Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002

Detalhes bibliográficos
Autor(a) principal: Rudge, Marilza Vieira Cunha [UNESP]
Data de Publicação: 2004
Outros Autores: Maestá, Izildinha [UNESP], Calderon, Iracema de Mattos Paranhos [UNESP], Rudge, Cibele Vieira Cunha [UNESP], Anzai, Álvaro [UNESP], Gushikem, Érica [UNESP], Conceição, Jane Amanda Jeronymo da [UNESP], Santos, Camila Rebouças Valência dos [UNESP]
Tipo de documento: Artigo de conferência
Idioma: por
Título da fonte: Repositório Institucional da UNESP
Texto Completo: http://ojs.unesp.br/index.php/revista_proex/article/view/155
http://hdl.handle.net/11449/143151
Resumo: General Objective: to evaluate the influence of the Delivery and Newborn Assistance Hierarchyzation Program on maternal and perinatal results in the DIR XI –SP region, from 1995 to 2002. Specific Objectives: to calculate the number of deliveries, Caesarean rates, the cause of hospitalar maternal mortality (HMMC) and precocious perinatal mortality rates (PPMR), in maternity hospitals of low risk (Hospital Regional-Associação Beneficente dos Hospitais Sorocabana – HR-ABHS) and high risk (Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP – HC-FMB). Methodology: descriptive and prospective study of hierarchyzation in delivery and newborn assistance, during eight years (1995-2002), in low risk (HR-ABHS) and high risk (HC-FMB) hospitals in the DIR XI region. The study included all the patients attended at these Services with daily record of standardized clinical protocol containing the following information: number of deliveries, Caesareans, maternal deaths, liveborns, stillborns and precocious neoborns (up to 7 days of age). The ?2 test and the calculus of simple linear correlation coefficient were used to assess the results. Results: the total of assisted deliveries in that period was 17748, being that, at the program settlement time, 410 deliveries/year at HR-ABHS and 1076/year at HC-FMB were performed. There was an increase of 2.5 times in the number of deliveries in low risk hospitals and, in high risk hospitals, that number was maintained. The number of deliveries in 2002 was similar for both Services. Caesarean rate decreased in both places, however, it was more accentuated in the low risk (HR-ABHS from 46.6% to 26.9%; ? < 0.0001) than in the high risk hospital (HC-FMB from 49.2% to 40.1%; ? < 0.0001). HMMC was lower at HR-ABHS (26.3 vs 128.7 / 100,000 liveborns; ? < 0.02). PPMR decreased in both Services, with more accentuated fall in the high risk hospital (HC-FMB from 60.8‰ to 26.2‰; ? < 0.00001) than in the low risk one (HR-ABHS from 9.7‰ to 6.7‰; ? < 0.04). Conclusions: The Delivery and Newborn Assistance Hierarchyzation Program improved the obstetric and perinatal assistance quality in the DIR XI – SP region: there was a decrease in Caesarean and perinatal mortality rates in both hospitals. Maternal mortality was higher in the high risk hospital, however, during two years, no death occurred in the tertiary hospital. There was no maternal mortality in the secondary hospital during six years. The importance of delivery and newborn hierarchyzation levels was proved by the decrease of Caesarean rates associated to diminished perinatal I mortality rate.
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spelling Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002Influence of hierarchyzation of obstetric and neonatal assistance in the DIR XI SP region on maternal and perinatal results from 1995 to 2002HierarchyzationDelivery assistanceMaternal and perinatal resultsBiológicasSaúdeHierarquizaçãoAssistência ao partoResultados maternos e perinataisGeneral Objective: to evaluate the influence of the Delivery and Newborn Assistance Hierarchyzation Program on maternal and perinatal results in the DIR XI –SP region, from 1995 to 2002. Specific Objectives: to calculate the number of deliveries, Caesarean rates, the cause of hospitalar maternal mortality (HMMC) and precocious perinatal mortality rates (PPMR), in maternity hospitals of low risk (Hospital Regional-Associação Beneficente dos Hospitais Sorocabana – HR-ABHS) and high risk (Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP – HC-FMB). Methodology: descriptive and prospective study of hierarchyzation in delivery and newborn assistance, during eight years (1995-2002), in low risk (HR-ABHS) and high risk (HC-FMB) hospitals in the DIR XI region. The study included all the patients attended at these Services with daily record of standardized clinical protocol containing the following information: number of deliveries, Caesareans, maternal deaths, liveborns, stillborns and precocious neoborns (up to 7 days of age). The ?2 test and the calculus of simple linear correlation coefficient were used to assess the results. Results: the total of assisted deliveries in that period was 17748, being that, at the program settlement time, 410 deliveries/year at HR-ABHS and 1076/year at HC-FMB were performed. There was an increase of 2.5 times in the number of deliveries in low risk hospitals and, in high risk hospitals, that number was maintained. The number of deliveries in 2002 was similar for both Services. Caesarean rate decreased in both places, however, it was more accentuated in the low risk (HR-ABHS from 46.6% to 26.9%; ? < 0.0001) than in the high risk hospital (HC-FMB from 49.2% to 40.1%; ? < 0.0001). HMMC was lower at HR-ABHS (26.3 vs 128.7 / 100,000 liveborns; ? < 0.02). PPMR decreased in both Services, with more accentuated fall in the high risk hospital (HC-FMB from 60.8‰ to 26.2‰; ? < 0.00001) than in the low risk one (HR-ABHS from 9.7‰ to 6.7‰; ? < 0.04). Conclusions: The Delivery and Newborn Assistance Hierarchyzation Program improved the obstetric and perinatal assistance quality in the DIR XI – SP region: there was a decrease in Caesarean and perinatal mortality rates in both hospitals. Maternal mortality was higher in the high risk hospital, however, during two years, no death occurred in the tertiary hospital. There was no maternal mortality in the secondary hospital during six years. The importance of delivery and newborn hierarchyzation levels was proved by the decrease of Caesarean rates associated to diminished perinatal I mortality rate.Objetivo geral: avaliar a influência do Programa de Hierarquização da Assistência ao Parto e Recém-nascido no resultado materno e perinatal, na Região da DIR XI - SP, entre os anos de 1995 e 2002. Objetivos específicos: calcular o número de partos, taxas de cesárea, Razão de Mortalidade Materna hospitalar (RMMH) e taxas de Mortalidade Perinatal precoce (MPN I), nas maternidades de baixo (Hospital Regional - Associação Beneficente dos Hospitais Sorocabana – HR-ABHS) e alto risco (Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP – HC-FMB). Metodologia: trabalho descritivo e prospectivo, da hierarquização no atendimento ao parto e ao recém-nascido, durante oito anos (1995-2002), em hospitais de baixo (HR-ABHS) e alto risco (HC-FMB), da região da DIR XI. Foram incluídas todas as pacientes atendidas nestes Serviços com registro diário de protocolo clínico padronizado com as seguintes informações: número de partos, cesáreas, mortes maternas, nativivos, natimortos e neomortos precoces (até 7 dias de vida). O teste do ?2 e o cálculo do coeficiente de correlação linear simples foram utilizados para avaliação dos resultados. Resultados: o total de partos assistidos no período foi de 17748, sendo que na implantação do programa eram realizados 410 partos / ano no HR-ABHS e 1076 partos / ano no HC-FMB. Houve aumento de 2,5 vezes no número de partos no hospital de baixo risco e manutenção do número de partos no alto risco. O número de partos em 2002 é semelhante nos dois Serviços. A taxa de cesárea declinou nos dois locais, porém, de forma mais acentuada no baixo risco (HR-ABHS de 46,6% para 26,9%; ? < 0,0001) que no alto risco (HC-FMB de 49,2% para 40,1%; ? < 0,0001). A RMMH foi menor no HR-ABHS (26,3 vs 128,7 / 100.000 nascidos vivos; ? < 0,02). A taxa de MPN I declinou nos dois serviços, com diminuição mais acentuada no alto risco (HC-FMB de 60,8‰ para 26,2‰; ? < 0,00001) do que no baixo risco (HR-ABHS de 9,7‰ para 6,7‰; ? < 0,04). Conclusões: o Programa de Hierarquização ao Parto e Recém-nascido melhorou a qualidade da assistência obstétrica e perinatal na região da DIR XI - SP: houve diminuição das taxas de cesárea e de mortalidade perinatal I nos dois hospitais. A morte materna foi mais freqüente no hospital de alto risco, mas durante dois anos não ocorreu nenhum óbito no hospital terciário. Não houve nenhum óbito materno no Hospital secundário durante seis anos. Comprovou-se a importância de níveis hierarquizados de assistência ao parto e recém-nascido, com a diminuição dos índices de cesárea associada à diminuição da taxa de mortalidade perinatal I.Universidade Estadual Paulista, Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina de BotucatuUniversidade Estadual Paulista (Unesp)Universidade Estadual Paulista (Unesp)Rudge, Marilza Vieira Cunha [UNESP]Maestá, Izildinha [UNESP]Calderon, Iracema de Mattos Paranhos [UNESP]Rudge, Cibele Vieira Cunha [UNESP]Anzai, Álvaro [UNESP]Gushikem, Érica [UNESP]Conceição, Jane Amanda Jeronymo da [UNESP]Santos, Camila Rebouças Valência dos [UNESP]2016-08-24T12:43:36Z2016-08-24T12:43:36Z2004info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/conferenceObject103-104application/pdfhttp://ojs.unesp.br/index.php/revista_proex/article/view/155Revista Ciência em Extensão, v. 1, n. 1, p. 103-104, 2004.1679-4605http://hdl.handle.net/11449/143151ISSN1679-4605-2004-01-01-103-104.pdf675868038883507890126679978042190679387622604743PROEXreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPporRevista Ciência em Extensãoinfo:eu-repo/semantics/openAccess2024-08-16T14:13:21Zoai:repositorio.unesp.br:11449/143151Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-16T14:13:21Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false
dc.title.none.fl_str_mv Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
Influence of hierarchyzation of obstetric and neonatal assistance in the DIR XI SP region on maternal and perinatal results from 1995 to 2002
title Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
spellingShingle Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
Rudge, Marilza Vieira Cunha [UNESP]
Hierarchyzation
Delivery assistance
Maternal and perinatal results
Biológicas
Saúde
Hierarquização
Assistência ao parto
Resultados maternos e perinatais
title_short Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
title_full Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
title_fullStr Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
title_full_unstemmed Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
title_sort Influência da hierarquização da assistência obstétrica e neonatal na região da DIR XI SP no resultado materno e perinatal, período de 1995-2002
author Rudge, Marilza Vieira Cunha [UNESP]
author_facet Rudge, Marilza Vieira Cunha [UNESP]
Maestá, Izildinha [UNESP]
Calderon, Iracema de Mattos Paranhos [UNESP]
Rudge, Cibele Vieira Cunha [UNESP]
Anzai, Álvaro [UNESP]
Gushikem, Érica [UNESP]
Conceição, Jane Amanda Jeronymo da [UNESP]
Santos, Camila Rebouças Valência dos [UNESP]
author_role author
author2 Maestá, Izildinha [UNESP]
Calderon, Iracema de Mattos Paranhos [UNESP]
Rudge, Cibele Vieira Cunha [UNESP]
Anzai, Álvaro [UNESP]
Gushikem, Érica [UNESP]
Conceição, Jane Amanda Jeronymo da [UNESP]
Santos, Camila Rebouças Valência dos [UNESP]
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidade Estadual Paulista (Unesp)
dc.contributor.author.fl_str_mv Rudge, Marilza Vieira Cunha [UNESP]
Maestá, Izildinha [UNESP]
Calderon, Iracema de Mattos Paranhos [UNESP]
Rudge, Cibele Vieira Cunha [UNESP]
Anzai, Álvaro [UNESP]
Gushikem, Érica [UNESP]
Conceição, Jane Amanda Jeronymo da [UNESP]
Santos, Camila Rebouças Valência dos [UNESP]
dc.subject.por.fl_str_mv Hierarchyzation
Delivery assistance
Maternal and perinatal results
Biológicas
Saúde
Hierarquização
Assistência ao parto
Resultados maternos e perinatais
topic Hierarchyzation
Delivery assistance
Maternal and perinatal results
Biológicas
Saúde
Hierarquização
Assistência ao parto
Resultados maternos e perinatais
description General Objective: to evaluate the influence of the Delivery and Newborn Assistance Hierarchyzation Program on maternal and perinatal results in the DIR XI –SP region, from 1995 to 2002. Specific Objectives: to calculate the number of deliveries, Caesarean rates, the cause of hospitalar maternal mortality (HMMC) and precocious perinatal mortality rates (PPMR), in maternity hospitals of low risk (Hospital Regional-Associação Beneficente dos Hospitais Sorocabana – HR-ABHS) and high risk (Hospital das Clínicas da Faculdade de Medicina de Botucatu – UNESP – HC-FMB). Methodology: descriptive and prospective study of hierarchyzation in delivery and newborn assistance, during eight years (1995-2002), in low risk (HR-ABHS) and high risk (HC-FMB) hospitals in the DIR XI region. The study included all the patients attended at these Services with daily record of standardized clinical protocol containing the following information: number of deliveries, Caesareans, maternal deaths, liveborns, stillborns and precocious neoborns (up to 7 days of age). The ?2 test and the calculus of simple linear correlation coefficient were used to assess the results. Results: the total of assisted deliveries in that period was 17748, being that, at the program settlement time, 410 deliveries/year at HR-ABHS and 1076/year at HC-FMB were performed. There was an increase of 2.5 times in the number of deliveries in low risk hospitals and, in high risk hospitals, that number was maintained. The number of deliveries in 2002 was similar for both Services. Caesarean rate decreased in both places, however, it was more accentuated in the low risk (HR-ABHS from 46.6% to 26.9%; ? < 0.0001) than in the high risk hospital (HC-FMB from 49.2% to 40.1%; ? < 0.0001). HMMC was lower at HR-ABHS (26.3 vs 128.7 / 100,000 liveborns; ? < 0.02). PPMR decreased in both Services, with more accentuated fall in the high risk hospital (HC-FMB from 60.8‰ to 26.2‰; ? < 0.00001) than in the low risk one (HR-ABHS from 9.7‰ to 6.7‰; ? < 0.04). Conclusions: The Delivery and Newborn Assistance Hierarchyzation Program improved the obstetric and perinatal assistance quality in the DIR XI – SP region: there was a decrease in Caesarean and perinatal mortality rates in both hospitals. Maternal mortality was higher in the high risk hospital, however, during two years, no death occurred in the tertiary hospital. There was no maternal mortality in the secondary hospital during six years. The importance of delivery and newborn hierarchyzation levels was proved by the decrease of Caesarean rates associated to diminished perinatal I mortality rate.
publishDate 2004
dc.date.none.fl_str_mv 2004
2016-08-24T12:43:36Z
2016-08-24T12:43:36Z
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dc.identifier.uri.fl_str_mv http://ojs.unesp.br/index.php/revista_proex/article/view/155
Revista Ciência em Extensão, v. 1, n. 1, p. 103-104, 2004.
1679-4605
http://hdl.handle.net/11449/143151
ISSN1679-4605-2004-01-01-103-104.pdf
6758680388835078
9012667997804219
0679387622604743
url http://ojs.unesp.br/index.php/revista_proex/article/view/155
http://hdl.handle.net/11449/143151
identifier_str_mv Revista Ciência em Extensão, v. 1, n. 1, p. 103-104, 2004.
1679-4605
ISSN1679-4605-2004-01-01-103-104.pdf
6758680388835078
9012667997804219
0679387622604743
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dc.publisher.none.fl_str_mv Universidade Estadual Paulista (Unesp)
publisher.none.fl_str_mv Universidade Estadual Paulista (Unesp)
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reponame:Repositório Institucional da UNESP
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reponame_str Repositório Institucional da UNESP
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repository.name.fl_str_mv Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)
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