Collaboration Is Essential to Improving Maternal and Newborn Health in Indonesia
September 14, 2018It'll take a nation to change the numbers for Indonesia's moms and babies.As Indonesia celebrates its 73rd year of independence, most people are aware of the country ’s impressive economic development over the past few years. But perhaps fewer are aware that, every hour, across this massive archipelago, two mothers and eight newborns die.The country still faces unacceptably high levels of maternal and newborn mortality. This is a multi-faceted and complex issue, which requires collaboration between all elements of society to ensure effective measures are taken to improve maternal and newborn wellbeing.The Intercensal Survey of 2015 estimated that the maternal mortality is 305 per 100,000 live births. The Indonesia Demographic and Health Survey 2017 data suggests newborn deaths are 15 per 1,000 live births.The country aims to reduce the maternal mortality ratio to less than 70 per 100,000 live births.Despite less maternal and newborn mortality between 1990 and 2015, Indonesia fell short of the Millennium Development Goals that require countries to reduce mortality rates by three quarters. In Asia, Indonesia ranks behind Bangladesh, Cambodia, and Myanmar on this front.Reducing maternal and newborn deaths is part of the Sustainable Development Goals (SDGs), a United Nations-led agenda guiding countries worldwide to work together to tackle global challenges over the next 15 years. Under Goal 3, countries agree to ensure healthy lives and promot...
Conditions: Pre-Eclampsia; Hypertension; Proteinuria in Pregnancy; Thrombocytopenia; Renal Insufficiency; Impaired Liver Function; Pulmonary Edema; Headache; Visual Impairment Intervention: Other: Non-interventional study Sponsor: Progenity, Inc. Recruiting
Conclusion: Nocturnal hypertension at high-risk mid-pregnancy is a frequent condition and a strong predictor for PEEC; the risk doubled for women not taking ASA.
CONCLUSIONS: Pregnant women with high risk for OSA are at increased risks for preeclampsia-eclampsia compared to those with low risk for OSA. Our results support a role for screening for OSA by BQ during antenatal care. PMID: 30484015 [PubMed - as supplied by publisher]
We examined the risk of adverse pregnancy outcomes in primiparous kidney donors compared to matched controls.MethodsFifty ‐nine women with a history of kidney donation prior to their first pregnancy with normal renal function and no history of kidney disease, diabetes or chronic hypertension were matched 1:4 by age (within 2 years) and race to women with two kidneys using data from an integrated healthcare delivery s ystem. Adverse pregnancy outcomes were defined as preterm delivery (delivery 3 days, infant death/transfer to acute facility and low birth weight (
This article discusses pregnancy-related considerations for meningioma, pituitary disorders, demyelinating disease, myasthenia gravis, thyroid eye disease, idiopathic intracranial hypertension, cerebral venous sinus thrombosis, stroke, migraine, and cranial neuropathies. The article also details the potential neuro-ophthalmic complications of preeclampsia and eclampsia and reviews the use of common diagnostic studies during pregnancy.
Complement-mediated thrombotic microangiopathy (TMA), also known as atypical hemolytic uremic syndrome (aHUS) is a rare, hereditary, progressive, life-threatening disorder caused by a disruption in regulation of the alternative pathway of the complement system. Eculizumab, a terminal complement inhibitor, has emerged as a first-line therapy, however data are limited to small case series (Brocklebank et al., 2017). Here, we present a diagnostically challenging case of complement-mediated TMA, who received eculizumab therapy with excellent hematologic response.A 68-year-old female with history of possible Sjogren's syndrome,...
INTRODUCTION: Pregnancy is a risk factor for venous thromboembolism (VTE) and VTE affects 1 in 500 to 1 in 2000 pregnancies. Up to 30-50% of women with pregnancy-associated VTE may have an inherited thrombophilia but this does not completely explain the thrombosis risk. Clinical risk factors for VTE including multiple births, inflammatory bowel disease, sickle cell disease, diabetes, increased maternal age, stillbirth, and smoking have been identified in relatively small cohorts. We conducted this large case-control study to identify patient and pregnancy-associated risk factors for VTE during pregnancy or within 6 weeks p...
We refer to the article on blood pressure measurement in obese pregnant women in the August edition of IJOA.1 On page 68, the statement is made that four devices are currently validated for blood pressure measurement in pre-eclampsia. However, the article in the Journal of Hypertension to which the authors refer, also includes as validated the Microlife 3AS1-2 device, which appears to have been omitted from reference in the article.
As women are becoming pregnant at older ages, hypertension in pregnancy is more commonly encountered. Pre-eclampsia affects 5% of women. Women with known medical problems who become pregnant can also have pre-existing hypertension. This all requires careful management, particularly regarding medication review to avoid teratogenicity. These women require a multidisciplinary approach, to monitor for and reduce the risk of developing pre-eclampsia.
DiscussionThis is the first and largest multicentre randomized controlled trial to assess the effect of LDA in preventing PE in a Chinese population. The results will potentially influence the prenatal care recommendations in China regarding intervention with LDA for PE.Trial registrationClinicalTrials.gov,NCT02797249. Registered on 7 June 2016.
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