Development of basic obstetric theater facility in a low-resource setting.

Abstract

In any given population or community, 15% of pregnant women can be expected to develop complications during pregnancy or delivery, and will require emergency obstetric care. Emergency preparedness should include establishing a functional operating theater (OT) to deal with complications and avert maternal and neonatal morbidity and mortality. The OT must be adequately equipped to handle common obstetric problems that include cesarean sections, uterine evacuations and manual removal of placenta (MROP), perineal repairs, examination under anesthesia (EUA) for hemorrhage and other conditions, laparotomy and immediate neonatal care. The feasibility of an effective referral system, with availability of transport and communication channels from the catchment area to the hospital with the OT should be planned from the outset. Monitoring and evaluation must be integral components of an obstetric OT, with defined analyses of outcomes and consequent remedial measures to maintain quality of service provision.