PROFILE AND FACTORS ASSOCIATED WITH OBSTETRIC EMERGENCY CARE SERVICE BY SAMU 192 IN ARAGUAÍNA, BRAZIL, FROM 2011 TO 2016

Abstract

Objective: to describe the obstetric care provided by SAMU 192 in Araguaína, Tocantins, Brazil, from January 2011 to December 2016. Methods: quantitative, cross-sectional and retrospective study, conducted according to STROBE recommendations, with 1,103 obstetric care records among the 31,891 registered in the period. Categorical variables were described by absolute and relative frequency and continuous variables by mean and standard deviation, with bootstrapping correction. The association between care characteristics and the diagnostic hypothesis of labor was estimated by Poisson regression with robust variance, in crude and adjusted models, with a sensitivity analysis restricted to complete records. The precepts of Resolution 466/2012 were observed. Results: obstetric care accounted for 3.4% of the total. The predominant profile comprised pregnant women aged 15 to 29 years (81.3%), multigravidas (56.6%), in the third trimester (62.6%), attended at home (91.5%) by a basic life support unit (96.0%) and referred to the reference maternity hospital (87.5%). Labor accounted for 57.8% of the diagnostic hypotheses and the early morning shift for 30.0% of the calls, of which 78.0% corresponded to labor, with an adjusted prevalence ratio of 1.27 (95%CI 1.14–1.41), maintained in the sensitivity analysis. Age group, parity and day of the week were not associated with the outcome. Heart rate was 7.65 bpm lower in calls for labor (95%CI −9.51 to −5.92). Conclusion: obstetric demand concentrated in the early morning hours, among young women at term, and the incompleteness of the records behaved as a marker of the type of occurrence rather than as random noise.