Reflections of the COVID-19 pandemic: medical decision-making in the post-abortion therapeutic approach in two public hospitals in the Federal District, Brazil
Objective: to discern potential shifts in medical decision-making regarding the selection of uterine evacuation techniques post-abortion in the first trimester within the context of the COVID-19 scenario at two public hospitals in the Federal District. Methods: employing a qualitative approach, the...
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| Format: | article |
| Status: | Published version |
| Publication Date: | 2023 |
| Country: | Brasil |
| Institution: | Fundação Oswaldo Cruz (FIOCRUZ) |
| Repository: | Cadernos Ibero-Americanos de Direito Sanitário (Online) |
| Language: | Portuguese |
| OAI Identifier: | oai:ojs.cadernos.prodisa.fiocruz.br:article/1026 |
| Online Access: | https://www.cadernos.prodisa.fiocruz.br/index.php/cadernos/article/view/1026 |
| Access Level: | Open access |
| Keyword: | Aborto Espontâneo Aborto Induzido Dilatação e Curetagem Tomada de Decisões COVID-19 Aborto Direito Saúde Coletiva Direito Sanitário Abortion, Spontaneous Abortion, Induced Dilatation and Curettage Decision Making Abortion Law Public Health Health Law Aborto Espontáneo Aborto Inducido Dilatación y Legrado Uterino Toma de Decisiones Derecho Salud Pública Derecho Sanitario |
| Summary: | Objective: to discern potential shifts in medical decision-making regarding the selection of uterine evacuation techniques post-abortion in the first trimester within the context of the COVID-19 scenario at two public hospitals in the Federal District. Methods: employing a qualitative approach, the study utilized two methodological procedures - documents and interviews. Data collection occurred between May and June of 2022. At Hospital A, prevalent post-abortion uterine evacuation techniques in 2020 were obtained from 25 consecutive records sourced from the surgical center book. At Hospital B, similar data was collected from 48 clinical records, encompassing 23 from 2019 and 25 from 2020. Semi-structured interviews were conducted with eleven health professionals, including three doctors, four nurses, and four nursing technicians, working in the obstetrics/surgical center of each hospital. Results: during the study period (2019 and 2020), both hospitals maintained supplies for adopting various uterine evacuation techniques. In Hospital A in 2020, medical decision-making predominantly favored manual intrauterine aspiration. Conversely, in 2019 at Hospital B, dilation and curettage were the preferred technique in 100% of cases, and despite remaining a priority in 78% of cases in 2020 during the COVID-19 period, there was a noticeable reduction compared to 2019. Hospital B also witnessed a heightened number of consultations and hospitalizations of women in the post-abortion process during the COVID-19 period compared to the pre-pandemic period. Conclusion: the pivotal factor influencing medical decision-making in both hospitals is the technical proficiency required for executing the chosen uterine evacuation technique. Received: 01/05/23|Review: 10/11/23|Accepted: 15/11/23 |
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