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Type: Journal article
Title: Use of evidence-based practices in pregnancy and childbirth: South East Asia optimising reporductive and child health in developing countries project
Author: Laopaiboon, M.
Lumbiganon, P.
McDonald, S.
Henderson-Smart, D.
Green, S.
Crowther, C.
Citation: PLoS One, 2008; 3(7):e2646-1-e2646-7
Publisher: Public Library of Science
Issue Date: 2008
ISSN: 1932-6203
Statement of
The SEA-ORCHID Study Group
Abstract: Background The burden of mortality and morbidity related to pregnancy and childbirth remains concentrated in developing countries. SEA-ORCHID (South East Asia Optimising Reproductive and Child Health In Developing countries) is evaluating whether a multifaceted intervention to strengthen capacity for research synthesis, evidence-based care and knowledge implementation improves adoption of best clinical practice recommendations leading to better health for mothers and babies. In this study we assessed current practices in perinatal health care in four South East Asian countries and determined whether they were aligned with best practice recommendations. Methodology/Principal Findings We completed an audit of 9550 medical records of women and their 9665 infants at nine hospitals; two in each of Indonesia, Malaysia and The Philippines, and three in Thailand between January-December 2005. We compared actual clinical practices with best practice recommendations selected from the Cochrane Library and the World Health Organization Reproductive Health Library. Evidence-based components of the active management of the third stage of labour and appropriately treating eclampsia with magnesium sulphate were universally practiced in all hospitals. Appropriate antibiotic prophylaxis for caesarean section, a beneficial form of care, was practiced in less than 5% of cases in most hospitals. Use of the unnecessary practices of enema in labour ranged from 1% to 61% and rates of episiotomy for vaginal birth ranged from 31% to 95%. Other appropriate practices were commonly performed to varying degrees between countries and also between hospitals within the same country. Conclusions/Significance Whilst some perinatal health care practices audited were consistent with best available evidence, several were not. We conclude that recording of clinical practices should be an essential step to improve quality of care. Based on these findings, the SEA-ORCHID project team has been developing and implementing interventions aimed at increasing compliance with evidence-based clinical practice recommendations to improve perinatal practice in South East Asia.
Keywords: SEA-ORCHID Study Group; Humans; Perinatal Care; Evidence-Based Medicine; Public Health Practice; Pregnancy; Parturition; Developing Countries; Child, Preschool; Infant; Child Health Services; Maternal Health Services; Asia, Southeastern; Thailand; Female
Rights: Copyright Crowther et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
RMID: 0020084399
DOI: 10.1371/journal.pone.0002646
Grant ID:
Appears in Collections:Obstetrics and Gynaecology publications

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