Utilization of Phyo Referral Score in assessing maternal referral quality in emergency cesarean section of maternal COVID-19 cases in Pekanbaru, Indonesia

Ilham Sejahtera Lubis; Eugenius Phyowai Ganap

doi:10.15562/bmj.v12i3.4700

Utilization of Phyo Referral Score in assessing maternal referral quality in emergency cesarean section of maternal COVID-19 cases in Pekanbaru, Indonesia

Ilham Sejahtera Lubis ,

Eugenius Phyowai Ganap ,

pdf |
DOI: https://doi.org/10.15562/bmj.v12i3.4700 |
Published: 2023-11-03

Abstract

Link of Video Abstract: https://youtu.be/H8GILKBIJwo

Introduction: During the Coronavirus disease 2019 (COVID-19) pandemic, basic and emergency obstetric healthcare was hampered due to health service protocol changes. The reduced coverage of antenatal service during the COVID-19 pandemic increased the number of undetected high-risk pregnancies and the likelihood of obstetric emergency cases. This study assessed maternal referral quality using the Phyo Referral Score (PRS) on emergency cesarean section (ECS) patients infected by SARS-CoV-2.

Methods: This retrospective cohort study used secondary data originating from patient medical records who went through ECS from 1 January 2021 to 31 December 2021. The subject was chosen purposively by the inclusion criteria. A Total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The data were described by frequencies, percentages, and mean ± standard deviation. The data was analyzed by Levene’s test and Chi-square test using IBM SPSS version 26.0.

Results: During the retrospective year, a total of 609 mothers went through Cesarean Section in 2021, there were 52 mothers who met the criteria. The most common indications of ECS were persistent fetal hypoxia (50.0%), placenta previa (13.5%), and maternal respiratory failure (13.5%). Most of the patients had good referral quality. From the parameters of PRS, patients are more likely to have good referral quality if accompanied by medical staff, receiving stabilization procedures, and communicating with the hospital by phone before being referred, and transported by ambulance within the same cities.

Conclusion: Accessibility is a critical component of obstetric emergency cases. Even during the COVID-19 pandemic, ensuring that mothers have a good referral quality to access advanced obstetrical care can help the survival of both mothers and fetuses.

References

World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic. 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
World Health Organization (WHO). Third round of the global pulses survey on continuity of essential health services during the covid-19 pandemic: Interim report November-December 2021. 2022. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2022.1.
Goyal M, Singh P, Singh K, Shekhar S, Agrawal N, Misra S. The effect of the COVID‐19 pandemic on maternal health due to delay in seeking health care: Experience from a tertiary center. International Journal of Gynaecology and Obstetrics. 2021;152:231–5.
Abdisa DK, Jaleta DD, Feyisa JW, Kitila KM, Berhanu RD. Access to maternal health services during COVID-19 pandemic, re-examining the three delays among pregnant women in Ilubabor zone, southwest Ethiopia: A cross-sectional study. PloS One. 2022;17:e0268196.
Aranda Z, Binde T, Tashman K, Tadikonda A, Mawindo B, Maweu D, et al. Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middle-income countries. BMJ Global Health. 2022;7:e007247.
Riau DKP. Profil Kesehatan Provinsi Riau Tahun 2020. Pekanbaru: Dinas Kesehatan Provinsi Riau; 2021.
Naqvi S, Naqvi F, Saleem S, Thorsten VR, Figueroa L, Mazariegos M, et al. Health care in pregnancy during the COVID-19 pandemic and pregnancy outcomes in six low- and-middle-income countries: Evidence from a prospective, observational registry of the Global Network for Women’s and Children’s Health. BJOG: An International Journal of Obstetrics & Gynaecology. 2022;129:1298–307.
Kugelman N, Lavie O, Assaf W, Cohen N, Sagi-Dain L, Bardicef M, et al. Changes in the obstetrical emergency department profile during the COVID-19 pandemic. The Journal of Maternal-Fetal & Neonatal Medicine. 2022;35:4116–22.
World Health Organization (WHO). WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.
Al-Jabir A, Kerwan A, Nicola M, Alsafi Z, Khan M, Sohrabi C, et al. Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 2 (surgical prioritisation). International Journal of Surgery. 2020;79:233–48.
Babidge WJ, Tivey DR, Kovoor JG, Weidenbach K, Collinson TG, Hewett PJ, et al. Surgery triage during the COVID-19 pandemic. Royal Australasian College of Surgeons. 2020;90:1558–65.
Ganap EP, Hakimi M, Emilia O. Assessment of Maternal Referral Systems in Dr. Sardjito General Hospital Using Phyo Referral Score: A Single-Center Preliminary Study. In: 4th International Symposium on Health Research (ISHR 2019). Atlantis Press; 2020. p. 238–40.
World Health Organization (WHO). Maternal mortality. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality#:~:text=Key%20facts,dropped%20by%20about%2034%25%20worldwide.
World Health Organization (WHO). Ending Preventable Maternal Mortality (EPMM): a renewed focus for improving maternal and newborn health and wellbeing. 2021. Available from: https://www.who.int/publications/i/item/9789240040519.
Ofosu B, Ofori D, Ntumy M, Asah-Opoku K, Boafor T. Assessing the functionality of an emergency obstetric referral system and continuum of care among public healthcare facilities in a low resource setting: an application of process mapping approach. BMC Health Services Research. 2021;21:402.
Bruce-Hickman K, Fan K, Plaat F, Sheth S. Decision-making on the labour ward during the COVID-19 pandemic. International Journal of Obstetric Anesthesia. 2021;45:150–1.
Abu Sabbah EA, Eqylan SB, Al-Maharma DY, Thekrallah F, Safadi RR. Fears and uncertainties of expectant mothers during the COVID-19 pandemic: trying to reclaim control. International Journal of Qualitative Studies on Health and Well-being. 2022;17.
Khetrapal Singh P, Jhalani M. Safeguarding essential health services during emergencies: lessons learnt from the {COVID}-19 pandemic. WHO South-East Asia J Public Health. 2020;9:93.
Seyed-Nezhad M, Ahmadi B, Akbari-Sari A. Factors affecting the successful implementation of the referral system: A scoping review. Journal of Family Medicine and Primary Care. 2021;10:4364–75.
De Simone B, Chouillard E, Di Saverio S, Pagani L, Sartelli M, Biffl W, et al. Emergency surgery during the {COVID}-19 pandemic: what you need to know for practice. annals. 2020;102:323–32.
Vousden N, Bunch K, Morris E, Simpson N, Gale C, O’Brien P, et al. The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS). PLoS ONE. 2021;16(5): e0251123.
Pierce-Williams RAM, Burd J, Felder L, Khoury R, Bernstein PS, Avila K, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. American Journal of Obstetrics and Gynecology MFM. 2020;2(3):100134.
Morán Antolín E, Broullón Molanes JR, de la Cruz Conty ML, Encinas Pardilla MB, Guadix Martín M del P, Sainz Bueno JA, et al. SARS-CoV-2 Infection and C-section: A prospective observational study. Viruses. 2021;13:2330.

[1] World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic. 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.

[2] World Health Organization (WHO). Third round of the global pulses survey on continuity of essential health services during the covid-19 pandemic: Interim report November-December 2021. 2022. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS_continuity-survey-2022.1.

[3] Goyal M, Singh P, Singh K, Shekhar S, Agrawal N, Misra S. The effect of the COVID‐19 pandemic on maternal health due to delay in seeking health care: Experience from a tertiary center. International Journal of Gynaecology and Obstetrics. 2021;152:231–5.

[4] Abdisa DK, Jaleta DD, Feyisa JW, Kitila KM, Berhanu RD. Access to maternal health services during COVID-19 pandemic, re-examining the three delays among pregnant women in Ilubabor zone, southwest Ethiopia: A cross-sectional study. PloS One. 2022;17:e0268196.

[5] Aranda Z, Binde T, Tashman K, Tadikonda A, Mawindo B, Maweu D, et al. Disruptions in maternal health service use during the COVID-19 pandemic in 2020: experiences from 37 health facilities in low-income and middle-income countries. BMJ Global Health. 2022;7:e007247.

[6] Riau DKP. Profil Kesehatan Provinsi Riau Tahun 2020. Pekanbaru: Dinas Kesehatan Provinsi Riau; 2021.

[7] Naqvi S, Naqvi F, Saleem S, Thorsten VR, Figueroa L, Mazariegos M, et al. Health care in pregnancy during the COVID-19 pandemic and pregnancy outcomes in six low- and-middle-income countries: Evidence from a prospective, observational registry of the Global Network for Women’s and Children’s Health. BJOG: An International Journal of Obstetrics & Gynaecology. 2022;129:1298–307.

[8] Kugelman N, Lavie O, Assaf W, Cohen N, Sagi-Dain L, Bardicef M, et al. Changes in the obstetrical emergency department profile during the COVID-19 pandemic. The Journal of Maternal-Fetal & Neonatal Medicine. 2022;35:4116–22.

[9] World Health Organization (WHO). WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020. 2020. Available from: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020.

[10] Al-Jabir A, Kerwan A, Nicola M, Alsafi Z, Khan M, Sohrabi C, et al. Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 2 (surgical prioritisation). International Journal of Surgery. 2020;79:233–48.

[11] Babidge WJ, Tivey DR, Kovoor JG, Weidenbach K, Collinson TG, Hewett PJ, et al. Surgery triage during the COVID-19 pandemic. Royal Australasian College of Surgeons. 2020;90:1558–65.

[12] Ganap EP, Hakimi M, Emilia O. Assessment of Maternal Referral Systems in Dr. Sardjito General Hospital Using Phyo Referral Score: A Single-Center Preliminary Study. In: 4th International Symposium on Health Research (ISHR 2019). Atlantis Press; 2020. p. 238–40.

[13] World Health Organization (WHO). Maternal mortality. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/maternal-mortality#:~:text=Key%20facts,dropped%20by%20about%2034%25%20worldwide.

[14] World Health Organization (WHO). Ending Preventable Maternal Mortality (EPMM): a renewed focus for improving maternal and newborn health and wellbeing. 2021. Available from: https://www.who.int/publications/i/item/9789240040519.

[15] Ofosu B, Ofori D, Ntumy M, Asah-Opoku K, Boafor T. Assessing the functionality of an emergency obstetric referral system and continuum of care among public healthcare facilities in a low resource setting: an application of process mapping approach. BMC Health Services Research. 2021;21:402.

[16] Bruce-Hickman K, Fan K, Plaat F, Sheth S. Decision-making on the labour ward during the COVID-19 pandemic. International Journal of Obstetric Anesthesia. 2021;45:150–1.

[17] Abu Sabbah EA, Eqylan SB, Al-Maharma DY, Thekrallah F, Safadi RR. Fears and uncertainties of expectant mothers during the COVID-19 pandemic: trying to reclaim control. International Journal of Qualitative Studies on Health and Well-being. 2022;17.

[18] Khetrapal Singh P, Jhalani M. Safeguarding essential health services during emergencies: lessons learnt from the {COVID}-19 pandemic. WHO South-East Asia J Public Health. 2020;9:93.

[19] Seyed-Nezhad M, Ahmadi B, Akbari-Sari A. Factors affecting the successful implementation of the referral system: A scoping review. Journal of Family Medicine and Primary Care. 2021;10:4364–75.

[20] De Simone B, Chouillard E, Di Saverio S, Pagani L, Sartelli M, Biffl W, et al. Emergency surgery during the {COVID}-19 pandemic: what you need to know for practice. annals. 2020;102:323–32.

[21] Vousden N, Bunch K, Morris E, Simpson N, Gale C, O’Brien P, et al. The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: A national cohort study using the UK Obstetric Surveillance System (UKOSS). PLoS ONE. 2021;16(5): e0251123.

[22] Pierce-Williams RAM, Burd J, Felder L, Khoury R, Bernstein PS, Avila K, et al. Clinical course of severe and critical coronavirus disease 2019 in hospitalized pregnancies: a United States cohort study. American Journal of Obstetrics and Gynecology MFM. 2020;2(3):100134.

[23] Morán Antolín E, Broullón Molanes JR, de la Cruz Conty ML, Encinas Pardilla MB, Guadix Martín M del P, Sainz Bueno JA, et al. SARS-CoV-2 Infection and C-section: A prospective observational study. Viruses. 2021;13:2330.

Utilization of Phyo Referral Score in assessing maternal referral quality in emergency cesarean section of maternal COVID-19 cases in Pekanbaru, Indonesia

Abstract

References

How to Cite

Search Panel