Monitoramento do processo de assistência pré-natal entre as usuárias do sistema único de saúde em município do sudeste brasileiro

Abstract

PURPOSE: to evaluate the evolution of adequacy of the care process among pregnant users of the Brazilian Single Health System (SUS, acronym in Portuguese) and to consolidate a methodology for monitoring the prenatal care. METHODS: this is a multiple time series study with auditing of prenatal cards of pregnant women who were attended for prenatal care in a city of the Brazilian Southeast (Juiz de Fora, Minas Gerais) in the initial semesters of 2002 and 2004 (370 and 1,200 cards, respectively) and gave birth using SUS services in term pregnancies (p ≤ 0.05). A three complementary level sequence was respected: utilization of prenatal care (beginning and number of visits) at level 1; utilization of prenatal care and obligatory clinical-obstetric procedures during prenatal visits (assessment of blood pressure (BP), weight, uterine fundal height (FH), gestational age (GA), fetal heart rate (FHR) and fetal presentation) at level 2; and utilization of prenatal care, obligatory clinical-obstetric procedures and basic laboratory tests, according to the Humanization Program of Prenatal Care and Birth (PHPN, acronym in Portuguese) (ABO/Rh, hemoglobin/hematocrit (Hb/Htc), VDRL, glycemia and urinalisys) at level 3. RESULTS: it was confirmed the high prenatal care coverage (99%), the increased mean number of visits per pregnant woman (6.4 versus 7.2%) and the decreased gestational age at the time of the first visit (17.4 versus 15.7 weeks). The proper registration of procedures and exams (exceptions: fetal Saúde.