Academic journal article Journal of Health Population and Nutrition

Profile of Maternal and Foetal Complications during Labour and Delivery among Women Giving Birth in Hospitals in Matlab and Chandpur, Bangladesh

Academic journal article Journal of Health Population and Nutrition

Profile of Maternal and Foetal Complications during Labour and Delivery among Women Giving Birth in Hospitals in Matlab and Chandpur, Bangladesh

Article excerpt

INTRODUCTION

Giving birth should be a time for celebration; however, for an estimated 358,000 women worldwide, pregnancy and childbirth end in death and mourning (1,2). Beyond these maternal deaths are numerous episodes of acute maternal complication: by some estimates, 9-10% of pregnant women or about 14 million women per year suffer from acute maternal complications (2,3). Estimate of the World Health Organization (WHO), United Nations Children's Fund, and United Nations Population Fund (approximately 15% of expected births suffering from obstetric complications) is more than double this figure: approximately 20 million women suffer from an obstetric complication. The consequences of birth and acute maternal complications, including death and disabilities, make up the largest burden of disease affecting women in developing countries (4-6).

In Bangladesh, an estimated 11,000-21,000 women die each year due to pregnancy-related complications (7), and a further 320,000 women suffer from injuries or disabilities caused by these complications during pregnancy and childbirth (8). Although most of these injuries or disabilities are not life-threatening, these may render women outcast from their family and society. Women with disabilities may also face cultural, social or other barriers to obtaining care and, therefore, become silent sufferers (9-11).

Measuring acute maternal complication is difficult, particularly in populations where not all women give birth in a hospital. The number and percentage of women in Bangladesh who suffer from acute maternal complications or medium or long-term disabilities are not yet known. The reliability of reported complications based on a woman's recall is poor, even if the woman suffered from a life-threatening complication (12,13). Reliable ascertainment of maternal complication requires observation by a trained service provider, and this is typically facility-based. For this reason, few studies have been able to measure the incidence of acute maternal complications at the population level (14,15).

The aim of the present study was to document the types and severity of acute maternal and foetal complications among women admitted to different hospitals around the time of childbirth and post-partum.

MATERIALS AND METHODS

Study area

We conducted the study in the icddr,b service area in Matlab, a rural area located about 55 km southeast of Dhaka, the capital of Bangladesh. In 2007, the population in the study area was approximately 113,660 (16). The major sources of income are fishing and farming, and about two-thirds of women have received institutional education (16). The area has been under surveillance since 1966 for vital events (births, deaths, marriages, migration) by the village-based Community Health Research Workers (CHRWs). At the time of this study, the CHRWs visited each household bi-monthly to collect data on the reproductive health status of women and determined pregnancy, using a pregnancy-detection strip. Other CHRWs provided services from fixed-site clinics bi-weekly, along with counselling pregnant women to seek antenatal care and attend hospital for safe delivery. These CHRWs also disseminated information to groups of pregnant women about home-based lifesaving skills for newborns, including management of the newborns during normal delivery and for maternal and neonatal complications, such as prolonged labour, excessive bleeding, and birth asphyxia (17-19).

The icddr,b service area has four subcentre clinics run by nurse-midwives and paramedical staff and a hospital in Matlab town with a 30-bed maternity unit run by doctors and nurses (16). Each subcentre clinic serves about 20,000 persons. They provide limited obstetric services 24 hours, including care for normal labour and delivery, the first dose of antibiotic for infection, the first dose of magnesium sulphate (MgS[O.sub.4]) for eclampsia, and oxytocin only for active management of third stage of labour (AMTSL). …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.