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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...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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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 |
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author | 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 |
author_facet | 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 |
author_sort | Poppens, McKayla |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10156771 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-101567712023-05-05 In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort 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 World J Surg Surgery in Low and Middle Income Countries 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. Springer International Publishing 2023-03-10 2023 /pmc/articles/PMC10156771/ /pubmed/36897375 http://dx.doi.org/10.1007/s00268-023-06964-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Surgery in Low and Middle Income Countries 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 In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort |
title | In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort |
title_full | In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort |
title_fullStr | In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort |
title_full_unstemmed | In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort |
title_short | In-Hospital Obstetric Delays in Rural Uganda: A Cross-Sectional Analysis of a Hospital Cohort |
title_sort | in-hospital obstetric delays in rural uganda: a cross-sectional analysis of a hospital cohort |
topic | Surgery in Low and Middle Income Countries |
url | 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 |
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