Dificuldades enfrentadas por gestantes de alto risco no pré-natal em uma maternidade de referência do Piauí

Abstract

High-risk pregnancies (HRG) occur in approximately 15% of pregnancies and are associated with gestational risk factors that increase the likelihood of unfavorable outcomes for both the mother and the fetus. Considering that maternal death results from situations that worsen during or after pregnancy and childbirth, most of these complications are preventable and treatable. Therefore, it is important to provide pregnant women with quality prenatal care, in order to pay attention and resolve potential problems. The objectives of this study are to understand the difficulties faced by high-risk pregnant women during prenatal care, characterize the sociodemographic profile of women with high-risk pregnancies treated at a reference maternity hospital in the state, reveal the risk factors that most affect pregnant women treated in high-risk prenatal care, and identify the main difficulties experienced by high-risk pregnant women during prenatal care. Descriptive, quantitative, and cross-sectional study conducted at a reference maternity hospital in Teresina, Piauí, with high-risk pregnant women aged 18 years or older who had at least 3 prenatal consultations. Pregnant women without a high-risk diagnosis, with gestational age below 22 weeks or above 37 weeks, and those with conditions that prevented participation in the study were excluded. Data were collected through a questionnaire prepared by the researcher and organized in spreadsheets in Excel Office (2013). Based on interviews with 150 high-risk pregnant women treated at the maternity hospital, it was observed that the majority were between 30 and 35 years old (31.3%), self-identified as brown (60%), were single (34.7%), did not have a paid job (55.3%), had a family income of one minimum wage (50%), were multiparous (70%), and started prenatal care in the first trimester (82%). The main high-risk diagnosis was gestational hypertension or preeclampsia (39.3%), followed by gestational diabetes mellitus (18.7%) and advanced maternal age (12%). The pregnant women (63.3%) considered the interaction/welcome with the health professional to be excellent. For 45% and 20.7% of the pregnant women, living too far from the maternity hospital and financial difficulty in traveling to the maternity hospital, respectively, are factors that imply remaining in high-risk prenatal care. This profile highlights socioeconomic vulnerability factors that are unfavorable for adherence to and continuity of high-risk prenatal care. These factors reveal weaknesses in the health care network for high-risk pregnant women and can negatively impact the continuity of care and maternal-fetal outcomes. Pregnant women's satisfaction with professionals was a determining factor for the quality of the service provided, demonstrating the need for interventions that ensure not only accessibility but also continuous quality of care. This study contributed to the understanding of the challenges faced by high-risk pregnant women and reinforces the importance of the need for investments in structuring the high-risk prenatal care network, in addition to implementing measures that minimize financial and geographic barriers.