Trial reportBMC pregnancy and childbirth2022
Improved maternal-fetal outcomes among emergency obstetric referrals following phone call communication at a teaching hospital in south western Uganda: a quasi-experimental study.
Trial report in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 16 citations in OpenAlex.
- Article
- Article
- Criteria based clinical audit of selected obstetric emergencies standard of care and feto-maternal outcomes in public hospitals of West Shoa Zone, Central Ethiopia.BMC pregnancy and childbirth · 2026Article
- Development of a clinical triage readiness and practice assessment tool for midwives in the maternity units of South Africa.BMC nursing · 2026Article
- Action and interaction strategies for enhancing upward referral of obstetric emergencies from community health centres in the eastern cape.Frontiers in global women's health · 2026Article
- Understanding Antecedents and Attributes in the Context of Upward Referral for Obstetric Emergencies: A Grounded Theory Study.F1000Research · 2026Article
- Cross-context qualitative synthesis of a mobile obstetric referral emergency system (MORES) in Ghana and Liberia.PloS one · 2026Article
- Perceptions and experiences of women referred during obstetric complications in Eastern Uganda: A qualitative study.PLOS global public health · 2025Article
- Incidence and factors associated with immediate adverse neonatal outcomes among emergency obstetric referrals in labor at a tertiary hospital in Uganda: a prospective cohort study.BMC pregnancy and childbirth · 2024Article
- Does the Referral System for Emergency Obstetric Care in India Require a Major Overhaul?Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency obstetric referrals develop adverse maternal-fetal outcomes partly due to delays in offering appropriate care at referral hospitals especially in resource limited settings. Referral hospitals do not get prior communication of incoming referrals leading to inadequate preparedness and delays of care. Phone based innovations may bridge such communication challenges. We investigated effect of a phone call communication prior to referral of mothers in labour as intervention to reduce preparation delays and improve maternal-fetal outcome at a referral hospital in a resource limited setting.
methodsThis was a quasi-experimental study with non-equivalent control group conducted at Mbarara Regional Referral Hospital (MRRH) in South Western Uganda from September 2020 to March 2021. Adverse maternal-fetal outcomes included: early neonatal death, fresh still birth, obstructed labour, ruptured uterus, maternal sepsis, low Apgar score, admission to neonatal ICU and hysterectomy. Exposure variable for intervention group was a phone call prior maternal referral from a lower health facility. We compared distribution of clinical characteristics and adverse maternal-fetal outcomes between intervention and control groups using Chi square or Fisher's exact test. We performed logistic regression to assess association between independent variables and adverse maternal-fetal outcomes.
resultsWe enrolled 177 participants: 75 in intervention group and 102 in control group. Participants had similar demographic characteristics. Three quarters (75.0%) of participants in control group delayed on admission waiting bench of MRRH compared to (40.0%) in intervention group [p = < 0.001]. There were significantly more adverse maternal-fetal outcomes in control group than intervention group (obstructed labour [p = 0.026], low Apgar score [p = 0.013] and admission to neonatal high dependency unit [p = < 0.001]). The phone call intervention was protective against adverse maternal-fetal outcome [aOR = 0.22; 95%CI: 0.09-0.44, p = 0.001].
conclusionThe phone call intervention resulted in reduced delay to patient admission at a tertiary referral hospital in a resource limited setting, and is protective against adverse maternal-fetal outcomes. Incorporating the phone call communication intervention in the routine practice of emergency obstetric referrals from lower health facilities to regional referral hospitals may reduce both maternal and fetal morbidities.
trial registrationPan African Clinical Trial Registry PACTR20200686885039.
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