Maternal Mortality and Morbidity Will Not Reduce in Low Resource Countries without the Anaesthetists’ Involvement

Elizabeth Ogboli-Nwasor

doi:10.4236/ojog.2014.45037

Elizabeth Ogboli-Nwasor

Open Access

https://doi.org/10.4236/ojog.2014.45037

Copy DOI

Abstract

Background: Maternal and foetal mortality is unacceptably high in most resource-limited countries and the practice of obstetric anaesthesia has an important influence on outcome for both mother and baby. The much needed close co-operation and collaboration between obstetricians and obstetric anaesthetist providers is crucial for the safety and comfort of parturients, particularly in low-resource environments. The current global maternal mortality is approximately 400 per 100,000 deliveries, with a range of 7 - 740 deaths per 100,000, demonstrating the inequality between the rich and poor countries. Many of the deaths could have been prevented by better essential obstetrics services including safe anaesthesia and surgery, provided such services are made available in a timely manner. Conclusion: Maternal mortality in low resource countries has its basis complex social, economic and political factors, underpinned by a lack of resources. Many of these factors are difficult and slow to resolve and are not specific to maternal health. Comprehensive essential obstetric care services at the district hospital level (first referral level) should include all the above plus safe surgery, safe anaesthesia, and blood transfusion. Government, donor agencies and all stakeholders must recognize the crucial role of anaesthesia in providing emergency obstetric care in hospitals. Advocacy by all concerned will help direct the scarce resources to the appropriate areas of need which includes provision of adequate facilities and manpower for safe anaesthesia.

Highlights

The maternal mortality ratio (MMR) is the ratio of maternal deaths to live births, the lifetime risk of maternalHow to cite this paper: Ogboli-Nwasor, E. (2014) Maternal Mortality and Morbidity Will Not Reduce in Low Resource Countries without the Anaesthetists’ Involvement
Official figures probably underestimate MMR as deaths due to childbirth may be wrongly attributed, denominator data are lacking and death registration systems poorly developed [1] in many low-resource countries
Maternal death is defined according to the tenth revision of the International Classification of Diseases, Injuries and Causes of Death (ICD 10) as: “the death of a woman while pregnant or within 42 days of termination of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes” [3]

Summary

Introduction

The maternal mortality ratio (MMR) is the ratio of maternal deaths to live births, the lifetime risk of maternal. (2014) Maternal Mortality and Morbidity Will Not Reduce in Low Resource Countries without the Anaesthetists’ Involvement. Maternal mortality and morbidity will not reduce in low resource countries without anaesthesia involvement. This statement is based on the Millennium Development Goal 5 which is to “Improve maternal health and reduce maternal mortality by 75% between 1990 and 2015”. 2) The proportion of women who were attended to by skilled health-care personnel at least once during pregnancy increased from 64% to 81%. Improvement in the coverage of these health-care interventions over the past two decades may have contributed to improved outcomes in those countries that have recorded reduction in maternal mortality rates. Efforts to improve maternal health and reduce maternal deaths should be focused on addressing inequalities across and within countries

The Influence of Obstetric Anaesthesia on Maternal Mortality

The Solutions

Findings

Conclusions