Auteurs : Goldenberg RL, McClure EM, Kodkany B, Wembodinga G, Pasha O, Esamai F, Tshefu A, Patel A, Mabaye H, Goudar S, Saleem S, Waikar M, Langer A, Bose CL, Rubens CE, Wright LL, Moore J, Blanc A.
Department of Obstetrics and Gynecology, Columbia University, NY 10032, USA. rlg88@columbia.edu
Int J Gynaecol Obstet. 2013 Sep;122(3):230-3
OBJECTIVE: To determine the feasibility of introducing a simple indicator of quality of obstetric and neonatal care and to determine the proportion of potentially avoidable perinatal deaths in hospitals in low-income countries.
METHODS: Between September 1, 2011, and February 29, 2012, data were collected from consecutive women who were admitted to the labor ward of 1 of 6 hospitals in 4 low-income countries. Fetal heart tones on admission were monitored, and demographic and birth data were recorded.
RESULTS: Data were obtained for 3555 women and 3593 neonates (including twins). The doptone was used on 97% of women admitted. The overall perinatal mortality rate was 34 deaths per 1000 deliveries. Of the perinatal deaths, 40%-45% occurred in the hospital and were potentially preventable by better hospital care.
CONCLUSION: The results demonstrated that it is possible to accurately determine fetal viability on admission via a doptone. Implementation of doptone use, coupled with a concise data record, might form the basis of a low-cost and sustainable program to monitor and evaluate efforts to improve quality of care and ultimately might help to reduce the in-hospital component of perinatal mortality in low-income countries. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
KEYWORDS: Doptone, Fetal heart tones, Hospital-based perinatal mortality, Neonatal mortality, Perinatal mortality, Stillbirth