Use of a criteria-based audit to optimize uptake of cesarean delivery in a low-resource setting

被引:1
作者
Mgaya, Andrew H. [1 ,2 ]
Kidanto, Hussein L. [2 ,3 ]
Nystrom, Lennarth [4 ]
Essen, Birgitta [2 ]
机构
[1] Muhimbili Natl Hosp, Dept Obstet & Gynaecol, Dar Es Salaam, Tanzania
[2] Uppsala Univ, Dept Womens & Childrens Hlth, Int Maternal & Child Hlth, Uppsala, Sweden
[3] Minist Hlth Community Dev Gender Elderly & Childr, Reprod & Child Hlth, Dar Es Salaam, Tanzania
[4] Umea Univ, Dept Publ Hlth & Clin Med, Epidemiol & Global Hlth Unit, Umea, Sweden
关键词
Cesarean delivery; Criteria-based audit; Fetal distress; Low-resource setting; Obstructed labor; Robson classification; SECTION; QUALITY;
D O I
10.1002/ijgo.12726
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective To evaluate the impact of a criteria-based audit (CBA) of obstructed labor and fetal distress on cesarean delivery and perinatal outcomes. Methods A cross-sectional study was performed at a tertiary referral hospital in Tanzania. Data were collected before and after CBA (January 2013-November 2013 and July 2015-June 2016). Outcomes of fetal distress (baseline CBA, n=248; re-audit, n=251) and obstructed labor (baseline CBA, n=260; re-audit n=250) were assessed using a checklist. Additionally, 27 960 parturients were assessed using the Robson classification. Results Perinatal morbidity and mortality decreased from 42 of 260 (16.2%) to 22 of 250 (8.8%) among patients with obstructed labor after CBA (P=0.012). Cesarean delivery rate decreased for referred term multiparas with induced labor or prelabor cesarean delivery (odds ratio [OR] 0.28, 95% confidence interval [CI] 0.09-0.82). Cesarean delivery rate for preterm pregnancies increased among both referred (OR 1.28, 95% CI 1.02-1.63) and non-referred (OR 2.78, 95% CI 1.98-3.90) groups. Neonatal distress rate decreased for referred term multiparas (OR 0.72, 95% CI 0.56-0.92), referred preterm pregnancies (OR 0.32, 95% CI 0.25-0.39), and non-referred preterm pregnancies (OR 0.26, 95% CI 0.18-0.36). Conclusion Use of CBA reduced poor perinatal outcomes of obstructed labor and increased uptake of cesarean delivery.
引用
收藏
页码:199 / 209
页数:11
相关论文
共 24 条
  • [21] Impact of early continuous positive airway pressure in the delivery room (DR-CPAP) on neonates < 1500 g in a low-resource setting: a protocol for a pilot feasibility and acceptability randomized controlled trial
    Burgoine, Kathy
    Ssenkusu, John M.
    Nakiyemba, Alice
    Okello, Francis
    Napyo, Agnes
    Hagmann, Cornelia
    Namuyonga, Judith
    Hewitt-Smith, Adam
    Martha, Muduwa
    Loe, Kate
    Grace, Abongo
    Denis, Amorut
    Wandabwa, Julius
    Olupot-Olupot, Peter
    PILOT AND FEASIBILITY STUDIES, 2024, 10 (01)
  • [22] Trends in caesarean section rates between 2007 and 2013 in obstetric risk groups inspired by the Robson classification: results from population-based surveys in a low-resource setting
    Hanson, C.
    Betran, A. P.
    Opondo, C.
    Mkumbo, E.
    Manzi, F.
    Mbaruku, G.
    Schellenberg, J.
    BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 2019, 126 (06) : 690 - 700
  • [23] Introduction of a standardised protocol, including systematic use of tranexamic acid, for management of severe adult trauma patients in a low-resource setting: the MSF experience from Port-au-Prince, Haiti
    Alessandro Jachetti
    Rose Berly Massénat
    Nathalie Edema
    Sophia C. Woolley
    Guido Benedetti
    Rafael Van Den Bergh
    Miguel Trelles
    BMC Emergency Medicine, 19
  • [24] Introduction of a standardised protocol, including systematic use of tranexamic acid, for management of severe adult trauma patients in a low-resource setting: the MSF experience from Port-au-Prince, Haiti
    Jachetti, Alessandro
    Massenat, Rose Berly
    Edema, Nathalie
    Woolley, Sophia C.
    Benedetti, Guido
    Van Den Bergh, Rafael
    Trelles, Miguel
    BMC EMERGENCY MEDICINE, 2019, 19 (01)