Cross-Sectional Survey to Assess Hospital System Readiness for Hemorrhage During and After Cesarean Delivery in Africa
Authors' conclusion
Important WHO-recommended measures to reduce hemorrhage during and after CD, are not currently available in many hospitals across Africa.
Study context
- Population
- Hospitals across 29 low- and middle-income countries in Africa (African Perioperative Research Group, African Perioperative Research Group (APORG))hospitals, 1 respondent each
- Participants
- 140 hospitals
- Outcome
- Hospital system readiness to implement World Health Organization (WHO) recommendations for prevention and treatment of PPH during and after cesarean delivery
Methodological detailssurvey of anesthesiologists and obstetricians, multinational
- Survey of anesthesiologists and obstetricians
- Multinational
Main finding
As reported in the abstract
Readiness for WHO PPH recommendations (hospitals)
- Oxytocin available
- 130/139 (93.5%)
- Misoprostol available
- 101/138 (73.2%)
- Heat-stable carbetocin available
- 12/138 [8.7%]
- Ergometrine available
- 35/135, [25.9%]
- Controlled cord traction always performed
- 133/135 (98.5%)
- Delayed cord clamping (when neonatal resuscitation not indicated)
- 86/134 [64.2%]
- Crystalloids always available
- 133/139 (95.7%)
- Crystalloids preferred initial resuscitation fluid
- 125/138 [90.6%]
- Uterine massage always performed
- 117/139 (84.2%)
- TXA always available
- 97/139 (69.8%)
- Immediate access to theater
- 126/139 [90.6%]
- Written protocols for PPH treatment
- 113/136 (83.1%)
Observational data: associations, not effects.
Secondary outcomes
Blood product availability (hospitals)
- Access to emergency blood
- 102/139 [73.4%]
- Platelets available
- 32/138 (23.2%)
- Cryoprecipitate available
- 21/138 (15.2%)
- Fibrinogen available
- 11/139 (7.9%)
Skilled human resources
- In-person specialist cover reduced after-hours
Original publication
Cross-Sectional Survey to Assess Hospital System Readiness for Hemorrhage During and After Cesarean Delivery in Africa. Anesth Analg. Published 6 November 2024. doi:10.
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