| Morbidade Materna Grave e Near Misses em Hospital de Referência Regional</td>
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<td colspan="2" class="text5">关键词:
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Near miss"'>Near miss</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Morbidade materna grave"'>Morbidade materna grave</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Mortalidade materna"'>Mortalidade materna</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Óbito materno"'>Óbito materno</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Critérios definidores"'>Critérios definidores</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Brasil"'>Brasil</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Near miss"'>Near miss</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Severe maternal morbidity"'>Severe maternal morbidity</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Maternal mortality"'>Maternal mortality</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Maternal Death"'>Maternal Death</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Defining criteria"'>Defining criteria</a>;
<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oakeywords:"Brazil"'>Brazil</a>;
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<td class="text2" colspan="2" style="color: #2575A5;">DOI : 10.1590/S1415-790X2011000200012</td>
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<td colspan="2" class="text5" style="color: #2575A5;">来源:<a
href='http://oa.las.ac.cn/oainone/service/browseall/viewmore?ptype=JA&q= AND oasourcestr:"DOAJ"'>
DOAJ</a></td>
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<h6>【 摘 要 】</h6>
<p style="text-align: justify; text-indent: 2em;">
OBJETIVO: Analisar perfil epidemiológico da morbidade materna grave/near miss em uma maternidade pública de referência regional, utilizando diferentes critérios identificadores. MÉTODOS: Trata-se de um estudo descritivo de corte transversal dos casos de morbidade materna grave/near miss realizado em Hospital de referência regional entre junho e outubro de 2009, identificados a partir dos livros de registro de internação da maternidade e análise dos prontuários clínicos. Foram estudadas mulheres que, durante a gestação, parto ou puerpério, apresentaram qualquer quadro clínico compatível com os critérios definidores de morbidade materna grave/near miss de Waterstone et al., Mantel et al. e Organização Mundial de Saúde. RESULTADOS: Entre as 1.544 internações foram identificadas 89 mulheres com morbidade materna grave, considerando os critérios adotados. As razões de morbidade materna grave/near miss variaram entre 81,4 a 9,4 por 1.000 NV, dependendo do critério utilizado. O índice de Mortalidade foi de 3,2%, chegando a 23% no critério da OMS. Das 89 mulheres, apenas 40% fizeram mais de seis consultas de pré-natal e 10% não realizaram qualquer consulta. Os marcadores mais encontrados foram a pré-eclâmpsia grave seguida de hemorragia grave, internação em UTI, Síndrome HELLP e eclâmpsia. Ocorreram três mortes maternas por causas obstétricas com RMM de 280/100.000 NV e uma morte tardia. O critério da OMS se mostrou mais específico, identificando os casos mais graves, enquanto o de Waterstone foi mais sensível. CONCLUSÃO: O estudo da morbidade materna grave/near miss em um hospital de referência regional pode contribuir para o conhecimento da magnitude deste evento, como também identificar suas características e condições clínicas mais frequentes, sendo extremamente importante para o enfrentamento da morbi-mortalidade materna.<br>OBJECTIVE: To investigate severe maternal morbidity/near misses in a tertiary public maternity in the state of Rio de Janeiro, using different identification criteria. METHODS: This is a cross-sectional study, performed in a regional reference hospital between June and October 2009, on severe maternal morbidity/near miss cases identified from the log books of the maternity hospital and review of medical records. This study focused on women who, during pregnancy, delivery, or the postpartum period, showed no clinical symptoms compatible with the defining criteria for severe maternal morbidity/near miss of Waterstone et al, Mantel et al. and the World Health Organization (WHO). RESULTS: Among the 1,544 admissions during the period studied, 89 women with severe maternal morbidity were identified, considering all criteria. The occurrence of severe maternal morbidity/near misses ranged from 81.4 to 9.4 per 1,000 live births (LB), depending on the criterion used. The mortality rate was 3.2%, reaching 23% in the WHO criteria. Only 40% of these women had more than six prenatal visits and 10% did not have any visit at all. The most common markers found were severe preeclampsia, followed by severe hemorrhage, ICU admissions, HELLP syndrome, and eclampsia. There were three maternal deaths with a MMR = 280/100.000 LB and one late death. The WHO criterion showed greater specificity, identifying more severe cases, while the Waterstone criterion was more sensitive. CONCLUSIONS: The study of severe maternal morbidity/near misses in a regional reference hospital can contribute to the knowledge of this event's magnitude, as well as to identify its most frequent characteristics and clinical conditions, being essential for dealing with maternal morbidity and mortality.</p>
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