Rosenfield A
Columbia University School of Public Health, New York, NY 10032.
JAMA. 1989 Jul 21;262(3):376-9.
Maternal mortality is one of the great neglected problems of health care in developing countries. The World Health Organization estimates that approximately 500,000 women die each year from pregnancy-related causes, more than 98% of these deaths occurring in the developing world. Maternal mortality rates in developing countries are as much as 100 times higher than those seen in industrialized countries. The most common causes include obstructed labor and ruptured uterus, postpartum hemorrhage, eclampsia, postpartum infection, and complications of illegal abortion. It is suggested that no new or costly technologies are needed; rather that appropriate priority-setting and allocation of needed resources are essential to the solution of the problem. There are few interventions that hold much hope of success at the village level, although antibiotics, ergonovine maleate, and sedatives might be usefully utilized, after appropriate training. Overall, however, networks of maternity care facilities, trained personnel, and means of transport are necessary to provide needed emergency maternity care services.
孕产妇死亡率是发展中国家医疗保健中一个被严重忽视的重大问题。世界卫生组织估计,每年约有50万妇女死于与妊娠相关的原因,其中超过98%的死亡发生在发展中世界。发展中国家的孕产妇死亡率比工业化国家高出多达100倍。最常见的原因包括产程梗阻和子宫破裂、产后出血、子痫、产后感染以及非法堕胎并发症。有人认为,解决这一问题并不需要新的或昂贵的技术;相反,适当的优先事项设定和所需资源的分配对于解决该问题至关重要。在村级层面,几乎没有什么干预措施有很大成功的希望,不过经过适当培训后,抗生素、马来酸麦角新碱和镇静剂可能会有用。然而,总体而言,需要有孕产妇护理设施网络、训练有素的人员和运输工具,以提供所需的紧急孕产妇护理服务。