Implementação do protocolo de acolhimento com classificação de risco em uma emergência obstétrica  <span class="so-article-trans-title" dir="auto"> Translated title: Implementation of protocol for reception with risk classification in an obstetric emergency unit </span>

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Abstract

Objetivo avaliar a implementação do Acolhimento com Classificação de Risco. Métodos estudo avaliativo com amostra de 736 instrumentos para classificação de risco, em um serviço de referência. Resultados identificou-se busca maior por atendimento de mulheres gestantes no terceiro trimestre, sendo a dor e o sangramento vaginal as principais queixas. Verificou-se também o número significativo de pacientes que procuraram o atendimento fora do ciclo gravídico-puerperal. Como classificação de risco, prevaleceu a cor verde e o tempo de espera de 51 minutos. Conclusão a clientela que busca atendimento ginecológico e obstétrico precisa ser melhor informada na atenção básica sobre os sinais e sintomas que caracterizam emergência e urgência, pois a grande procura pelo serviço de forma desnecessária e a falta de treinamento dos profissionais da própria emergência obstétrica acarretou tempo de espera acima do preconizado pelo Ministério da Saúde do Brasil.

Translated abstract

Objective to evaluate the implementation of reception with risk classification. Methods evaluative study with a sample of 736 instruments for risk classification in a reference service. Results authors identified greater search for care by pregnant women in the third trimester of pregnancy, being the pain and vaginal bleeding the main complaints. There was also a significant number of patients seeking care out of the period of pregnancy and childbirth. As risk classification, there was prevalence of the green color and the waiting time of 51 minutes. Conclusion the clientele seeking gynecological and obstetric care in primary care needs further information about the signs and symptoms that characterize emergency care, because there has been great unnecessary demand for the service and the lack of training of professionals from the obstetric emergency unit led to waiting time above the recommended by the Brazilian Ministry of Health.

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Oral antibiotic prescribing during pregnancy in primary care: UK population-based study.

Antonia Ridolfi, Ruth Gilbert, Stephen Evans … (2010)

To examine patterns of prescribing of oral antibiotics during pregnancy and to determine whether women were more or less likely to receive specific types of antibiotics in pregnancy than in the years before and after pregnancy. Finally, to identify socio-demographic factors associated with antibiotic prescribing in pregnancy. We identified 114 999 women who gave live birth between 1992 and 2007 in The Health Improvement Network (THIN) UK primary care database. Antibiotic prescribing during pregnancy was estimated for each calendar year between 1992 and 2007. Self-controlled case series (SCCS) methodology was used to compare antibiotic prescribing during pregnancy with the years before and after pregnancy, and Poisson regression to examine association between demographic factors and antibiotic prescribing. A third of pregnant women received at least one antibiotic prescription during pregnancy. In each trimester, 14% of women received at least one antibiotic. Prescribing of antibiotics was lower in pregnancy than during a comparable period 1 year earlier [incidence rate ratio (IRR) 0.91 (95% CI 0.90-0.93)], but some antibiotics were prescribed more frequently in pregnancy: broad-spectrum penicillins [IRR 1.46 (1.42-1.49)]; cephalosporins [IRR 2.22 (2.13-2.31)]; and antibiotics for urinary tract infections [IRR 2.29 (2.01-2.61)]. Respiratory, urinary, skin and ear infections were the commonest indications. Urinary indications increased and respiratory, skin and ear infection indications declined during pregnancy, although a large proportion were prescribed without indication. Young age and social deprivation were associated with increased antibiotic prescribing during pregnancy. Antibiotic prescribing is widespread in pregnancy although marginally reduced compared with the year before pregnancy. There were substantial changes in types of antibiotics as well as in their indications during pregnancy. This may be explained by changes in threshold for treatment, diseases, detection and recording. Younger women and women from deprived areas were most likely to receive antibiotics in pregnancy.