Sustainable scale-up of active management of the third stage of labor for prevention of postpartum hemorrhage in Ecuador. Hermida, J., Salas, B., & Sloan, N., L. International Journal of Gynecology and Obstetrics, 117(3):278-282, 2012. ![Sustainable scale-up of active management of the third stage of labor for prevention of postpartum hemorrhage in Ecuador [link]](https://bibbase.org/img/filetypes/link.svg "link")
Website abstract bibtex Objective: To analyze the Ecuadorian experience regarding the adoption, scale-up, and institutionalization of active management of the third stage of labor (AMTSL) for prevention of postpartum hemorrhage via continuous quality improvement (CQI) processes. Methods: Average AMTSL implementation rates for women with vaginal deliveries were compared using unweighted provincial aggregate data from facilities participating in 3 phases of AMTSL programming. Months taken to implement AMTSL at 80% or more and 90% or more compliance were compared across phases. Results: Rate of oxytocin administration during the first 3 months was 5.0% in phase 1, 9.8% in phase 2, and 72.2% in phase 3 (P = 0.001 vs phases 1 and 2). The average number of months provinces took to increase oxytocin administration to 80% or more and 90% or in more women with vaginal deliveries was, respectively, 21.6 ± 18.7 and 30.6 ± 16.4 in phase 1, 23.5 ± 15.1 and 30.1 ± 14.9 in phase 2, and 4.7 ± 4.9 (P = 0.01 vs phase 1; P = 0.001 vs phase 2) and 4.0 ± 3.4 (P = 0.001 vs phases 1 and 2) in phase 3. By December 2009, AMTSL implementation was sustained at 90% or more in all provinces. Conclusion: CQI processes identified resistance and operational barriers, and developed mechanisms to overcome them. © 2012 International Federation of Gynecology and Obstetrics.
@article{
title = {Sustainable scale-up of active management of the third stage of labor for prevention of postpartum hemorrhage in Ecuador},
type = {article},
year = {2012},
keywords = {Active management of the third stage of labor,Maternal mortality,Oxytocin,Postpartum hemorrhage,Quality improvement},
pages = {278-282},
volume = {117},
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city = {Affiliation: University Research Co. LLC, 7200 Wisconsin Avenue, Bethesda, MD 20814, United States},
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created = {2016-08-21T22:19:17.000Z},
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last_modified = {2017-03-14T09:54:45.334Z},
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abstract = {Objective: To analyze the Ecuadorian experience regarding the adoption, scale-up, and institutionalization of active management of the third stage of labor (AMTSL) for prevention of postpartum hemorrhage via continuous quality improvement (CQI) processes. Methods: Average AMTSL implementation rates for women with vaginal deliveries were compared using unweighted provincial aggregate data from facilities participating in 3 phases of AMTSL programming. Months taken to implement AMTSL at 80% or more and 90% or more compliance were compared across phases. Results: Rate of oxytocin administration during the first 3 months was 5.0% in phase 1, 9.8% in phase 2, and 72.2% in phase 3 (P = 0.001 vs phases 1 and 2). The average number of months provinces took to increase oxytocin administration to 80% or more and 90% or in more women with vaginal deliveries was, respectively, 21.6 ± 18.7 and 30.6 ± 16.4 in phase 1, 23.5 ± 15.1 and 30.1 ± 14.9 in phase 2, and 4.7 ± 4.9 (P = 0.01 vs phase 1; P = 0.001 vs phase 2) and 4.0 ± 3.4 (P = 0.001 vs phases 1 and 2) in phase 3. By December 2009, AMTSL implementation was sustained at 90% or more in all provinces. Conclusion: CQI processes identified resistance and operational barriers, and developed mechanisms to overcome them. © 2012 International Federation of Gynecology and Obstetrics.},
bibtype = {article},
author = {Hermida, J and Salas, B and Sloan, N L},
journal = {International Journal of Gynecology and Obstetrics},
number = {3}
}
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