COMPREHENSIVE NURSING CARE IN HIGH-RISK PRENATAL CARE FOR PREGNANT WOMEN WITH MATERNAL OR FETAL HEART DISEASE: AN EXPERIENCE REPORT

Abstract

Objective: To report the experience of providing Complementary High-Risk Prenatal Care to pregnant women with maternal or fetal heart diseases in a cardiology reference hospital. Method: A descriptive study of the Experience Report type, which describes Nursing Consultations in the Complementary High-Risk Prenatal Care Program for pregnant women diagnosed with maternal or fetal heart diseases. The experience occurred during a supervised extracurricular internship at the high-complexity outpatient clinic of a reference hospital in Belém, Pará, between August and December 2024. The program serves pregnant women up to 24 weeks of gestation with a diagnosis of maternal (congenital or acquired) or fetal heart disease. Results: Access to the service is made through Primary Health Units, with 100% referral via the Unified Health System (SUS). Pregnant women are classified according to their clinical condition (Functional Classes I to IV), determining the frequency of obstetric and cardiological follow-up. They receive multidisciplinary support, including obstetric nurses, psychologists, social workers, doctors, dentists, and nutritionists. The obstetric nurse conducts periodic consultations, measuring blood pressure, weight, uterine height, and fetal heartbeats, in addition to identifying early signs of heart failure and monitoring the birth plan. However, the socio-economic difficulties faced by the pregnant women were observed, as most of them were from remote areas far from the state capital, which hindered regular access to care, even with the Treatment Outside the Home (TFD), which guarantees access to care through SUS for patients without adequate assistance in their municipality. This affected the continuity of high-risk prenatal care and influenced the pregnancy outcome. Conclusion: The follow-up of pregnant women in high-risk prenatal care emphasized the importance of nursing assistance during consultations, promoting awareness about maternal-fetal care and the condition of the pregnant woman. Socio-economic difficulties impact access to services, compromising follow-up. The implementation of strategies, such as TFD, helps minimize these barriers. The program stands out as a model of comprehensive and humanized care provided by SUS for high-risk pregnant women.