Linked Life Data

11440893

Source:http://linkedlifedata.com/resource/pubmed/id/11440893

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2001-7-6
pubmed:abstractText
At Ziguinchor Regional Hospital (ZRH) in Senegal, 80% of maternal deaths are associated with late referral of dystocia cases. The gynecology and obstetrics team of the ZRH, in collaboration with the teaching staff of the Institute of Health and Development (ISED), tried to find ways to combat maternal mortality and stillbirth, based on double-entry contigency tables and a logical framework. We developed a tool more elaborate than a simple decision tree: the dystocial risk score. This tool has three components: A column provides a list of eight characteristics to check for in the woman: history of cesarean section, limping, less than 150 cm in height, no living child, less than 18 years old, more than 35 years old, other risk factors, no risk factors. A horizontal section provides a checklist of possible outcomes of the pregnancy itself: obstacle praevia, precedence, noncephalic presentation, uterine length of over 35 cm, loss of amniotic fluid over 12 hours or more, other abnormalities, no abnormalities. A rectangular grid indicates the prognosis. This grid consists of three zones: a large blue zone (dangerous), a medium-sized grey zone (doubtful) and a small blue zone (hopeful). A positive DRS is obtained if there is at least one cross in the dangerous zone and/or at least two crosses in the doubtful zone. If these conditions are not fulfilled, the DRS is negative. A positive DRS indicates that the woman should be referred to a center specialized in obstetric emergency care. This tool was validated in a study of 376 pregnant women carried out over a period of six months. It was found to have a sensitivity of 83.6%, a specificity of 90.1%, a positive predictive value of 72.3% and a negative predictive value of 94.1%. The DRS is a simple, easy-to-use decision-making tool. The large-scale use of this tool (by midwives, chief nurses and health workers) would accelerate the identification of pregnant women with a high risk of dystocia. The timely referral of these women to specialized emergency obstetrics centers would increase the efficacy of care and would reduce the levels of maternal mortality and stillbirth.
pubmed:language
fre
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
1157-5999
pubmed:author
pubmed:issnType
Print
pubmed:volume
11
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
133-8
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed:articleTitle
[A new decision support tool in the campaign against maternal mortality: the Dystocia Risk Score].
pubmed:affiliation
Clinique gynécologique et obstétricale du centre hospitalier régional de Ziguinchor, Sénégal.
pubmed:publicationType
Journal Article, English Abstract, Validation Studies