Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil
Autor(a) principal: | |
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Data de Publicação: | 2005 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/31917 |
Resumo: | OBJECTIVE: To evaluate the quality of birth care based on the World Health Organization guidelines. METHODS: A case-control study was carried out in a public and a private maternity hospitals contracted by the Brazilian Health System in the city of Rio de Janeiro, Brazil, from October 1998 to March 1999. The sample comprised 461 women in the public maternity hospital (230 vaginal deliveries and 231 Cesarean sections) and 448 women in the private one (224 vaginal deliveries and 224 Cesarean sections). Data was collected through interviews with puerperal women and review of medical records. A summarization score of quality of delivery care was constructed. RESULTS: There was low frequency of practices that should be encouraged, such as having an accompanying person (1% in the private hospital for both vaginal delivery and C-sections), freedom of movements throughout labor (9.6% of C-sections in the public hospital and 9.9% of vaginal deliveries in the private hospital) and breastfeeding in the delivery room (6.9% of C-sections in the public hospital and 8.0% of C-sections in the private hospital). There was a high frequency of known harmful practices such as enema administration (38.4%); routine pubic shaving; routine intravenous infusion (88.8%); routine use of oxytocin (64.4%), strict bed rest throughout labor (90.1%) and routine supine position in labor (98.7%) in vaginal deliveries. The best summarizing scores were seen in the public maternity hospital. CONCLUSIONS: The two maternity hospitals have a high frequency of interventions during birth care. In spite of providing care to higher risk pregnant women, the public maternity hospital has a less interventionist profile than the private one. Procedures carried out on a routine basis should be pondered based on evidence of their benefits. |
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Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil Qualidade da atenção ao parto em maternidades do Rio de Janeiro Saúde materno-infantilQualidade de serviços de saúdePartoParto obstétricoParto normalPesquisa sobre serviços de saúdeMaternal and child healthQuality of health careDeliveryobstetricNatural childbirthHealth services research OBJECTIVE: To evaluate the quality of birth care based on the World Health Organization guidelines. METHODS: A case-control study was carried out in a public and a private maternity hospitals contracted by the Brazilian Health System in the city of Rio de Janeiro, Brazil, from October 1998 to March 1999. The sample comprised 461 women in the public maternity hospital (230 vaginal deliveries and 231 Cesarean sections) and 448 women in the private one (224 vaginal deliveries and 224 Cesarean sections). Data was collected through interviews with puerperal women and review of medical records. A summarization score of quality of delivery care was constructed. RESULTS: There was low frequency of practices that should be encouraged, such as having an accompanying person (1% in the private hospital for both vaginal delivery and C-sections), freedom of movements throughout labor (9.6% of C-sections in the public hospital and 9.9% of vaginal deliveries in the private hospital) and breastfeeding in the delivery room (6.9% of C-sections in the public hospital and 8.0% of C-sections in the private hospital). There was a high frequency of known harmful practices such as enema administration (38.4%); routine pubic shaving; routine intravenous infusion (88.8%); routine use of oxytocin (64.4%), strict bed rest throughout labor (90.1%) and routine supine position in labor (98.7%) in vaginal deliveries. The best summarizing scores were seen in the public maternity hospital. CONCLUSIONS: The two maternity hospitals have a high frequency of interventions during birth care. In spite of providing care to higher risk pregnant women, the public maternity hospital has a less interventionist profile than the private one. Procedures carried out on a routine basis should be pondered based on evidence of their benefits. OBJETIVO: Avaliar a qualidade da atenção durante o processo de trabalho de parto de acordo com normas da Organização Mundial de Saúde. MÉTODOS: Trata-se de estudo do tipo caso-controle, realizado em duas maternidades: pública e conveniada com o Sistema Único de Saúde, no Município do Rio de Janeiro. A amostra foi composta por 461 mulheres na maternidade pública (230 partos vaginais e 231 cesáreas) e por 448 mulheres na maternidade conveniada (224 partos vaginais e 224 cesáreas). De outubro de 1998 a março de 1999, foram realizadas entrevistas com puérperas e revisão de prontuários. Foi construído escore sumarizador da qualidade do atendimento. RESULTADOS: Observou-se baixa freqüência de algumas práticas que devem ser encorajadas, como presença de acompanhante (1% na maternidade conveniada, em ambos os tipos de parto), deambulação durante o trabalho de parto (9,6% das cesáreas na maternidade pública e 9,9% dos partos vaginais na conveniada) e aleitamento na sala de parto (6,9% das cesáreas na maternidade pública e 8,0% das cesáreas na conveniada). Práticas comprovadamente danosas e que devem ser eliminadas como uso de enema (38,4%), tricotomia, hidratação venosa de rotina (88,8%), uso rotineiro de ocitocina (64,4%), restrição ao leito durante o trabalho de parto (90,1%) e posição de litotomia (98,7%) para parto vaginal apresentaram alta freqüência. Os melhores resultados do escore sumarizador foram obtidos na maternidade pública. CONCLUSÕES: As duas maternidades apresentam freqüência elevada de intervenções durante a assistência ao parto. A maternidade pública, apesar de atender clientela com maior risco gestacional, apresenta perfil menos intervencionista que maternidade conveniada. Procedimentos realizados de maneira rotineira merecem ser discutidos à luz de evidências de seus benefícios. Universidade de São Paulo. Faculdade de Saúde Pública2005-08-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rsp/article/view/3191710.1590/S0034-89102005000400020Revista de Saúde Pública; Vol. 39 No. 4 (2005); 645-654 Revista de Saúde Pública; Vol. 39 Núm. 4 (2005); 645-654 Revista de Saúde Pública; v. 39 n. 4 (2005); 645-654 1518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/rsp/article/view/31917/33901Copyright (c) 2017 Revista de Saúde Públicainfo:eu-repo/semantics/openAccessd'Orsi, EleonoraChor, DóraGiffin, KarenAngulo-Tuesta, AntoniaBarbosa, Gisele PeixotoGama, Andrea de SouzaReis, Ana CristinaHartz, Zulmira2012-07-08T22:44:47Zoai:revistas.usp.br:article/31917Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2012-07-08T22:44:47Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil Qualidade da atenção ao parto em maternidades do Rio de Janeiro |
title |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil |
spellingShingle |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil d'Orsi, Eleonora Saúde materno-infantil Qualidade de serviços de saúde Parto Parto obstétrico Parto normal Pesquisa sobre serviços de saúde Maternal and child health Quality of health care Delivery obstetric Natural childbirth Health services research |
title_short |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil |
title_full |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil |
title_fullStr |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil |
title_full_unstemmed |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil |
title_sort |
Quality of birth care in maternity hospitals of Rio de Janeiro, Brazil |
author |
d'Orsi, Eleonora |
author_facet |
d'Orsi, Eleonora Chor, Dóra Giffin, Karen Angulo-Tuesta, Antonia Barbosa, Gisele Peixoto Gama, Andrea de Souza Reis, Ana Cristina Hartz, Zulmira |
author_role |
author |
author2 |
Chor, Dóra Giffin, Karen Angulo-Tuesta, Antonia Barbosa, Gisele Peixoto Gama, Andrea de Souza Reis, Ana Cristina Hartz, Zulmira |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
d'Orsi, Eleonora Chor, Dóra Giffin, Karen Angulo-Tuesta, Antonia Barbosa, Gisele Peixoto Gama, Andrea de Souza Reis, Ana Cristina Hartz, Zulmira |
dc.subject.por.fl_str_mv |
Saúde materno-infantil Qualidade de serviços de saúde Parto Parto obstétrico Parto normal Pesquisa sobre serviços de saúde Maternal and child health Quality of health care Delivery obstetric Natural childbirth Health services research |
topic |
Saúde materno-infantil Qualidade de serviços de saúde Parto Parto obstétrico Parto normal Pesquisa sobre serviços de saúde Maternal and child health Quality of health care Delivery obstetric Natural childbirth Health services research |
description |
OBJECTIVE: To evaluate the quality of birth care based on the World Health Organization guidelines. METHODS: A case-control study was carried out in a public and a private maternity hospitals contracted by the Brazilian Health System in the city of Rio de Janeiro, Brazil, from October 1998 to March 1999. The sample comprised 461 women in the public maternity hospital (230 vaginal deliveries and 231 Cesarean sections) and 448 women in the private one (224 vaginal deliveries and 224 Cesarean sections). Data was collected through interviews with puerperal women and review of medical records. A summarization score of quality of delivery care was constructed. RESULTS: There was low frequency of practices that should be encouraged, such as having an accompanying person (1% in the private hospital for both vaginal delivery and C-sections), freedom of movements throughout labor (9.6% of C-sections in the public hospital and 9.9% of vaginal deliveries in the private hospital) and breastfeeding in the delivery room (6.9% of C-sections in the public hospital and 8.0% of C-sections in the private hospital). There was a high frequency of known harmful practices such as enema administration (38.4%); routine pubic shaving; routine intravenous infusion (88.8%); routine use of oxytocin (64.4%), strict bed rest throughout labor (90.1%) and routine supine position in labor (98.7%) in vaginal deliveries. The best summarizing scores were seen in the public maternity hospital. CONCLUSIONS: The two maternity hospitals have a high frequency of interventions during birth care. In spite of providing care to higher risk pregnant women, the public maternity hospital has a less interventionist profile than the private one. Procedures carried out on a routine basis should be pondered based on evidence of their benefits. |
publishDate |
2005 |
dc.date.none.fl_str_mv |
2005-08-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/31917 10.1590/S0034-89102005000400020 |
url |
https://www.revistas.usp.br/rsp/article/view/31917 |
identifier_str_mv |
10.1590/S0034-89102005000400020 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/31917/33901 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2017 Revista de Saúde Pública info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2017 Revista de Saúde Pública |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 39 No. 4 (2005); 645-654 Revista de Saúde Pública; Vol. 39 Núm. 4 (2005); 645-654 Revista de Saúde Pública; v. 39 n. 4 (2005); 645-654 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221783716003840 |