African Evaluation Database

4636

Source

Scopus

Electronic ID

2-s2.0-84930671344

Authors

Souza J.P., Oladapo O.T., Bohren M.A., Mugerwa K., Fawole B., Moscovici L., Alves D., Perdona G., Oliveira-Ciabati L., Vogel J.P., Tunçalp O., Zhang J., Hofmeyr J., Bahl R., Gülmezoglu A.M.

Title

The development of a Simplified, Effective, Labour Monitoring-to-Action (SELMA) tool for Better Outcomes in Labour Difficulty (BOLD): Study protocol Obstetrics

Publication Year

2015

Source Title

Reproductive Health

Volume

Issue

Citations

DOI

10.1186/s12978-015-0029-4

URL

https://www.scopus.com/inward/record.uri?eid=2-s2.0-84930671344&partnerID=40&md5=a41d8e3a223dab806aca2830757b020a

Affiliations

Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Ribeirão Preto SP, Brazil; GLIDE Technical Cooperation and Research, Ribeirão Preto SP, Brazil; UNDP-UNFPA-UNICEF-WHO World Bank Spec. Prog. of Res., Devmt. and Res. Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, United States; Department of Obstetrics and Gynaecology, Makere University, Kampala, Uganda; Department of Obstetrics and Gynaecology, College of Medicine, Ibadan, Nigeria; Shanghai Jiaotong University, School of Medicine, Shanghai, China; Department of Obstetrics and Gynaecology, Frere Maternity Hospital, P Bag X9047, East London, South Africa; Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Avenue Appia 20, Geneva, Switzerland

Authors with Affiliations

Souza, J.P., Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Ribeirão Preto SP, Brazil, GLIDE Technical Cooperation and Research, Ribeirão Preto SP, Brazil; Oladapo, O.T., UNDP-UNFPA-UNICEF-WHO World Bank Spec. Prog. of Res., Devmt. and Res. Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland; Bohren, M.A., UNDP-UNFPA-UNICEF-WHO World Bank Spec. Prog. of Res., Devmt. and Res. Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St., Baltimore, MD, United States; Mugerwa, K., Department of Obstetrics and Gynaecology, Makere University, Kampala, Uganda; Fawole, B., Department of Obstetrics and Gynaecology, College of Medicine, Ibadan, Nigeria; Moscovici, L., Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Ribeirão Preto SP, Brazil, GLIDE Technical Cooperation and Research, Ribeirão Preto SP, Brazil; Alves, D., Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Ribeirão Preto SP, Brazil; Perdona, G., Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Ribeirão Preto SP, Brazil; Oliveira-Ciabati, L., Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, Ribeirão Preto SP, Brazil, GLIDE Technical Cooperation and Research, Ribeirão Preto SP, Brazil; Vogel, J.P., UNDP-UNFPA-UNICEF-WHO World Bank Spec. Prog. of Res., Devmt. and Res. Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland; Tunçalp, O., UNDP-UNFPA-UNICEF-WHO World Bank Spec. Prog. of Res., Devmt. and Res. Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland; Zhang, J., Shanghai Jiaotong University, School of Medicine, Shanghai, China; Hofmeyr, J., Department of Obstetrics and Gynaecology, Frere Maternity Hospital, P Bag X9047, East London, South Africa; Bahl, R., Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Avenue Appia 20, Geneva, Switzerland; Gülmezoglu, A.M., UNDP-UNFPA-UNICEF-WHO World Bank Spec. Prog. of Res., Devmt. and Res. Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva, Switzerland

Abstract

Background: The partograph is currently the main tool available to support decision-making of health professionals during labour. However, the rate of appropriate use of the partograph is disappointingly low. Apart from limitations that are associated with partograph use, evidence of positive impact on labour-related health outcomes is lacking. The main goal of this study is to develop a Simplified, Effective, Labour Monitoring-to-Action (SELMA) tool. The primary objectives are: to identify the essential elements of intrapartum monitoring that trigger the decision to use interventions aimed at preventing poor labour outcomes; to develop a simplified, monitoring-to-action algorithm for labour management; and to compare the diagnostic performance of SELMA and partograph algorithms as tools to identify women who are likely to develop poor labour-related outcomes. Methods/Design: A prospective cohort study will be conducted in eight health facilities in Nigeria and Uganda (four facilities from each country). All women admitted for vaginal birth will comprise the study population (estimated sample size: 7,812 women). Data will be collected on maternal characteristics on admission, labour events and pregnancy outcomes by trained research assistants at the participating health facilities. Prediction models will be developed to identify women at risk of intrapartum-related perinatal death or morbidity (primary outcomes) throughout the course of labour. These predictions models will be used to assemble a decision-support tool that will be able to suggest the best course of action to avert adverse outcomes during the course of labour. To develop this set of prediction models, we will use up-to-date techniques of prognostic research, including identification of important predictors, assigning of relative weights to each predictor, estimation of the predictive performance of the model through calibration and discrimination, and determination of its potential for application using internal validation techniques. Discussion: This research offers an opportunity to revisit the theoretical basis of the partograph. It is envisioned that the final product would help providers overcome the challenging tasks of promptly interpreting complex labour information and deriving appropriate clinical actions, and thus increase efficiency of the care process, enhance providers' competence and ultimately improve labour outcomes. Please see related articles ' http://dx.doi.org/10.1186/s12978-015-0027-6 ' and ' http://dx.doi.org/10.1186/s12978-015-0028-5 '. © 2015 Souza et al.; licensee BioMed Central.

Author Keywords

Decision-support tool; Labour monitoring; Partograph

Index Keywords

Article; clinical assessment tool; clinical trial; cohort analysis; decision support system; diagnostic test accuracy study; female; fetus; health care facility; hospital admission; human; internal validity; intrapartum care; major clinical study; medical record; multicenter study; newborn; Nigeria; outcome assessment; perinatal morbidity; perinatal mortality; population research; practice guideline; prediction; predictive value; pregnancy outcome; prognosis; prospective study; sample size; Simplified Effective Labor Monitoring to Action; Uganda; vaginal delivery

Funding Details

None