas em uma maternidade: estudo descritivo

Aim: to describe the profile of high-risk pregnant women attending the HUAP maternity hospital. Method: descriptive, retrospective and documentary research, with a quantitative approach, performed at a hospital in Niterói/RJ. Data were collected in 2013, through 148 medical records of high-risk pregnant women admitted to the hospital, from July 1, 2011 to June 30, 2012, and treated by descriptive statistics. Results: the majority of the pregnant women were young (up to 30 years old), with a companion and resided in the metropolitan region II/RJ. Half of them had one or two living children; 59.5% were multigravida; 79.1% had never aborted; and, among those who showed previous delivery (n=93), 64.5% had submitted to cesarean section. Regarding prenatal care, 93.3% presented attendance to the appointments. Most of the pregnant women went to the hospital through their own choice (42.6%) as they presented symptoms of general practice. Fifty-nine cases were identified 59 causes for hospitalization, with higher occurrence due to premature amniorrexis and arterial hypertension. Conclusion: the presented results can trigger proposals of protocols of attendance and monitoring of this clientele.

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Aspectos relacionados às internações por intercorrências gestacionais

Enfermagem em Foco ◽

10.21675/2357-707x.2020.v11.n4.3137 ◽

2021 ◽

Vol 11 (4) ◽

Author(s):

Flávia Daniele de Alencar Medeiros ◽

Monaliza De Goes e Silva ◽

Jaqueline Carvalho e Silva Sales ◽

Samila Gomes Ribeiro ◽

Fernando José Guedes da Silva Júnior ◽

...

Keyword(s):

High Risk ◽

Marital Status ◽

Pregnant Women ◽

Pregnancy Complications ◽

Medical Records ◽

Maternity Hospital ◽

Severe Preeclampsia ◽

P Value ◽

Las Mujeres ◽

And Control

Objetivo: Analisar aspectos relacionados às internações por intercorrências gestacionais. Método: Estudo quantitativo, retrospectivo, realizado em maternidade pública de Teresina, Piauí, Brasil, com 367 prontuários de gestantes internadas na ala de alto risco, no período de 2015-2016. Realizou-se análises descritivas e inferenciais. Resultados: Gestantes possuíam média de 25,1 anos (Desvio padrão=7,2), a maioria com companheiro (68,4%), ensino fundamental incompleto (32,7%), do lar (58,6%) e procedentes do interior do Piauí (47,7%). As intercorrências gestacionais mais frequentes foram: Pré-eclâmpsia Grave (33,9%), Amniorrexe Prematura (16,4%) e Oligohidramnio (16,1%). Os aspectos relacionados à Pré-eclâmpsia Grave foram faixa etária (p-valor=0,03) e situação conjugal (p-valor=0,03); à Amniorrexe Prematura foram situação conjugal (p-valor=0,01), procedência (p-valor=0,03) e Infecção do Trato Urinário (p-valor<0,01); e, ao Oligohidramnio associado à procedência (p-valor=0,01). Conclusão: A assistência no período pré-natal, parto e puerpério deve ser recurso utilizado na prevenção e controle de intercorrências que podem atenuar danos ao binômio mãe e filho.Descritores: Gestantes; Complicações na Gravidez; Gravidez de Alto Risco; Enfermagem.Related aspects with hospitalizations due to pregnancy complications Objective: To analyze aspects related to hospitalizations due to pregnancy complications. Method: Quantitative, retrospective study, carried out in a public maternity hospital in Teresina, Piauí, Brazil, with 367 medical records of pregnant women hospitalized in the high-risk ward, in the period 2015-2016. Descriptive and inferential analyzes were carried out. Results: Pregnant women had an average of 25.1 years (standard deviation = 7.2), most with a partner (68.4%), incomplete elementary school (32.7%), home (58.6%) and coming from from the interior of Piauí (47.7%). The most frequent gestational complications were: Severe Preeclampsia (33.9%), Premature Amniorrexis (16.4%) and Oligohydramnios (16.1%). The aspects related to severe preeclampsia were age group (p-value = 0.03) and marital status (p-value = 0.03); Premature Amniorrexis were marital status (p-value = 0.01), origin (p-value = 0.03) and Urinary Tract Infection (p-value <0.01); and the Oligohydramnium associated with the origin (p-value = 0.01). Conclusion: Assistance in the prenatal, childbirth and puerperium period should be a resource used in the prevention and control of complications that can mitigate damage to the mother and child.Descriptors: Pregnant Women; Pregnancy Complications; Pregnancy, High-Risk; Nursing.Aspectos relacionados con hospitalizaciones por complicaciones del embarazo Objetivo: analizar aspectos relacionados con las hospitalizaciones por complicaciones del embarazo. Métodos: Estudio cuantitativo, retrospectivo, realizado en un hospital público de maternidad en Teresina, Piauí, Brasil, con 367 registros médicos de mujeres embarazadas hospitalizadas en la sala de alto riesgo, en el período 2015-2016. Se realizaron análisis descriptivos e inferenciales. Resultados: las mujeres embarazadas tuvieron un promedio de 25.1 años (desviación estándar = 7.2), la mayoría con una pareja (68.4%), escuela primaria incompleta (32.7%), desde casa (58.6%) y provenientes de del interior de Piauí (47.7%). Las complicaciones gestacionales más frecuentes fueron: preeclampsia severa (33.9%), amniorrexis prematura (16.4%) y oligohidramnios (16.1%). Los aspectos relacionados con la preeclampsia severa fueron el grupo de edad (valor p = 0.03) y el estado civil (valor p = 0.03); La amniorrexis prematura fue el estado civil (valor p = 0.01), el origen (valor p = 0.03) y la infección del tracto urinario (valor p <0.01); y el oligohidramio asociado con el origen (valor p = 0.01). Conclusión: La asistencia en el período prenatal, de parto y puerperio debe ser un recurso utilizado en la prevención y el control de complicaciones que pueden mitigar el daño a la madre y al niño.Descriptores: Mujeres embarazadas; Complicaciones del embarazo; Embarazo de alto riesgo; Enfermería.

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The experiences of maternity in front of hospitalization in high risk pregnances

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.960 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Ciciliotti da Silva ◽

B Heintze Ferreira ◽

D Fraga Santos ◽

F Fernandes ◽

Bersot Magalhães ◽

...

Keyword(s):

Public Health ◽

High Risk ◽

Pregnant Women ◽

Maternity Hospital ◽

High Risk Pregnancy ◽

Structured Interviews ◽

The Public ◽

Prenatal Consultation ◽

Risk Pregnancy ◽

Specialized Care

Abstract Introduction The pregnancy-puerperal cycle is defined as a moment that involves physical, psychological and social changes. There are pregnancies that require specialized care and attention due to the presence of risk factors that may be prior to pregnancy and / or that may be associated with the pregnancy condition itself, which characterize them as high-risk pregnancies. Currently, prenatal care with risk stratification is the main care strategy for pregnant women, once the risk classification is identified, it is possible to promote interventions according to the health needs of each pregnant woman. For this, the risk assessment is carried out at each prenatal consultation, so that, depending on the course of pregnancy, hospitalization becomes necessary. The diagnosis of high-risk pregnancies accompanied by hospitalization has impacts on the woman's life, such as loss of autonomy, a sense of failure and the incidence of greater care and interventions by the health team and the family that can configure practices to control their bodies. Objective This work aims to identify the hospitalization process during high-risk pregnancy as a space for the production of projects, resistance and protagonism through the protocols and regulations that configure the hospital context. Methodology This is an exploratory analysis of a qualitative approach in public health. A reference maternity hospital in high-risk pregnancy located in a teaching hospital in Greater Vitória was chosen. It will be used to define sampling for convenience. The data will be collected through semi-structured interviews and on-site observations by the researcher. The data analysis methodology used will be content analysis. Expected Results It is expected to understand the various practices of protagonism and resistance that permeate the care of hospitalized pregnant women. Key messages This work has an impact on the improvement of the maternal and child care network of the public health system in Brazil. This work allows to evaluate the quality of the assistance provided in the public maternity.

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Quality of life of high risk pregnant women during prenatal care

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2019-0595 ◽

2020 ◽

Vol 73 (suppl 5) ◽

Author(s):

Ivyna Pires Gadelha ◽

Priscila de Souza Aquino ◽

Marianne Maia Dutra Balsells ◽

Flaviane Fabrício Diniz ◽

Ana Karina Bezerra Pinheiro ◽

...

Keyword(s):

Quality Of Life ◽

High Risk ◽

Pregnant Women ◽

Family Relationship ◽

Maternity Hospital ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Statistical Program

ABSTRACT Objective: to analyze the quality of life of high-risk pregnant women. Methods: an observational and cross-sectional study, carried out in a tertiary maternity hospital located in Fortaleza, with 276 high-risk pregnant women. A questionnaire was applied containing socioddemographic, clinical and obstetric data and The Mother-Generated Index. Descriptive analyzes were performed using the Jamovi statistical program®, version 0.9. Results: most areas were negatively influenced by pregnancy. “Satisfaction with pregnancy”, “family relationship” and “relationship with the partner” obtained the highest means of primary score, while “physical condition/disposition” and “financing” obtained the lowest means. The highest secondary scores were in “satisfaction with pregnancy”, “family relationship” and “relationship with the partner”, while the lowest were in “financing” and “psychological/emotional”. Conclusion: the total primary score mean was 6.03, suggesting a good quality of life. The Mother Generated Index made it possible to identify aspects of life that go beyond pre-formulated assessments of the construct.

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The Effect of Referral Process and Complications to Maternal Mortality

Jurnal Berkala Epidemiologi ◽

10.20473/jbe.v3i3.2015.400-411 ◽

2015 ◽

Vol 3 (3) ◽

pp. 400

Author(s):

Indah Handriani ◽

Soenarnatalina Melaniani

Keyword(s):

High Risk ◽

Maternal Mortality ◽

Pregnant Women ◽

Medical Records ◽

Multivariable Analysis ◽

Secondary Data ◽

Case Control ◽

Referral Process

ABSTRACTMaternal Mortality Rate (MMR) in East Java was still high. in 2013, MMR in sidoarjo district has readed 96.27 per 100,000 live birth. This aim of this study was to the effect of the referral process to maternal mortality in RSUD Sidoarjo. This research was analytic observational with case control design. The Samples of this study were 25 pregnant women who were referred to RSUD Sidoarjo and death. The case controls were 50 pregnant women who were referred to RSUD Sidoarjo who did not experience death. Techniques of data collection using secondary data from the register book maternal and neonatal Emergency (MNE) and medical records and interviews with the mother/family/husband of respondents. The data was analyzed by using univariable, bivariable and multivariable analysis with logistic regression. The results of this study confirmed that the referral process was poor (OR=9,783,95% CI: 2,275 to 42,072, p=0,002) and the complications (OR=0,005,95%CI: 0,001-0,057, p=0,000).thus, the incidence maternal mortality increased. The conclusion of this study is the referral process and the complications to maternal mortality affect the occurrence of maternal mortality. Midwives need to conduct health education should be given to women in their productive age, increase the participation of families, communities and cadres in the process of early detection of complications during pregnancy, childbirth and postpartum, the quality of antenatal care (ANC) and the quality of referrals should be improved by creating a close referral system in a region associated with a high risk pregnant women were detected inventoried and scheduled control/termination and monitored (follow-up) so that high risk always monitored.Keywords: maternal mortality, referral process, complications

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An Integrative Screening Tool of Alcohol Exposure During Early Pregnancy: Combining of the CDT Biomarker with Green Page Questionnaire

Alcohol and Alcoholism ◽

10.1093/alcalc/agz073 ◽

2019 ◽

Author(s):

María Luisa Azurmendi-Funes ◽

Miriam Martínez-Villanueva ◽

Juan Luís Delgado-Marín ◽

Rebecca Ramis ◽

Miguel Felipe Sánchez-Sauco ◽

...

Keyword(s):

High Risk ◽

Alcohol Use ◽

Pregnant Women ◽

Early Pregnancy ◽

Characteristic Curve ◽

Alcohol Exposure ◽

First Trimester ◽

Maternity Hospital ◽

A Value ◽

Risk Pregnancy

Abstract Aims In current clinical practice, prenatal alcohol exposure is usually assessed by interviewing the pregnant woman by applying questionnaires. An alternative method for detecting alcohol use is to measure the biomarker carbohydrate-deficient transferrin (CDT). However, few studies measure CDT during pregnancy. This study examines the utility of CDT biomarker in the screening of alcohol exposure during early pregnancy. Methods A cohort of 91, first-trimester pregnant women assigned to a public reference maternity hospital, was screened using the Green Page (GP) questionnaire, an environmental exposure tool. CDT levels and other biomarkers of alcohol use were measured and compared with questionnaire data. Results About 70% of the mothers in the study consumed alcohol during early pregnancy and 22% met high-risk criteria for prenatal exposure to alcohol. CDT measurement showed a statistically significant area under the receiver operating characteristic curve with a value of 0.70. For a value of 0.95% of CDT, a specificity of 93% was observed. The most significant predictors of CDT were the number of binge drinking episodes, women’s body mass index and European white race. Conclusion Pregnant women with a CDT value >0.95% would be good candidates for the performance of the GP questionnaire during early pregnancy in order to detect potential high-risk pregnancy due to alcohol exposure.

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High-risk pregnancy: clinical-epidemiological profile of pregnant women attended at the prenatal service of the Public Maternity Hospital of Rio Branco, Acre

Revista Brasileira de Saúde Materno Infantil ◽

10.1590/1806-93042018000300007 ◽

2018 ◽

Vol 18 (3) ◽

pp. 559-566

Author(s):

Aline Fernanda Silva Sampaio ◽

Maria José Francalino da Rocha ◽

Elaine Azevedo Soares Leal

Keyword(s):

High Risk ◽

Pregnant Women ◽

Gestational Hypertension ◽

Maternity Hospital ◽

Cross Sectional Study ◽

Chronic Hypertension ◽

Cross Sectional ◽

The Public ◽

Risk Pregnancy ◽

Epidemiological Profile

Abstract Objectives: to describe the clinical and epidemiological profile of the pregnant women treated at the high-risk prenatal service of the Public Maternity Hospital of Rio Branco, Acre Methods: a cross-sectional study of326pregnant women attended at the Rio Branco high risk prenatal outpatient clinic from April to May 2016. Interviews were conducted with a structured questionnaire. Results: the results showed that the mean age of women was 28 years old, schooling equal to or higher than high school (58.8%), married / stable union (81.7%), unemployed (50%); (26.4%), four or more pregnancies (32.8%), prenatal start with gestational age <12 weeks (69.3%), and 3 to 5 prenatal consultations (58%). The most frequent clinical antecedents were obesity (35%) and chronic hypertension (8%). The most frequent clinical and obstetric complications were urinary tract infection (39.9%), weight gain (30.4%), anemia (14%), threat of abortion (11%) and gestational hypertension (10.4%) Conclusions: knowledge about the clinical-epidemiological profile of high-risk pregnant women helps to create strategic health services instruments and, consequently, to reduce maternal mortality.

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Alert for TSH Measurement in High-Risk Pregnancies in Brazil

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1732 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A848-A849

Author(s):

Lívia Marcela Santos ◽

Déborah Buso Piccinalli Marietto ◽

Juliana Miyuki Miura ◽

Luisa Lacaz Martins Megale ◽

Gabriela Terzian Ganadjian ◽

...

Keyword(s):

Public Health ◽

High Risk ◽

Health System ◽

Pregnant Women ◽

Medical Records ◽

Public Health System ◽

Overt Hypothyroidism ◽

Average Weight ◽

Free T4 ◽

Cross Sectional

Abstract Introduction: The hypothyroidism during pregnancy can lead to alterations in fetal neurological formation and has metabolic impact on pregnant women. If not diagnosed and treated it can cause complications during pregnancy and childbirth, besides causing changes in fetal formation. The TSH test is not part of routine examinations of the pregnancy monitoring care in Brazilian public health system (SUS). The test is not requested in low-risk pregnant women like those at high risk. The Overt Hypothyroidism (no subclinical) is prevalent in 0.3% to 0.5% of pregnant women and is asymptomatic in 70% of these patients. Thus, in order to avoid risks to the mother and fetus health due absence of early diagnosis, it would be ideal for pregnancy monitoring care examinations in the public health system to request a TSH test, especially in high-risk pregnancies. Method: A cross-sectional observational study was approved by the Ethics Committee (CAAE 22906619.2.0000.0062) to review 83 medical records of high-risk pregnant women in a Brazilian public hospital, State of São Paulo, Brazil in 2020. Inclusion criteria: All patients who are being followed up in high-risk childbirth or are hospitalized in the high-risk sector on the maternity during the year 2020. Complete medical records containing the data proposed to be researched and results of exams to be analyzed in the research. Results: The study included the review of 83 medical records of high-risk pregnant women with average age of 30 years old, average gestational age of 31 weeks and average weight of 84 kg. From these 11.4% (n = 10) declared that they had hypothyroidism and 2.4% (n = 2) hyperthyroidism in the first consultation. The 47% (n = 39) had their TSH measured during pregnancy, of which TSH had changed 30.8% (n = 12), 5.1% (n = 2) with suppressed TSH and 25.6% (n = 10) with TSH above the limit for pregnancy. Of the pregnant women who had a diagnosis prior to the pregnancy of hypothyroidism, only 1 did not have their TSH collected during pregnancy. Of the pregnant women who had hyperthyroidism, all had TSH collected during pregnancy, but kept TSH suppressed and free T4 at the upper limit throughout the pregnancy. 10% (n = 8) had gestational bleeding, of which only 25% (n = 2) had TSH measured at some point during pregnancy, of these, one had an altered TSH, but no medication was prescribed or the test repeated. Conclusion: Recognizing that the evolution of pregnancy depends on the normal thyroid eixo, we believe that for high-risk pregnant women they should have their thyroid eixo evaluated in the first trimester.

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Usefulness of COVID-19 screen-and-test approach in pregnant women: an experience from a country with low COVID-19 burden

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0368 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Anja Šterbenc ◽

Tanja Premru Sršen ◽

Miha Lučovnik ◽

Marijana Vidmar Šimic ◽

Lili Steblovnik ◽

...

Keyword(s):

Pregnant Women ◽

Medical Records ◽

Maternity Hospital ◽

Clinical Suspicion ◽

Protective Equipment ◽

Test Results ◽

Hospital Database ◽

Test Strategies ◽

Universal Testing ◽

High Clinical Suspicion

AbstractObjectivesInformation on the usefulness of screen-and-test strategies of pregnant women for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is lacking.MethodsWe retrospectively reviewed the Ljubljana Maternity Hospital database and searched for pregnant women, who were admitted to the hospital between March 15 and May 16, 2020, for a planned procedure or hospitalization. Their medical records were examined and SARS-CoV-2 test results were retrieved.ResultsDuring the two-month period analyzed, there were a total of 265 scheduled admissions of pregnant women to our hospital. Two hundred two (76.2%) were tested for SARS-CoV-2 1 day prior to admission. All tested negative for SARS-CoV-2 RNA, regardless of having coronavirus disease 2019 (COVID-19)-compatible signs or symptoms (n=28) or not (n=174).ConclusionsIn a population with a low SARS-CoV-2 burden, usefulness of universal testing of pregnant women before admission to the hospital is limited. We recommend that obstetric units in regions with low SARS-CoV-2 burden enforce rational use of personal protective equipment and diligent screening protocols using targeted questionnaires, whereas SARS-CoV-2 laboratory testing should be performed only in screen-positives: those with high clinical suspicion of COVID-19 and/or suspected epidemiological history.

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Covid-19 and pregnancy: the experience of a tertiary maternity hospital

Journal of Perinatal Medicine ◽

10.1515/jpm-2021-0070 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Panagiotis Antsaklis ◽

Konstantinos Tasias ◽

Alexandros Psarris ◽

Marianna Theodora ◽

George Daskalakis ◽

...

Keyword(s):

Pregnant Women ◽

Medical Records ◽

Clinical Status ◽

Maternity Hospital ◽

Neonatal Outcomes ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Neonatal Deaths ◽

Maternal And Neonatal Outcomes ◽

Polymerase Chain

Abstract Objectives The aim of our study is to present the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and evaluate its impact on maternal and neonatal outcomes. Methods We retrospectively reviewed the medical records of all COVID-19 positive pregnant women who were admitted to “Alexandra” maternity hospital from March to December 2020 (n=40). The infection status was determined via real-time polymerase chain reaction (RT-PCR) of nasopharyngeal swab specimen. We documented the demographic features, clinical status, pregnancy characteristics and maternal and fetal outcomes. Results Forty COVID-19 positive pregnant women were admitted to our clinic during the study period. Mean maternal age was 27.6 years. Gestational age (GA) ranged from 10–42 weeks of pregnancy with mean GA calculated at 38+3 weeks. Associated comorbidities included hypertension, hypothyroidism, epilepsy, hepatitis B and asthma. Thirty-five out of 40 women delivered within the study period. Cesarean section was performed in 57.1% of the cases. Most of the cases (87.5%) were asymptomatic while ventilation was required for only one patient. All neonates tested negative for SARS-CoV-2. Neither maternal nor neonatal deaths occurred. Conclusions In alignment to other studies, our data show that the course of coronavirus disease 2019 (COVID-19) during pregnancy in the majority of cases is mild and neonatal outcomes also appear favorable.

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Construction of integral index for comprehensive assessment and analysis of risk factors for lower limb varicose veins during pregnancy

Perm Medical Journal ◽

10.17816/pmj37625-32 ◽

2021 ◽

Vol 37 (6) ◽

pp. 25-32

Author(s):

T. P. Shevlyukova ◽

N. B. Chabanova ◽

A. A. Ermakova ◽

P. A. Ermakova

Keyword(s):

Risk Factors ◽

High Risk ◽

Pregnant Women ◽

Varicose Veins ◽

Significant Risk ◽

Maternity Hospital ◽

Lower Limbs ◽

Integral Index ◽

Favorable Prognosis ◽

Medium Risk

Objective. To develop a model of an integral index for complex assessment of varicose vein risk factors and estimate the influence of pregnancy on the occurrence of chronic vein diseases. Varicose veins (VV) and chronic venous insufficiency are one of the most widespread human diseases. This pathology in pregnancy has a clear picture, which is quite different from varicose veins in non-pregnant women. Materials and methods. Analysis of 1974 individual medical cards of pregnant women and puerperas of Maternity Hospital № 2 for the period of 20162019 was carried out. Out of them, 456 cards had a diagnosis of varicose veins of the lower limbs. The method was based on statistical analysis and integral indices. Results. The following risk diapasons were determined: low risk (favorable prognosis) 0.440.85; medium risk (favorable prognosis is possible) 0.861.28; high risk (unfavorable prognosis) 1.292.13. The quantity of pregnancies is not an unfavorable prognosis for women. Long statistical loads give unfavorable prognosis (1.341.43); family predisposition is an unfavorable prognosis (1.66); lifting loads depending on the quantity in grams (1000 favorable sign; 500010 000 unfavorable (1.211.870)); wearing tight clothes is not an unfavorable prognosis (0.88); hypodynamia medium risk (1.14); diet low and medium risk (0.750.95), obesity high risk (1.242.15). Conclusions. The obtained results permitted to detect the most significant risk factors for varicose veins during pregnancy. Medium and high-risk indices are the following: long statistical loads, family predisposition, lifting loads, hypodynamia, diet and obesity. They influence the development of varicose veins. There is a possibility to present a prospective prognosis for pregnant women and develop a complex of measures to decrease risks for chronic vein diseases taking into account individual features of patients.

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