Avaliação dos registros da caderneta da gestante no pré-natal de risco habitual em São Luís - MA

Abstract

Since its implantation, the pregnant woman's card has been considered fundamental because it enables the recording of the main gestational monitoring data and acts as a tool for professional intercommunication, facilitating the flow of information and allowing the continuity of care wherever the pregnant woman is taken care of. In addition, it has been used as a tool to evaluate prenatal care services, considering that the quality of the records can be a reflection of the quality of care provided. Therefore, the objective of this study was to evaluate the records of the pregnant woman's passbooks in prenatal care at usual risk in São Luís - MA, ascertaining the legibility, completeness and appropriateness of the registered content. Therefore, an evaluative, descriptive and quantitative study was carried out in nine primary health care units in São Luís - MA, from May 2017 to September 2018. The research sample consisted of the number of pregnant women's passbooks selected over two consecutive months in each unit, totalizing 105 passbooks. The records were considered legible, illegible or partially legible; completeness was classified according to the quality levels: excellent (incompleteness <5%), good (5% ≤ incompleteness <10%), regular (10% ≤ incompleteness <20%), poor (20% ≤ incompleteness <50%), and very poor (incompleteness ≥ 50%); and the appropriateness of the content was ascertained according to the recommendations of the Stork Network strategy. The results showed that 92.4% of the passbooks were considered with readable records. The evaluation of completeness showed that 7.6% presented completeness regular, 72.4% completeteness poor and 20.0% completeness very poor. It should be noted that no passbook was classified with excellent or good record. The evaluation by sections showed that the section of Complementary Routine Examinations presented the best results, while the section of Complementary Activities presented the lowest levels of completeness. Through the records referring to the signature and professional category, it was found that 2.9% of the pregnant women consulted only with physicians, 30.5% only with nurses and 66.7% with physicians and nurses. The verification of the adequacy of the recorded content to the parameters recommended by the Stork Network showed that, among the criteria evaluated, the ones that presented the greatest inadequacy were the uroculture examination (39.1%), the onset of prenatal care in the first trimester (33.3%) and dTpa vaccination (28.6%). It was concluded that the records in the pregnant women's passbooks in the usual risk prenatal in São Luís were predominantly poor, denoting a devaluation of this instrument and a probable noncompliance with recommendations of the Ministry of Health for quality assistance.