Atendimento à gestante vítima de acidente ofídico: um instrumento assistencial para a enfermagem

Abstract

Introduction: Snake poisonings represent a huge problem for global public health. The genus Bothrops is responsible for 80 to 90% of snakebite cases in Brazil, its venom causes coagulation disorders. Snake bite poisoning during pregnancy is not common, however the toxin in snake venom is an active coagulating agent that reaches the placental circulation, crosses the placental barrier causing systemic poisoning in the fetus, even if there is no maternal poisoning. Objective: To propose a guidance instrument for nursing when caring for pregnant women who are victims of snakebites. Methodology: This is a research with two types of associated studies: A methodological study, consisting of the stages of the Integrative Literature Review and elaboration of the proposed guidance instrument. It is a descriptive quantitative study, describing the clinical-epidemiological profile of bothropic snakebites in pregnant women in Brazil. Results: In the Review stage, after the analysis process, the final sample was composed of 11 articles that address snakebites during pregnancy. In all studies, maternal and fetal complications were considered to develop the objectives proposed in this research. In maternal complications, we highlighted placental hemorrhage/uterine wall present in 9 of the 11 studies; placental abruption reported in 8 articles; hypovolemic/hemorrhagic shock, premature contraction and premature labor present in 6 articles each. In fetal complications, we had fetal hypoxia/anoxia, abortion/fetal death and prematurity mentioned in 6 of the 11 articles and hydrocephalus reported in 4. In the scientific production stage, two scientific articles were produced, one that addresses maternal- fetal aspects of the snakebite accident and another on the clinical-epidemiological description of the Botrophic accident in pregnant women in Brazil; in addition to the Nursing Care Protocol for Pregnant Women Victims of Botropic Ophidian Accidents, constructed in the form of a table, for better visualization and understanding of the subject, including assessment, effect of botropic venom and implications for pregnancy, as well as actions for the nursing team to carry out during service, this production will be validated later. Final Considerations: This study had limitations in relation to information on snakebites involving pregnant women, mainly with cases reported in scientific studies in Brazil and in relation to the completeness of the information available in the databases. In view of this, it is believed that the Care Protocol proposed in this dissertation will be of great value in managing cases, especially in the Amazonian Context, and could serve as a basis for future technologies.