Relação entre o índice de Kessner modificado por Takeda com os indicadores de gravidade nos partos da zona leste da cidade de São Paulo

Abstract

The main causes of maternal deaths in developing and underdeveloped countries are mostly preventable and are directly related to morbidities arising from the gestational process, childbirth and puerperium, being the most prevalent postpartum hemorrhages, hypertensive alterations, sepsis, Obstructed deliveries and complications related to unsafe abortion. Morbidity predates death, and maternal death directly and indirectly affects society, impacting at least three families, as well as being a potential source of social problems arising from the child who was left without the mother. This is one of the main reasons to be concerned with studies that address maternal morbidity and its causes. It is a descriptive, cross-sectional quantitative study based on the analysis of the variables of the pregnant woman's card and the diagnoses identified in the discharge summaries. The data were collected through a field survey conducted in the following neighborhoods: Sapopemba, Aricanduva, São Mateus and Cidade Tiradentes (eastern zone of the city of São Paulo). The objective of the present research is to identify the relations of the application of the Kessner Index modified by Takeda in the card of the pregnant woman with the indicators of severity in childbirth. For this, the method used was the analysis and categorization of the data of filling the variables of the pregnant woman's card using the Kessner Index modified by Takeda. Subsequently, considering the SUS procedures table, the severity indicators were identified in the discharge summaries. Diagnoses and special procedures were analyzed in the cards of the pregnant women and high summaries (n = 360) that could include the criterion of maternal morbidity and other procedures not usually used in the pregnancy-puerperal period. Statistical analysis was used to identify associations between categorization by the Kessner Index modified by Takeda and the severity indicators present in the discharge summaries. Regarding the results, it was observed that in the relationship of this categorization with the severity indicators, there is a higher incidence of risks for inappropriate categorization 8.89% when compared to the appropriate 1.67% and the intermediate 4.44%. Prenatal care in the eastern zone of São Paulo was classified as intermediate (56.9%). It is worth mentioning that 84.7% presented some inadequacy if we consider what the Ministry of Health recommends, only 15.3% (adequate) met the requirements. The most relevant inadequacies in the pregnant woman 's card: 79.4% of absence of records in the second request of serology for syphilis and 81.8% of absence of ABO - Rh registries.