Abstract
RESUMO Objetivo: compreender o significado de gestar para mulheres portadoras de cardiopatia; desvelar sentidos da mundanidade do ser-aí-mulher em risco reprodutivo no vivido/vivência da gestação de alto risco por cardiopatia. Método: pesquisa qualitativa sustentada na fenomenologia Heideggeriana. Foram entrevistadas 17 mulheres entre os meses de julho a dezembro de 2014 que gestaram com cardiopatia em instituição de referência para risco materno. Resultados: o movimento analítico hermenêutico permitiu a emersão das Unidades de Significação: saber do risco e tanto planejar quanto não saber como evitar, e se surpreender ao se descobrir grávida; falar como se sentiu física e emocionalmente na gestação; sentir-se segura pela rotina de acompanhamento pré-natal. Os sentidos desvelados apontaram para a fragilidade dos saberes das participantes acerca do risco reprodutivo. Conclusão: o enfermeiro e a equipe de saúde devem considerar em sua prática clínica o cuidado intersubjetivo que favorece a integralidade da atenção à saúde. As discussões sobre o risco percebido por parte da gestante devem se integrar à condução do pré-natal suscitando um impacto positivo na saúde da mulher. Considera-se a fenomenologia de Martin Heidegger como referencial que permite alcançar resultados de pesquisas qualitativas no campo epistemológico de interesse acerca da essência humana por meio das experiências vividas.
Highlights
According to the Brazilian Mortality Information System (SIM), 53,523 deaths of women at childbearing age were reported in 2015.1 Of these, 1,178 were indicated as maternal deaths, of which about 9% were related to indirect obstetric causes in the list of cardiocirculatory diseases that complicate pregnancy, childbirth and the puerperium
The 17 participants had a mean age of 30 years, and the diagnoses of a heart disease were related to rheumatic heart disease (6), with three being respectively concomitant to murmur, mitral insufficiency and mitral valve lesion; ischemic heart disease (2), with one being followed by arrhythmia; congenital heart disease (1); arrhythmia (2), with one being diagnosed with Wolff Parkinson-White syndrome; mitral insufficiency (4); dilated cardiomyopathy (2), with one being followed by peripartum cardiopathy
The women at reproductive risk who got pregnant while having a heart disease meant: knowing the risk and planning and ignoring how to avoid it, and getting surprised when finding out pregnancy; telling how they felt physically and emotionally during pregnancy; feeling safe due to the prenatal follow-up routine
Summary
According to the Brazilian Mortality Information System (SIM), 53,523 deaths of women at childbearing age were reported in 2015.1 Of these, 1,178 were indicated as maternal deaths, of which about 9% were related to indirect obstetric causes in the list of cardiocirculatory diseases that complicate pregnancy, childbirth and the puerperium. The possibility of surgical corrections of congenital heart defects, and the higher occurrence of coronary artery disease in women at present favor the increase of high-risk pregnancies due to heart diseases. In this perspective, the risk involved in pregnancy is associated with higher rates of maternal death, regardless of the classification of functional capacity of the heart; especially in pregnant women with congenital heart disease, there is an increased risk of the fetus developing structural abnormalities, associated with a higher occurrence of infant morbidity and mortality.[3,4]. The reproductive health care of women at childbearing age ranging from 10 to 49 years is important, and requires, from the healthcare system, measures aimed at comprehensive care, especially with regard to the promotion of maternal health.[5,6]
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