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便携式产科超声服务创新在埃塞俄比亚半城市卫生中心避免母婴发病率和死亡率方面的贡献:一项回顾性基于设施的研究。

Contribution of portable obstetric ultrasound service innovation in averting maternal and neonatal morbidities and mortalities at semi-urban health centers of Ethiopia: a retrospective facility-based study.

机构信息

USAID Transform: Primary Health Care Activity, JSI Research & Training Institute Inc, Addis Ababa, Ethiopia.

Ministry of Health, Maternal and Child Health Directorate, Addis Ababa, Ethiopia.

出版信息

BMC Pregnancy Childbirth. 2022 Apr 28;22(1):368. doi: 10.1186/s12884-022-04703-1.

Abstract

BACKGROUND

The maternal and neonatal mortalities in Ethiopia are high. To achieve the Sustainable Development Goals, innovations in ultrasound scanning and surveillance activities have been implemented at health centers for over 2 years. This study aims to estimate the contribution of obstetric ultrasound services on averted maternal and neonatal morbidities and mortalities in Ethiopia.

METHODS

A retrospective facility-based cross-sectional study design was conducted in 25 selected health centers. Data were extracted from prenatal ultrasound registers. SPSS version 25 was used for analysis. To claim statistically significant relationship among sartorial variables, a chi-square test was analyzed and P < 0.05 was the cut-off point.

RESULTS

Over the 2 years, 12,975 pregnant women were scanned and 52.8% of them were residing in rural areas. Abnormal ultrasound was reported in 12.7% and 98.4% of them were referred for confirmation of diagnosis and treatment. The ultrasound service has contributed to the prevention of 1,970 maternal and 19.05 neonatal morbidities and mortalities per 100,000 and 1,000 live births respectively. The averted morbidities and mortalities showed a statistically significant difference among women residing in rural and semi-urban areas, X, df (10) = 24.07, P = 0. 007 and X, df (5) = 20.87. P = 0.00, 1 respectively.

CONCLUSION

After availing the appropriate ultrasound machines with essential supplies and capacitating mid-level providers, significant number of high-risk pregnant women were identified on time and managed or referred to health facilities with safe delivery services. Therefore, scaling-up limited obstetric ultrasound services in similar setups will contribute to achieving the Sustainable Development Goals by 2030. It is recommended to enhance community awareness for improved utilization of ultrasound services by pregnant women before the 24th week of gestational age.

摘要

背景

埃塞俄比亚的母婴死亡率很高。为了实现可持续发展目标,在过去的两年中,已经在卫生中心实施了超声扫描和监测活动方面的创新。本研究旨在评估产科超声服务对埃塞俄比亚母婴发病率和死亡率的降低作用。

方法

采用回顾性基于机构的横断面研究设计,在 25 个选定的卫生中心进行。数据从产前超声登记册中提取。使用 SPSS 版本 25 进行分析。为了在变量之间声称存在统计学上的显著关系,进行了卡方检验,并且 P < 0.05 作为截止点。

结果

在过去的两年中,对 12975 名孕妇进行了扫描,其中 52.8%的孕妇居住在农村地区。报告了 12.7%的异常超声,其中 98.4%的孕妇被转诊以确认诊断和治疗。超声服务对预防每 10 万例和每 1000 例活产中的 1970 例产妇发病率和 19.05 例新生儿发病率和死亡率做出了贡献。在农村和半城市地区的妇女中,超声服务预防的发病率和死亡率存在统计学上的显著差异,X,df(10)= 24.07,P = 0.007 和 X,df(5)= 20.87,P = 0.001。

结论

在提供适当的超声机和基本用品并为中级提供者提供能力建设后,及时识别出大量高危孕妇,并对其进行管理或转诊至提供安全分娩服务的卫生机构。因此,在类似环境中扩大有限的产科超声服务将有助于在 2030 年前实现可持续发展目标。建议提高社区意识,以改善孕妇在妊娠 24 周前利用超声服务的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7381/9052561/0cecebcae96e/12884_2022_4703_Fig1_HTML.jpg

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