Validity of women's self-reported obstetric complications in rural Ghana

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.