In-hospital stillbirth of fetuses weighing 2,500g or more in 2018 and 2019 in the city of Rio de Janeiro: an analysis of prenatal care, childbirth and death surveillance (Atena Editora)

Abstract

In-hospital stillbirth of fetuses weighing 2,500g or more is a sentinel event given the possibility of preventable death. Objective : To analyze data from assistance to pregnant women who resulted in in-hospital stillbirths weighing 2500g or more. Method: This is a descriptive, retrospective study carried out with secondary data from the stillbirth database of SMS/RJ. For this study, in-hospital deaths with birth weight greater than or equal to 2,500g that occurred in the years 2018 and 2019 were selected, which were investigated with a home visit. Results: In the years 2018 and 2019, there were 326 stillbirths of mothers residing in the MRJ, weighing 2,500g or more. Stillbirths were classified for the most part as preventable (78%). For most pregnant women, prenatal care was characterized by an adequate number of consultations (85.3%), performance of routine exams (92.7%) and vaccination schedule (73.2%). However, low adherence of pregnant women to the indicated treatments was found (46.3%), low record of access to specialists when indicated (34.1%) and little use of collective health education practices (2.4%). In hospital care, just over half of the women (56.1%) had a record of the recommended rapid test exams, there was a low record of the participation of a companion in the reports of labor (31.7%), a high percentage (92, 7%) did not have the fetal heartbeat auscultation test performed in the first consultation (reception and risk classification). Stillbirth occurred with hospitalization time longer than six hours (48.8%), in only 2.4% of the medical records there were records of the opportunity for parents/relatives to visualize the fetus. Death surveillance identified user complaints related to maternity care (51.2%) and prenatal care (2.4%). Most deaths were discussed in the technical groups of the primary care coordinators (73.2%). Conclusion: The high percentage of preventable stillbirths demonstrates the need for qualified care. The fetal death investigation service pointed out problems, but did not make the appropriate recommendations for managers and professionals. Although the deaths occurred in the hospital environment, it is known that the prenatal service is directly associated with the prevention of morbidities and mortality.