Adherencia a las buenas prácticas clínicas en el manejo de la morbilidad materna extremadamente grave

Abstract

Introduction: Surveillance of extreme maternal morbidity is a complement to the assessment and improvement of the quality of health services.
Objective: To evaluate adherence to good clinical practices in Managing Extremely Severe Maternal Morbidity.
Methods: A descriptive cross-sectional study was carried out in women with extremely severe maternal morbidity at Mariana Grajales Gyneco-Obstetric University Hospital, Villa Clara, Cuba, from 2012 to 2015. An intentional sample of 93 was chosen from 577 patients treated. In addition, the hospital records and individual and hospital medical records were reviewed.
Results: In the primary care clinic 80 cases were registered as obstetric risk. Only 88.2% had performed the initial complementary exams in re-evaluation consultations conducted at 14.1 weeks on average. Moreover, 94.6% had registered tension and weight curves in their obstetric control card. Uterine height only appeared registered in 96.8% of cases.
In secondary care, color code was applied in 92 patients and obstetric risk was identified in 91. Upon admission, 85 women were diagnosed. Puerperium care and follow-up protocols were applied by the institution's commission in all cases.
Conclusions: Deficiencies are detected in the process of providing care to extremely severe maternal morbidity. During this period, early pregnancy uptake, care for the immediate and mediate puerperium and follow-up by the institution's extremely serious maternal morbidity commission were assessed as acceptable.