PERFIL EPIDEMIOLÓGICO DE GESTANTES COM COVID-19 SUBMETIDAS À PARTO CESAREANO: BASES PARA DESENVOLVIMENTO DE PROTOCOLO DE ANESTESIA

• Autor(a) principal: Eduardo Jorge Yamada, Eduardo Jorge Yamada
• Data de Publicação: 2023
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional Universidade Franciscana
• Texto Completo: http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/1194
• topic: Saúde Materno-Infantil; Atenção à Saúde; Tecnologia de Produtos; Covid 19; Gestantes; Raquianestesia; Cesárea; BNT162b2; Maternal and Child Health; Delivery of Health Care; Products Tecnology; Covid-19; Pregnant women; Spinal anesthesia, Cesarean section; BNT162b2.; Saúde Materno Infantil

Among the Sustainable Development Goals (SDGs) of the 2030 Agenda of the World Health Organization (WHO), the goal related to improving the health conditions of the population stands out: “Ensure a healthy life and promote well-being for all, at all ages”. The Ministry of Health's Research Agenda (APPMS) also ensures Axis 06 - Communicable Diseases - and Axis 14 - Maternal and Child Health in its priority axes. At the end of 2019, an infection of the respiratory tract began to spread in China, and soon, in the world (Covid-19). Of the various recommendations for anesthesia in high-risk pregnant women with Covid-19, one of the highlights was the occupational protection of health workers exposed to the virus when performing cesarean delivery procedures (general anesthesia), due to the formation of aerosols containing SARS- CoV-2. Objectives: To describe the epidemiological profile of high-risk pregnant women with Covid-19 undergoing cesarean delivery in a reference maternity hospital in southern Brazil and to develop a service protocol covering the anesthetic management for cesarean delivery anesthesia in patients with Covid-19 and the anesthesiologist labor protection. Methodology: The dissertation was organized into: integrative literature review, research on the Epidemiological Profile of pregnant women with acute Covid-19 - retrospective cohort study, research on the Anesthesiological Profile of pregnant women with acute Covid-19 - retrospective cohort study, and elaboration of the technical product: Anesthesia protocol for pregnant women with Covid-19. Results: We identified 129 cases of pregnant patients with Covid-19, who showed a greater tendency to be admitted to the ICU (OR= 10.2) and a greater chance of death than non-vaccinated patients without Covid-19 (OR = 3.21) and their newborns had a greater chance of being admitted to the Neonatal ICU (OR = 1.90) and a greater tendency of neonatal death (OR = 1.25). Conclusions: No drug interactions were detected between the main drugs used in spinal anesthesia for cesarean section, both in vaccinated and non-vaccinated patients. Spinal anesthesia is safe in asymptomatic patients or those with mild or moderate symptoms, and patients with concomitant comorbidities are at greater risk of prolonged ICU stay and death. The study data demonstrate a higher risk of ICU admission and death in patients with Covid 19, as well as their newborns, for the variants studied. Product and its applicability: Service protocol was elaborated – “Anesthesia for pregnant women with Covid-19”. Its importance is based on the fact that, when established, it standardizes procedures, increases patient safety, and reduces overall treatment costs. It has the potential to be replicated in all Public Hospitals in Brazil, under the management of EBSERH – Empresa Brasileira de Serviços Hospitalares.