Observational studyBMJ open2016
Characteristics and outcomes of women using emergency medical services for third-trimester pregnancy-related problems in India: a prospective observational study.
Observational study in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 24 citations in OpenAlex.
- Efficacy of prehospital amiodarone on survival in adult out-of-hospital cardiac arrest: a retrospective observational study.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Article
- Emergency medical team interventions involving pregnant patients of the Warmian-Masurian Voivodeship (Poland) in 2020-2022.BMC pregnancy and childbirth · 2026Article
- Lived experiences of Iranian prehospital emergency technicians in facing women's emergencies: a phenomenological study.BMC emergency medicine · 2024Article
- Paediatric use of emergency medical services in India: A retrospective cohort study of one million children.Journal of global health · 2022Observational
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- Suspected Labour as a Reason for Emergency Medical Services Team Interventions in Poland-A Retrospective Analysis.Healthcare (Basel, Switzerland) · 2021Article
- Suspected Miscarriage in the Experience of Emergency Medical Services Teams-Preliminary Study.International journal of environmental research and public health · 2021Article
- Polish Medical Air Rescue Interventions Concerning Pregnant Women in Poland: A 10-year Retrospective Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- Non-Conveyance Due to Patient-Initiated Refusal in Emergency Medical Services: A Retrospective Population-Based Registry Analysis Study in Riyadh Province, Saudi Arabia.International journal of environmental research and public health · 2021Article
- Development and implementation of a novel Web-based gaming application to enhance emergency medical technician knowledge in low- and middle-income countries.AEM education and training · 2021Article
- Continuing Education for Prehospital Healthcare Providers in India - A Novel Course and Concept.Open access emergency medicine : OAEM · 2020Article
- Article
- Reducing early infant mortality in India: results of a prospective cohort of pregnant women using emergency medical services.BMJ open · 2018Article
- Pregnant women who requested a '108' ambulance in two states of India.BMJ global health · 2018Article
- Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesCharacterise the demographics, management and outcomes of obstetric patients transported by emergency medical services (EMS).
designProspective observational study.
settingFive Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014.
participantsThis study enrolled a convenience sample of 1684 women in third trimester of pregnancy calling with a 'pregnancy-related' problem for free-of-charge ambulance transport. Calls were deemed 'pregnancy related' if categorised by EMS dispatchers as 'pregnancy', 'childbirth', 'miscarriage' or 'labour pains'. Interfacility transfers, patients absent on ambulance arrival and patients refusing care were excluded.
main outcome measuresEmergency medical technician (EMT) interventions, method of delivery and death.
resultsThe median age enrolled was 23 years (IQR 21-25). Women were primarily from rural or tribal areas (1550/1684 (92.0%)) and lower economic strata (1177/1684 (69.9%)). Time from initial call to hospital arrival was longer for rural/tribal compared with urban patients (66 min (IQR 51-84) vs 56 min (IQR 42-73), respectively, p<0.0001). EMTs assisted delivery in 44 women, delivering the placenta in 33/44 (75%), performing transabdominal uterine massage in 29/33 (87.9%) and administering oxytocin in none (0%). There were 1411 recorded deliveries. Most women delivered at a hospital (1212/1411 (85.9%)), however 126/1411 (8.9%) delivered at home following hospital discharge. Follow-up rates at 48 hours, 7 days and 42 days were 95.0%, 94.4% and 94.1%, respectively. Four women died, all within 48 hours. The caesarean section rate was 8.2% (116/1411). On multivariate regression analysis, women transported to private hospitals versus government primary health centres were less likely to deliver by caesarean section (OR 0.14 (0.05-0.43))
conclusionsPregnant women from vulnerable Indian populations use free-of-charge EMS for impending delivery, making it integral to the healthcare system. Future research and health system planning should focus on strengthening and expanding EMS as a component of emergency obstetric and newborn care (EmONC).
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