The Safety and Feasibility of a Family First Aid Approach for the Management of Postpartum Hemorrhage in Home Births: A Pre-post Intervention Study in Rural Pakistan
| Autor: | Dina Abbas, Imtiaz Kamal, Sadiqua N. Jafarey, Rasha Dabash, Yi-Ling Tan, Jill Durocher, Meighan Mary, Arjumand Rabbani, Beverly Winikoff |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Postnatal Care Rural Population medicine.medical_specialty Epidemiology Home deliveries Third trimester Self-care interventions Article Post-intervention 03 medical and health sciences 0302 clinical medicine Primary outcome Pregnancy Intervention (counseling) Oxytocics Medicine First Aid Humans Family Pakistan 030212 general & internal medicine Prospective Studies Misoprostol Home Childbirth 030219 obstetrics & reproductive medicine business.industry Obstetrics Public health Postpartum Hemorrhage Public Health Environmental and Occupational Health Postpartum hemorrhage (PPH) Obstetrics and Gynecology PPH management Pediatrics Perinatology and Child Health Home births Feasibility Studies Female business First aid medicine.drug Program Evaluation |
| Zdroj: | Maternal and Child Health Journal |
| ISSN: | 1573-6628 |
| Popis: | Objective To evaluate the safety and feasibility of a Family First Aid approach whereby women and their families are provided misoprostol in advance to manage postpartum hemorrhage (PPH) in home births. Methods A 12-month prospective, pre-post intervention study was conducted from February 2017 to February 2018. Women in their second and third trimesters were enrolled at home visits. Participants and their families received educational materials and were counseled on how to diagnose excessive bleeding and the importance of seeking care at a facility if PPH occurs. In the intervention phase, participants were also given misoprostol and counselled on how to administer the four 200 mcg tablets for first aid in case of PPH. Participants were followed-up postpartum to collect data on use of misoprostol for Family First Aid at home deliveries (primary outcome) and record maternal and perinatal outcomes. Results Of the 4008 participants enrolled, 97% were successfully followed-up postpartum. Half of the participants in each phase delivered at home. Among home deliveries, the odds of reporting PPH almost doubled among in the intervention phase (OR 1.98; CI 1.43, 2.76). Among those reporting PPH, women in the intervention phase were significantly more likely to have received PPH treatment (OR 10.49; CI 3.37, 32.71) and 90% administered the dose correctly. No maternal deaths, invasive procedures or surgery were reported in either phase after home deliveries. Conclusions The Family First Aid approach is a safe and feasible model of care that provides timely PPH treatment to women delivering at home in rural communities. |
| Databáze: | OpenAIRE |
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