Using the Bologna Score to assess normal delivery healthcare

Describing the obstetric care provided in public maternity hospitals during normal labour using the Bologna Score in the city of Natal, Northeastern Brazil.

METHOD

A quantitative cross-sectional study conducted with 314 puerperal women. Data collection was carried out consecutively during the months of March to July 2014.

RESULTS

Prenatal care was provided to 95.9% of the mothers, beginning around the 1^st trimester of pregnancy (72.3%) and having seven or more consultations (51%). Spontaneous vaginal delivery was planned for 88.2% women. All laboring women were assisted by a health professional, mostly by a physician (80.6%), and none of them obtained 5 points on the Bologna Score due to the small percentage of births in non-supine position (0.3%) and absence of a partogram (2.2%). A higher number of episiotomies were observed among primiparous women (75.5%).

CONCLUSION

The score obtained using the Bologna Index was low. Thus, it is necessary to improve and readjust the existing obstetrical model.

Descriptors
Natural Childbirth; Obstetric Nursing; Prenatal Care; Health Evaluation

Variables	General (n = 314)		Primiparous (n = 151)		Multiparous (n = 163)		p-value
	n	%	n	%	N	%
Age group (years)
< 20	70	22.3	60	85.7	10	14.3	< 0.001
20-29	169	53.8	78	46.2	91	53.8
≥ 30	75	23.9	13	17.3	62	82.7
Education level (years)
< 9	137	43.6	37	27.0	100	73.0	< 0.001
≥ 9	177	56.4	114	64.4	63	35.6
Marital status
Single	247	78.7	120	48.6	127	51.4	0.784
Other	67	21.3	31	46.3	36	53.7
Profession
Housewife/Stay-at-home mother	176	56.1	80	45.5	96	54.5	0.291
Other	138	43.9	71	51.4	67	48.6
Income (wages)^† † Excluded: unable to inform (1.59%; n=5); ^x × Minimum wage = R$724,00;
< 1	40	12.9	8	20.0	32	80.0	< 0.001
1 to 2	246	79.6	124	50.4	122	49.6
3 and +	23	7.4	15	65.2	8	34.8
Prenatal care
Yes	301	95.9	148	49.2	153	50.8	0.089^* * Fisher's exact test
No	13	4.1	3	23.1	10	76.9
Beginning of prenatal care (months)^‡ ‡ Values for mothers who received prenatal care (95.86%; n=301); ^§ § Excluded: unable to inform (0.33%; n=1);
≤ 3	217	72.3	115	53.0	102	47.0	0.040
> 3	83	27.7	33	39.8	50	60.2
Prenatal consultations^‡ ‡ Values for mothers who received prenatal care (95.86%; n=301); ^¥ ¥ Excluded: not identified (0.33%; n=1);
1-3	28	9.3	14	50.0	14	50.0	0.018
4-6	119	39.7	47	39.5	72	60.5
≥ 7	153	51.0	87	56.9	66	43.1
Prematurity^£ £ Excluded: not identified (1.27%; n=4);
< 37	2	0.7	2	100.0	0	0.0	0.230^* * Fisher's exact test
≥ 37	301	99.3	147	47.7	161	52.3
Low weight^€ € Excluded: not identified (1.59%; n=5).
<2.500	5	1.6	3	60.0	2	40.0	0.672^* * Fisher's exact test
≥2.500	304	98.4	144	47.4	160	52.6
Apgar at 1 minute
≤ 7	33	10.5	22	66.7	11	33.3	0.024
> 7	281	89.5	129	45.9	152	54.1
Apgar at 5 minutes
≤ 7	4	1.27	2	50.0	2	50.0	1.000
> 7	310	98.73	149	48.1	161	51.9
Episiotomy
Yes	159	50.6	120	75.5	39	24.5	< 0.001
No	155	49.4	31	20.0	124	80.0

Item	n	%
Presence of a companion	269	85.7
Use of a partogram	7	2.2
Lack of stimulation	124	39.5
Delivery in non-supine position	1	0.3
Skin to skin contact	248	79.0

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Isaiane da Silva Carvalho. Campus Universitário, Departamento de Enfermagem, Lagoa Nova, CEP 59078-900 - Natal, RN, Brazil. isaianekarvalho@hotmail.com

Brasil

Brasil

Using the Bologna Score to assess normal delivery healthcare* * Extracted from the dissertation "Avaliação da qualidade da assistência à mulher e ao filho durante o parto normal", Pós-Graduação em Enfermagem, Universidade Federal do Rio Grande do Norte; 2014.

Utilización del índice de Bologna para evaluación de la asistencia al parto normal

Abstract

OBJECTIVE

METHOD

RESULTS

CONCLUSION

Using the Bologna Score to assess normal delivery healthcare^* * Extracted from the dissertation "Avaliação da qualidade da assistência à mulher e ao filho durante o parto normal", Pós-Graduação em Enfermagem, Universidade Federal do Rio Grande do Norte; 2014.