Near miss materno: fatores influenciadores e direcionamentos para redução da morbidade e mortalidade materna
DOI:
https://doi.org/10.15253/2175-6783.2018193182Palabras clave:
Mortalidade Materna; Morbidade; Saúde Materna; Near Miss; Enfermagem.Resumen
Objetivo: analisar as evidências científicas acerca dos fatores que influenciam os casos de near miss materno e possíveis direcionamentos para redução da morbidade e mortalidade materna. Métodos: revisão integrativa com 2.895 artigos encontrados e 17 selecionados. Resultados: os fatores que influenciam nos casos de near miss foram: atrasos nos cuidados obstétricos; despreparo da equipe de saúde; condições precárias dos serviços; disponibilidade limitada de derivados de sangue; e deficiência no pré-natal, no uso de Práticas Baseadas em Evidências e nas auditorias. Como principais direcionamentos para minimizar esses eventos, evidenciaram-se: fortalecer a rede de referência e contrarreferência; realizar capacitação profissional; melhorar a cobertura do pré-natal; e investir na infraestrutura, na gestão de processos e em auditorias clínicas. Conclusão: os fatores que influenciam os casos de near miss materno englobam desde o atraso nos cuidados até a não realização do pré-natal, cuja melhoria na gestão constitui o principal direcionamento.
Citas
Fernandes BB, Nunes FBBF, Prudêncio PS, Mamede FV. Epidemiological research of the maternal deaths and compliance with the fifth millennium development goal. Rev Gaúcha Enferm. 2015; 36(esp):192-9. doi: http://dx.doi.org/10.1590/1983-1447.2015.esp.56792
Norhayati MN, Hazlina NHN, Sulaiman Z, Azman MY. Severe maternal morbidity and Near misses in tertiary hospitals, Kelantan, Malaysia: a cross-sectional study. BMC Public Health. 2016; 16:229. doi: http://doi.org/10.1186/s12889-016-2895-2
Rosendo TMSS, Roncalli AG. Prevalência e fatores associados ao Near miss materno: inquérito populacional em uma capital do Nordeste Brasileiro. Ciênc Saúde Coletiva. 2015; 20(4):1295-304. doi: http://dx.doi.org/10.1590/1413-81232015204.09052014
Monte AS, Teles LMR, Costa CC, Gomes LFS, Damasceno AKC. Analysis of the potentially life threatening conditions of women in intensive care units. Rev Rene. 2017; 18(4):461-7. doi: http://dx.doi.org/10.15253/2175-6783.2017000400006
Whittemore R, Knafl K. The integrative re-view: updated methodology. J Adv Nurs. 2005; 52(5):546-53. doi:http://doi.org/10.1111/j.1365-2648.2005.03621.x
World Health Organization: Evaluating the quality of care for severe pregnancy complications: the WHO near-miss approach for maternal health. Geneva: WHO; 2011
Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA group preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097
Ursi ES, Gavão CM. Prevenção de lesões de pele no perioperatório: revisão integrativa da literatura. Rev Latino-am Enfermagem. 2006; 14(1):124-31. doi:http://dx.doi.org/10.1590/S0104-11692006000100017
Cecatti JC, Souza, JP, Oliveira Neto AF, Parpinelli MA, Sousa MH, Say L, et al. Pre-validation of the WHO organ dysfunction based criteria for identification of maternal Near miss. Reprod Health. 2011; 8:22. doi: https://doi.org/10.1186/1742-4755-8-22
Morse ML, Fonseca SC, Gottgtroy CL, Waldmann CS, Gueller E. Severe maternal morbidity and near misses in a regional reference hospital. Rev Bras Epidemiol. 2011; 14(2):310-22. doi: http://dx.doi.org/10.1590/S1415-790X2011000200012
Lotufo FA, Parpinelli MA, Haddad SM, Surita FG, Cecatti JG. Applying the new concept of maternal near-miss in an intensive care unit. Clinics. 2012; 67(3):225-30. doi: http://dx.doi.org/10.6061/clinics/2012(03)04
Lobato G, Nakamura-Pereira M, Mendes-Silva W, Dias MAB, Reichenheim ME. Comparing different diagnostic approaches to severe maternal mor-bidity and near-miss: a pilot study in a Brazilian tertiary hospital. Eur J Obstet Gynecol Reprod Biol. 2013; 167(1):24-8. doi: http://doi.org/10.1016/j.ejogrb.2012.10.030
Oliveira LC, Costa AR. Fetal and neonatal deaths among cases of maternal near miss. Rev Assoc Med Bras. 2013; 59(5): 487-94. doi: http://dx.doi.org/10.1016/j.ramb.2013.08.004
Dias MAB, Domingues RMSM, Schilithz AOC, Nakamura-Pereira M, Diniz CSG, Brum IR, et al. Incidence of maternal near miss in hospital childbirth and postpartum: data from the Birth in Brazil study. Cad Saúde Pública. 2014; 30(Suppl1):169-81. doi: http://dx.doi.org/10.1590/0102-311X00154213
Galvão LPL, Alvim-Pereira F, Mendonça CMM, Menezes FEF, Góis KAM, Ribeiro Jr RF, et al. The prevalence of severe maternal morbidity and near miss and associated factors in Sergipe, Northeast Brazil. BMC Pregnancy Childbirth. 2014; 14(25):1-8. doi: http://dx.doi.org/10.1186/1471-2393-14-25
Karolinski A, Mercer R, Micone P, Ocampo C, Mazzoni A, Fontana O, et al. The epidemiology of life-threatening complications associated with reproductive process in public hospitals in Argentina. BJOG. 2013; 120(13):1685-94. doi: http://doi.org/10.1111/1471-0528.12395
Van den Akker T, Beltman J, Leyten J, Mwagomba B, Meguid T, Stekelenburg J, et al. The WHO maternal near miss approach: consequences at Malawian district level. PLoS One. 2013; 8:e54805-10. doi: https://doi.org/10.1371/journal.pone.0054805
Nelissen E, Mduma E, Broerse J, Ersdal H, Evjen-Olsen B, van Roosmalen J, et al. Applicability of the WHO maternal near miss criteria in a low-resource setting. PLoS One. 2013; 8:e61248-10. doi: https://doi.org/10.1371/journal.pone.0061248
Litorp H, Kidanto HL, Rööst M, Abeidl M, Nyström LN, Essén B. Maternal near-miss and death and their association with caesarean section complications: a cross-sectional study at a university hospital and a regional hospital in Tanzania. BMC Pregnancy Childbirth. 2014; 14:244. doi: https://doi.org/10.1186/1471-2393-14-244
Jabir M, Abdul-Salam I, Suheil DM, Al-Hilli W, Abul-Hassan S, Al-Zuheiri A, et al. Maternal Near miss and quality of maternal health care in Baghdad, Iraq. BMC Pregnancy Childbirth. 2013; 13:11. doi: https://doi.org/10.1186/1471-2393-13-11
Rana A, Baral G, Dangal G. Maternal Near-Miss: A multicenter surveillance in Kathmandu valley. J Nepal Med Assoc [Internet]. 2013 [cited 2017 Nov. 10]; 52(190):299-304. Available from: http://jnma.com.np/jnma/index.php/jnma/article/view/256/1570
Shen FR, Liu M, Zhang X, Yang W, Chen YG. Factors associated with maternal near-miss morbidity and mortality in Kowloon Hospital, Suzhou, China. Int J Gynecol Obstet. 2013; 123(1):64-7. doi: http://dx.doi.org/10.1016/j.ijgo.2013.06.011
Tunçalp O, Hindin MJ, Adu-Bonsaffoh K, Adanu RM. Assessment of maternal near-miss and quality of care in a hospital-based study in Accra, Ghana. Int J Gynecol Obstet. 2013; 123(1):58-63. doi: http://doi.org/10.1016/j.ijgo.2013.06.003
Luexay P, Malinee L, Pisake L, Bouvier-Colle MH. Maternal near-miss and mortality in Sayaboury Province, Lao PDR. BMC Public Health. 2014; 14:945. doi: https://doi.org/10.1186/1471-2458-14-945
Pandey A, Das V, Agarwal A, Agrawal S, Misra D, Jaiswal N. Evaluation of obstetric Near miss and maternal deaths in a tertiary care hospital in North India: shifting focus from mortality to morbidity. J Obstet Gynaecol India. 2014; 64(6):394-9. doi: http://doi.org/10.1007/s13224-014-0552-1
David E, Machungo F, Zanconato G, Cavaliere E, Fiosse S, Sululu C, et al. Maternal near miss and maternal deaths in Mozambique: a cross-sectional, region-wide study of 635 consecutive cases assisted in health facilities of Maputo province. BMC Pregnancy Childbirth. 2014; 14:401. doi: https://doi.org/10.1186/s12884-014-0401-3
Pacagnella RC, Cecatti JG, Parpinelli MA, Sousa MH, Haddad SM, Costa ML, et al. Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study. BMC Pregnancy Childbirth. 2014; 5;14:159. doi: http://doi.org/10.1186/1471-2393-14-159
Knight HE, Self A, Kennedy SH. Why are women dying when they reach hospital on time? A systematic review of the “third delay”. PLoS One. 2013; 8:e63846. doi: https://doi.org/10.1371/journal.pone.0063846
Organização Mundial da Saúde. Recomendações da OMS para a prevenção e tratamento da hemorragia pós-parto [Internet]. 2014 [citado 2017 11 out]. Disponível em: http://apps.who.int/iris/bitstream/10665/75411/12/9789248548505_por.pdf
Aguiar CA, Tanaka ACA. Memórias coletivas de mulheres que vivenciaram o near miss materno: necessidades de saúde e direitos humanos. Cad Saúde Pública. 2016; 32(9):e00161215. doi: http://dx.doi.org/10.1590/0102-311X00161215
