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Abstract
Introduction: the presence of perinatal mortality events requires actions of health institutions, which must implement strategies, in order to improve conditions and health status taking into account the causes of events. Objective: identify factors associated with perinatal mortality of the population of health care affiliates of the department of Nariño in 2007. Materials and Methods: this is a quantitative, descriptive, retrospective-evaluative research, since the data correspond to the documentary revision of the medical records of pregnant women with mortality events in 2007. 100% of cases of perinatal mortality were taken, representing the total population. Socio-demographic variables, case studies (protocol handling care, completion of the notification sheet, compliance with technical norms and practice guides) were considered. 34 events were studied, of which 61.8% died in the antepartum, 20.6% in the intrapartum and 17.6% at pre-discharge. A verification guide was applied to each event, while the data was consolidated in the statistical information system EPIINFO version 2000, and the crossing of existing variables was carried out. Once the findings were identified regarding the causes of risk, the chi2 was applied in order to determine the value of P, raising the base line in order to prioritize plans and projects aimed at reducing perinatal mortality rate for the health care provider. Results: of the total population of mothers between the ages of 23 and 26, present the highest number of cases, 56% came from towns and had complete primary schooling, 23% have a spouse, 26% have a history of multiparity. During their pregnancy, these women attended four general medical checks-ups carried out by the primary care level, of which 67% did not use birth control. Regarding the risks the mothers have, there were three cases with chronic hypertension, 3 cases of urinary tract infections, tobacco and alcohol usage, psychological disorders; intrauterine growth retardation was reported in 1 case, which were classified as high-risk pregnancy; 6 pregnancies were not classified, which had relevant aspects to consider. The study demonstrated the failure to record aspects on the medical history. In the childbirth and puerperium process, the gestation period ranged from 28 to 40 weeks, of which 71% had a vaginal delivery, 26.57% C-section, half of which were attended by obstetricians and the remainder by a general physician; 11% did not register any data and 5% corresponds to other patients. The first attention level was used in 70% of the cases. The most frequent causes of complications during childbirth include the retention of placental remains, preterm delivery, fetal distress, hypovolemic shock, third trimester hemorrhage. As far as the mandatory notifications of perinatal mortality cases, these were reported to Epidemiological Surveillance System (Sivigila), in none of the events was field research conducted, no analysis committees were carried out to examine perinatal deaths. The perinatal form was carried out in 100% of the cases, but in the analysis of the data confrontation with the medical records, these two do not agree, possibly due to the fact that they were filled-out by different health care professionals.
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References
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