Document Detail

Role of antenatal care in reducing maternal mortality.
MedLine Citation:
PMID:  1627055     Owner:  NLM     Status:  MEDLINE    
Maternal mortality in the developed nations has been considerably reduced, but it still is very high in developing nations. I carried out an indepth study of maternal mortality at N. Wadia Maternity Hospital, Bombay. India, from 1929 to 1988, which revealed that the MMR which was 1920 per 100,000 live births during 1929-1939 period has declined to 82 per 100,000 live births during 1980-1988 period. This achievement in reduction of maternal mortality over the decades was due to multiple factors like increased and effective antenatal, intranatal, and postnatal care. This study shows the apathy of pregnant women to come forward to avail of antenatal care though available even free of charge nearby. To give maximum benefits to pregnant women specially in the developing nations, we have to carry the antenatal care at the door-steps of the community.
Nowrosjee Wadia Maternity Hospital, Bombay, India, is the setting for these observations on the decline in maternal mortality (MM) from 1920/100,000 live births (LBs) in 1929-39 to 82/100,000 LBs in 1980-88, and the discussion of the role prenatal care continues to play in reducing maternal mortality. A reduction in maternal mortality was due to multiple factors: prenatal, intranatal, and postnatal care; a variety of new biochemical and biophysical methods of examination; newer diagnostic and therapeutic measures; and effective management of labor. MM falls within the range for developing countries which is 50-2000/100,000 LBs and is approaching the developed countries MM which is 5-20/100,000 LBs. The direct obstetric death rate also declined from 670/100,000 to 41/100,000 between 1929-39 and 1980-89. For the same period, the indirect obstetric death rate declined from 690/100,000 to 29/100,000. 52% of the births were attended by trained personnel. Prenatal registration was 6.1% in the 1st trimester, 64.7% in the 2nd trimester, and 29.2% in the 3rd trimester for 2 years during 1987 and 1988. These figures reflect utilization when medical facilities are free of charge and available within a kilometer's distance from one's residence. Illiteracy is given as the nonuse reason. Many women believe that registration at any time entitles one to admission for delivery. In fact, 88.01% (800 cases) of unbooked or emergency cases resulted in MM in 1929-39 while only 11.99% (109 cases) of booked cases resulted in MM. By 1980-89, booked cases of MM were 41.40% (29 cases) and 58.60% (41 cases) were unbooked. Among booked patients for 3 years between January 181 and December 1983, 36.2% had fewer-than 3 prenatal visits, 63.8% had more than 3 prenatal visits, of which .41% had medical or surgical complications, and 1.67% had obstetric complications. Among unbooked patients, there were 1.29% with medical or surgical complications and 4.49% with obstetric complications. Admissions to the prenatal ward with obstetric complications between 1981-83 and 1987-88 were greatest for hypertensive disorders (26.72% and 25.1%, respectively) followed by delivery during stay (25/9% and 32.4%), observation (20.49% and 17.4%), and anemia disorders (22.62% and 19/8%). Recommendations are made for primary health care in rural areas where prenatal care and health services are brought to the doorsteps of the community with traditional birth attendants, and mobile prenatal clinic vans.
R D Pandit
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Asia-Oceania journal of obstetrics and gynaecology / AOFOG     Volume:  18     ISSN:  0389-2328     ISO Abbreviation:  Asia Oceania J Obstet Gynaecol     Publication Date:  1992 Mar 
Date Detail:
Created Date:  1992-08-10     Completed Date:  1992-08-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8102781     Medline TA:  Asia Oceania J Obstet Gynaecol     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  1-6     Citation Subset:  IM; J    
Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, G.S. Medical College, Bombay, India.
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MeSH Terms
Maternal Health Services*
Maternal Mortality* / trends

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