OBSTETRICAL REFERRALS BY TRADITIONAL BIRTH ATTENDANTS

Authors

  • Rozina Mustafa
  • Haleema Hashmi
  • Rubina Mustafa

Abstract

Background: In Pakistan 90% of births are conducted by TBA’s. In most cases, TBA’s are unable todiagnose the complications and are often unable to take decisions on timely referral. The objective ofthis study was to determine the prevalence, nature and outcome of life threatening obstetricalconditions in referrals by Traditional Birth Attendants (TBAs). Methods: This Observational,Descriptive study was conducted from January to December 2007, in the obstetrical unit of FatimaHospital, Baqai Medical University, a tertiary care community based hospital. The study includedpatients referred by TBA’s who developed life threatening obstetric conditions (LTOCs). Results:Total 64 patients were referred by TBA’s. The prevalence was 7.8%. Out of them, 53 (82.8%)patients admitted with life threatening obstetric conditions. The near-miss morbidities andmortalities were 45 (84.9%) and 8 (15%) respectively. Maternal mortality to Near-miss morbidityratio was 1:6. Obstructed labour caused near-miss morbidity in 32 (60.3%) patients with nomortality. Postpartum haemorrhage as life threatening condition developed in 16 (30.1%) patientswith 10 (18.8%) near-miss morbidities and 6 (11.3%) mortalities. Puerperal sepsis accounted for 1(1.88%) near-miss morbidity and 2 (3.76%) mortalities. The mortality index for puerperal sepsis is(66.6%) almost double of postpartum haemorrhage (37.5%). Conclusion: Mortality to near missmorbidity ratio is high. Misidentification and late referrals of complicated cases by TBA’s wereresponsible for near-miss morbidities and mortalities.Keywords: Traditional Birth Attendants, Life threatening obstetric conditions, Maternal mortality

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Published

2012-12-01

Issue

Vol. 24 No. 3-4 (2012): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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