Reference Maternity Hospital Research Articles

Neonatal uterine prolapse: case report in a maternity in the Brazilian Amazon

Objective: To present a case of neonatal uterine prolapse at a reference maternity hospital. Methodology: This is a case report of neonatal uterine prolapse that occurred at a tertiary maternity hospital in Manaus, Amazonas, Brazil. The data presented were collected from medical records that contained the history and reports of the examinations performed. Results and Discussion: The newborn was delivered vaginally in cephalic presentation. The apgar scores were 8 and 10 (at 1 and 5 min of life, respectively). On physical examination, the patient weighed 2,971 g, had mild edema, atypical facies, a visible increase in head circumference, flexed limbs, and reduced subcutaneous tissue. On the 4th postoperative day of myelomeningocele repair, a pinkish, edematous, interlabial mass was observed in the genital region, compatible with uterine cervix prolapse. At 15 days of age, a Foley probe No. 6 was inserted, inflated with 5 mL distilled water, and occluded with a dermal dressing concomitant with local estrogen application (1 mL) once a day. Conclusion: Uterine prolapse is a rare condition in newborns and is usually associated with spina bifida. The treatment is conservative in most cases, and the prognosis is generally favorable.

ARE ADVERSE NEONATAL OUTCOMES MORE FREQUENT IN ADOLESCENT PREGNANCIES?

Adolescent pregnancy is a complex issue since it has been associated to adverse fetal and maternal outcomes. Method: This is a cross-sectional analytical study, having as a data source the medical records of pregnant women at a reference maternity hospital, located in the northeast of Brazil. Data was collected on maternal age, gestational age at delivery, birth weight, type of delivery, 1- and 5-minute Apgar scores less than 7, and fetal deaths. For the analysis of data, two groups were distinguished according to age: 1) girls aged 13-19 years old, and 2) women aged 20-34 years old. Results: A total of 1642 pregnant women’s medical records were included in this study, 28.1% belonged to adolescent mothers, and 71.9% to adult mothers. In the comparison between groups, there were significantly more cesarean deliveries to mothers aged 20-34 years (p<.001); and a significantly higher proportion of preterm deliveries in the group of adolescent mothers (p=.0239). The other study variables did not present statistical significance. Conclusions: Adolescent mothers are at higher odds of preterm birth, and since this factor is associated short- and long-term adverse outcomes for the neonate, there is a need to prioritize this age group in prenatal care.

Prevalence and maternal risk factors of congenital malformations in newborns from Sergipe, Northeastern Brazil

Introduction: Due to the importance of infant death caused by congenital malformations worldwide, more studies are necessary to determine the prevalence of these disorders serving as the basis for more effective control measures. Objective: To determine the prevalence and evaluate maternal risk factors for congenital malformations in newborns. Methods: A cross-sectional and retrospective study was performed in the reference maternity hospital for high-risk pregnancies in the state of Sergipe, northeastern Brazil. Data were collected from the medical records and declarations of live births of 16,518 births between January 2014 and December 2016, being included children with identified congenital malformations. Data were analyzed using the odds ratio, chi-square, and Fisher's exact test with p<0.05. Results: The study population was composed of 369 newborns with congenital malformations, which corresponds to 2.23% of total births. 53.9% were male, 47.9% had low birth weight and, 52.5% had adequate Apgar score. Anomalies affecting the musculoskeletal system were the most prevalent (30.9%), with polydactyly being the most frequent (53.5%). The number of prenatal consultations, education, and gestational age were the main observed maternal risk factors of congenital malformations. Anomalies of the circulatory system (OR=3.2 CI95% 1.3-7.84), multiple malformations (OR=9.24 CI95% 3.07-27.83), and chromosomal syndromes (OR=2.72 CI95% 1.48-5.01) were the most commonly associated with newborn deaths. Conclusion: The study presents the prevalence and risk factors related to malformations in the state of Sergipe, and improvements on maternal care and socioeconomic variables are important to decrease the number of malformations cases in Brazil.

Association between breastfeeding and complementary feeding in pre-pandemic and pandemic COVID-19 times: Maternar cohort study

ObjectiveEvaluate the association between breastfeeding, exclusive breastfeeding at six months and the introduction of complementary feeding during the pre-pandemic and the COVID-19 pandemic periods. MethodsCohort study conducted with puerperal women and their newborns in the immediate postpartum period at a reference maternity hospital in Southern Brazil between 2018-2020. The COVID-19 pandemic period and the need to work outside the home during restricted circulation were the factors of exposure. The outcome evaluated was the weaning in the first six months (breastfeeding and exclusive breastfeeding) and the introduction of complementary feeding before the sixth month of life. Results547 puerperal women and their newborns were included. During the COVID-19 pandemic, there was a higher risk to weaning of exclusive breastfeeding up until six months (RR 1.16; 95%CI 1.03-1.31) and introducing complementary feeding early (RR 1.40; 95%CI 1.01-1.96). The need to work outside the home during the COVID-19 pandemic increased the risk of not breastfeeding exclusively at the sixth month (RR 1.27; 95%CI 1.08-1.49). ConclusionsThe difficulties of the pandemic did reflect negatively on breastfeeding and complementary feeding practices. The pandemic was a risk factor for the early weaning of exclusive breastfeeding and the introduction of complementary feeding. However, not having to work outside the home during the pandemic period was a protective factor for exclusive breastfeeding at six months.

Epidemiological profile of the reported cases of maternal and congenital syphilis in a reference maternity hospital from Belo Horizonte

Epidemiological profile of the reported cases of maternal and congenital syphilis in a reference maternity hospital from Belo Horizonte

Ansiedade e depressão em profissionais de enfermagem de uma maternidade durante a pandemia de COVID-19

ABSTRACT Objective To estimate the prevalence of anxiety and depression symptoms and their related factors among nursing professionals in a maternity hospital during the COVID-19 pandemic. Method Observational, descriptive and cross-sectional study carried out with 189 nursing professionals from a reference maternity hospital in Fortaleza-Ceará. Data collection took place over three months, from August to October 2020, using the Sociodemographic and Clinical Form and the Hospital Anxiety and Depression Scale. Factors related to depression or anxiety were determined by bivariate analysis using the chi-square (nominal) and Wilcoxon (numerical) tests, with a significance of p<0.05. Results The prevalence of anxious and depressive symptoms was estimated in 58.3% and 29.6% of the participants, respectively. About 53.5% were removed due to suspected COVID-19 and 58% were infected with the virus. It was observed that professionals who worked in the emergency, obstetric clinic and maternal Intensive Care Unit were the most exposed to the risk of having depression (p=0.01055). Conclusion and implications for practice High prevalence of anxiety and depression symptoms among participants, regardless of whether they are on the front lines of the pandemic or not. The situation requires meeting the demands of mental health.

Impacto das instruções verbais na contração do assoalho pélvico no puerpério imediato

Abstract Introduction: Pregnancy predisposes the emergence of pelvic floor dysfunctions (PFD), postpartum being the opportune moment to assess these muscles. Objective: To investigate the effect of instructions and verbal feedback on the contraction capacity of pelvic floor muscles (PFM) in postpartum women. Methods: Quasi-experimental study with 109 women in the immediate vaginal postpartum at a reference maternity hospital in Fortaleza, Ceará state, Brazil. PFM were visually inspected using the visual contraction scale (0 = no visible contraction; 1 = weak visible contraction; 2 = visible contraction with perineal elevation), in addition to observing the use of accessory muscles and movements. Assessments occurred in consecutive moments: 1 - PFM contraction at a verbal command; 2 - contraction after instructions on structure, function and correct contraction; and 3 - contraction after feedback on the use of accessory muscles and reinforcement of correct contraction. Cochran’s Q test and a 5% significance level were used to compare the outcomes between different moments. Results: At the first assessment, 15.6% of the postpartum women did not exhibit visible PFM contraction (grade 0). Of these, 70.5% changed their contraction grade after instructions and feedback. At the end, 45.9% of women correctly contracted their PFM with perineal elevation (grade 2) (p < 000.1). The use of accessory muscles (abductors, abdominals and gluteal) declined after instructions and feedback (p < 000.1). Perineal trauma, forceps delivery, previous information and fear of feeling pain were not associated with contraction grade. Conclusion: Instructions and verbal feedback are useful tools for correct PMF contraction in the immediate postpartum.

Nutritional Factors Associated with Late-Onset Sepsis in Very Low Birth Weight Newborns.

Background: Delayed onset of minimal enteral nutrition compromises the immune response of preterm infants, increasing the risk of colonization and clinical complications (e.g., late-onset sepsis). This study aimed to analyze associations between late-onset sepsis in very low birth weight infants (<1500 g) and days of parenteral nutrition, days to reach full enteral nutrition, and maternal and nutritional factors. Methods: A cross-sectional study was carried out with very low birth weight infants admitted to a neonatal intensive care unit (NICU) of a reference maternity hospital of high-risk deliveries. Data regarding days of parenteral nutrition, days to reach full enteral nutrition, fasting days, extrauterine growth restriction, and NICU length of stay were extracted from online medical records. Late-onset sepsis was diagnosed (clinical or laboratory) after 48 h of life. Chi-squared, Mann–Whitney tests, and binary logistic regression were applied. Results: A total of 97 preterm infants were included. Of those, 75 presented late-onset sepsis with clinical (n = 40) or laboratory (n = 35) diagnosis. Maternal urinary tract infection, prolonged parenteral nutrition (>14 days), and extrauterine growth restriction presented 4.24-fold, 4.86-fold, and 4.90-fold higher chance of late-onset sepsis, respectively. Conclusion: Very low birth weight infants with late-onset sepsis had prolonged parenteral nutrition and took longer to reach full enteral nutrition. They also presented a higher prevalence of extrauterine growth restriction than infants without late-onset sepsis.

Adherence of professionals to good obstetric practices and interventions performed with parturients

Objective: to analyze the association between good obstetric practices and types of delivery. Methods: a cross-sectional study, carried out with 207 pregnant women admitted to two reference maternity hospitals, whose data were collected through a questionnaire and chart analysis and analyzed by Pearson’s chi-square test. Results: it was observed that the parturients with vaginal delivery were oriented about relaxation techniques and non-pharmacological measures for pain relief, encouraged not to remain in bed and to use the Swiss ball. In contrast, women who underwent a cesarean section reported not receiving such interventions. The use of squatting exercises, massages, hot baths and encouragement not to wander were mentioned less frequently by the participants, regardless of the route of delivery. Conclusion: it was observed that good obstetric practices were associated with the normal delivery route, while in cesarean delivery, such practices were implemented less frequently.

Sociodemographic and obstetric factors associated with the interruption of breastfeeding within 45 days postpartum - Maternar Cohort Study

Abstract Objectives: to evaluate and identify the prevalence of interruption of breastfeeding (BF) in the period of up to 45 days postpartum and the associated sociodemographic and obstetric factors. Methods: cohort of 622 puerperal women, selected between 2018 and 2019 in a reference maternity hospital in the South Brazil. Data collection was carried out in two phases, the first in the maternity hospital during hospitalization of the puerperal woman and the newborn and the second through a telephone call, which occurred 60 days after birth. Poisson regressions with robust variance were performed to identify the factors associated with interruption of BF in the first 45 days of life. The variables that presented p&lt;0.20 in the crude analysis were included in the adjusted analysis. Results: the interruption of BF at 45 days was identified in 14% of the sample. Higher maternal age (PR= 0.46; CI95%= 0.22-0.93), eight years or less of education (PR= 2.11; CI95%= 1.05-4.25), support from the maternal grandmother (PR= 1.91; CI95%= 1.20-3.06) and receiving complement at the maternity hospital (PR= 1.53; CI95%= 1.04-2.25) were factors related to the interruption of BF in the 45-day postpartum period. Conclusion: maternal age ≥35 was a protective factor, and less education, the support of the maternal grandmother and receiving complement at the maternity hospital were predictors of early breastfeeding abandonment.

Characteristics of abortion cases in a reference maternity hospital in Northern B

Objetivos: descrever as características dos casos de abortamento e analisar a ocorrência de complicações decorrentes de aborto em uma maternidade de referência. Métodos: trata-se de uma pesquisa documental, censitária e de abordagem quantitativa. O estudo foi realizado com 393 mulheres. Os dados foram analisados à luz da estatística descritiva e análise inferencial. A projeto de pesquisa foi submetido e aprovado pelo Comitê de Ética em Pesquisa da Fundação Santa Casa de Misericórdia do Pará, com o número do CAAE 60112316.9.0000.5171. Resultados: ocorreram abortamentos, em sua maioria, em mulheres de idade entre 16 e 23 anos, solteiras, que relataram não serem diabéticas nem fazer uso de álcool, tabaco, outras drogas. A maioria dos abortamentos era do tipo incompleto e retido. Notou-se, entretanto, que nos abortamentos do tipo infectado houve maiores frequências absolutas de abortos complicados. Não foi observada associação entre complicações por aborto com as variáveis do estudo. Conclusão: os resultados deste estudo avultam para a realização de novas pesquisas sobre outras variáveis na análise da ocorrência de abortamentos e suas complicações, além de estudos que utilizem outros desenhos de pesquisa e investiguem fatores protetores para a gestação.

Assessment of morbidity and mortality in newborns with late prematurity: experience of a reference maternity in the northeast of Brazil.

Late preterm infants show high rates of adverse perinatal outcomes. The aim of this study is to assess the morbidity and mortality of newborns (NBs) with late preterm birth in a reference maternity hospital in northeastern Brazil. Retrospective cohort study from March 1st to July 15th, 2017. A total of 204 NBs with gestational age between 34 and 36 weeks and six days were evaluated and compared to 205 full-term NBs (39 and 40 weeks and six days). Perinatal outcomes including neonatal morbidity were evaluated. The Student's t and ANOVA tests were used for normal variables, and the Wilcoxon, Mann-Whitney and Kruskal-Wallis tests for non-normal variables. Late preterm infants showed significant higher rates of hypothermia, hypoglycemia, respiratory distress syndrome, jaundice in need of phototherapy (67.6%), admission to the neonatal intensive care unit (ICU), and difficulty breastfeeding compared to full-term NBs (P<0.001). Respiratory distress was the main indication for the admission of late preterm infants (P<0.001) to neonatal ICU. Late preterm infants had a longer hospital stay (6.9 vs. 3.7 days, P<0.001). There were three deaths in the group of late preterm NBs, and none in the group of term NBs. Late preterm NBs presented higher rates of morbidity and mortality when compared to full-term NBs.

PROFILE OF NEONATAL INFECTIONS IN A MATERNITY OF REFERENCE IN THE STATE OF PIAUÍ

Health Care Related Infections (HAI) can be defined as those acquired through hospital procedures. In 2018, it was estimated that 5.3 million children worldwide died from preventable causes, most in the neonatal period. In Brazil, 60% of infant mortality occurs in the neonatal period, with neonatal infections being the main causes. The objective of this work, then, was to know the profile of neonatal infections in a reference maternity hospital in the state of Piauí. This is a retrospective, descriptive, exploratory, cross-sectional study with a quantitative approach on the profile of HAIs in Neonatal Intensive Care Units (NICU). It was observed that 54.79% of the registered HAI cases were Primary Bloodstream Infection and it was observed that the global density of infections was 55.6 infections/1,000 patients/day. The incidence density of IPCSL by central venous catheter/day in the unit was at an average of 24.32 per year, a number that is higher than that reported in the literature. In 463 cases of infection, the main isolated microorganism associated with episodes of infections was coagulase-negative Staphylococcus (SCoN) (229 cases). In view of these aspects, the study revealed high rates of incidence and prevalence of HAIs in the NICU, as well as the main microorganisms responsible for these infections. It reinforces the importance of implementing measures to be adopted for the treatment and/or prevention of HAIs in order to optimize the care provided to newborns.

FACTORS THAT INTERFERE IN THE QUALITY OF LIFE RELATED TO THE HEALTH OF WOMEN IN THE POSTPARTUM PERIOD IN NORTHEASTERN BRAZIL

ABSTRACT Objective to analyze the sociodemographic, obstetric, type of delivery and professional factors that provided care that can influence the quality of life related to women's health in the immediate puerperium period. Method cross-sectional, correlational study conducted in a reference maternity hospital, with 272 women in the immediate puerperium period hospitalized in the rooming-in accommodation. A sociodemographic, clinical and obstetric questionnaire and the Short Form Health Survey-36 scale were used to assess health-related quality of life. Results regarding age, there was a significant association in the domains functional capacity and general status, with better scores for ages up to 29 years. Regarding education, significance was observed in the functional capacity domain with better scores for 9 to 11 years of schooling. The analysis of obstetric complications showed statistical significance in the general health status domain p&lt;0.05. By correlating the type of delivery and the attending professional, the mean scores showed that the domains limitation due to physical aspects, pain, vitality, social aspects, limitations due emotional aspects and mental health presented higher means for normal delivery performed by nurses, with statistical significance in the domains: pain (p&lt;0.05), vitality (p&lt;0.05) and mental health (p=0.05). Conclusion these analyzed factors interfere in the quality of life of women in the postpartum period. Thus, considering these questions provides complementary information to the use of the Short Form Health Survey-36, highlighting areas that need greater attention and that can be worked on even in prenatal care.

Multidrug resistance and its association with Enterobacteriales and age among pregnant Peruvian women with- bacteremia.

This study aimed to assess the prevalence of multidrug resistance (MDR) and its associated factors among pregnant Peruvian women with bacteremia. In an 18-month cross-sectional study, all pregnant women were routinely tested with a presumptive diagnosis of sepsis admitted to the largest reference maternity hospital (Instituto Nacional Materno Perinatal) in Lima, Peru for bacteremia. Every isolate was tested for antimicrobial susceptibility as defined by the Institute of Clinical and Laboratory Standards (CLSI). Additionally, associated factors were assessed with MDR and the number of resistant antimicrobial categories using robust Poisson regression models with link log, especially focused on its association with age and bacterial families or species. A total of 236 blood cultures of pregnant women (33.4 ± 11.4 years old) was analyzed. The prevalence of MDR was 70% (95% confidence interval [CI]: 64%-76%). The main etiological agent was Escherichia coli (65%), showing an MDR rate of 74% (68%-81%). Overall, we observed that the MDR rate was associated with Enterobacteriales (adjusted prevalence rate, (aPR) = 1.29; 95% CI: 1.03-1.61) and age 35 or older (PR = 1.18; 95% CI: 1.01-1.39). However, the number of resistant antimicrobial categories was associated with Enterobacteriales (aPR = 1.44; 95% CI: 1.25-1.67) and hospital-acquired infections (PR = 0.81; 95% CI: 1.01-1.39). The prevalence of MDR among pregnant women with sepsis was alarmingly high, being even higher among women age 35 or older and among those with hospital-acquired infections.

Multidrug resistance bacteremia in neonates and its association with late-onset sepsis and Coagulase-negative Staphylococci.

This study aimed to assess the association between multidrug resistance (MDR) and late-onset sepsis (LOS) among newborns with bloodstream infection (BSI). In this cross-sectional study, we routinely tested every newborn with a presumptive diagnosis of sepsis admitted to the largest reference maternity hospital in Lima, Peru for BSI over an 18-month period. We tested every isolate for MDR by using the disk-diffusion method and assessed its associated factors by using a robust Poisson regression analysis with a particular focus on its association with LOS (vs. early-onset sepsis, EOS). We analyzed a total of 489 subjects, including 340 (69%) newborns with LOS, and estimated an MDR rate of 80% (95% confidence interval, CI: 76%-83%), which was significantly higher (p-value < 0.001) among LOS (85%; 95% CI: 81%-89%) than EOS cases (67%; 95% CI: 59%-75%). The primary isolate was coagulase-negative Staphylococci (CoNS) (60%), which exhibited a limited subset of antibiotic MDR patterns, most of which were characterized by their resistance to cefoxitin, gentamicin, and clindamycin and levofloxacin. Overall, the prevalence of MDR was higher among LOS compared to EOS cases (adjusted prevalence ratio [aPR] = 1.28; 95% CI: 1.14-1.45), and among BSI due to CoNS compared to other bacteria (Apr = 1.10; 95% CI: 1.01-1.20). MDR among newborns with sepsis is exceptionally high, being even higher among those with LOS than newborns with EOS, and among those infected with CoNS compared to other bacteria. Furthermore, CoNS exhibited a limited subset of MDR patterns, which could be used to guide therapeutic decisions.

Análise dos óbitos fetais ocorridos em uma maternidade de referência

Objetivo: Analisar os óbitos fetais, segundo características sócio-demográficas, clínicas e critérios de evitabilidade, ocorridos em uma maternidade. Métodos: Estudo retrospectivo dos óbitos fetais ocorridos no período de 2014 a 2017. Elaborou-se uma planilha no Excel 2010, com as variáveis contidas na ficha de investigação de óbitos fetais. Realizaram-se análises descritivas e classificaram-se as causas dos óbitos, conforme critério de evitabilidade, por faixa de peso (1500g-2500g; &gt;2500g). Resultados: Ocorreram 1029 óbitos no período. A taxa de mortalidade fetal foi de 25,1/1000 nascidos vivos (NV) em 2013 e 26,1/1000 NV em 2017. 39,9% das mães tinham entre 20 a 40 anos e 39,9% possuíam mais 8 anos de estudo. As patologias mais citadas durante a gravidez foram: hipertensão arterial/DHEG (33,1%), hemorragia/ DPP/ placenta prévia (31,1%) e infecção urinária (20,1%). No momento da internação, 38,4% apresentavam amniorrexe prematura sem trabalho de parto, 9,7% pré-eclampsia grave e 9,1% apresentaram descolamento prematuro da placenta. As principais intercorrências durante o parto foram: eclampsia / hipertensão (25,6%), hemorragia (20,2%). Dos 570 óbitos fetais (acima de 1500g) analisados, 84,9% ocorreram por causas evitáveis, 4,9% por causas não claramente evitáveis e 10,2% por causas mal definidas. As principais causas dos óbitos fetais evitáveis (n=484) foram classificadas como: reduzíveis por adequada atenção à mulher na gestação (56,6%) e adequada atenção à mulher no parto (36,4%) e adequada atenção ao recém-nascido (7,0%). Conclusão: os achados revelam uma proporção alta de óbitos fetais que poderiam ser evitados com ações voltadas a melhoria na qualidade da assistência ao pré-natal e ao parto.

Gestantes de alto risco: uma análise da autoestima e fatores associados em uma maternidade de referência na cidade do Recife, PE, Brasil

A pesquisa tem como objetivo correlacionar com os padrões de autoestima e fatores associados em gestantes de alto risco em uma maternidade de referência na cidade do Recife, Pernambuco, Brasil. Trata-se de um estudo descritivo, transversal, com abordagem quantitativa. A população amostral incluiu 112 mulheres, gestantes, adultas. Na coleta de dados foi utilizado um formulário adaptado da versão no Brasil da Escala de Autoestima de Rosenberg (EAR), acrescido de questões socioeconômicas, obstétricas e reprodutivas. Observou-se que escolaridade foi í única variável com associação significativa com autoestima (p &lt; 0,05) e para a referida variável se destaca que o percentual com autoestima insatisfatória reduziu com o grau de escolaridade, sendo 96,0% entre as que tinham até fundamental incompleto, 75,0% entre as que ensino fundamental e 61,0% entre as que tinham ensino médio/superior. Reconhece-se que as maternidades funcionam muitas vezes como porta de acesso para identificação e acolhimento dessas gestantes sendo necessária a atualização/capacitação dos profissionais de saúde para o atendimento adequado e direcionado, uma vez que poucas mulheres têm acesso í avaliação de seu estado emocional durante a gestação.

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

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.

Profile on childbirth care at a public maternity hospital

Abstract Objectives: to describe the profile on childbirth care at a reference maternity hospital in the State of Piauí based on the 2018 World Health Organization Recommendations. Methods: retrospective cross-sectional quantitative study, descriptive documentary, population census, containing vaginal deliveries performed in 2017. The data was entered in Microsoft Excel for simple statistical analysis. Results: the percentages registered at the Centro Obstétrico Superior (Superior Obstetric Center) and Centro de Parto Normal (Normal Delivery Center) were, respectively, 85.5% and 98% with the presence of a companion, 34.2% and 94% used the partogram, 63.8% and 98% took non-pharmacological methods for pain relief, 74.8% and 98.7% received fluids during labor. Amniotomy at 15.2% and 17.2%, oxytocin was administered at 26.5% and 14.6% in the 1st and 2nd periods, non-lithotomic position at 39.7% and 93.4%, episiotomy 9.9% and 6.6%. After birth, 85.5% and 96% of newborns had skin-to-skin contact and, in 65.5% and 94% there were maternal breastfeeding promotion. Conclusions: this study comprehended the indicators on childbirth care service, which are, in general, better than the national and the northeast region ones. The importance of registering indicators to evaluate care is emphasized.