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The evidence for emergency obstetric care
Author(s) -
Paxton A.,
Maine D.,
Freedman L.,
Fry D.,
Lobis S.
Publication year - 2005
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2004.11.026
Subject(s) - medicine , observational study , psychological intervention , medline , systematic review , childbirth , cochrane library , ranking (information retrieval) , clinical study design , population , pregnancy , clinical trial , randomized controlled trial , nursing , environmental health , surgery , machine learning , biology , political science , computer science , law , genetics , pathology
Purpose We searched for evidence for the effectiveness of emergency obstetric care (EmOC) interventions in reducing maternal mortality primarily in developing countries. Methods We reviewed population‐based studies with maternal mortality as the outcome variable and ranked them according to the system for ranking the quality of evidence and strength of recommendations developed by the US Preventive Services Task Force. A systematic search of published literature was conducted for this review, including searches of Medline, PubMed, Cochrane Database of Systematic Reviews, the Cochrane Pregnancy and Childbirth Database and the Cochrane Controlled Trials Register. Results The strength of the evidence is high in several studies with a design that places them in the second and third tier in the quality of evidence ranking system. No studies were found that are experimental in design that would give them a top ranking, due to the measurement challenges associated with maternal mortality, although many of the specific individual clinical interventions that comprise EmOC have been evaluated through experimental design. There is strong evidence based on studies, using quasi‐experimental, observational and ecological designs, to support the contention that EmOC must be a critical component of any program to reduce maternal mortality.