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In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort

BACKGROUND: Deaths related to pregnancy and childbirth are extremely high in low-resource countries such as Uganda. Maternal mortality in low- and middle-income countries is related to delays in seeking, reaching, and receiving adequate health care. This study aimed to investigate the in-hospital de...

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Detalles Bibliográficos
Autores principales: Poppens, McKayla, Oke, Rasheedat, Carvalho, Melissa, Ledesma, Yeranui, Okullu, Silas, Ariokot, Mary Goretty, Agwang, Esther, Ekuchu, Peter, Wange, Hyginus, Boeck, Marissa, Juillard, Catherine, Ajiko, Mary Margaret, Dicker, Rochelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10156771/
https://www.ncbi.nlm.nih.gov/pubmed/36897375
http://dx.doi.org/10.1007/s00268-023-06964-z
Descripción
Sumario:BACKGROUND: Deaths related to pregnancy and childbirth are extremely high in low-resource countries such as Uganda. Maternal mortality in low- and middle-income countries is related to delays in seeking, reaching, and receiving adequate health care. This study aimed to investigate the in-hospital delays to surgical care for women in labor arriving to Soroti Regional Referral Hospital (SRRH). METHODS: From January 2017 to August 2020, we collected data on obstetric surgical patients in labor using a locally developed, context-specific obstetrics surgical registry. Data regarding patient demographics, clinical and operative characteristics, as well as delays in care and outcomes were documented. Descriptive and multivariate statistical analyses were conducted. RESULTS: A total of 3189 patients were treated during our study period. Median age was 23 years, most gestations were at term (97%) at the time of operation, and nearly all patients underwent Cesarean Section (98.8%). Notably, 61.7% of patients experienced at least one delay in their surgical care at SRRH. Lack of surgical space was the greatest contributor to delay (59.9%), followed by lack of supplies or personnel. The significant independent predictors of delayed care were having a prenatal acquired infection (AOR 1.73, 95% CI 1.43–2.09) and length of symptoms less than 12 h (AOR 0.32, 95% CI 0.26–0.39) or greater than 24 h (AOR 2.61, 95% CI 2.18–3.12). CONCLUSION: In rural Uganda, there is a significant need for financial investment and commitment of resources to expand surgical infrastructure and improve care for mothers and neonates.