CGPH FACULTY: Suellen Miller
DATE OF PUBLICATION: November 2014
REGION: Africa
REFERENCE: Butrick E, Penn A, Itakura K, Mkumba G, Winter K, Amafumba R, Miller S. Access to transport for women with hypovolemic shock differs according to weeks of pregnancy. Int J Gynaecol Obstet. 2014 Nov;127(2):171-4. doi: 10.1016/j.ijgo.2014.05.008. Epub 2014 Jun 27.
SUMMARY/ABSTRACT: The objective was to examine whether women with hypovolemic shock secondary to obstetric hemorrhage are transported to referral hospitals differently depending on weeks of pregnancy in Zambia. In a retrospective study, transport type, wait time, and transit time were assessed for women with obstetric hemorrhage and hypovolemic shock transported from 26 primary health centers to three referral hospitals during 2007-2012. A mean arterial pressure of less than 60 mm Hg was used to indicate severe shock. Women were split into two categories on the basis of the number of weeks of pregnancy (<24 weeks vs ≥24 weeks). Women at 24 weeks of pregnancy or more were given preference for ambulance transport even when signs of shock were equivalent. Policy-makers aiming to lower maternal mortality need to address transport issues regardless of the etiology of hemorrhage or week of pregnancy.
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