Figure 1
Study Population.
Figure 2
Frequency of cases presenting for care per month by hospital site.
Table 1
Overall Cohort Characteristics.
| Characteristics | n (%)/median (IQR) |
|---|---|
| Maternal age in years | 26 (22, 31) |
| Gravidity | 2 (1, 3) |
| Parity | 1 (0, 2) |
| Gestational weeks | 38 (36, 38) |
| Reason for care* | |
| pelvic pain | 415 (85.2%) |
| vaginal bleeding | 17 (3.5%) |
| vaginal discharge | 10 (2.1%) |
| evaluation for pre-eclampsia | 5 (1.0%) |
| evaluation of hypertension | 12 (2.5%) |
| Suspect abnormal pre-treatment diagnosis | |
| multi-gestation | 5 (0.9%) |
| breech presentation | 8 (1.4%) |
| transverse presentation | 3 (0.5%) |
| cephalopelvic disproportion | 19 (3.4%) |
| ectopic pregnancy | 0 (0.0%) |
| placental abruption | 1 (0.2%) |
| placenta previa | 3 (0.5%) |
| Abortion | 28 (5.1%) |
| retained products | 2 (0.4%) |
| Patient disposition | |
| birthing room for vaginal delivery | 472 (80.8%) |
| operating room for C section | 23 (3.9%) |
| admitted to ward for observation | 12 (2.1%) |
| discharged for outpatient follow up | 10 (1.7%) |
| transferred for further care | 67 (11.5%) |
| Care outcome# | |
| live birth | 469 (94.0%) |
| post-partum hemorrhage | 12 (2.4%) |
| perinatal infant mortality | 15 (3.0%) |
| maternal mortality | 3 (0.6) |
[i] * Reason for obstetrical evaluation if not or in addition to concern for normal labor.
# Provides data only for patients not transferred for further care.
Table 2
Characteristics by hospital site.
| Characteristics | Fort Liberte Hospital (n = 213) | Centre Medicosocial de Ouanaminthe (n = 376) | p |
|---|---|---|---|
| n (%)/median (IQR) | n (%)/median (IQR) | ||
| Maternal age in years | 27 (23, 32) | 26 (22, 31) | 0.12 |
| Gravida | 2 (1, 3) | 2 (1, 3) | 0.13 |
| Para | 1 (0, 2) | 1 (0, 2) | 0.02 |
| Gestational weeks | 36 (34, 38) | 38 (38, 38) | <0.001 |
| Reason for care* | |||
| pelvic pain | 172 (85.6%) | 243 (85.0%) | 0.85 |
| vaginal bleeding | 12 (6.0%) | 5 (1.8%) | 0.021 |
| vaginal discharge | 6 (3.0%) | 4 (1.4%) | 0.408 |
| evaluation for pre-eclampsia/eclampsia | 3 (1.5%) | 2 (0.7%) | 0.393 |
| evaluation of hypertension | 9 (4.5%) | 3 (1.1%) | 0.033 |
| Suspected abnormal pre-treatment diagnosis | |||
| multi-gestation | 3 (1.5%) | 2 (0.6%) | 0.360 |
| breech presentation | 3 (1.5%) | 5 (1.4%) | 1.00 |
| transverse presentation | 2 (1.0%) | 1 (0.3%) | 0.302 |
| cephalopelvic disproportion | 13 (6.4%) | 6 (1.7%) | 0.003 |
| ectopic pregnancy | 0 (0.0%) | 0 (0.0%) | – |
| placental abruption | 1 (0.5%) | 0 (0.0%) | 0.365 |
| placenta previa | 0 (0.0%) | 3 (0.9%) | 0.557 |
| Abortion | 18 (8.9%) | 10 (2.8%) | 0.002 |
| retained products | 0 (0.0%) | 2 (0.6%) | 0.536 |
| Patient disposition | |||
| birthing room for vaginal delivery | 150 (71.1%) | 322 (86.3%) | <0.001 |
| operating room for cesarean section | 23 (10.9%) | 0 (0.0%) | |
| admitted to ward for observation | 5 (2.4%) | 7 (1.9%) | |
| discharged for outpatient follow up | 0 (0.0%) | 10 (2.7%) | |
| transferred for further care | 33 (15.6%) | 34 (9.1%) | |
| Care outcome# | |||
| live birth | 156 (89.7%) | 313 (96.3%) | 0.002 |
| post-partum hemorrhage | 9 (5.2%) | 3 (0.9%) | |
| perinatal infant mortality | 9 (5.2%) | 6 (1.8%) | |
| maternal mortality | 0 (0.0%) | 3 (0.9%) | |
[i] * Reason for obstetrical evaluation if not or in addition to concern for normal labor.
# Provides data only for patients not transferred for further care.
Table 3
Evaluation of Potential Clinical Utility of Ultrasound.
| Outcomes | ||||
|---|---|---|---|---|
| Transferred | Delivery Complicationsβ | |||
| Overall Cohort | ||||
| OR (95% CI) | aOR¶ (95% CI) | OR (95% CI) | aOR¶ (95% CI) | |
| Diagnosis assisted by ultrasoundɛ | 14.2 (7.80–25.7)* | 128.8 (17.0–975.3)* | 90.5 (33.5–244–6)* | 41.4 (6.0–283.6)* |
| Fort Liberté Hospital Cohort | ||||
| OR (95% CI) | aOR¶ (95% CI) | OR (95% CI) | aOR§ (95% CI) | |
| Diagnosis assisted by ultrasoundɛ | 7.2 (3.2–16.2)* | 131.9 (4.12–4226.0)# | 21.2 (6.7–67.5) | 19.1 (6.0–61.5)* |
| Centre Medicosocial de Ouanaminthe Cohort | ||||
| OR (95% CI) | aOR (95% CI) | OR (95% CI) | aOR§ (95% CI) | |
| Diagnosis assisted by ultrasoundɛ | 28.0 (11.2–70.1)* | 126.0 (99.6–1663.2) | 1074.3 (103.3–11173.6)* | 725.5 (55.5–9477.3)* |
[i] ɛ includes multiple gestation, breech, transverse, cephalopelvic disproportion, ectopic pregnancy, placental abruption, placenta previa, abortion and retained products.
β includes post-partum hemorrhage, perinatal death, and maternal mortality.
¶ multivariate model adjusted for maternal age and gestational weeks.
§ multivariate model adjusted for maternal age.
* associate p value < 0.001.
# associated p value < 0.01.