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A multifaceted intervention to increase prophylactic oxytocin use during the third stage of labor and to reduce routine episiotomies in Nicaragua.
García-Elorrio, Ezequiel; Aleman, Alicia; Cafferata, Maria L; Colomar, Mercedes; Tomasso, Giselle; Lacayo, Yann; Espinoza, Henry; Villadiego, Shirley; Engelbrecht, Susheela; Althabe, Fernando.
Afiliação
  • García-Elorrio E; Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina. Electronic address: egarciaelorrio@iecs.org.ar.
  • Aleman A; Montevideo Clinical and Epidemiological Research Unit (UNICEM), Montevideo, Uruguay.
  • Cafferata ML; Montevideo Clinical and Epidemiological Research Unit (UNICEM), Montevideo, Uruguay.
  • Colomar M; Montevideo Clinical and Epidemiological Research Unit (UNICEM), Montevideo, Uruguay.
  • Tomasso G; Montevideo Clinical and Epidemiological Research Unit (UNICEM), Montevideo, Uruguay.
  • Lacayo Y; Program for Appropriate Technology in Health (PATH), Managua, Nicaragua.
  • Espinoza H; Program for Appropriate Technology in Health (PATH), Managua, Nicaragua.
  • Villadiego S; Program for Appropriate Technology in Health (PATH), Seattle, WA, USA.
  • Engelbrecht S; Program for Appropriate Technology in Health (PATH), Seattle, WA, USA.
  • Althabe F; Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina.
Int J Gynaecol Obstet ; 127(1): 31-4, 2014 Oct.
Article em En | MEDLINE | ID: mdl-25005056
OBJECTIVE: To assess the effect of a multifaceted intervention among skilled birth attendants on the use of oxytocin during the third stage of labor, the active management of the third stage of labor (AMTSL), and the rate of routine episiotomy during vaginal births in two health districts in Nicaragua. METHODS: An uncontrolled before-and-after study design was used. The rates of oxytocin use in the third stage of labor, AMTSL, and episiotomy were measured for vaginal births occurring in eight hospitals and health centers during 2011-2012, before and after implementation of a multifaceted facility-based intervention. The intervention involved the use of opinion leaders, interactive workshops to develop and implement evidence-based guidelines, academic detailing, the use of reminders, and feedback on the rates of oxytocin use and episiotomy. RESULTS: Oxytocin use during the third stage of labor increased significantly from 95.3% to 97.4% (P=0.003). The episiotomy rate dropped significantly from 31.2% to 21.2% overall, and from 59.6% to 40.5% in primiparous women (P<0.001 for both comparisons). CONCLUSION: The multifaceted intervention improved the targeted care practices during childbirth. However, a further decrease in the routine use of episiotomy would be desirable.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ocitócicos / Ocitocina / Atenção à Saúde / Episiotomia / Hemorragia Pós-Parto Tipo de estudo: Clinical_trials / Guideline / Observational_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Adult / Female / Humans / Male / Pregnancy País/Região como assunto: America central / Nicaragua Idioma: En Revista: Int J Gynaecol Obstet Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
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Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ocitócicos / Ocitocina / Atenção à Saúde / Episiotomia / Hemorragia Pós-Parto Tipo de estudo: Clinical_trials / Guideline / Observational_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Adult / Female / Humans / Male / Pregnancy País/Região como assunto: America central / Nicaragua Idioma: En Revista: Int J Gynaecol Obstet Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos