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Frontiers in perinatal medicine
Int J Gynecol Obstet, 1993, 40: 263-279
263
International Federation of Gynecology and Obstetrics
Citations from the Literature This is a selection of abstracts taken from the literature in the field of obstetrics and gynecology which the Journal’s Editors feel may be of interest to our readers*
GENERAL ASPECTS
Ethical problems in neonatal iatemive care unit decision making on the neonate with poor prognok
Reprodnetive health: A glohd overview
Nishida H; Sakamoto S
Fathalla MF Special Programme of Research, Dev and Res Training Hum Repro, World Health Organization, 1211 Geneva 27, CHE
EARLY HUM DEV 1992 29/l-3 (35-42) A global overview of reproductive health outlines major challenges for action. Worldwide, 60 million to 80 million couples suffer from infertility. At the same time, there is a striking unmet need for contraception in developing countries. Unsafe abortion practices result in between 115 000 and 204 000 deaths each year. Female genital mutilation in one form or another continues to exist in around 40 countries. A second generation of organisms has now made sexually transmitted diseases the most common group of notifiable diseases in most countries. For the year 2000, it is projected that there will be a cumulative total of about 40 million HIV infections in men, women and children. About half a million women die each year because of complications related to pregnancy and childbirth. A total of about 15 million infants and children die annually, mostly from preventable childhood diseases. At least 17% of all babies in developing countries are born with a low birth weight.
medical
Maternal and Perinatal Center, Tokyo Women5 Med College, 8-l Kawada-cho, Tokyo 162, JPN
EARLY HUM DEV 1992 29/l-3 (403-406) In current NICU (neonatal intensive care units), it is inevitable that ethical decisions on neonates with a poor prognosis will have to be made. At Tokyo Women’s Medical College, we have been applying our own policy of medical decision making, which is somewhat different to those of most western countries. Most families are not asked to make final decisions and the ethical committee is not actively involved. Staff in the NICU make the decision after plenary discussions. The position after decision making is not to discontinue the life supporting system but to observe, with no additional treatments and with routine care (class C). From October 1984 to September 1989,58 out of 1589 neonates admitted to the NICU at Tokyo Women’s Medical College died and 32 (55%) of them were classilied as class C. The main causes of medical decision making were; non-viable (4/4, lOO%), lethal malformations (13120, 65%) and birth asphyxia (15119, 79%). Health service support of breast feeding -
Are we practising
what we preach?
Frontiers in perimtnl medicine Rooth G Department of Pediatrics, Univ of Uppsala ofre Slottsgatan 14C, S-75 310 Uppsala. SWE EARLY HUM DEV 1992 29/l-3 (21-26) A few of the topics of particular interest in perinatal medicine such as surfactants, erythropoietin, cordocentesis and computer assisted decision support are briefly reviewed. Asphyxia and oxygen toxicity are discussed as is the increase in the formation of free radicals which is part of reoxygenation. The infinitely larger problem of the poor in developing countries can best be improved - at least - partially by extending family planning techniques universally, othewise the population explosion will counteract any other improvements.
*Generated from the Excerpta Medica Database, EMBASE.
Beeken S; Waterston T Community Child Health, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE. GBR
BR MED J 1992 305/6848 (285-287) Objective - To ascertain the attitudes of health professionals and breast feeding mothers to breast feeding and their views on current practice. Design - Questionnaire to all midwives and health visitors and to breast feeding mothers in Newcastle upon Tyne. Setting - Maternity units and community in Newcastle upon Tyne. Subjects - 127 hospital midwives, 23 community midwives, 63 health visitors and 50 first time breast feeding mothers. Results - Optimum practice guidelines were not followed. 30 (60%) mothers said they were separated from their babies on the first night after birth. 82 (42%) professionals said that breast fed babies were frequently given water to drink. 28 (56%) babies in the mothers survey had received food or water other than breast milk; 19 of these had been given water. Professionals expressed mainly positive attiInt J Gynecol Obstet 40
263
International Federation of Gynecology and Obstetrics
Citations from the Literature This is a selection of abstracts taken from the literature in the field of obstetrics and gynecology which the Journal’s Editors feel may be of interest to our readers*
GENERAL ASPECTS
Ethical problems in neonatal iatemive care unit decision making on the neonate with poor prognok
Reprodnetive health: A glohd overview
Nishida H; Sakamoto S
Fathalla MF Special Programme of Research, Dev and Res Training Hum Repro, World Health Organization, 1211 Geneva 27, CHE
EARLY HUM DEV 1992 29/l-3 (35-42) A global overview of reproductive health outlines major challenges for action. Worldwide, 60 million to 80 million couples suffer from infertility. At the same time, there is a striking unmet need for contraception in developing countries. Unsafe abortion practices result in between 115 000 and 204 000 deaths each year. Female genital mutilation in one form or another continues to exist in around 40 countries. A second generation of organisms has now made sexually transmitted diseases the most common group of notifiable diseases in most countries. For the year 2000, it is projected that there will be a cumulative total of about 40 million HIV infections in men, women and children. About half a million women die each year because of complications related to pregnancy and childbirth. A total of about 15 million infants and children die annually, mostly from preventable childhood diseases. At least 17% of all babies in developing countries are born with a low birth weight.
medical
Maternal and Perinatal Center, Tokyo Women5 Med College, 8-l Kawada-cho, Tokyo 162, JPN
EARLY HUM DEV 1992 29/l-3 (403-406) In current NICU (neonatal intensive care units), it is inevitable that ethical decisions on neonates with a poor prognosis will have to be made. At Tokyo Women’s Medical College, we have been applying our own policy of medical decision making, which is somewhat different to those of most western countries. Most families are not asked to make final decisions and the ethical committee is not actively involved. Staff in the NICU make the decision after plenary discussions. The position after decision making is not to discontinue the life supporting system but to observe, with no additional treatments and with routine care (class C). From October 1984 to September 1989,58 out of 1589 neonates admitted to the NICU at Tokyo Women’s Medical College died and 32 (55%) of them were classilied as class C. The main causes of medical decision making were; non-viable (4/4, lOO%), lethal malformations (13120, 65%) and birth asphyxia (15119, 79%). Health service support of breast feeding -
Are we practising
what we preach?
Frontiers in perimtnl medicine Rooth G Department of Pediatrics, Univ of Uppsala ofre Slottsgatan 14C, S-75 310 Uppsala. SWE EARLY HUM DEV 1992 29/l-3 (21-26) A few of the topics of particular interest in perinatal medicine such as surfactants, erythropoietin, cordocentesis and computer assisted decision support are briefly reviewed. Asphyxia and oxygen toxicity are discussed as is the increase in the formation of free radicals which is part of reoxygenation. The infinitely larger problem of the poor in developing countries can best be improved - at least - partially by extending family planning techniques universally, othewise the population explosion will counteract any other improvements.
*Generated from the Excerpta Medica Database, EMBASE.
Beeken S; Waterston T Community Child Health, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE. GBR
BR MED J 1992 305/6848 (285-287) Objective - To ascertain the attitudes of health professionals and breast feeding mothers to breast feeding and their views on current practice. Design - Questionnaire to all midwives and health visitors and to breast feeding mothers in Newcastle upon Tyne. Setting - Maternity units and community in Newcastle upon Tyne. Subjects - 127 hospital midwives, 23 community midwives, 63 health visitors and 50 first time breast feeding mothers. Results - Optimum practice guidelines were not followed. 30 (60%) mothers said they were separated from their babies on the first night after birth. 82 (42%) professionals said that breast fed babies were frequently given water to drink. 28 (56%) babies in the mothers survey had received food or water other than breast milk; 19 of these had been given water. Professionals expressed mainly positive attiInt J Gynecol Obstet 40