By Jane Collingwood
Technologies to prevent and manage obstetric complications are being neglected in under-resourced countries, say researchers.
Several measures can be taken to make labour safer in low-resource settings, say Dr Vivien Davis Tsu and colleagues from PATH, a nonprofit health consultancy based in Seattle, USA.
In BJOG: An International Journal of Obstetrics and Gynaecology, they report on the slow progress in reducing maternal death and illness in under-resourced countries. At present, over 500,000 women die every year due to pregnancy-related complications. These include haemorrhage, eclampsia, obstructed labour, infection, and unsafe abortion.
"The vast majority of these women live in low-resource settings, where skilled attendance and comprehensive emergency obstetric care remain largely unavailable," the experts write.
However, new technologies could improve the situation, they believe. Misoprostol can be administered orally to prevent postpartum haemorrhage where oxytocin is not available, they explain. It can also be used to treat complications arising after an unsafe abortion or incomplete miscarriage.
The authors also outline a simplified caesarean technique that can be performed by staff with limited training with limited facilities.
"Maternal mortality has rightly been a focus of the Millennium Development Goals, since pregnancy-related complications take the lives of half a million women each year," said Dr Tsu.
"While progress has been frustratingly slow, especially in Africa where some of the highest rates of maternal death occur, there are real opportunities for making headway in low-income countries if we take advantage of some of the new and underutilised technologies that are available."
Dr Tsu also called for renewed efforts to improve the availability of skilled midwives.
Tsu, V. D. and Coffey, P. New and underutilised technologies to reduce maternal mortality and morbidity: what progress have we made since Bellagio 2003? BJOG, An International Journal of Obstetrics & Gynaecology, Vol. 116, January 2009, pp. 247-56.
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