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Int J Gynaecol Obstet ; 131(2): 209-15, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26294169

RESUMO

OBJECTIVE: To examine the effects of the Advanced Life Support in Obstetrics (ALSO) program on maternal outcomes in four low-income countries. METHODS: Data were obtained from single-center, longitudinal cohort studies in Colombia, Guatemala, and Honduras, and from an uncontrolled prospective trial in Tanzania. RESULTS: In Colombia, maternal morbidity and the number of near misses increased after ALSO training, but maternal mortality decreased. In Guatemala, sustained reductions in overall maternal mortality and mortality from postpartum hemorrhage (PPH) were recorded after ALSO implementation. In Honduras, there was a significant decrease in episiotomy rates, and increases in active management of the third stage of labor (AMTSL), vacuum-assisted delivery, and reported comfort managing obstetric emergencies. In Tanzania, the frequency of PPH and severe PPH decreased after training, while management improved. CONCLUSION: In low-income countries, ALSO training was associated with decreased in-hospital maternal mortality, episiotomy use, and PPH. AMTSL and vacuum-assisted vaginal delivery increased in frequency after ALSO training.


Assuntos
Países em Desenvolvimento , Cuidados para Prolongar a Vida/métodos , Obstetrícia/educação , Avaliação de Programas e Projetos de Saúde/estatística & dados numéricos , Adulto , Colômbia , Parto Obstétrico/tendências , Feminino , Guatemala , Honduras , Mortalidade Hospitalar/tendências , Humanos , Estudos Longitudinais , Mortalidade Materna/tendências , Near Miss/tendências , Hemorragia Pós-Parto/mortalidade , Gravidez , Estudos Prospectivos , Tanzânia
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