Methodology of studying and preventing maternal morbidity and mortality
Tokova, Z.Z.
Akusherstvo i Ginekologiia 1988(2): 54-57
1988
ISSN/ISBN: 0300-9092 PMID: 3377132 Document Number: 319972
Basic principles of the public health system adopted in the Soviet Union are briefly discussed with special emphasis on the role of various risk factors in the prediction and prevention of maternal morbidity and mortality. The majority of risk factors for noninfectious diseases are associated with behavior and life style. Development of a healthy life style depends upon one's social activities, occupation, level of education, and ethnic factors. The network of free health care services is essential for a healthy life style, but other factors, such as type of nutrition, living conditions, and personal hygiene play an equally important role. The strategy of prevention of maternal morbidity and mortality is based on identification of risk factors for pregnancy, labor and the post partum period. Such risk factors as age, nationality, presence of extragenital diseases, and pregnancy complications should be ascertained during early pregnancy. Maternal mortality indices are correlated with the level of education: the higher the level the lower the mortality. The differences between mortality indices for urban and rural populations are associated with the differences in the life style, personal hygiene, and availability of health care facilities. Frequent pregnancies and pregnancies during an early and late reproductive period are considered a universal risk factor. Risk factors can be divided into prenatal and intranatal. Prenatal risk factors include a history of gynecological diseases, while intranatal factors include labor complications (hemorrhage, rupture of the uterus, sepsis, amniotic fluid embolism). Uncontrollable risk factors include age, population density, climate, or seasonal factors.