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Audit of a program to increase the use of vacuum extraction in Mulago Hospital, Uganda

Overview of attention for article published in BMC Pregnancy and Childbirth, September 2016
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Citations

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86 Mendeley
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Title
Audit of a program to increase the use of vacuum extraction in Mulago Hospital, Uganda
Published in
BMC Pregnancy and Childbirth, September 2016
DOI 10.1186/s12884-016-1052-3
Pubmed ID
Authors

Barbara Nolens, John Lule, Flavia Namiiro, Jos van Roosmalen, Josaphat Byamugisha

Abstract

Prolonged second stage of labour is a major cause of perinatal and maternal morbidity and mortality in low-income countries. Vacuum extraction is a proven effective intervention, hardly used in Africa. Many authors and organisations recommend (re)introduction of vacuum extraction, but successful implementation has not been reported. In 2012, a program to increase the use of vacuum extraction was implemented in Mulago Hospital, Uganda. The program consisted of development of a vacuum extraction guideline, supply of equipment and training of staff. The objective of this study was to investigate the impact of the program. Audit of a quality improvement intervention with before and after measurement of outcome parameters. Mulago Hospital, the national referral hospital for Uganda with approximately 33 000 deliveries per year. It is the university teaching hospital for Makerere University and most of the countries doctors and midwives are trained here. Data was collected from hospital registers and medical files for a period of two years. Main outcome measures were vacuum extraction rate, intrapartum stillbirth, neonatal death, uterine rupture, maternal death and decision to delivery interval. Mode of delivery and outcome of 12 143 deliveries before and 34 894 deliveries after implementation of the program were analysed. The vacuum extraction rate increased from 0.6 - 2.4 % of deliveries (p < 0.01) and was still rising after 18 months. There was a decline in intrapartum stillbirths from 34 to 26 per 1000 births (-23.6 %, p < 0.01) and women with uterine rupture from 1.1 - 0.8 per 100 births (-25.5 %, p < 0.01). Decision to delivery interval for vacuum extraction was four hours shorter than for caesarean section. A program to increase the use of vacuum extraction was successful in a high-volume university hospital in sub-Saharan Africa. The use of vacuum extraction increased. An association with improved maternal and perinatal outcome is strongly suggested. We recommend broad implementation of vacuum extraction, whereby university hospitals like Mulago Hospital can play an important role.To support implementation, we recommend further research into outcome of vacuum extraction and into vacuum extraction devices for low-income countries. Such studies are now in progress at Mulago Hospital.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 86 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 86 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 24 28%
Researcher 14 16%
Student > Ph. D. Student 8 9%
Student > Bachelor 8 9%
Student > Postgraduate 6 7%
Other 9 10%
Unknown 17 20%
Readers by discipline Count As %
Medicine and Dentistry 32 37%
Nursing and Health Professions 13 15%
Social Sciences 9 10%
Psychology 4 5%
Engineering 1 1%
Other 8 9%
Unknown 19 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 September 2016.
All research outputs
#4,204,354
of 8,342,643 outputs
Outputs from BMC Pregnancy and Childbirth
#1,188
of 1,688 outputs
Outputs of similar age
#128,022
of 252,381 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#74
of 100 outputs
Altmetric has tracked 8,342,643 research outputs across all sources so far. This one is in the 47th percentile – i.e., 47% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,688 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one is in the 26th percentile – i.e., 26% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 252,381 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 45th percentile – i.e., 45% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 100 others from the same source and published within six weeks on either side of this one. This one is in the 23rd percentile – i.e., 23% of its contemporaries scored the same or lower than it.