Faculty of Nursing, Kilimanjaro Christian Medical University College, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Sex Reprod Healthc. 2021 Sep;29:100646. doi: 10.1016/j.srhc.2021.100646. Epub 2021 Jul 10.
Timely identification of danger signs and prompt referral to higher level may prevent complication associated with childbirth. With a high MMR in Tanzania, there is need to highlight the information on the proportion of women referred to tertiary healthcare, their basic characteristics and outcomes. This study aimed to determine the proportion, basic characteristics and outcomes among women referred while in labour, from lower health facilities to a tertiary hospital in northern Tanzania.
A descriptive retrospective study based on a hospital birth registry was conducted using consecutive stored data on pregnant women referred while in labour and managed at a tertiary hospital in northern Tanzania, between the years 2000 and 2015.
During the study period, a total of 53,662 deliveries were managed. Among these, 6066 women were referred from lower health facilities, with 4193 (69.2%) of them being referred while in labour. The main reason for referral was poor progress of labour (31.0%), followed by prolonged labour (27.1%) and obstructed labour (19.5%). The rate of caesarean section was 44.6%. A total of 292 maternal deaths occurred between 2000 and 2015. Of these, almost a quarter (22.6%) occurred in women referred from other health facilities while in labour.
Majority of referred women while in labour from lower health facilities are linked to maternal complications associated with childbirth. This underscores the need to further explore the competence of lower health facilities to quickly detect complications and provide effective emergency obstetric care, as well as timely referral to higher-level facility.
及时识别危险信号并迅速转诊至更高一级医疗机构，可预防分娩相关并发症。坦桑尼亚的孕产妇死亡率较高，因此需要强调将妇女转诊至三级保健机构的比例、其基本特征和结局方面的信息。本研究旨在确定在坦桑尼亚北部，从较低级别卫生机构转诊至三级医院分娩的妇女的比例、基本特征和结局。
这是一项基于医院分娩登记的描述性回顾性研究，使用了坦桑尼亚北部一家三级医院连续存储的、关于在分娩时转诊并接受管理的孕妇数据。
在研究期间，共管理了 53662 例分娩。其中，6066 例来自较低级别的卫生机构，其中 4193 例（69.2%）是在分娩时转诊的。转诊的主要原因是产程进展不良（31.0%），其次是产程延长（27.1%）和产道梗阻（19.5%）。剖宫产率为 44.6%。2000 年至 2015 年期间，共有 292 例产妇死亡。其中，将近四分之一（22.6%）发生在分娩时从其他卫生机构转诊来的妇女中。
来自较低级别卫生机构的分娩时转诊的大多数妇女都与分娩相关的产妇并发症有关。这突显出需要进一步探讨较低级别卫生机构的能力，以快速发现并发症并提供有效的紧急产科护理，以及及时转诊至更高一级的机构。
