Bladder care and management of prolonged/obstructed labor for obstetric fistula: A global survey of intrapartum and postpartum clinical practices
Keywords:bladder care., maternal morbidity, obstetric fistula, prolonged/obstructed labor, urinary catheterization
Aims: To understand intrapartum and postpartum clinical practices among skilled birth attendants in low- and middle-income countries (LMICs).
Methods: This survey, based on clinical guidelines and curricula, was administered online in French and English, from May-Oct, 2017. Summaries of respondent characteristics, knowledge, and practices were generated. Chi-square tests investigated significant disparities by region, facility type, and geography. Data were analyzed using Stata v12.
Results: Respondents (222) were primarily midwives (61%) and OB-GYNs (15%); 56% in Africa and 39% in South-East Asia. A majority practice many recommended practices related to intrapartum/postpartum bladder care and P/OL management. Most reported using partograph to monitor labor (99%), monitoring voiding frequency for postpartum patients (95%), and utilizing UC after P/OL (94%). Findings revealed a lack ofprotocols on bladder care and P/OL management, variation in practice by region, and less access to in-service training and supplies in Africa and public facilities.
Conclusions: Findings reveal a strong foundation for standardization in intrapartum/postpartum bladder care and P/OL management. UC after P/OL appears feasible and acceptable, meaning its systematic practice can be scaled up to prevent obstetric fistula and other sequelae of P/OL in low-resource settings. However, SBAs need protocols, in-service training, and consistent supplies, especially in Africa and public facilities.
How to Cite
Copyright on any research article in the Nepal Journal of Obstetrics and Gynaecology is retained by the author(s).
The authors grant the Nepal Journal of Obstetrics and Gynaecology a license to publish the article and identify itself as the original publisher.
Articles in the Nepal Journal of Obstetrics and Gynaecology are Open Access articles published under the Creative Commons CC BY-NC License (https://creativecommons.org/licenses/by-nc/4.0/)This license permits use, distribution and reproduction in any medium, provided the original work is properly cited, and it is not used for commercial purposes.