Abstract
Abstract Objectives: to analyze adverse outcomes in teaching maternity hospitals in Maceió, Alagoas, Brazil. Methods: a cross-sectional, retrospective and analytical study was carried out with a random sample of 480 medical records of postpartum women in 2016 using the Adverse Outcome Index: in-hospital maternal death, neonatal in-hospital death> 2500g and> 37 weeks, uterine rupture, unplanned maternal admission to intensive care unit, delivery trauma to the newborn, return to the operating room, admission to an intensive neonatal unit with >2500g and > 37 weeks for more than one day, Apgar <7 at the fifth minute, maternal hemotransfusion and fourth-degree perineal laceration. The data were analyzed using the Statistical Package for Social Sciences software version 22.0. Results: the results showed a 21% rate of adverse outcomes, at a rate of 26.4 for every 1,000 births, with a greater occurrence of neonatal intensive care admission with>2500g and>37 weeks for more than one day (52. 5%), maternal blood transfusion (20.8%) and unplanned maternal admission in intensive care (17.8%). Conclusions: the evaluation of adverse outcomes evidenced a high proportion of births with undesirable results, which allowed the analysis of the outlook of unfavorable outcomes related to safety in maternity wards through the use of indicators.
Highlights
Pregnancy and childbirth are physiological events that represent the third cause of hospitalization in Brazil, with varying degrees of complexity, from natural conditions, in the absence of complications, to the presence of pathologies and situations that require specialized demands from health services.[1,2] Health services in the obstetric area represent critical nodes for the quality of hospital service and patient safety.[3]
The sample consisted of 480 medical records and considered as a calculation reference the guidelines proposed by the instrument adapted from the Institute for Healthcare Improvement (IHI) for the assessment of adverse events in childbirth,[13,14] evaluating the year 2016, with the analysis of 10 medical records referring to each fortnight of 2016
The age ranged from 13 to 46 years, with an average of 25 years (± 7.3), with 16.2% under 18 years old; 58.6% of women had less than nine years of schooling, 56.3% had some paid activity, 97.3% were of mixed ethnicity, 52.4% had a partner and 52.3% came from other municipalities in the interior of State
Summary
Pregnancy and childbirth are physiological events that represent the third cause of hospitalization in Brazil, with varying degrees of complexity, from natural conditions, in the absence of complications, to the presence of pathologies and situations that require specialized demands from health services.[1,2] Health services in the obstetric area represent critical nodes for the quality of hospital service and patient safety.[3]. Unfavorable outcomes or complications of childbirth can be used to assess the quality of care, through indicators of the damage profile, which provides the analysis of causes, risk factors and care results.[9,10] The evaluation of results in health services is shown to be advantageous for associating outcome measures with patient safety assessment, 11 representing incidents and adverse situations that impact health systems
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