PATOLOŠKA TRUDNOĆA KAO UZROK BOLOVANJA U RADNICA ZAPOSLENIH U ZDRAVSTU
Imamović N, Franjkić-Misija P, Tunjić S.
Dom zdravlja Tuzla, Služba specifične zdravstvene zaštite - medicina rada Tuzla, Bosna i Hercegovina

Trudnoća je s biološkog stanovišta posve normalna pojava i čini dio reproduktivne funkcije čovjeka. Ukoliko u trudnoći dođe do fizioloških poremećaja, koji su posljedica prisustva i razvoja ploda u organizmu majke, govorimo o patološkoj trudnoći. Ona zahtjeva liječenje i praćena je privremenom spriječenošću za rad.

CILJ: Interesovala nas je učestalost patoloških trudnoća, najčešća vrsta patološke trudnoće, i u kojoj mjeri su patološke trudnoće uzrok bolovanja u radnica u zdravstvu.

MATERIJAL I METODE: Obrađena je medicinska dokumentacija 574 zdravstvene radnice zaposlene u Domu zdravlja Tuzla u periodu od 1998 - 2002 godine. Izdvojena je grupa od 67 trudnica, a potom analiziran broj, vrsta patološke trudnoće po dobu, dužini radnog staža, zanimanju, ishodu trudnoće, te broju izgubljenih radnih dana, indeksu težine i incidencija bolovanja.

REZULTATI: U analiziranom petogodišnjem periodu bilo je 67 trudnica. U 53 (79,1%) je utvrđena patološka trudnoća, i to u 41 (77,3%) radilo se o prijetećem pobačaju, a u 5 (9,4%) trudnica o gestozi. Prosječna životna dob trudnica bila je 28 godina, a dužina radnog staža 10,1 godina. Po zanimanju 17 (32%) su medicinske sestre, 16 (30,1%) ljekari, te 10 (18,8%) fizioterapeuti. U 31 (58,4%) trudnica radilo se o prvoj, a u 22 (41,5%) o drugoj ili trećoj trudnoći. Ishod patološke trudnoće je u 42 (79,8%) ročni porod, u 2 (3,7%) prijevremeni porod, 4 (7,5%) spontani pobačaj, a u 5 (9,4%) ishod nepoznat. Ukupan broj izgubljenih radnih dana zbog patoloških stanja u trudnoći je 3375, indeks težine je 63,6 dana, a stopa odsutnosti 9,2.

ZAKLJUČAK: Procenat patoloških trudnoća kod radnica u zdravstvu je veoma visok, a posljednih godina je u porastu i to najčešće zbog prijetećeg pobačaja. Broj izgubljenih radnih dana i dužina bolovanja je takođe povećana, ali je i ishod patološke trudnoće u najvećem procentu ročni porod. Neophodno je nastaviti ispitivanje mogućih uzroka negativnog dejstva na tok trudnoće i rađanje zdravog i živog djeteta u zaposlenih žena u zdravstvu.

PATHOLOGICAL PREGNANCY AS A CAUSE FOR SICK LEAVES OF FEMALE WORKERS EMPLOYED IN HEALTH SERVICES
Imamović N, Franjkić-Misija P, Tunjić S.
Health Centre Tuzla, Service of Specific Health Protection - Occupational Medicine, Tuzla, Bosnia and Herzegovina

From biological point of view the pregnancy is a totally normal phenomenon, part of the reproductive function of a human being. If physiological disorders occur during the pregnancy, resulting from the presence and the development of the embryo in the mother's organism, her health condition is disturbed, pathological conditions in pregnancy occurs pathological pregnancy, which call for treatment and sick leaves.

AIM: We were interested in the pathological pregnancy frequency, the most frequent kinds of pathological pregnancies and to which extent these conditions are the reason for sick leaves with the female workers in health services.

MATERIAL AND METHODS: Processed was the medical documentation of 574 female workers at the Health Centre Tuzla over the period between the years 1998 - 2002. There were singled out 67 pregnant women and then the number, the kind of pathological pregnancy by age, by the working service length, profession, pregnancy outcome, and by the number of lost working days, the severity index and sick leave incidence were analysed.

RESULTS: Over the analysed period of five years there were 67 pregnant women. In 53 of them (79,1%) pathological pregnancy was established and with 41 of them (77,3%) it was the case of threatening abortion followed by gestosis in 5 (9,4%) of pregnant women. The average age is 28 years, and the working service length is 10,1 years. Speaking of profession 17 (32%) of them are nurses, l6 (30,1%) are doctors and 10 (18,8%) of them are physioterapeuts. In 31 (58,4%) pregnant woman it was the case of the first pregnancy and in 22 (41,5%) of them it was the case of the second or third pregnancy. The outcome of the pathological pregnancy in 42 (79,8%) is delivery within the term, in 2 (3,7%) were premature, delivery, in 4 (7,5%), spontaneous abortion and in 5 (9,4%) the outcome is unknown. The total number of lost working days, due to the pathological condition during the pregnancy, amounts to 3375, severity index amounts to 63,6 days and the absence rate amounts to 9,2.

CONCLUSION: The percentage of pathological pregnancies with the female workers in the field of the health services is very high and has been increasing over the recent years, mostly owing to the threatening abortion. The number of lost working days and the sick leave length has also been increased but the outcome of the pathological pregnancy is in the highest percentage delivery within the term. It is necessary to go on investigating into the possible causes for the negative effects upon the course of pregnancy of an employed woman in health services and achieving in this way the desire of pregnant woman - a living and healthy child.