Yayla Murat
Dicle University School of Medicine, Obstetrics and Gynecology Department, Diyarbakir, Turkey.
J Perinat Med. 2003;31(5):386-91. doi: 10.1515/JPM.2003.059.
Of all health statistics mentioned by the World Health Organization (WHO), maternal mortality is unique in showing the largest discrepancy between developed and developing countries. Approximately 90% of maternal deaths (more than 0.5 million each year) occur in developing countries. Over the last century, almost all countries have accepted antenatal care principles. However, insufficiency of resources and lack of women's compliance were the main handicaps in developing countries and compelled these countries to apply various standard programs. Unfortunately, these programs are not sufficiently effective in the prevention and treatment of maternal mortality. Fixing the number (quantity) of antenatal visits and the static approach affect the "quality" of antenatal care. Bleeding, chronic anemia, hypertensive disorders, obstructed labor, unsafe abortions and infections are the main factors leading to maternal mortality. The majority of these factors are preventable. It is important to suspect the presence of any of these factors and to intervene promptly both during antenatal care and immediately after delivery. The evidence-based approach is a way of reaching this solution. Antenatal care is a concept that extends from pre-pregnancy to postpartum, leading to effective emergency care for unpredictable and predictable complications during pregnancy and childbirth. Worldwide policies are not always applicable to each country, coercing national policies. There is still a need for prospective randomized trials to clarify this concept and the relevant policies.
在世界卫生组织(WHO)提及的所有健康统计数据中,孕产妇死亡率在显示发达国家与发展中国家之间最大差异方面独具特色。约90%的孕产妇死亡(每年超过50万例)发生在发展中国家。在过去一个世纪里,几乎所有国家都接受了产前保健原则。然而,资源不足和妇女依从性差是发展中国家的主要障碍,迫使这些国家实施各种标准项目。不幸的是,这些项目在预防和治疗孕产妇死亡方面效果并不充分。确定产前检查的次数(数量)和静态方法会影响产前保健的“质量”。出血、慢性贫血、高血压疾病、难产、不安全堕胎和感染是导致孕产妇死亡的主要因素。这些因素中的大多数是可预防的。在产前保健期间以及分娩后立即怀疑存在这些因素中的任何一种并及时进行干预很重要。循证方法是达成这一解决方案的途径。产前保健是一个从孕前延伸至产后的概念,可为孕期和分娩期间不可预测和可预测的并发症提供有效的紧急护理。全球政策并不总是适用于每个国家,从而促使各国制定本国政策。仍需要进行前瞻性随机试验来阐明这一概念及相关政策。