Quality assessment of mobile applications on postpartum hemorrhage management

A descriptive evaluative study, carried out from January to February 2023 on the App Store^® and Google Play Store^®. The Mobile Application Rating Scale was used to assess quality (engagement, functionality, aesthetics, information and subjective quality). Information extraction and assessment on postpartum hemorrhage was carried out using a table with information based on official documents, containing stratification, prevention, diagnosis and treatment.

Results:

Seven applications were included; of these, three were in English, six had an Android operating system. The quality mean was 3.88. The highest means were for functionality, reaching 5.0 (n = 6), and the lowest were for engagement, less than 3.0 (n = 4). The majority of applications presented less than 50% of the information on postpartum hemorrhage management.

Conclusion:

The applications assessed achieved an acceptable quality mean and, according to health organizations’ current protocols, did not contain the necessary information for complete postpartum hemorrhage management.

DESCRIPTORES
Postpartum Hemorrhage; Mobile Applications; Telemedicine; Evaluation Study

Name	Developer	Language	Operational system	Update month/year	Review score^* The assessment score refers to the one available in the store where it was extracted and ranges from 0 to 5 stars. *It was not possible to access the number of downloads, as it was not available on the platform (zero?). /number of reviews	Number of downloads	Size
Maternal & Newborn Care Plans	AFRA Dev	English	Android	December 2022	0/0	>10,000	11.1 MB
Postpartum Hemorrhage	Prof. Pinki Shrivastava	English	Android	April 2022	0/0	>100	7.88 MB
Risco Hemorrágico Obstétrico	Juliano Gaspar (Faculdade de Medicina de Minas Gerais - UFMG)	Portuguese	Android	November 2018	5/18	>50	21.93 MB
El embarazo y el parto seguros	Hesperian health guides	Spanish	Android	March 2017	3.4/110	>10,000	14.15 MB
GPCs Ginecología y Obstetricia	Jorge Madrigal Veja	Spanish	Android	January 2021	0/0	>50,000	54.83 MB
Safe delivery	Maternity foundation	Customizable (30 versions)	Android	October 2022	0/0	>100,000	11.85 MB
ACOG DII SMI	Fountainhead Mobile Solutions	English	iOS	February 2022	0/0	^** The assessment score refers to the one available in the store where it was extracted and ranges from 0 to 5 stars. *It was not possible to access the number of downloads, as it was not available on the platform (zero?).	41.1 MB

APPLICATION NAME	MOBILE APPLICATION RATING SCALE (MARS) SCORE
APPLICATION NAME	Engagement mean	Functionality mean	Aesthetics mean	Information mean	Overall quality mean	Subjective quality mean
Maternal & Newborn Care Plans	2.2	5.0	3.7	3.4	3.57	2.2
Postpartum Hemorrhage	2.2	5.0	3.3	3.0	3.37	1.5
Risco Hemorrágico Obstétrico	3.2	5.0	3.7	4.4	4.07	4.2
El embarazo y el parto seguros	2.8	5.0	3.0	3.7	3.62	2.5
GPCs Ginecología y Obstetricia	2.4	4.5	4.0	4.5	3.85	2.2
Safe delivery	4.6	5.0	5.0	4.1	4.67	5.0
ACOG DII SMI	3.4	4.7	3.7	4.3	4.02	4.0
Rating mean	2.97	4.88	3.85	3.91	3.88	3.37

INFORMATION ABOUT PPH MANAGEMENT	APPLICATION NAME
	Maternal & Newborn Care Plans	Postpartum Hemorrhage	Risco Hemorrágico Obstétrico	El embarazo y el parto seguros	GPCs Ginecología y Obstetricia	Safe Delivery	ACOG DII SMI
	Percentual de informações presentes por categoria
DEFINITION/STRATIFICATIONS	60%	60%	0%	20%	20%	0%	0%
PPH (vaginal)	P	P	–	P	P	–	–
PPH (caesarian)	–	–	–	–	–	–	–
Massive PPH	–	–	–	–	–	–	–
Primary PPH	P	P	–	–	–	–	–
Secondary PPH	P	P	–	–	–	–	–
PREVENTION	20%	20%	100%	0%	60%	40%	100%
Risk factors	–	–	P	–	P	–	P
Antepartum RS	–	–	P	–	–	–	P
Intrapartum RS	–	–	P	–	–	–	P
PM care	P	–	P	–	P	P	P
PM medications	–	P	P	–	P	P	P
DIAGNOSIS	40%	20%	0%	40%	60%	0%	60%
Visual estimation	–	–	–	P	P	–	P
Weighing pads/pads	P	–	–	–	–	–	P
Collecting devices	–	–	–	–	–	–	P
Clinical parameters	P	P	–	P	P	–	–
Shock Index	–	–	–	–	P	–	–
TREATMENT	60%	40%	0%	40%	60%	80%	80%
Medicinal	P	P	–	P	P	P	P
Non-surgical	–	–	–	–	P	P	P
Surgical	–	–	–	–	P	–	P
Trauma, thrombin and tissue treatments	P	–	–	–	–	P	–
Assistance behaviors	P	P	–	P	–	P	P
% TOTAL INFORMATION	45%	35%	25%	25%	50%	30%	60%

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Érika Maria Alves da Silva Av. Prof. Moraes Rego, 844-900, Cidade Universitária 50670-420 – Recife, PE, Brazil erika.maria@ufpe.br