[RhD alloimmunization in pregnant women in Rio de Janeiro State, Brazil: perspectives and challenges].

Autor: Beserra AH; Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil., Artmann E; Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil., Santos MC; Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Jazyk: portugalština
Zdroj: Cadernos de saude publica [Cad Saude Publica] 2016 Nov 01; Vol. 32 (11), pp. e00005516. Date of Electronic Publication: 2016 Nov 01.
DOI: 10.1590/0102-311X00005516
Abstrakt: This study shows research results on the persistence of RhD alloimmunization in pregnant women seen in the public healthcare network in Rio de Janeiro State, Brazil, through patient file analysis and interviews with administrators, health professionals, and patients. We analyzed 289 patient files of RhD-negative pregnant women seen from 2004 to 2012 at the State Reference Center. Individual interviews were held with 15 individuals. The interviews revealed factors contributing to persistence of the problem, such as: loss of restructuring of the Program for the Prevention of RhD Alloimmunization (PPARhD); lack of a system for monitoring the Program; low linkage between the referral and counter-referral network during prenatal care; insufficient training of the health professionals treating pregnant women at risk; and insufficient visibility of the program for RhD alloimmunization prevention. These critical points highlight the need for the State Health Department to reinforce prioritization of the program for alloimmunization prevention and invest in referral and counter-referral in the healthcare network. The study showed that the problem has multiple causes and requires interdisciplinary and complex measures related to comprehensive prenatal care.
Databáze: MEDLINE