Prenatal assessment of high-risk pregnancies in primary and specialized outpatient care: a mixed study

Abstract

Objectives: to assess high-risk prenatal care and identify strategies for improving care. Methods: a mixed study of a prospective cohort, with 319 mothers in a public maternity hospital, from October 2016 to August 2017, using a semi-structured instrument and interview. Analysis was performed using the chi-square test (p≤0.05). The qualitative approach was carried out through interviews with guiding questions to 13 managers, at their workplace, between January and March 2020, analyzed under social phenomenology. Results: higher rates of inadequacy were identified for all criteria. However, when care was shared, there was a higher rate for performing tests (p=0.023), consultations (p=0.002), risk stratification (p=0.013) and emergency information (≤0.000). Weaknesses in the record evidenced impairment in communication and continuity of care. Final Considerations: shared care is a strategy for improving care, however there is a need to strengthen effective referral and counter-referral to care continuity.