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Glob Health Sci Pract. 2015 Jun 17;3(2):300-4. doi: 10.9745/GHSP-D-14-00239.

Bedside Availability of Prepared Oxytocin and Rapid Administration After Delivery to Prevent Postpartum Hemorrhage: An Observational Study in Karnataka, India.

Author information

1
Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, MA, USA.
2
Ariadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, MA, USA.
3
Ariadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, MA, USA Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, MA, USA.
4
Massachusetts General Hospital, Boston, MA, USA.
5
Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Boston, MA, USA London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK.
6
Ariadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, MA, USA Harvard Medical School, Department of Global Health and Social Medicine, Boston, MA, USA.
7
Jawaharlal Nehru Medical College, Women's and Children's Health Research Unit, Karnataka, India.

Abstract

Postpartum hemorrhage is a leading cause of maternal death worldwide. Rapid provision of uterotonics after childbirth is recommended to reduce the incidence and severity of postpartum hemorrhage. Data obtained through direct observation of childbirth practices, collected in a study of the World Health Organization's Safe Childbirth Checklist in Karnataka, India, were used to measure if oxytocin prepared for administration and available at the bedside before birth was associated with decreased time to administration after birth. This was an observational study of provider behavior: data were obtained during a baseline assessment of health worker practices prior to introduction of the Safe Childbirth Checklist, representing behavior in the absence of any intervention. Analysis was based on 330 vaginal deliveries receiving oxytocin at any point postpartum. Oxytocin was prepared and available at bedside for approximately 39% of deliveries. We found that advance preparation and bedside availability of oxytocin was associated with increased likelihood of oxytocin administration within 1 minute after delivery (adjusted risk ratio = 4.89, 95% CI = 2.61, 9.16), as well as with decreased overall time to oxytocin administration after delivery (2.9 minutes sooner in adjusted models, 95% CI = -5.0, -0.9). Efforts to reduce postpartum hemorrhage should include recommendations and interventions to ensure advance preparation and bedside availability of oxytocin to facilitate prompt administration of the medicine after birth.

PMID:
26085025
PMCID:
PMC4476866
DOI:
10.9745/GHSP-D-14-00239
[Indexed for MEDLINE]
Free PMC Article

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