Bradley S E K, Prata N, Young-Lin N, Bishai D M
Constella Futures, One Thomas Circle NW, Washington, DC, USA.
Int J Gynaecol Obstet. 2007 Apr;97(1):52-6. doi: 10.1016/j.ijgo.2006.12.005. Epub 2007 Feb 20.
To test the cost-effectiveness of training traditional birth attendants (TBAs) to recognize postpartum hemorrhage (PPH) and administer a rectal dose of misoprostol in areas with low access to modern delivery facilities.
A cost-effectiveness analysis, modeling two hypothetical cohorts of 10,000 women each giving birth with TBAs: one under standard treatment (TBA referral to hospital after blood loss >or=500 ml), and one attended by TBAs trained to recognize PPH and to administer 1000 microg of misoprostol at blood loss >or=500 ml.
The misoprostol strategy could prevent 1647 cases of severe PPH (range: 810-2920) and save $115,335 in costs of referral, IV therapy and transfusions (range: $13,991-$1,563,593) per 10,000 births. By preventing severe disease and saving money, it dominates the standard approach.
Training TBAs to administer misoprostol to treat PPH has the potential to both save money and improve the health of mothers in low-resource settings.
在难以获得现代分娩设施的地区，测试培训传统助产士（TBA）识别产后出血（PPH）并直肠给予米索前列醇剂量的成本效益。
进行成本效益分析，对两组各10000名由传统助产士接生的假设队列进行建模：一组采用标准治疗（失血≥500毫升后将传统助产士转诊至医院），另一组由经过培训以识别产后出血并在失血≥500毫升时给予1000微克米索前列醇的传统助产士接生。
米索前列醇策略每10000例分娩可预防1647例严重产后出血（范围：810 - 2920例），并在转诊、静脉治疗和输血成本方面节省115335美元（范围：13991 - 1563593美元）。通过预防严重疾病和节省资金，该策略优于标准方法。
培训传统助产士使用米索前列醇治疗产后出血有可能在资源匮乏地区既节省资金又改善母亲的健康状况。
