Evidence map›Paper›PMID 40512829›Full record

ArticlePloS one2025

Effect of active follow-up of women with previous cesarean delivery on uptake of timely safe obstetric and surgical care: Comparison between pre-intervention and intervention cohorts in Rwanda.

Josée Uwamariya, Gloriose Abayisenga, Ntwali Ndizeye, Fidele Nkurunziza, Albert Bisore Ngemanyi, Christian Mazimpaka, Jean Maurice Munyabarenzi, Rosine Bigirimana, Gilbert Rukundo, François Regis Cyiza and 6 more

Abstract readComparative Study
In one paragraph

Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Estimating the prevalence of vaginal birth after cesarean section and repeat cesarean section: An analysis of nationally representative household surveys in 59 low- and middle-income countries.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Josée UwamariyaUSAID MOMENTUM Safe Surgery in Family Planning and Obstetrics/IntraHealth International, Kigali, Rwanda.ORCID https://orcid.org/0000-0003-2448-2190
Gloriose AbayisengaUSAID MOMENTUM Safe Surgery in Family Planning and Obstetrics/IntraHealth International, Kigali, Rwanda.
Ntwali NdizeyeUSAID MOMENTUM Safe Surgery in Family Planning and Obstetrics/IntraHealth International, Kigali, Rwanda.
Fidele NkurunzizaUSAID MOMENTUM Safe Surgery in Family Planning and Obstetrics/IntraHealth International, Kigali, Rwanda.
Albert Bisore NgemanyiUSAID MOMENTUM Safe Surgery in Family Planning and Obstetrics/IntraHealth International, Kigali, Rwanda.
Christian MazimpakaUSAID Ingobyi Activity/IntraHealth International, Kigali, Rwanda.
Jean Maurice MunyabarenziUSAID MOMENTUM Safe Surgery in Family Planning and Obstetrics/IntraHealth International, Kigali, Rwanda.
Rosine BigirimanaUSAID MOMENTUM Safe Surgery in Family Planning and Obstetrics/IntraHealth International, Kigali, Rwanda.
Gilbert RukundoRwanda Biomedical Center, Kigali, Rwanda.
François Regis CyizaRwanda Biomedical Center, Kigali, Rwanda.
Farhad KhanEngenderHealth, Washington, United States of America.
Renae StaffordEngenderHealth, Washington, United States of America.
Karen LevinEngenderHealth, Washington, United States of America.
Anne Fitzgerald VinluanIntraHealth International, Chapel Hill, North Carolina, United States of America.
Kathryn MimnoIntraHealth International, Chapel Hill, North Carolina, United States of America.
Dieudonne NdatimanaUSAID Ingobyi Activity/IntraHealth International, Kigali, Rwanda.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe rate of cesarean delivery (CD) in Rwanda has increased significantly from 2.2% in 2000 to 15.6% in 2020. Given increasing risks in subsequent pregnancy following CD it is important that women who have had a prior cesarean section plan and schedule CD in later pregnancies. This study assessed the effectiveness of the USAID MOMENTUM Safe Surgery in Family Planning and Obstetrics intervention in reducing emergency CDs among women with previous CDs.

methodsWe conducted a cohort study in four public hospitals and 64 health centers across Rwanda, comparing two non-parallel cohorts: a pre-intervention cohort (December 2021-February 2022) and an intervention cohort (November 2022-May 2023). Exploratory data analysis and logistic regression were conducted to analyze the emergency CD rate and any associated factors.

resultsThe pre-intervention group comprised 212 women, whereas the intervention group involved 283 women, of whom 189 were included in the analysis. Among the 189 women in the intervention group, 87.3% reported to the hospital within five days post-referral when they were first called. The percentage of women who consulted for a delivery plan within 36-38 weeks of gestation increased from 37.6% in the pre-intervention group to 62.4% in the intervention group. Consequently, in the adjusted logistic regression model, there was still a significant association between the intervention and reduced odds of emergency CD, with a 81% reduction in the odds of delivery by emergency CD (0.187; 95% CI: [0.115; 0.298]) compared to pre-intervention.

conclusionThis study demonstrates the effectiveness of an active follow-up intervention in promoting delivery planning and reducing emergency CD rates among pregnant women with previous CD scars. The comprehensive intervention, including tailored education and personalized phone conversations around the delivery period, appears to have contributed to increased awareness and motivation for women to seek timely care at the hospital for delivery planning.

Indexed as

Cesarean SectionAdultCohort StudiesFemaleFollow-Up StudiesHumansPregnancyRwandaYoung Adult

Identifiers

PMID40512829
PMCPMC12165374

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.