Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade.

Autor: Anger HA; Gynuity Health Projects, New York, New York, United States of America., Durocher J; Gynuity Health Projects, New York, New York, United States of America., Dabash R; Gynuity Health Projects, New York, New York, United States of America., Hassanein N; Obstetrician/Gynecologist Consultant, Alexandria, Egypt., Ononge S; Makerere University School of Health Sciences, Kampala, Uganda., Burkhardt G; Gynuity Health Projects, New York, New York, United States of America.; Department of Obstetrics and Gynecology, University of New Mexico, Albuquerque, New Mexico, United States of America., Frye LJ; Gynuity Health Projects, New York, New York, United States of America., Diop A; Gynuity Health Projects, New York, New York, United States of America., Beye Diop SBM; Centre De Santé Philippe Senghor, Dakar, Senegal., Darwish E; Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt., Ramadan MC; El Galaa Maternity Teaching Hospital, Cairo, Egypt., Kayaga J; Global Health Uganda, Kampala, Uganda., Charles D; Gynuity Health Projects, New York, New York, United States of America., Gaye A; Obstetrician/Gynecologist Consultant, Dakar, Senegal., Eckardt M; Global Health Innovation Lab, Massachusetts General Hospital, Boston, Massachusetts, United States of America., Winikoff B; Gynuity Health Projects, New York, New York, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2021 Feb 08; Vol. 16 (2), pp. e0245988. Date of Electronic Publication: 2021 Feb 08 (Print Publication: 2021).
DOI: 10.1371/journal.pone.0245988
Abstrakt: Objective: We aimed to determine the risk of postpartum infection and increased pain associated with use of condom-catheter uterine balloon tamponade (UBT) among women diagnosed with postpartum hemorrhage (PPH) in three low- and middle-income countries (LMICs). We also sought women's opinions on their overall experience of PPH care.
Methods: This prospective cohort study compared women diagnosed with PPH who received and did not receive UBT (UBT group and no-UBT group, respectively) at 18 secondary level hospitals in Uganda, Egypt, and Senegal that participated in a stepped wedge, cluster-randomized trial assessing UBT introduction. Key outcomes were reported pain (on a scale 0-10) in the immediate postpartum period and receipt of antibiotics within four weeks postpartum (a proxy for postpartum infection). Outcomes related to satisfaction with care and aspects women liked most and least about PPH care were also reported.
Results: Among women diagnosed with PPH, 58 were in the UBT group and 2188 in the no-UBT group. Self-reported, post-discharge antibiotic use within four weeks postpartum was similar in the UBT (3/58, 5.6%) and no-UBT groups (100/2188, 4.6%, risk ratio = 1.22, 95% confidence interval [CI]: 0.45-3.35). A high postpartum pain score of 8-10 was more common among women in the UBT group (17/46, 37.0%) than in the no-UBT group (360/1805, 19.9%, relative risk ratio = 3.64, 95% CI:1.30-10.16). Most women were satisfied with their care (1935/2325, 83.2%). When asked what they liked least about care, the most common responses were that medications (580/1511, 38.4%) and medical supplies (503/1511, 33.3%) were unavailable.
Conclusion: UBT did not increase the risk of postpartum infection among this population. Women who receive UBT may experience higher degrees of pain compared to women who do not receive UBT. Women's satisfaction with their care and stockouts of medications and other supplies deserve greater attention when introducing new technologies like UBT.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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