OJPM  Vol.4 No.9 , September 2014
Maternal Mortality Interventions: A Systematic Review
ABSTRACT
Background: In order to achieve the World Health Organization’s Millennium Development Goal of reducing maternal mortality by three quarters by 2015, a strong global commitment is needed to address this issue in low-income nations where the risk to women is greatest. A comprehensive international effort must include provision of obstetric and general medical care as well as community-based interventions, with an emphasis on the latter in nations where the majority of women deliver babies at home without a trained attendant. Methods: This systematic analysis evaluates interventions published in Medline and CINAHL whose outcome measure is maternal mortality. Analysis includes components of the intervention, nation and maternal death rates. Results: Nine studies documented the effectiveness of various clinical and community-based interventions, including specific drug regimens and procedures, in reducing the risk of maternal death. Six studies reported interventions that did not significantly alter maternal mortality outcomes, and the intervention in one study demonstrated increased risk of maternal death. Conclusion: The dearth of evidence highlights the need for increased focus on translational research that bridges the gap between medical advances and community-based interventions that are feasible in low-income nations. This cannot be accomplished without a stronger commitment to reducing maternal mortality by global health practitioners and researchers.

Cite this paper
Piane, G. and Clinton, E. (2014) Maternal Mortality Interventions: A Systematic Review. Open Journal of Preventive Medicine, 4, 699-707. doi: 10.4236/ojpm.2014.49079.
References
[1]   Park, K. (2008) The Death of Isabella Della Volpe: Four Eyewitness Accounts of a Postmortem Caesarean Section in 1545. Bulletin of the History of Medicine, 82, 169-87.
http://dx.doi.org/10.1353/bhm.2008.0030

[2]   Dunn, P.M. (2004) Jean-Louis Baudelocque (1746-1810) of Paris and L’art des Accouchemens. Archives of Disease in Childhood (Fetal and Neonatal Edition), 89, 591.
http://dx.doi.org/10.1136/adc.2003.044008

[3]   Campbell, M. (2004) William Smellie’s Obstetrical Forceps. The Australian & New Zealand College of Obstetricians and Gynaecologists, 44, 184-185.

[4]   Cleary-Goldman, J. and Robinson, J.N. (2003) The Role of Episiotomy in Current Obstetric Practice. Seminars in Perinatology, 27, 3-12.
http://dx.doi.org/10.1053/sper.2003.50000

[5]   Fekete, S. (1970) Adatok Semmelweis Pesti Tanari Jelolesehez. Oryostorteneti Kozlemenyek, 55-56, 233-234.

[6]   Pinn, G. (1998) Quinine for Cramps. Australian Family Physician, 27, 922-923.

[7]   Nelson, R. (2004) Blood on Demand. American Heritage of Invention & Technology, 19, 24-31.

[8]   Danic, B. and Lefrere, J.J. (2008) Transfusion and Blood Donation on the Screen. Transfusion, 48, 1027-1031.

[9]   Hare, R. (1983) The Scientific Activities of Alexander Fleming, Other than the Discovery of Penicillin. Medical History, 27, 347-372.
http://dx.doi.org/10.1017/S0025727300043386

[10]   Gogtay, J.A. (2007) The Impact of Generic Antiviral Drugs. IDRugs, 10, 881-884.

[11]   Michener, J.L., Yaggy, S., Lyn, M., Warburton, S., Champagne, M., Black, M., et al. (2008) Improving the Health of the Community: Duke’s Experience with Community Engagement. Academic Medicine: Journal of the Association of American Medical Colleges, 83, 408-413.
http://dx.doi.org/10.1097/ACM.0b013e3181668450

[12]   World Health Organization (2008) Why Do So Many Women Still Die in Pregnancy or Childbirth?
http://www.who.int/features/qa/12/en/index.html

[13]   World Health Organization (2008) Maternal Health.
http://www.who.int/topics/maternal_health/en/

[14]   World Health Organization (1992) International Statistical Classification of Disease and Related Health Problems. Tenth Revision, 1992 (ICD-10), Geneva.

[15]   Piane, G.M. (2014) Correlates of Maternal Mortality by Nation. Open Journal of Preventive Medicine, In Press.

[16]   Adewole, I.F., Oladokun, A., Okewole, A.I., Omigbodun, A.O., Afolabi, A., Ekele, B., Audu, L.R. and Obed, Y. (2000) Magnesium Sulphate for Treatment of Eclampsia: The Nigerian Experience. African Journal of Medicine and Medical Sciences, 29, 239-241.

[17]   Noor, S., Halimi, M., Faiz, N.R., Gull, F. and Akbar, N. (2004) Magnesium Sulphate in the Prophylaxis and Treatment of Eclampsia. Journal of Ayub Medical College, Abbottabad, 16, 50-54.

[18]   Wang, Y., Walli, A.K., Schulze, A., Blessing, F., Fraunberger, P., Thaler, C., Seidel, D. and Hasbargen, U. (2006) Heparin-Mediated Extracorporeal Low Density Lipoprotein Precipitation as a Possible Therapeutic Approach in Preeclampsia. Transfusion and Apheresis Science, 35, 103-110.
http://dx.doi.org/10.1016/j.transci.2006.05.010

[19]   Espinoza, J., Romero, R., Nien, J.K., Gomez, R., Kusanovic, J.P., Gonçalves, L.F., Medina, L., Edwin, S., Hassan, S., Carstens, M. and Gonzalez, R. (2007) Identification of Patients at Risk for Early Onset and/or Severe Preeclampsia with the Use of Uterine Artery Doppler Velocimetry and Placental Growth Factor. American Journal of Obstetrics and Gynecology, 196, 326.e1-326.e13.
http://dx.doi.org/10.1016/j.ajog.2006.11.002

[20]   Patel, A., Goudar, S.S., Geller, S.E., Kodkany, B.S., Edlavitch, S.A., Wagh, K., Patted, S.S., Naik, V.A., Moss, N. and Derman, R.J. (2006) Drape Estimation vs. Visual Assessment for Estimating Postpartum Hemorrhage. International Journal of Gynecology and Obstetrics, 93, 220-224.
http://dx.doi.org/10.1016/j.ijgo.2006.02.014

[21]   Schaider, J., Ngonyani, S., Tomlin, S., Rydman, R. and Roberts, R. (1999) International Maternal Mortality Reduction: Outcome of Traditional Birth Attendant Education and Intervention in Angola. Journal of Medical Systems, 23, 99-105. http://dx.doi.org/10.1023/A:1020537202451

[22]   Derman, R.J., Kodkany, B.S., Goudar, S.S., Geller, S.E., Naik, V.A., Bellad, M.B., Patted, S.S., Patel, A., Edlavitch, S.A., Hartwell, T., Chakraborty, H. and Moss, N. (2006) Oral Misoprostol in Preventing Postpartum Haemorrhage in Resource-Poor Communities: A Randomised Controlled Trial. Lancet, 368, 1248-1253.
http://dx.doi.org/10.1016/S0140-6736(06)69522-6

[23]   West Jr., K.P., Katz, J., Khatry, S.K., LeClerq, S.C., Pradhan, E.K., Shrestha, S.R., Connor, P.B., Dali, S.M., Christian, P., Pokhrel, R.P. and Sommer, A. (1999) Double Blind, Cluster Randomised Trial of Low Dose Supplementation with Vitamin A or Beta Carotene on Mortality Related to Pregnancy in Nepal: The NNIPS-2 Study Group. British Medical Journal, 318, 570-575.
http://dx.doi.org/10.1136/bmj.318.7183.570

[24]   Kayongo, M., Esquiche, E., Luna, M.R., Frias, G., Vega-Centeno, L. and Bailey, P. (2006) Strengthening Emergency Obstetric Care in Ayacucho, Peru. International Journal of Gynecology and Obstetrics, 92, 299-307.
http://dx.doi.org/10.1016/j.ijgo.2005.12.005

[25]   Bakr, A.F. and Karkour, T. (2005) Effect of Predelivery Vaginal Antisepsis on Maternal and Neonatal Morbidity and Mortality in Egypt. Journal of Women’s Health, 14, 496-501.
http://dx.doi.org/10.1089/jwh.2005.14.496

[26]   Guilleminault, C., Palombini, L., Poyares, D., Takaoka, S., Huynh, N.T. and El-Sayed, Y. (2007) Pre-Eclampsia and Nasal CPAP: Part 1. Early Intervention with Nasal CPAP in Pregnant Women with Risk-Factors for Preeclampsia: Preliminary Findings. Sleep Medicine, 9, 9-14.
http://dx.doi.org/10.1016/j.sleep.2007.04.020

[27]   Roes, E.M., Raijmakers, M.T., Boo, T.M., Zusterzeel, P.L., Merkus, H.M., Peters, W.H. and Steegers, E.A. (2006) Oral N-Acetylcysteine Administration Does Not Stabilise the Process of Established Severe Preeclampsia. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 127, 61-67.
http://dx.doi.org/10.1016/j.ejogrb.2005.09.007

[28]   Rotchell, Y.E., Cruickshank, J.K., Gay, M.P., Griffiths, J., Stewart, A., Farrell, B., Ayers, S., Hennis, A., Grant, A., Duley, L. and Collins, R. (1998) Barbados Low Dose Aspirin Study in Pregnancy (BLASP): A Randomised Trial for the Prevention of Pre-Eclampsia and Its Complications. British Journal of Obstetrics and Gynaecology, 105, 286-292. http://dx.doi.org/10.1111/j.1471-0528.1998.tb10088.x

[29]   Zvandasara, P., Hargrove, J.W., Ntozini, R., Chidawanyika, H., Mutasa, K., Iliff, P.J., Moulton, H., Mzengeza, F., Malaba, L.C., Ward, B.J., Nathoo, K.J., Zijenah, L.S., Mbizvo, M., Zunguza, C. and Humphrey, J.H. (2006) Mortality and Morbidity among Postpartum HIV-Positive and HIV-Negative Women in Zimbabwe: Risk Factors, Causes, and Impact of Single-Dose Postpartum Vitamin A Supplementation. Journal of Acquired Immune Deficiency Syndromes, 43, 107-116.
http://dx.doi.org/10.1097/01.qai.0000229015.77569.c7

[30]   Jokhio, A.H., Winter, H.R. and Cheng, K.K. (2005) An Intervention Involving Traditional Birth Attendants and Perinatal and Maternal Mortality in Pakistan. The New England Journal of Medicine, 352, 2091-2099.
http://dx.doi.org/10.1056/NEJMsa042830

[31]   Chigbu, C.O. and Iloabachie, G.C. (2007) The Burden of Caesarean Section Refusal in a Developing Country Setting. BJOG: An International Journal of Obstetrics & Gynaecology, 114, 1261-1265.
http://dx.doi.org/10.1111/j.1471-0528.2007.01440.x

 
 
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