ABSTRACT
Objectives:
to assess high-risk prenatal care and identify strategies for improving care.
Methods:
a mixed study of a prospective cohort, with 319 mothers in a public maternity hospital, from October 2016 to August 2017, using a semi-structured instrument and interview. Analysis was performed using the chi-square test (p≤0.05). The qualitative approach was carried out through interviews with guiding questions to 13 managers, at their workplace, between January and March 2020, analyzed under social phenomenology.
Results:
higher rates of inadequacy were identified for all criteria. However, when care was shared, there was a higher rate for performing tests (p=0.023), consultations (p=0.002), risk stratification (p=0.013) and emergency information (≤0.000). Weaknesses in the record evidenced impairment in communication and continuity of care.
Final Considerations:
shared care is a strategy for improving care, however there is a need to strengthen effective referral and counter-referral to care continuity.
Descriptors:
Prenatal Care; Pregnancy, High-Risk; Primary Health Care; Secondary Care; Health Services Administration
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*ABO – classification of human blood; †Rh – blood group system; ‡VDRL – Venereal Disease Research Laboratory; §HIV – Human Immunodeficiency Virus; ||Examination performed in the 1st, 2nd, 3rd trimesters in susceptible pregnant women or 1st trimester in non-susceptible pregnant women; ¶HBsAg – hepatitis B virus surface antigen.
*PN – prenatal; †GA – gestational age; ‡Origin of the pregnant woman to carry out childbirth in the same city as the maternity hospital or use of medical transport or ambulance; §PR – puerperal return; ||LPD – last period date; ¶PCD – probable childbirth date.