Evaluation of the obstetric risk in prenatal care in a basic level of complexity

Abstract

Introduction: Prenatal care (PC) is recommended to be carried out in each pregnant woman aimed at identifying any risks that might compromise her health and that of her fetus, to intervene them for a safe and healthy pregnancy.

Objective: To determine if the Obstetric Risk (OR) classification at the Eastern Health Network (ESE O) meets the shock plan criteria defined by the Secretariat of Public Health (SSP) in 2012.

Methods: An analysis of the case histories of 165 pregnant women was carried out. Follow-up of standards and guidelines were considered.

Results: Adherence of general practitioners (GP) and obstetrician-gynaecologists (OG) to the shock plan OR classification was found; the first PC occurred before week 12 in almost 50% of the pregnant women, however, 70% of the institutions attended the first PC in the second or third trimester of pregnancy. No statistical difference in OR classification was found at the first PC, between GP and OG (p-value=0.06). The opportunity for evaluation by the OG was not done as recommended for high or very high-risk pregnant women, 27.8% of pregnant women did not have an appointment with the OG.

Conclusion: No clear decisions were found aimed at reviewing the initial classification of the OR, expected by the 36 weeks of pregnancy by the GO, generating unnecessary referrals to higher levels of care. The new-born weight was not associated to the OR classification. Systematic evaluations of this type are required in all health entities that care for pregnant women.