Day hospital in obstetrics

Abstract

Introduction: Gestational diabetes requires an interdisciplinary approach that guarantees timely diagnosis, early initiation of treatment, therapeutic education, and continuous follow-up throughout pregnancy. Different organizational models of Day Hospitals, adapted to the characteristics and resources of each institution, are implemented in public hospitals in Northeast Argentina.

Objective: To describe the organization and clinical activity of Day Hospital models for Gestational Diabetes implemented in four public hospitals in Northeast Argentina.

Materials and Methods: A description was made of the care models developed at the Ángela I. de Llano Hospital and the José R. Vidal Hospital (Corrientes), the Julio C. Perrando Hospital (Resistencia), and the Posadas Maternal and Neonatal Hospital (Misiones).

At the Ángela I. de Llano Hospital, the Day Hospital operates on Wednesdays and Fridays, providing an average of 30 medical consultations per week. At the José Ramón Vidal Hospital, the operation is similar, with 50 medical consultations per week.

In both, care includes an initial nursing evaluation, clinical and anthropometric monitoring, education on self-monitoring of blood glucose and insulin therapy, joint care by a diabetologist and obstetrician, nutritional assessment, distribution of educational materials from the EduGest Project, and provision of insulin and test strips.

At the Julio C. Perrando Hospital, care is organized through protected appointments coordinated between Obstetrics and Nutrition and Diabetes, with an average of 75 medical consultations per week. The process includes diabetological, obstetric, and nutritional evaluations, dietary education, and joint follow-up. Patients requiring intensive care are seen at the Day Hospital of the Obstetrics and Gynecology Service. At the Posadas Maternal and Neonatal Hospital, the Day Hospital integrates gestational diabetes care into the monitoring of high-risk pregnancies. It has four beds, two reclining chairs, a nurse educator's office, daily educational workshops for four pregnant women, a glucometer bank, and an interdisciplinary team comprised of specialists in obstetrics, diabetology, nutrition, fetal medicine, mental health, social work, cardiology, dentistry, and kinesiology.

Conclusions: The implemented models demonstrate that the Day Hospital constitutes a flexible organizational strategy for the interdisciplinary care of gestational diabetes. Despite differences in operational modalities, they promote timely access, therapeutic education, interdisciplinary coordination, and continuity of care, optimizing care for pregnant women with diabetes in public hospitals in the Northeast region of Argentina.