Abstract
BackgroundMaternal and neonatal mortality figures remain unacceptably high worldwide and new approaches are required to address this problem. This paper evaluates the impact on maternal and neonatal mortality of a pregnancy care package for rural areas of developing countries with portable ultrasound and blood/urine tests.MethodsAn observational study was conducted, with intervention and control groups not randomly assigned. Setting: Rural areas of the districts of Senahu, Campur and Carcha, in Alta Verapaz Department (Guatemala). The control group is composed by 747 pregnant women attended by the community facilitator, which is the common practice in rural Guatemala. The intervention group is composed by 762 pregnant women attended under the innovative Healthy Pregnancy project. That project strengthens the local prenatal care program, providing local nurses training, portable ultrasound equipment and blood and urine tests. The information of each pregnancy is registered in a medical exchange tool, and is later reviewed by a gynecology specialist to ensure a correct diagnosis and improve nurses training.ResultsNo maternal deaths were reported within the intervention group, versus five cases in the control group. Regarding neonatal deaths, official data revealed a 64 % reduction for neonatal mortality. A 37 % prevalence of anemia was detected. Non-urgent referral was recommended to 70 pregnancies, being fetal malpresentation the main reported cause.ConclusionImpact data on maternal mortality (reduction to zero) and neonatal mortality (NMR was reduced to 36 %) are encouraging, although we are aware of the limitations of the study related to possible biasing and the small sample size.The major reduction of maternal and neonatal mortality provides promising prospects for these low-cost diagnostic procedures, which allow to provide high quality prenatal care in isolated rural communities of developing countries.Trial registrationThis research was not registered because it is an observational study where the assignment of the medical intervention was not at the discretion of the investigators.
Highlights
Maternal and neonatal mortality figures remain unacceptably high worldwide and new approaches are required to address this problem
This paper evaluates the impact on maternal and neonatal mortality of a pregnancy care package designed for rural areas of developing countries
The prenatal care kit is composed by a portable ultrasound equipment and dried blood screening (DBS) tests
Summary
Maternal and neonatal mortality figures remain unacceptably high worldwide and new approaches are required to address this problem. This paper evaluates the impact on maternal and neonatal mortality of a pregnancy care package for rural areas of developing countries with portable ultrasound and blood/urine tests. Well into the XXI century, maternal and neonatal mortality figures remain unacceptably high worldwide. It should be noted that almost half of these under five-year-old deaths occur during the neonatal period (before reaching 28 days) [3]. An important fact to understand this problem is that in developing countries, there were 40 million births without skilled health staff assistance; and more than 32 million of these births occurred in rural areas [3], where only one in every three women with an obstetric emergency received attention on time [4]
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