Abnormal obstetric shock index and associated factors among immediate postpartum women following vaginal delivery at a tertiary hospital in Southwestern Uganda
Loading...
Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
Research Square
Abstract
Early recognition of haemodynamic instability after birth and prompt interventions are necessary to
reduce adverse maternal outcomes due to postpartum haemorrhage. Obstetric shock Index (OSI) has
been recommended as a simple, accurate, reliable, and low-cost early diagnostic measure that identifies
hemodynamically unstable women.
Objectives
We determined the prevalence of abnormal obstetric shock index and associated factors among women
in the immediate postpartum period following vaginal delivery at Mbarara Regional Referral Hospital
(MRRH) in southwestern Uganda.
Methods
We conducted a cross-sectional study at the labour suite and postnatal ward of MRRH from January
2022 to April 2022. We systematically sampled women who had delivered vaginally, and measured their
blood pressures and pulse rates at 1 hour postpartum. We excluded mothers with hypertensive disorders
of pregnancy. Sociodemographic, medical and obstetric data were obtained through intervieweradministered
questionnaires. The prevalence of abnormal OSI was the proportion of participants with an
OSI ≥ 0.9 (calculated as the pulse rate divided by the systolic BP). Logistic regression analysis was used
to determine associations between abnormal OSI and independent variables.
Results
We enrolled 427 women with a mean age of 25.66 ± 5.30 years. Of these, 83 (19.44%), 95% CI (15.79–
23.52) had an abnormal obstetric shock index. Being referred [aOR 2.34, 95% CI (1.41–3.89), p = 0.001],
having had an episiotomy/perineal laceration [aOR 1.90, 95% CI (1.15–3.13), p = 0.012] and having a
visually estimated blood loss > 200 mls [aOR 1.78, 95% CI (1.06–3.01), p = 0.028] were significantly
associated with abnormal OSI.
Conclusion
Approximately one in every five women who delivered vaginally at MRRH during the study period had an
abnormal OSI. We recommend that clinicians have a high index of suspicion for haemodynamic
instability among women in the immediate postpartum period. Mothers who are referred in from other facilities, those that get episiotomies/perineal lacerations and those with estimated blood loss > 200mls
should be prioritized for close monitoring.
Description
Keywords
Obstetric Shock Index, Postpartum period, Prevalence, Pregnancy
Citation
Agaba, D. C., Lugobe, H. M., Migisha, R., Jjuuko, M., Saturday, P., Kisombo, D., ... & Ngonzi, J. (2022). Abnormal obstetric shock index and associated factors among immediate postpartum women following vaginal delivery at a tertiary hospital in Southwestern Uganda. https://doi.org/10.21203/rs.3.rs-2398722/v1