Implicações na assistência obstétrica prestada por profissionais da saúde no contexto da pandemia do novo coronavírus

Abstract

Recently, a coronavirus infection quickly spread from China to other parts of the world and to this day has been causing physical and mental damage. The World Health Organization estimates that to date around 326,279,424 new cases of COVID-19 have been confirmed, resulting in 5,536,609 deaths in all countries worldwide. It represents epidemiological risk factors, people who have traveled to epidemic countries or regions, close contact with infected people, elderly people over 60 years of age, pre-existing respiratory morbidities, high-risk pregnant women and postpartum women. Recently, pregnant women of any gestational age, and women who had a miscarriage or fetal loss were included in this group. As the coronavirus appears to increase the risk of complications in the puerperal pregnancy cycle, the management of these women should ideally be controlled and rigorous. This research aims to identify the implications for the care provided to pregnant and postpartum women by health professionals who work in obstetric care in the context of the new coronavirus pandemic. This is a cross-sectional study carried out from March 18 to June 15, 2020, in the State of Santa Catarina. For the data collection stage, a duly trained team recruited individuals through digital media. In the questionnaire there were questions related to socioeconomic and demographic characteristics and related to prenatal and puerperal care. The collected data were exported and analyzed by the IBM® SPSS software, version 20.0. The goodness of fit was assessed using the Hosmer-Lemeshow test. For data analysis, multivariate logistic regression was used. The project was approved by the Ethics and Research Committee with Human Beings of the Federal University of Fronteira Sul (CEP/UFFS), under opinion n◦ 4,051,806. Participated in the study 196 health professionals who exclusively care for pregnant and postpartum women and who provide childbirth care in the state of Santa Catarina. There was a predominance of female individuals, 188 (95.9%) and nurses, 106 (54.1%). Regarding the measures adopted to prevent COVID-19, 121 (61.7%) were tested, 55 (28.1%) were removed and only 12 (6.1%) were diagnosed with the virus. The changes in obstetric care during the COVID-19 pandemic regarding the outbreak response measures in the final model were: screening patients for symptoms of COVID-19 infection with care flowchart (p=0.000, OR 0.06 CI 95% 0.01 – 0.22), consideration of changing the route of birth (p=0.001, OR 6.12 95% CI 1.85 – 20.20) and breastfeeding in the first hour of life (p =0.001, OR 0.02-IC 95% 0.00 - 0.10). The study made it possible to observe several impacts of the COVID-19 pandemic on the daily work of health professionals. Based on the analysis, one can observe the emergence of new needs and changes in obstetric care in response to the COVID-19 outbreak.