Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade.
<h4>Objective</h4>We aimed to determine the risk of postpartum infection and increased pain associated with use of condom-catheter uterine balloon tamponade (UBT) among women diagnosed with postpartum hemorrhage (PPH) in three low- and middle-income countries (LMICs). We also sought wome...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2021-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0245988 |
| _version_ | 1798033588857339904 |
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| author | Holly A Anger Jill Durocher Rasha Dabash Nevine Hassanein Sam Ononge Gillian Burkhardt Laura J Frye Ayisha Diop Seynabou Bop Moctar Beye Diop Emad Darwish Mohamed Cherine Ramadan Juliana Kayaga Dyanna Charles Alioune Gaye Melody Eckardt Beverly Winikoff |
| author_facet | Holly A Anger Jill Durocher Rasha Dabash Nevine Hassanein Sam Ononge Gillian Burkhardt Laura J Frye Ayisha Diop Seynabou Bop Moctar Beye Diop Emad Darwish Mohamed Cherine Ramadan Juliana Kayaga Dyanna Charles Alioune Gaye Melody Eckardt Beverly Winikoff |
| author_sort | Holly A Anger |
| collection | DOAJ |
| description | <h4>Objective</h4>We aimed to determine the risk of postpartum infection and increased pain associated with use of condom-catheter uterine balloon tamponade (UBT) among women diagnosed with postpartum hemorrhage (PPH) in three low- and middle-income countries (LMICs). We also sought women's opinions on their overall experience of PPH care.<h4>Methods</h4>This prospective cohort study compared women diagnosed with PPH who received and did not receive UBT (UBT group and no-UBT group, respectively) at 18 secondary level hospitals in Uganda, Egypt, and Senegal that participated in a stepped wedge, cluster-randomized trial assessing UBT introduction. Key outcomes were reported pain (on a scale 0-10) in the immediate postpartum period and receipt of antibiotics within four weeks postpartum (a proxy for postpartum infection). Outcomes related to satisfaction with care and aspects women liked most and least about PPH care were also reported.<h4>Results</h4>Among women diagnosed with PPH, 58 were in the UBT group and 2188 in the no-UBT group. Self-reported, post-discharge antibiotic use within four weeks postpartum was similar in the UBT (3/58, 5.6%) and no-UBT groups (100/2188, 4.6%, risk ratio = 1.22, 95% confidence interval [CI]: 0.45-3.35). A high postpartum pain score of 8-10 was more common among women in the UBT group (17/46, 37.0%) than in the no-UBT group (360/1805, 19.9%, relative risk ratio = 3.64, 95% CI:1.30-10.16). Most women were satisfied with their care (1935/2325, 83.2%). When asked what they liked least about care, the most common responses were that medications (580/1511, 38.4%) and medical supplies (503/1511, 33.3%) were unavailable.<h4>Conclusion</h4>UBT did not increase the risk of postpartum infection among this population. Women who receive UBT may experience higher degrees of pain compared to women who do not receive UBT. Women's satisfaction with their care and stockouts of medications and other supplies deserve greater attention when introducing new technologies like UBT. |
| first_indexed | 2024-04-11T20:32:44Z |
| format | Article |
| id | doaj.art-c2d557f96ddf44f989be2396f9da218c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T20:32:44Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-c2d557f96ddf44f989be2396f9da218c2022-12-22T04:04:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01162e024598810.1371/journal.pone.0245988Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade.Holly A AngerJill DurocherRasha DabashNevine HassaneinSam OnongeGillian BurkhardtLaura J FryeAyisha DiopSeynabou Bop Moctar Beye DiopEmad DarwishMohamed Cherine RamadanJuliana KayagaDyanna CharlesAlioune GayeMelody EckardtBeverly Winikoff<h4>Objective</h4>We aimed to determine the risk of postpartum infection and increased pain associated with use of condom-catheter uterine balloon tamponade (UBT) among women diagnosed with postpartum hemorrhage (PPH) in three low- and middle-income countries (LMICs). We also sought women's opinions on their overall experience of PPH care.<h4>Methods</h4>This prospective cohort study compared women diagnosed with PPH who received and did not receive UBT (UBT group and no-UBT group, respectively) at 18 secondary level hospitals in Uganda, Egypt, and Senegal that participated in a stepped wedge, cluster-randomized trial assessing UBT introduction. Key outcomes were reported pain (on a scale 0-10) in the immediate postpartum period and receipt of antibiotics within four weeks postpartum (a proxy for postpartum infection). Outcomes related to satisfaction with care and aspects women liked most and least about PPH care were also reported.<h4>Results</h4>Among women diagnosed with PPH, 58 were in the UBT group and 2188 in the no-UBT group. Self-reported, post-discharge antibiotic use within four weeks postpartum was similar in the UBT (3/58, 5.6%) and no-UBT groups (100/2188, 4.6%, risk ratio = 1.22, 95% confidence interval [CI]: 0.45-3.35). A high postpartum pain score of 8-10 was more common among women in the UBT group (17/46, 37.0%) than in the no-UBT group (360/1805, 19.9%, relative risk ratio = 3.64, 95% CI:1.30-10.16). Most women were satisfied with their care (1935/2325, 83.2%). When asked what they liked least about care, the most common responses were that medications (580/1511, 38.4%) and medical supplies (503/1511, 33.3%) were unavailable.<h4>Conclusion</h4>UBT did not increase the risk of postpartum infection among this population. Women who receive UBT may experience higher degrees of pain compared to women who do not receive UBT. Women's satisfaction with their care and stockouts of medications and other supplies deserve greater attention when introducing new technologies like UBT.https://doi.org/10.1371/journal.pone.0245988 |
| spellingShingle | Holly A Anger Jill Durocher Rasha Dabash Nevine Hassanein Sam Ononge Gillian Burkhardt Laura J Frye Ayisha Diop Seynabou Bop Moctar Beye Diop Emad Darwish Mohamed Cherine Ramadan Juliana Kayaga Dyanna Charles Alioune Gaye Melody Eckardt Beverly Winikoff Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade. PLoS ONE |
| title | Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade. |
| title_full | Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade. |
| title_fullStr | Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade. |
| title_full_unstemmed | Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade. |
| title_short | Postpartum infection, pain and experiences with care among women treated for postpartum hemorrhage in three African countries: A cohort study of women managed with and without condom-catheter uterine balloon tamponade. |
| title_sort | postpartum infection pain and experiences with care among women treated for postpartum hemorrhage in three african countries a cohort study of women managed with and without condom catheter uterine balloon tamponade |
| url | https://doi.org/10.1371/journal.pone.0245988 |
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