| Advanced life support in obstetrics (ALSO) and post-partum hemorrhage: a prospective intervention study in Tanzania. | |
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MedLine Citation:
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PMID: 21388368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the impact of Advanced Life Support in Obstetrics (ALSO) training on staff performance and the incidences of post-partum hemorrhage (PPH) at a regional hospital in Tanzania. DESIGN: Prospective intervention study. SETTING: A regional, referral hospital. POPULATION: A total of 510 women delivered before and 505 after the intervention. METHODS: All high- and mid-level providers involved in childbirth at the hospital attended a two-day ALSO provider course. Staff management was observed and post-partum bleeding assessed at all vaginal deliveries for seven weeks before and seven weeks after the training. MAIN OUTCOME MEASURES: PPH (blood loss ≥500ml), severe PPH (blood loss ≥1000ml) and staff performance to prevent, detect and manage PPH. RESULTS: The incidence of PPH was significantly reduced from 32.9 to 18.2%[RR 0.55 (95%CI: 0.44-0.69)], severe PPH from 9.2 to 4.3%[RR 0.47 (95%CI: 0.29-0.77)]. The active management of the third stage of labor was also significantly improved. There was a significant decrease in episiotomies. By visual estimation, staff identified one in 25 of the PPH cases before the ALSO training and one in five after the training. A significantly higher proportion of women with PPH had continuous uterine massage, oxytocin infusion and bimanual compression of the uterus after the training. CONCLUSIONS: A two-day ALSO training course can significantly improve staff performance and reduce the incidence of PPH, at least as evaluated by short-term effects. |
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Authors:
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Bjarke Lund Sorensen; Vibeke Rasch; Siriel Massawe; Juma Nyakina; Peter Elsass; Birgitte Bruun Nielsen |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2011-04-15 |
Journal Detail:
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Title: Acta obstetricia et gynecologica Scandinavica Volume: 90 ISSN: 1600-0412 ISO Abbreviation: Acta Obstet Gynecol Scand Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-05-19 Completed Date: 2011-07-18 Revised Date: 2012-02-23 |
Medline Journal Info:
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Nlm Unique ID: 0370343 Medline TA: Acta Obstet Gynecol Scand Country: England |
Other Details:
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Languages: eng Pagination: 609-14 Citation Subset: IM |
Copyright Information:
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© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology. |
Affiliation:
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Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Denmark. bjarkebjarke@yahoo.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Cardiopulmonary Resuscitation* Episiotomy / statistics & numerical data Female Hospitals, District / statistics & numerical data Humans Incidence Infant, Newborn Inservice Training* Labor, Obstetric* Life Support Care / methods* Massage Medical Staff, Hospital / education* Nursing Staff, Hospital / education* Oxytocin / administration & dosage Postpartum Hemorrhage / epidemiology*, prevention & control* Pregnancy Prospective Studies Tanzania / epidemiology Uterus |
| Chemical | |
Reg. No./Substance:
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50-56-6/Oxytocin |
| Comments/Corrections | |
Comment In:
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Acta Obstet Gynecol Scand. 2012 Feb;91(2):274; author reply 275
[PMID:
22044031
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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