Obstetric mortality and its causes in developing countries

Article Abstract:

The Royal College of Obstetricians and Gynecologists (RCOG) works to improve standards of obstetric care both in Britain and other countries; however, in spite of efforts by this group and others, the gap between standards of obstetric care in Britain and the developing world continues to widen. In addition, the medical training provided in Britain to foreign doctors may be inappropriate for conditions they will face in their countries. Studies of worldwide maternal death rates indicate that 500,000 women die yearly during pregnancy and childbirth, with additional thousands falling prey to severe and disabling diseases; 99 percent of deaths occur in developing countries. In these countries, the maternal death rate is 400 deaths per 100,000 population, compared with 6 deaths per 100,000 population in Western Europe. Because of unreliable reporting of maternal deaths, these grim figures probably underestimate the problem. The perinatal death rate (death during the weeks just before or just after childbirth), a sensitive indicator of maternal care, may be as high as 60 to 70 deaths per 1,000 population in India. Death often results from complications that are treatable by modern medicine, such as bleeding, bloodborne infections, eclampsia (a toxic condition of pregnancy that can often be prevented), complications of labor, illegal abortions, or viral hepatitis (a liver infection). Malnutrition, uncontrolled fertility, poor obstetric care and ineffective public health services allow infectious agents easy access to pregnant women, while poverty, nutritional problems, belief systems that favor the use of traditional midwives, and other factors further elevate the risk for complications during pregnancy. Poor care, and limited access to care, are the basic problems. The World Health Organization has set the goal of reducing maternal mortality in the developing world by 50 percent by the year 2000. Specific programs and recommendations toward this end are discussed. The overall strategy relies on preventive care, prenatal screening, and referral of high-risk pregnancies to medical centers. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Social aspects, Standards, International aspects, Developing countries, Mothers, Maternal mortality, Obstetrics, Maternal health services, Royal College of Obstetricians and Gynaecologists

---

Early postoperative mortality following hysterectomy. A Danish population based study, 1977-1981

Article Abstract:

Hysterectomy (removal of the uterus) is a common operation, and it is estimated that 7,000 of these operations are performed each year in Denmark alone. Eighty percent of hysterectomies are for nonmalignant conditions. Even though this surgery is common, few studies have examined the safety of hysterectomy or related mortality. A recent report (1988) from the New York State Department of Health estimated mortality following hysterectomy at 35 deaths per 10,000 operations, with higher mortality (202 per 10,000) for hysterectomy in patients with cancer. To estimate mortality resulting from hysterectomy in a Danish population, the medical records of 29,192 women who had a hysterectomy between 1977 and 1981 were reviewed. The study included only women without cancer and who were not having any other type of surgery. The records showed that 47 out of the 29,192 women died within 30 days of the operation, putting the overall mortality at 16 deaths per 10,000 operations. For the sample population, it was estimated that only seven deaths should have occurred for every 10,000 operations. The risk of dying following the operation increased as the age of the patient increased. In this study, mortality was not related to the type of surgical procedure used, and 90 percent of the operations were performed through the abdomen. However, previous studies have indicated that mortality is higher for the abdominal method than when the vaginal method of surgery is used. In conclusion, at a mortality of 16 cases per 10,000 operations, hysterectomy is a safe procedure compared with other types of operations. In this study, women who underwent a hysterectomy had a six-fold greater chance of dying within 30 days than women in the general population. (Consumer Summary produced by Reliance Medical Information, Inc.)

Denmark, Hysterectomy

---

Similar abstracts:

• Abstracts: Pectus deformities: causes and effects. Repetitive strain injury: causes, treatment and prevention. Exploring the non-viral infectious causes of cancer
• Abstracts: Vaccines. Evaluating new vaccines for developing countries: efficacy or effectiveness? Pediatricians Alerted to Five New Vaccines
• Abstracts: Accumulation of penicillin in vaginal fluid. Postoperative urinary tract infection in gynecology: implications for an antibiotic prophylaxis policy
• Abstracts: Increased high-density lipoprotein levels caused by a common cholesteryl-ester transfer protein gene mutation
• Abstracts: Multifetal pregnancy reduction and disposal of untransplanted embryos in contemporary Jewish law and ethics. Cervical cancer in Jewish women

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.