The relationship between the use of the partograph and birth outcomes at Korle-Bu teaching hospital
| Autor: | Florence Gans-Lartey, Faustina Oware Gyekye, Beverley O'Brien, Donald Schopflocher |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Cross-sectional study MEDLINE Psychological intervention Developing country Ghana Uterine Monitoring Nursing Pregnancy Maternity and Midwifery medicine Humans Fetal Monitoring Hospitals Teaching Diagnostic Equipment Retrospective Studies Labor Obstetric business.industry Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Retrospective cohort study medicine.disease Obstetric Labor Complications Cross-Sectional Studies Maternal Mortality Family medicine Apgar Score Female Maternal death Apgar score business |
| Zdroj: | Midwifery. 29:461-467 |
| ISSN: | 0266-6138 |
| DOI: | 10.1016/j.midw.2012.03.002 |
| Popis: | Objective maternal mortality represents the single greatest health disparity between high and low income countries. This inequity is especially felt in low income countries in sub Saharan Africa and Southeast Asia where 99% of the global burden of maternal death is borne. A goal of MDG 5 is to reduce maternal mortality and have a skilled attendant at every birth by 2015. A critical skill is ongoing intrapartum monitoring of labour progress and maternal/fetal well-being. The WHO partograph was designed to assess these parameters. Design and setting a retrospective review of charts ( n =1,845) retrieved consecutively over a 2 month period in a tertiary teaching hospital in Ghana was conducted to assess the adequacy of partograph use by skilled birth attendants and the timeliness of action taken if the action line was crossed. WHO guidelines were implemented to assess the adequacy of partograph use and how this affected maternal neonatal outcomes. Further, the timeliness and type of action taken if action line was crossed was assessed. Findings partographs were adequately completed in accordance with WHO guidelines only 25.6% (472) of the time and some data appeared to be entered retrospectively. Partograph use was associated with less maternal blood loss and neonatal injuries. When the action line was crossed (464), timely action was taken only 48.7% of the time and was associated with less assisted delivery and a fewer low Apgar scores and NICU admissions. Conclusion when adequately used and timely interventions taken, the partograph was an effective tool. Feasibility of partograph use requires more scrutiny; particularly identification of minimum frequency for safe monitoring and key variables as well as a better understanding of why skilled attendants have not consistently ‘bought in' to partograph use. Frontline workers need access to ongoing and current education and strategically placed algorhythims. |
| Databáze: | OpenAIRE |
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