This retrospective study assessed the utility of women's self-reports to id
entify Obstetric complications in rural Ghana. All consenting obstetric and
postpartum inpatients, presenting from the seventh month of gestation to 4
2 days postpartum, were interviewed at the Holy Family Hospital, Techiman a
nd were asked about their signs and symptoms. A combination of clinical exa
mination and laboratory testing of urine and blood samples was used for det
ermining case status. Self-reported obstetric complications of 340 women we
re compared with the corresponding diagnostic status for their sensitivity,
specificity, predictive value, and test-efficiency. Using algorithms that
could not be practically applied at the community level, self-reported symp
toms correctly identified the majority (75%) of complicated and uncomplicat
ed pregnancies, but missed one-quarter of cases requiring emergency obstetr
ic care. The positive predictive value of 50% indicates that women's self-r
eported symptoms should not be used in estimating the incidence of these co
nditions or in identifying women requiring referral in this population.