Banca de DEFESA: ROMINA MARGARITA HAMUI

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
DISCENTE : ROMINA MARGARITA HAMUI
DATA : 07/08/2020
HORA: 14:00
LOCAL: Aplicativo Zoom
TÍTULO:

Delays in hospital care and abortion complications: a study of users of the public health system in Brazilian northeast. 

PALAVRAS-CHAVES:

Induced abortion, length of stay, post-abortion complications, post-abortion care, women’s health 

PÁGINAS: 50
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
RESUMO:

Background: Abortion brings to surface existing inequities in different populations, mostly in contexts where its practice is criminalized. Abortion´s complications as a death´s cause are less frequent than other obstetric causes, but when they occur, they tend to be more lethal. Delays in seeking care, as well as in receiving adequate and opportune treatment, have been highlighted as determinant factors on the evolution of negative health events. On the present study, the objective was to analyze this last delay, and its association with complications due to abortion. Methods: This research integrates GravSus-NE, a multicenter study conducted in three cities of the Northeast of Brazil: Salvador, Recife and São Luís. Between August and December of 2010, all women who were 18th years old or more, admitted due to abortion, in 19 public maternity centers, were evaluated. Data were collected from face to face interviews and medical records. . Descriptive, stratified and multivariated analyses were done, and the Youden Index was used to estimate delay. Two models were created, one for all women, and one for those who arrived at the health services in good clinic conditions, in order to point out the complications occurred during their time inside the care units, and associated factors. Results: A total of 2371 women were included in this study. Most of them were 30 years old or less (62,3%), with a median of 27 years old, and 89,6% declared themselves as black or mixed race. In general, women arrived in good health conditions (90,5%), however 4,0% arrived in regular conditions and 5,5% in severe or very severe conditions. The median time between admission and uterine evacuation procedures was 7,9 hours. Based on the Youden Index, a time cut point was calculates, which settled in 10 hours, from which the appearance of complications arised considerably. Black women and those admitted during night shifts, were most represented among those who had to wait for 10 hours or more. Delay in uterine evacuation procedures was associated with severe complications (OR 1,97; IC95% 1,55-2,51), and in sub analysis evaluating only the women who arrived at the health services in good health conditions, this association was also present (OR 2,56; IC95% 1,85-3,55), even when adjusting for gestational age and kind of abortion declared. Discussion: Women´s profile is consistent with that described in literature, expressing the social vulnerability of those admitted for abortion in the public heath system in Brazil. The original contribution brought by this study, is the objective measure of time lapse between admission and realization of uterine evacuation procedures, and the establishment of a time cutpoint, based on conceptual and epidemiologic criteria, in order to define delay. Nevertheless, further research is still needed to test this delay in other samples and populations, as well as to develop new measures of it, in order to heighten its accuracy for the prevention of life threatening complications to women.

MEMBROS DA BANCA:
Presidente - 405.836.197-20 - ESTELA MARIA MOTTA LIMA LEAO DE AQUINO - UFBA
Interno - 000.000.000-00 - GREICE MARIA DE SOUZA MENEZES - UFBA
Externo à Instituição - LEILA ADESSE
Externo à Instituição - THALIA VELHO BARRETO DE ARAUJO