ROME, Oct. 10, 2012 /CNW/ - "Many preventable deaths occur during pregnancy and childbirth in the developing world where maternal mortality ranges from 200 to 2,000 per 100,000 live births. Moreover, for each woman who dies, an estimated 16 to 30 survive avoidable complications, often miserably," said Professor Gamal Serour, President of the International Federation of Gynecology and Obstetrics (FIGO), presenting the most recent Initiatives for the prevention and treatment of post-partum haemorrhage (PPH) and obstetric fistula in low-resource countries at the FIGO2012 Congress in Rome, Italy.
PPH is the first cause of maternal mortality in low-resource countries, accounting for approximately 30% of maternal deaths. For PPH prevention and treatment uterotonic therapy is key. The most widely recommended agent is oxytocin, which requires parenteral administration, as well as sterile equipment, and refrigeration, all factors hindering its use in low-resource settings.
Misoprostol, a synthetic E1 prostaglandin analogue available in tablet form, stable at room temperature, well absorbed orally and sublingually, has increasingly been adopted as an alternative strategy for PPH care.
"Our PPH Initiative, funded by a grant to Gynuity Health Projects from the Bill&Melinda Gates Foundation, advocates for and disseminates evidence-based information on misoprostol for PPH. It is part of a global project for translating scientific and operational research into effective policies and practice," Professor Hamid Rushwan, FIGO Chief Executive, explained.
A major concern for women who give birth in low-resource countries is obstetric fistula, perhaps the most tragic of preventable childbirth complications, as affected women in nearly all cases lose their babies, suffer from health problems, including chronic incontinence, and are often abandoned by their husbands, forced to live social segregation.
Obstetric fistula, a hole in the birth canal usually caused by prolonged obstructed labour, is largely avoidable by delaying the age of first pregnancy, stopping harmful traditional practices, and granting timely access to obstetric care. According to the WHO, each year between 50,000 to 100,000 women develop fistula. More than 2,000,000 women live with untreated fistula in sub-Saharan Africa and Asia.
FIGO recently launched the Fistula Initiative which focuses on its prevention and treatment in 12 African and Asian countries. With the aim to ensure high quality clinical training for the care of women with obstetric fistula and to increase capacity of services and staff to provide comprehensive management of fistula, FIGO co-ordinated the production, funded by the United Nations Population Fund (UNFPA), of the Global Competency-Based Fistula Surgery Training Manual.
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