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High proportions of obstetric referrals in Addis Ababa: the case of term premature rupture of membranes

Overview of attention for article published in BMC Research Notes, January 2016
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Title
High proportions of obstetric referrals in Addis Ababa: the case of term premature rupture of membranes
Published in
BMC Research Notes, January 2016
DOI 10.1186/s13104-016-1852-6
Pubmed ID
Authors

Alemnesh H. Mirkuzie, Mitike Molla Sisay, Mulu Muleta Bedane

Abstract

The Public Health Centers (HCs) provide basic obstetric and neonatal care to about 80 % of the eligible population in Addis Ababa. Hospitals provide comprehensive services and are referral centers for complications that cannot be managed at the HCs. This study assessed the proportion of obstetric referrals in general and referrals due to premature rupture of membranes (PROM) at term in particular, from the HCs in Addis Ababa and explored its appropriateness and management in hospitals. The study used a sequential explanatory mixed methods design. Routine retrospective data were collected from ten randomly selected HCs in 2012. Key informant interviews were conducted using a guide developed following a preliminary analysis of the quantitative data. Ten head midwives, one from each health center participated in the interviews. Of the 9340 mothers who sought skilled birth care in the ten HCs in 2012, 2820 (30.3 %) were diagnosed with obstetric complications and referred to hospital. Term PROM accounted for 557 (19.7 %) of the referrals and it was widely varied across the HCs. Fifteen (7.8 %) mothers who were referred for PROM, had intact membranes upon hospital examinations. Forty-two (77.8 %) of the referred mothers who had spontaneous labour and delivery could have been misclassified as not having labour upon referral. In the interviews, variations in diagnosing and managing term PROM were identified as themes. Three HCs relayed solely on mothers' self reports of amniotic fluid leakage to diagnose, two HCs did complementary speculum/vaginal examination, three HCs monitored sign of labour on top of confirming the leakage. Regarding management, two HCs practiced expectant management, three referred mothers after 30 min of observation while others issued referral right away. All providers reported the lack of clinical guidelines for most common obstetric problems in their HC. The study reported large proportion of obstetric referrals in general and PROM referrals in particular as well as variations in diagnosing and managing term PROM. These could largely be attributed to lack of clinical guidelines for most common obstetric complications at the HCs and competency gap among providers. Addressing the identified gaps and strengthening the primary care settings could contribute to improved quality of obstetric care and outcomes.

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 80 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 80 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 18 23%
Researcher 8 10%
Student > Postgraduate 8 10%
Student > Bachelor 5 6%
Student > Ph. D. Student 5 6%
Other 9 11%
Unknown 27 34%
Readers by discipline Count As %
Medicine and Dentistry 21 26%
Nursing and Health Professions 12 15%
Social Sciences 9 11%
Economics, Econometrics and Finance 2 3%
Agricultural and Biological Sciences 1 1%
Other 8 10%
Unknown 27 34%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 24 February 2016.
All research outputs
#3,697,165
of 7,269,211 outputs
Outputs from BMC Research Notes
#927
of 1,868 outputs
Outputs of similar age
#152,590
of 283,156 outputs
Outputs of similar age from BMC Research Notes
#58
of 110 outputs
Altmetric has tracked 7,269,211 research outputs across all sources so far. This one is in the 28th percentile – i.e., 28% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,868 research outputs from this source. They receive a mean Attention Score of 4.5. This one is in the 35th percentile – i.e., 35% 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 283,156 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 110 others from the same source and published within six weeks on either side of this one. This one is in the 36th percentile – i.e., 36% of its contemporaries scored the same or lower than it.