Hospitalizations leading causes for maternal disorders

Veras, Thaise Castanho da Silva; Mathias, Thais Aidar de Freitas

doi:10.1590/S0080-623420140000300003

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Original Article • Rev. esc. enferm. USP 48 (03) • June 2014 • https://doi.org/10.1590/S0080-623420140000300003 copy

Hospitalizations leading causes for maternal disorders^* * Extracted from the thesis "Morbidade materna e morbidade materna grave (near miss): análise das internações financiadas pelo Sistema Único de Saúde", Universidade Estadual de Maringá, 2011.

Las principales causas de hospitalizaciones por trastornos maternos

Authorship SCIMAGO INSTITUTIONS RANKINGS

Presenting the rates of obstetric admissions of women living in Paraná in 2010.Method: A descriptive study in which the admission information of the hospital system of the Unified Health System was analyzed. Data from women aged between 10 to 49 years available on the DATASUS website were analyzed, using percentage and according to primary diagnosis, age and Regional Health area.Results: The Rate of Obstetric Complications (RtOC) was 38%, increasing with the age of women. Complications of labor and delivery (10.5%), and pregnancy with abortive outcome (9.1%) were the diagnoses with highest RtOC. The RtOC ranged between 8.4% in Telêmaco Borba, until 62.6% in Ponta Grossa.Conclusion: The healthcare team should monitor the rates of admissions for obstetric complications as these indicate the quality of health care of women, mainly focused on labor, delivery and women of older age. 

Pregnancy; Hospitalization; Information systems; Obstetrical nursing; Maternal mortality

Primary Diagnosis	10 to 19	20 to 34	35 to 49	Total
N	%	RtOC	N	%	RtOC	N	%	RtOC	N	%	RtOC
Complications of labor and delivery	2407	30.2	10.2	6392	28.4	10.6	910	19.6	10.8	9709	27.6	.
Abnormal uterine contraction	760	31.6	3.2	1748	27.3	2.9	229	25.2	2.7	2737	28.2	2.9
Obstructed labor due to pelvic abnormality	552	22.9	2.3	1570	24.6	2.6	215	23.6	2.5	2337	24.1	2.5
Others	1095	45.5	4.6	3074	48.1	5.1	466	51.2	5.5	4635	47.7	5
Pregnancy with abortive outcome	1549	19.4	6.6	5209	23.1	8.6	1714	36.9	20.2	8472	24.1	9.1
Miscarriage	712	46.0	3	2332	44.8	3.9	777	45.3	9.2	3821	45.1	4.1
Other abnormal products of conception	516	33.3	2.2	1701	32.7	2.8	571	33.3	6.7	2788	32.9	3
Others	321	20.7	1.4	1176	22.6	2	366	21.4	4.3	1863	22.0	2
Assistance to the mother for reasons linked to the fetus, amniotic cavity and problems of childbirth	1587	19.9	6.7	4007	17.8	6.6	704	15.1	8.3	6298	17.9	6.8
Membrane rupture	533	33.6	2.3	1322	33.0	2.2	289	41.1	3.4	2144	34.0	2.3
False labor	448	28.2	1.9	921	23.0	1.5	133	18.9	1.6	1502	23.9	1.6
Others	606	38.2	2.6	1764	44.0	2.9	282	40.1	3.3	2652	42.1	2.9
Other maternal disorders related to pregnancy	1220	15.3	5.2	2994	13.3	5	531	11.4	6.3	4745	13.5	5.1
Haemorrhage in early pregnancy	489	40.1	2.1	1308	43.7	2.2	247	46.2	2.9	2044	43.1	2.2
Urinary tract infections in pregnancy	489	40.1	2.1	863	28.8	1.4	118	22.2	1.4	1470	31.0	1.5
Others	242	19.8	1	823	27.5	1.4	166	31.3	2	1231	25.9	1.3
Edema, proteinuria, hypertension disorder in pregnancy, labor and puerperal period	578	7.2	2.5	2157	9.6	3.6	501	10.8	5.9	3236	9.2	3.4
Gestational hypertension with proteinuria	207	35.8	1	860	39.9	1.4	170	33.9	2	1237	38.2	1.3
Pre-existing hypertension with severe complication, labor puerperal	138	23.9	0.6	521	24.2	0.9	147	29.3	1.7	806	24.9	0.9
Others	233	40.3	1	776	36.0	1.3	184	36.7	2.2	1193	36.9	1.4
Other obstetric conditions not elsewhere classified	325	4.1	1.4	1005	4.5	1.7	137	2.9	1.6	1467	4.2	1.6
Puerperal complications	154	1.9	0.7	332	1.5	0.6	59	1.3	0.7	545	1.6	0.6
Childbirth with ICU admission and/or death	35	0.4	0.2	78	0.3	0.1	28	0.6	0.3	141	0.4	0.2
Diagnoses in other chapters of ICD-10	124	1.6	0.5	345	1.5	0.6	65	1.4	0.8	534	1.5	0.6
Total	7979	100.0	33.8	22519	100.0	37.3	4649	100.0	54.9	35147	100.0	37.8

Regional Health Area	Total admissions^* * Sum of admissions for primary (111,409) and secondary diagnosis (09) of the pregnancy, childbirth and postpartum chapter, and admissions with complications (525).	Delivery	Delivery (%)	Complications
n(a)	%	vaginal	cesarean	n(b)	rate (b/a)
01^st Paranaguá	3111	2457	79.0	66.3	33.7	687	28.0
02^nd Metropolitana	36381	29949	82.3	68.2	31.8	13457	44.9
03^rd Ponta Grossa	8658	6717	77.6	65.8	34.2	4203	62.6
04 ^th Irati	2347	1755	74.8	68.5	31.5	752	42.8
05 ^th Guarapuava	5728	5151	89.9	69.4	30.6	999	19.4
06 ^th União da Vitória	2310	1833	79.4	62.7	37.3	961	52.4
07 ^th Pato Branco	2906	2508	86.3	66.1	33.9	599	23.9
08 ^th Francisco Beltrão	2919	2593	88.8	57.8	42.2	1091	42.1
09 ^th Foz do Iguaçu	5253	4199	79.9	66.1	33.9	1256	29.9
10 ^th Cascavel	5973	5215	87.3	56.5	43.5	1335	25.6
11 ^th Campo Mourão	3750	2953	78.7	51.1	48.9	971	32.9
12 ^th Umuarama	1975	1622	82.1	56.5	43.5	451	27.8
13 ^th Cianorte	1346	1001	74.4	76.6	23.4	360	36.0
14 ^th Paranavaí	2338	1794	76.7	57.9	42.1	627	34.9
15 ^th Maringá	6187	4521	73.1	48.3	51.7	2260	50.0
16 ^th Apucarana	3033	2417	79.7	56.1	43.9	933	38.6
17 ^th Londrina	7146	6393	89.5	62.1	37.9	2148	33.6
18 ^th Cornélio Procópio	2393	2041	85.3	74.7	25.3	448	22.0
19^th Jacarezinho	2752	2207	80.2	73.2	26.8	753	34.1
20^thToledo	2569	2369	92.2	61.2	38.8	567	23.9
21^st Telêmaco Borba	1820	1722	94.6	79.7	20.3	144	8.4
22^nd Ivaiporã	1048	980	93.5	65.0	35.0	145	14.8
Paraná	111943	92397	82.5	64.5	35.5	35147	37.8

Primary diagnosis on admission	10 to 19	20 to 34	35 to 49	Total
N	%	N	%	N	%	N	%
Pregnancy with abortive outcome	-	-	1	6.3	-	-	1	3.6
Edema, proteinuria and hypertensive disorders in pregnancy, birth and puerperium	-	-	5	31.3	3	30.0	8	28.6
Assistance to the mother for reasons linked to the fetus, amniotic cavity and problems of childbirth	-	-	-	-	2	20.0	2	7.1
Complications of labor and delivery	-	-	2	12.5	1	10.0	3	10.7
Delivery	1	50.0	7	43.8	4	40.0	12	42.9
Other obstetric conditions not elsewhere classified	-	-	1	6.3	-	-	1	3.6
Shock not elsewhere classified	1	50.0	-	-	-	-	1	3.6
Total	2	100.0	16	100.0	10	100.0	28	100.0

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[1] Correspondence: Thaise Castanho da Silva.  Av. Prefeito Moacyr Castanho,1517 – Centro.  CEP 86360-000 – Bandeirantes, PR, Brazil

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Hospitalizations leading causes for maternal disorders* * Extracted from the thesis "Morbidade materna e morbidade materna grave (near miss): análise das internações financiadas pelo Sistema Único de Saúde", Universidade Estadual de Maringá, 2011.

Las principales causas de hospitalizaciones por trastornos maternos

Hospitalizations leading causes for maternal disorders^* * Extracted from the thesis "Morbidade materna e morbidade materna grave (near miss): análise das internações financiadas pelo Sistema Único de Saúde", Universidade Estadual de Maringá, 2011.