Antenatal care in developing countries
Nylander, P.P.; Adekunle, A.O.
Bailliere's Clinical Obstetrics and Gynaecology 4(1): 169-186
1990
ISSN/ISBN: 0950-3552 PMID: 2205429 DOI: 10.1016/s0950-3552(05)80218-4Document Number: 373705
Prenatal care, the most important factor determining the outcome of pregnancy, is limiting in developing countries either because of no or inadequate facilities or underutilization. WHO estimated that only 29-36% of African, 20-61% of Asian and 69-89% of South American births have maternity care. Existing services and underutilized because of illiteracy, the most important factor, cultural practices, religious practices, and the subordinate status of women. Care in developing countries is exemplified by describing prenatal care in urban University College Hospital, Ibadan, Nigeria, in a rural town of 30,000 in Western Nigeria and in the Ibarapa District in 1989, and care by TBAs. Routine care provided in the rural clinics included Talqvist hemoglobin count, history to determine Sickling, iron, folic acid and antimalarials if available, and referral to the weekly consultant clinic if the woman is under 5 ft in height, primigravid and 36 weeks gestation, uncertain of dates, has discrepancy in fundal height for dates, is ill or has history suggestive of abnormal pregnancy. Pregnant women usually used the clinic for antenatal care, but only 45% delivered in maternities. The review ends with brief discussions of management of malaria, anemia, hemoglobinopathy, malnutrition and teenage pregnancy. Anemia, common to all, is managed by transfusion of packed cells with administration of a loop diuretic to prevent hear failure.