Assessment of Acute Obstetrical Needs and the Potential Utility of Point-Of-Care Ultrasound in the North East Region of Haiti: A Cross-Sectional Study.
Abortion, Spontaneous
/ diagnostic imaging
Abruptio Placentae
/ diagnostic imaging
Acute Disease
Adult
Breech Presentation
/ diagnostic imaging
Cephalopelvic Disproportion
/ diagnostic imaging
Cesarean Section
Cross-Sectional Studies
Delivery, Obstetric
Female
Haiti
Humans
Labor Presentation
Maternal Mortality
Obstetric Labor Complications
/ diagnostic imaging
Obstetrics
Patient Transfer
Perinatal Mortality
Placenta Previa
/ diagnostic imaging
Point-of-Care Systems
Point-of-Care Testing
Postpartum Hemorrhage
Pregnancy
Pregnancy, Ectopic
/ diagnostic imaging
Pregnancy, Multiple
Ultrasonography, Prenatal
Young Adult
Journal
Annals of global health
ISSN: 2214-9996
Titre abrégé: Ann Glob Health
Pays: United States
ID NLM: 101620864
Informations de publication
Date de publication:
03 07 2020
03 07 2020
Historique:
entrez:
18
7
2020
pubmed:
18
7
2020
medline:
6
7
2021
Statut:
epublish
Résumé
Point-of-care ultrasound (POCUS) implemented through task shifting to nontraditional users has potential as a diagnostic adjuvant to enhance acute obstetrical care in resource-constrained environments with limited access to physician providers. This study evaluated acute obstetrical needs and the potential role for POCUS programming in the North East region of Haiti. Data was collected on all women presenting to the obstetrical departments of two Ministry of Public Health and Population (MSPP)-affiliated public hospitals in the North East region of Haiti: Fort Liberté Hospital and Centre Medicosocial de Ouanaminthe. Data was obtained via retrospective review of hospital records from January 1 through March 31, 2016. Trained personnel gathered data on demographics, obstetrical history, diagnoses, clinical care and outcomes using a standardized tool. Diagnoses Data were collected from 589 patients during the study period. Median maternal age was 26 years and median gestational age was 38 weeks. The most common reason for seeking care was pelvic pain (85.2%). Sixty-seven (11.5%) women were transferred to other facilities for higher-level care. Among cases not transferred, post-partum hemorrhage, infant mortality and maternal mortality occurred in 2.4%, 3.0% and 0.6% of cases, respectively. There were 69 cases with diagnoses that could have benefited from POCUS use. Between sites, significantly more cases had the potential for improved diagnostics with POCUS at Fort Liberté Hospital (19.8%) than Centre Medicosocial de Ouanaminthe (8.2%) (p < 0.001). Acute obstetrical care is common and POCUS has the potential to impact the care of obstetrical patients in the North East region of Haiti. Future programs evaluating the feasibility of task shifting and the sustainable impacts of acute obstetric POCUS in Haiti will be important.
Sections du résumé
Background
Point-of-care ultrasound (POCUS) implemented through task shifting to nontraditional users has potential as a diagnostic adjuvant to enhance acute obstetrical care in resource-constrained environments with limited access to physician providers.
Objective
This study evaluated acute obstetrical needs and the potential role for POCUS programming in the North East region of Haiti.
Methods
Data was collected on all women presenting to the obstetrical departments of two Ministry of Public Health and Population (MSPP)-affiliated public hospitals in the North East region of Haiti: Fort Liberté Hospital and Centre Medicosocial de Ouanaminthe. Data was obtained via retrospective review of hospital records from January 1 through March 31, 2016. Trained personnel gathered data on demographics, obstetrical history, diagnoses, clinical care and outcomes using a standardized tool. Diagnoses
Results
Data were collected from 589 patients during the study period. Median maternal age was 26 years and median gestational age was 38 weeks. The most common reason for seeking care was pelvic pain (85.2%). Sixty-seven (11.5%) women were transferred to other facilities for higher-level care. Among cases not transferred, post-partum hemorrhage, infant mortality and maternal mortality occurred in 2.4%, 3.0% and 0.6% of cases, respectively. There were 69 cases with diagnoses that could have benefited from POCUS use. Between sites, significantly more cases had the potential for improved diagnostics with POCUS at Fort Liberté Hospital (19.8%) than Centre Medicosocial de Ouanaminthe (8.2%) (p < 0.001).
Conclusion
Acute obstetrical care is common and POCUS has the potential to impact the care of obstetrical patients in the North East region of Haiti. Future programs evaluating the feasibility of task shifting and the sustainable impacts of acute obstetric POCUS in Haiti will be important.
Identifiants
pubmed: 32676301
doi: 10.5334/aogh.2597
pmc: PMC7333557
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
72Informations de copyright
Copyright: © 2020 The Author(s).
Déclaration de conflit d'intérêts
The authors have no competing interests to declare.
Références
Am J Clin Nutr. 2015 Oct;102(4):721-8
pubmed: 26245806
N Engl J Med. 1995 Apr 27;332(17):1113-7
pubmed: 7700283
J Ultrasound Med. 2010 Apr;29(4):673-7
pubmed: 20375391
Trans R Soc Trop Med Hyg. 2013 Jul;107(7):405-10
pubmed: 23764740
Obstet Gynecol. 2004 Oct;104(4):727-33
pubmed: 15458893
Am J Trop Med Hyg. 1999 Jan;60(1):119-23
pubmed: 9988334
Am J Obstet Gynecol. 1999 Nov;181(5 Pt 1):1216-21
pubmed: 10561648
J Ultrasound Med. 2008 Dec;27(12):1735-43
pubmed: 19022999
Prehosp Disaster Med. 2015 Dec;30(6):599-605
pubmed: 26548802
Int J Epidemiol. 2020 Jan 13;:
pubmed: 31930286
Am J Emerg Med. 2010 Oct;28(8):970-1
pubmed: 20708876
Prehosp Disaster Med. 2015 Dec;30(6):553-9
pubmed: 26487267
BMC Int Health Hum Rights. 2009 Mar 27;9:4
pubmed: 19327157
PLoS Med. 2017 May 30;14(5):e1002307
pubmed: 28558024