International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
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Int J Gynaecol Obstet · Oct 2012
Reducing maternal, newborn, and infant mortality globally: an integrated action agenda.
There has been increasing awareness over recent years of the persisting burden of worldwide maternal, newborn, and child mortality. The majority of maternal deaths occur during labor, delivery, and the immediate postpartum period, with obstetric hemorrhage as the primary medical cause of death. Other causes of maternal mortality include hypertensive diseases, sepsis/infections, obstructed labor, and abortion-related complications. ⋯ Recent data also suggest that sufficient evidence- and consensus-based interventions exist to address reproductive, maternal, newborn, and child health globally, and if implemented at scale, these have the potential to reduce morbidity and mortality. There is an urgent need to put elements in place to promote integrated interventions among healthcare professionals and their associations. What is needed is the political will and partnerships to implement evidence-based interventions at scale.
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Int J Gynaecol Obstet · Oct 2012
Improving maternal and perinatal outcomes in the hypertensive disorders of pregnancy: a vision of a community-focused approach.
The hypertensive disorders of pregnancy (HDP; pre-existing hypertension, gestational hypertension, and pre-eclampsia) remain important causes of maternal morbidity and mortality, especially in low- and middle-income countries. The paper summarizes the current state of evidence around possible technologies to support community-based improvements in maternal and perinatal outcomes for women with pre-eclampsia. Through the testing and, where proven, introduction of these technologies, we believe that HDP-related progress toward achieving Millennium Development Goal 5 can best be accelerated. The evidence and discussion are presented under the following headings: (1) prediction; (2) prevention; (3) diagnosis; (4) risk stratification; (5) decision aids; (6) treatment; (7) geographic information systems; (8) communication; and (9) community and patient education.
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The effect of HIV infection on maternal mortality is best documented in South Africa, where HIV prevalence rates in pregnancy are among the highest in the world. Since 1998, detailed data on maternal deaths in South Africa have been available in the form of Confidential Enquiries reports. The latest report (Saving Mothers Report, 2005-2007) suggests that the maternal mortality ratio in HIV-infected women was about 10 times higher than in uninfected women. ⋯ The most common causes of maternal death among HIV-positive women were nonpregnancy-related infections, including AIDS, pneumonia, tuberculosis, and meningitis. HIV-infected pregnant women were also at greater risk of dying from pregnancy-related sepsis and complications of abortion than their uninfected counterparts. Reduction of HIV-related maternal deaths must be seen as a worldwide priority in maternal health care.
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Int J Gynaecol Obstet · Oct 2012
From safe motherhood, newborn, and child survival partnerships to the continuum of care and accountability: moving fast forward to 2015.
The present paper provides an overview of the Safe Motherhood Initiative, Healthy Newborn Partnership, and Child Survival Partnership and their eventual merge into the Partnership for Maternal, Newborn and Child Health (PMNCH) in 2005. The promise and past successes of the PMNCH are highlighted, with a particular focus on the PMNCH's partner-centric approach showing the importance of collaboration for progress. The aims of the strategic framework for 2012-2015 are presented within the context of the Global Strategy for Women's and Children's Health, launched in 2010, and growing political momentum to achieve Millennium Development Goals 4 and 5 (reduce child mortality and improve maternal health, respectively). The next 4 years leading to 2015 are critical, and the global community must continue to work together to ensure all women and children are reached with key interventions proven to reduce mortality.