Juliano Gaspar

Maternal and Neonatal Healthcare Information System: Development of an Obstetric Electronic Health Record and Healthcare Indicators Dashboard

Development and use of specific information systems are nowadays a priority to healthcare organizations. This interdisciplinary paper, between Medicine and Computer Science, comprises an exploratory survey of obstetric and neonatal assistance during the process of birth by focusing on clinical records. It also involves the development of a healthcare indicators dashboard and the implementation of an Obstetric Electronic Health Record. All these efforts aim to improve quality of healthcare assistance. This prototype has been installed within a Brazilian university hospital. Preliminary results included 907 deliveries (from August to December 2012). The Cesarean section rate was 36.4% (65.4% high-risk pregnancy). Among the perinatal indicators, the Apgar Score bellow seven in the 5th minute was 5.56% and 0.93% whenever considering only fetuses defined as compatible with life. Disclosure and discussion of these data proved to be able to contribute to researches and to management of an obstetric healthcare unit.

Is a Decision Support System Based on Robson's Classification Enough to Reduce Cesarean Section Rates?

The cesarean section (CS) rates are important global indicators for measuring the access to obstetric services. In 2001, Robson proposed a CS classification in ten-groups as the most appropriate to compare surgery rates. However, having a decisional support system from Robsons Classification is enough to reduce CS rates? The births analysis that occurred in 2016, inside a public hospital maternity, showed 1,946 deliveries of which 35.7% were CS with a positive growth trend (R2 = 0.137). The monthly analysis of the combined groups 1 to 4 from Robsons Classification allows the development of goals to improve labour assistance, and also preventing CS in parturient groups where preventable.

Use of Geographic Information System Tools in Research on Neonatal Outcomes in a Maternity- School in Belo Horizonte - Brazil

Aim: This study proposes to evaluate the spatial distribution of the public obstetric care in the city of Belo Horizonte. It will also correlate the primary care units (PCU) with the immediate neonatal outcomes of a maternity-school of Belo Horizonte, according to risk pregnancy and obstetric outcome. Method: Descriptive geographic-spatial research. This study analyzed a cohort of 2956 newborn who received care at birth in maternity-school, Hospital das Clinicas (HC) of Federal University of Minas Gerais (UFMG) between the January/2013 to July/2014. The gestational risk, the local of primary care unit (PCU) of prenatal, immediate neonatal outcome was studied. The QGIS 2.4 open source software was used to generate thematic maps and analyses. Results: It was observed that among the 2083 births analyzed 1154 (55.4%) were classified as high risk for maternal and 634 (30.4%) with poor neonatal outcome, also, that has a concentration of women living in the northwest of the city to officially refer to their childbirth mothers in the maternity-school. In cases of high risk pregnancy and perinatal complications referencing also occurs from practically all other regions of the city. Discussion: The integration of hospital clinical and administrative data with cartographic databases, through through this study, was able to make clear the patterns of referencing for childbirth in maternity-school in high risk pregnancy. Despite the limitations of a descriptive study, the analysis makes clear that the choice of place of childbirth, exceeds the matters set out in government planning of emergency obstetric referencing by sanitary districts.