Delays in receiving obstetric care and poor maternal outcomes: results from a national multicentre cross-sectional study

Introduction: In preeclampsia, hypoxemia may result from a number of mechanisms. Preeclampsia remains a complex and poorly understood disease. Currently, there are no reliable predictors of preeclampsia for early diagnosis to avoid adverse maternal or perinatal outcomes. Objective: The objective was to evaluate the efficacy of oxygen saturation (SpO2) as a predictor of adverse maternal outcome in women with preeclampsia. Methodology: We conducted the cross-sectional study on 182 preeclamptic women selected by random sampling technique. They were divided into two groups on the basis of oxygen saturation: 29 preeclamptic women (Group L) having oxygen saturation 95% or below and 153 women (Group H) having oxygen saturation 96% or above. The groups were statistically compared with respect to age, gestational age, proteinuria, severity of hypertension and developing different adverse effect of preeclampsia. Women with any medical disorders were excluded. Results: After statistical analysis, it was seen that the women having Spo2 ≤ 95% (L-Group) had experienced more adverse 2 outcomes. They were more hypertensive and more proteinuric, had higher liver enzyme levels, lower platelet counts, and were more likely to have experienced cardio-respiratory symptoms. Women with adverse outcomes were also more likely to have had therapeutic interventions, including corticosteroids, antihypertensives, and magnesium sulphate. Conclusion: Women having SpO2 ≤ 95% (L-Group) had more adverse 2 outcomes in comparison to SpO2 ≥96%(H-Group).

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Distance as a barrier to obstetric care among indigenous women in Panama: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-034763 ◽

2020 ◽

Vol 10 (3) ◽

pp. e034763

Author(s):

Paloma Acevedo ◽

Sebastian Martinez ◽

Leonardo Pinzon ◽

Emmanuelle Sanchez-Monin ◽

Solis Winters

Keyword(s):

Prenatal Care ◽

Health Services ◽

Health Centre ◽

Obstetric Care ◽

Cross Sectional Study ◽

Indigenous Women ◽

Sectional Study ◽

Cross Sectional ◽

Percentage Points ◽

Care Utilisation

ObjectivesWe assess the relationship between distance to a woman’s assigned health clinic and obstetric care utilisation.DesignWe employ a cross-sectional study design using baseline data from the evaluation of a conditional cash transfer programme to promote greater utilisation of maternal and infant health services. Data were collected between December 2016 and January 2017.SettingThe study is conducted in Ngäbe Buglé, the largest of Panama’s three indigenous territories, where maternal mortality is three times the national average.ParticipantsWe analyse a representative sample of 1336 indigenous women with a birth in the 12 months prior to the survey.Primary and secondary outcome measuresPrimary outcomes include obstetric care utilisation measures for prenatal, childbirth and postpartum events. Secondary outcomes include reasons for not receiving prenatal care, alarming symptoms, child weight at birth and stillbirths or miscarriages.ResultsCompared with women in closest geographic proximity to a health centre (top quintile, Q1), women who lived farthest from a health centre (bottom quintile, Q5) had significantly lower obstetric care utilisation outcomes for critical prenatal, childbirth and postpartum events. Mothers in Q5 were 36 percentage points less likely to have had at least one prenatal care appointment in a hospital, health centre or clinic compared with mothers in Q1 (p<0.01), and 52 percentage points less likely to attend an institutional first appointment (p<0.01). The gap in institutional delivery and postnatal care between mothers in Q1 and Q5 was about 35 percentage points (p<0.01). All utilisation outcomes were negatively correlated with distance, and differences in obstetric care utilisation persisted even when controlling for household wealth, maternal age and maternal education.ConclusionDistance is an important barrier to obstetric care utilisation, with women in more distant locations suffering significantly lower use of prenatal, childbirth and postpartum care compared with women in closer vicinity to a health establishment. Expanding the supply of healthcare and implementing demand side incentives to promote the use of health services in remote communities are relevant policies to reduce disparities in obstetric care utilisation.Trial registration numberAEA Registry (RCT ID AEARCTR-0001751).

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Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study

BMC Pregnancy and Childbirth ◽

10.1186/1471-2393-11-11 ◽

2011 ◽

Vol 11 (1) ◽

Cited By ~ 38

Author(s):

Shamsun Nahar ◽

Morsheda Banu ◽

Hashima E Nasreen

Keyword(s):

Emergency Obstetric Care ◽

Obstetric Care ◽

Cross Sectional Study ◽

Urban Slums ◽

Sectional Study ◽

Cross Sectional ◽

Development Intervention

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Knowledge of partograph and its associated factors among obstetric care providers in North Shoa Zone, Central Ethiopia: a cross sectional study

BMC Research Notes ◽

10.1186/s13104-015-1363-x ◽

2015 ◽

Vol 8 (1) ◽

Cited By ~ 7

Author(s):

Negash Wakgari ◽

Gizachew Assefa Tessema ◽

Abdella Amano

Keyword(s):

Associated Factors ◽

Obstetric Care ◽

Cross Sectional Study ◽

Care Providers ◽

Sectional Study ◽

Cross Sectional ◽

Central Ethiopia ◽

Obstetric Care Providers

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Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-018739 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018739 ◽

Cited By ~ 2

Author(s):

Pontius Bayo ◽

Imose Itua ◽

Suzie Paul Francis ◽

Kofi Boateng ◽

Elijo Omoro Tahir ◽

...

Keyword(s):

Primary Outcome ◽

Postpartum Haemorrhage ◽

South Sudan ◽

Emergency Obstetric Care ◽

Obstetric Care ◽

Cross Sectional Study ◽

Obstetric Complications ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional

ObjectiveTo determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication.DesignThis was a retrospective cross-sectional study.SettingFour primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan.ParticipantsAll admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications.Primary and secondary outcome measuresThe primary outcome was met need for EmOC, which was defined as the proportion of all women with direct major obstetric complications in 2015 treated in health facilities providing EmOC services. The frequency of each complication and the interventions for treatment were the secondary outcomes.ResultsTwo hundred and fifty four major obstetric complications were admitted in 2015 out of 390 expected from 2602 pregnancies, representing 65.13% met need. The met need was highest (88%) for Nyong Payam, an urban area, compared with the other two rural payams, and 98.8% of the complications were treated from the hospital, while no complications were treated from three PHCCs. The most common obstetric complications were abortions (45.7%), prolonged obstructed labour (23.2%) and haemorrhage (16.5%). Evacuation of the uterus for retained products (42.5%), caesarean sections (32.7%) and administration of oxytocin for treatment of postpartum haemorrhage (13.3%) were the most common interventions.ConclusionThe met need for EmOC in Torit County is low, with 35% of women with major obstetric complications not accessing care, and there is disparity with Nyong Payam having a higher met need. We suggest more support supervision to the PHCCs to increase access for the rural population.

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Maternity handover in Kerala: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20183560 ◽

2018 ◽

Vol 5 (9) ◽

pp. 3760 ◽

Cited By ~ 1

Author(s):

Aadil Sheikh ◽

Jessica Dunphy ◽

Claire Humphries ◽

Christina MacArthur ◽

Semira Manaseki-Holland

Keyword(s):

Healthcare Provider ◽

Tertiary Care ◽

Obstetric Care ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Community Health Services ◽

High Rate ◽

Sectional Study ◽

Cross Sectional ◽

The Impact

Background: The objective of the study was to explore the referral system from the community to hospital obstetric care in Kerala, India.Methods: Cross-sectional study. A total of 206 obstetric inpatients in 3 hospitals in Kerala, India completed an orally-administered questionnaire regarding referral and attitudes towards healthcare information.Results: Among 206 respondents, 19 (9%) had been referred from another healthcare provider. In multivariate analysis, referral was independently associated with being in a tertiary hospital (p<0.001). At total of 17 referred women received a document containing hand-written notes from their previous healthcare provider. Just 3 of the documents available to view were formal referral documents; others were test results and/or hospital notes. A total of 170 (86%) of the 206 women thought that receiving documents such as referral letters was important; mostly because it helped them understand their condition and explain it to others (91%).Conclusions: A high rate of self-referral (91%) was reported by obstetric inpatients. It appears that some women who are referred do not receive a formal referral document. Participants thought that receiving referral documents was important. A strong health system requires transfer of information between primary and secondary/tertiary care services, which India is seeking to develop. Further research is needed into why women are not accessing community health services and the impact of the content of referral documents on patient care.

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Utilization of Obstetric Analgesia for Labor Pain Management and Associated Factors among Obstetric Care Providers in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study

Obstetrics and Gynecology International ◽

10.1155/2021/9973001 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Rediet Gido ◽

Tesfaye Assebe Yadeta ◽

Abera Kenay Tura

Keyword(s):

Addis Ababa ◽

Obstetric Care ◽

Cross Sectional Study ◽

Public Hospitals ◽

Labor Pain ◽

Care Providers ◽

Sectional Study ◽

Cross Sectional ◽

Obstetric Analgesia ◽

Obstetric Care Providers

Background. In low-income countries, pain-free labor initiative is an emerging concept and still parturient undergoes through painful labor; this is not different in Ethiopia; despite the national direction to use analgesia for labor pain and strong demand from the women, evidence on utilization of obstetric analgesia for labor pain management in Ethiopia is scarce. The objective of this study was to assess level of obstetric analgesia utilization and associated factors among obstetric care providers in public hospitals in Addis Ababa, Ethiopia. Methods. An institution-based cross-sectional study was used. All obstetric care providers working in labor and delivery units in public hospitals in Addis Ababa were included. The data were collected using a self-administered structured questionnaire. After checking for completeness, data were entered into Epi-data 3.1 and analyzed using SPSS 20. Bivariate and multivariable logistic regressions were used to identify factors associated with utilization of obstetric analgesia. Result. Of 391 obstetric care providers included in the study, 143 (36.6%; 95% CI: 31.5–40.9%) reported providing labor analgesia. Having adequate knowledge (AOR 2.7; 95% CI: 1.37–5.23), ten and more years of work experience (AOR 4.3; 95% CI: 1.81–10.13), and availability of analgesics (AOR 3.3; 95% CI: 1.99–5.53) were significantly associated with providing labor analgesia. Conclusion. Slightly more than 3 in 10 obstetric care providers reported providing labor analgesics to women. Training of providers and ensuring adequate supply of analgesics is required to make sure that women in labor would not suffer from labor pain.

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