Strategies to prevent eclampsia in a developing country: I. Reorganization of maternity services

McCaw-Binns, Affette; Ashley, DE; Knight, L. W.; MacGillivray, Ian; Golding, Jean

doi:10.1016/j.ijgo.2004.07.008

Cited by 32 publications

(35 citation statements)

References 12 publications

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“…In 1998 the Ministry of Health rolled out a national high risk antenatal care system[26], [27] to improve referral of women at risk of pregnancy complications for management by the obstetric teams at regional hospitals (see Figure 2). By 2002, 85% of antenatal women could access specialist care, although women had to travel beyond their usual community of residence.…”

Section: Discussionmentioning

confidence: 99%

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

2011

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BackgroundDecreases in direct maternal deaths in Jamaica have been negated by growing indirect deaths. With sickle cell disease (SCD) a consistent underlying cause, we describe the epidemiology of maternal deaths in this population.MethodsDemographic, service delivery and cause specific mortality rates were compared among women with (n = 42) and without SCD (n = 376), and between SCD women who died in 1998–2002 and 2003–7.ResultsWomen with SCD had fewer viable pregnancies (p: 0.02) despite greater access to high risk antenatal care (p: 0.001), and more often died in an intensive care unit (p: 0.002). In the most recent period (2003–7) SCD women achieved more pregnancies (median 2 vs. 3; p: 0.009), made more antenatal visits (mean 3.3 vs. 7.3; p: 0.01) and were more often admitted antenatally (p:<0.0001). The maternal mortality ratio for SCD decedents was 7–11 times higher than the general population, with 41% of deaths attributable to their disorder. Cause specific mortality was higher for cardiovascular complications, gestational hypertension and haemorrhage. Respiratory failure was the leading immediate cause of death.ConclusionsWomen with SCD experience a significant excess risk of dying in pregnancy and childbirth [MMR: (SCD) 719/100,000, (non SCD) 78/100,000]. MDG5 cannot be realised without improving care for women with SCD. Tertiary services (e.g. ventilator support) are needed at regional centres to improve outcomes in this and other high risk populations. Universal SCD screening in pregnancy in populations of African and Mediterranean descent is needed as are guidelines for managing SCD pregnancies and educating families with SCD.

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Section: Discussionmentioning

confidence: 99%

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

2011

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“…This failure may lead to delayed decision in seeking care, which is reported to be a contributing factor in 30%-77% of all maternal deaths [8,9]. Studies indicate that education about pregnancy danger signs and symptoms targeting healthcare providers at different levels, as well as women of reproductive age, increased awareness and recognition of complications, motivated women to seek timely support, and improved referral to health services [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Awareness of danger signs and symptoms of pregnancy complication among women in Jordan

Okour

Alkhateeb

Amarin

2012

Intl J Gynecology & Obste

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“…Jamaica has shown that an aggressive health system approach can greatly reduce the incidence of and deaths from eclampsia. 11,12 Some common nonobstetric lifethreatening conditions should also get attention during antenatal care-malaria, hepatitis, diabetes, HIV/AIDS, sickle cell anemia, and measles are the most important ones. 13 Although good nutrition is obviously desirable during pregnancy, its role in safe pregnancy and delivery is often overstated.…”

Section: During Pregnancymentioning

confidence: 99%

Saving Mother's Lives: Programs That Work

Fortney

Leong²

2009

Clinical Obstetrics &Amp; Gynecology

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Maternal mortality is a complex problem requiring complex responses. Nevertheless, every intervention must operate through one of 3 pathways: preventing pregnancy, preventing complications, or preventing death when obstetric complications occur. We describe interventions following each pathway and assess their evidence base. In general, the more specific the intervention (such as procedures) the stronger the evidence. Broad interventions ("programs" for example) have a weaker evidence base although evidence is accumulating. The potential for robust evidence for effective programs is limited by epidemiologic design-the logistic difficulties of randomization, blinding, and single impact variables.

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Strategies to prevent eclampsia in a developing country: I. Reorganization of maternity services

Abstract: Reorganization of maternal care can have major public health benefits and cost savings; however, women need to be alerted to recognise and act upon signs of impending eclampsia.

Cited by 32 publications

References 12 publications

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

Excess Risk of Maternal Death from Sickle Cell Disease in Jamaica: 1998–2007

Awareness of danger signs and symptoms of pregnancy complication among women in Jordan

Saving Mother's Lives: Programs That Work

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