Sanga Karen, de Costa Caroline, Mola Glen
Department of Obstetrics and Gynaecology, Goroka General Hospital, EHP Papua New Guinea.
Aust N Z J Obstet Gynaecol. 2010 Feb;50(1):21-4. doi: 10.1111/j.1479-828X.2009.01116.x.
Papua New Guinea is a developing country with a population of six million, facing significant geographical, cultural and economic barriers to the provision of antenatal and intrapartum care. The maternal mortality ratio (MMR) is an internationally regarded index of the quality of a country's maternity services; the most recently reported MMR for Papua New Guinea of 773 deaths per 100 000 births is one of the highest in the world.
To review information about women who died from pregnancy-related causes, both direct and indirect, in the Goroka General Hospital (GGH) during the period 1st January 2005 to 31st May 2008.
A retrospective review was undertaken of the charts of women recorded as dying in the Obstetrics and Gynecology (O&G) ward of GGH in the study period.
The charts of 21 women who died from pregnancy-related causes were reviewed and information collated. Puerperal sepsis and sepsis complicating unsafe abortion were the most common causes of maternal death accounting for 48% deaths. Other causes included ectopic pregnancy and postpartum haemorrhage. Contributing factors included residence in a rural area, geographical and transport difficulties accessing care, non-use of family planning services, non-booking for antenatal care and late presentation in pregnancy or labour, and under-resourcing of services at GGH. The socio-economic status of most of the women was low, and where educational attainments were recorded these were also low. 71% of women identified themselves as practising Christians.
Better outreach services to provide health information and antenatal care, with specific counselling about the need for supervised delivery, are urgently required in the Eastern Highlands Province that GGH serves if numbers of maternal deaths are to be reduced. Working through churches in the region may be the most appropriate way to provide information and services to women because a majority of women adhere to Christianity and can be reached in this way.
巴布亚新几内亚是一个拥有600万人口的发展中国家，在提供产前和产时护理方面面临重大的地理、文化和经济障碍。孕产妇死亡率（MMR）是国际上衡量一个国家孕产妇服务质量的指标；巴布亚新几内亚最近报告的孕产妇死亡率为每10万例分娩中有773例死亡，是世界上最高的之一。
回顾2005年1月1日至2008年5月31日期间在戈罗卡综合医院（GGH）死于直接和间接妊娠相关原因的妇女的信息。
对研究期间在GGH妇产科病房记录为死亡的妇女病历进行回顾性研究。
对21名死于妊娠相关原因的妇女的病历进行了回顾并整理了信息。产褥期败血症和不安全堕胎并发败血症是孕产妇死亡的最常见原因，占死亡人数的48%。其他原因包括异位妊娠和产后出血。促成因素包括居住在农村地区、获得护理存在地理和交通困难、未使用计划生育服务、未进行产前检查预约以及孕期或分娩时就诊过晚，以及GGH的服务资源不足。大多数妇女的社会经济地位较低，在有教育程度记录的情况下，教育程度也较低。71%的妇女表明自己是基督教信徒。
如果要减少孕产妇死亡人数，GGH所服务的东高地省迫切需要更好的外展服务，以提供健康信息和产前护理，并就监督分娩的必要性提供具体咨询。通过该地区的教会开展工作可能是向妇女提供信息和服务的最合适方式，因为大多数妇女信奉基督教，通过这种方式可以接触到她们。
