RESUMEN
OBJECTIVE: to portray the creation of a gestational risk classification based on the profile of maternal deaths in a municipality where the rate of these deaths is high, and its use in prenatal care. METHODS: the profile was prepared using records of maternal deaths that occurred between 2008 and 2013, considering age, schooling, race/skin color, place of residence, pre-existing disease, reproductive history. RESULTS: maternal death was most frequent in women of brown/black skin color, aged 30-39, with low schooling, living in socially vulnerable districts and with heart disease as the main pre-existing disease; gestational risk was classified based on this profile, whereby points (1-3) were assigned to each lowest/highest frequency and care priorities (P) were defined - PI=regular risk (4-9pt: routine consultation/examination), PII=high risk (10-16pt: reduce waiting time for consultation/examination by 50%), and PIII=very high Risk (≥17pt: access to consultation/examination within 7 days). CONCLUSION: the new classification improved healthcare professionals' awareness of determinants surrounding maternal death and the need to prioritize access to prenatal care according to risk.