Estratificação de risco gestacional dos casos de near miss materno no Estado do Paraná no ano de 2023

Abstract

Maternal near miss is defined as: "a woman who nearly died but survived a serious complication occurring during pregnancy, childbirth, or within 42 days after termination." Factors such as advanced maternal age, previous cesarean sections, high-risk pregnancies, and clinical management failures contribute to these occurrences. The high prevalence of maternal morbidity, especially in pregnant women with pre-existing comorbidities, highlights the need for enhanced care for women classified as high-risk. Reporting and stratifying pregnancy risk is considered an important tool, capable of presenting data on incidents, providing a learning environment, and sharing information that contributes to patient safety and prevention strategies. Incident reporting is common practice in healthcare settings, where various events can compromise patient care. This is a cross-sectional, quantitative, and analytical study that used data from the Maternal Near Miss Reporting System of the Paraná State Health Department (SESA), with a sample of 302 cases reported in 2023, aiming to analyze gestational risk stratification and verify the epidemiological, obstetric, and clinical profile of women who underwent MNM in the State of Paraná in 2023. The majority of postpartum women were between 19 and 29 years old (48.2%), white (62.6%), with a predominance of cases in multiparous women (59.6%), 46.1% had no complications in previous pregnancies, and 51.3% of the sample were classified as high-risk pregnancies. There were failures in risk stratification in 11.3% of cases, where the biggest failure was in the classification of women with normal risk who should have been at intermediate risk (58.8%), 4.3% were not stratified, and in 7.9% of the notifications, information was not included on whether or not they were stratified. Approximately 34.8% of the women had previous comorbidities. Delays and delays, classified as delay I, were present in 20.5%, delay II (6.6%) and Delay II (24.5%) of the notifications analyzed. Upon arrival at the service, 37.1% were classified as emergencies (red color). The results reinforce the importance of quality prenatal care, identification of gestational risk factors, strengthening health systems, and ongoing professional education. These actions are essential to ensuring adequate care for women, promoting their health and well-being during pregnancy and childbirth, highlighting the need for future studies to improve the findings and develop new prevention strategies.