Document Detail


Advanced life support in obstetrics (ALSO) and post-partum hemorrhage: a prospective intervention study in Tanzania.
MedLine Citation:
PMID:  21388368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Bjarke Lund Sorensen; Vibeke Rasch; Siriel Massawe; Juma Nyakina; Peter Elsass; Birgitte Bruun Nielsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-15
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  90     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-19     Completed Date:  2011-07-18     Revised Date:  2012-02-23    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  609-14     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, Denmark. bjarkebjarke@yahoo.dk
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MeSH Terms
Descriptor/Qualifier:
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:
50-56-6/Oxytocin
Comments/Corrections
Comment In:
Acta Obstet Gynecol Scand. 2012 Feb;91(2):274; author reply 275   [PMID:  22044031 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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