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Essential interventions for maternity care in low resource countries
International Journal of Gynecology and Obstetrics 104 (2009) 80
Contents lists available at ScienceDirect
International Journal of Gynecology and Obstetrics j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / i j g o
FIGO COMMITTEE REPORT
Essential interventions for maternity care in low resource countries
The following essential interventions prepared by the FIGO Safe Motherhood and Newborn Health Committee were approved by the FIGO Executive Board in October 2007. Description
Levela
1. Prenatal visits 4 (at least 1 before 22 weeks and 1 at 36 weeks of gestation); iron and folate supplements; tetanus toxoid; antimalarial therapy 2. Skilled attendance during prenatal, intrapartum, and postpartum period for mother and newborn, to include provision of family planning and support for breastfeeding 3. Clean delivery kit, clean place of delivery 4. Active management of the third stage of labor (AMTSL) 5. Communication and referral network 6. Antenatal steroid for women in premature labor 7. Vacuum extraction for prolonged second stage 8. Safe abortion within the limits of the law. Post abortion care/uterine aspiration for incomplete and/or septic abortion 9. PMTCT and counseling for treatment of HIV positive 10. Basic EmOC, including magnesium sulfate (MgSO4) for pre-eclampsia and eclampsia; assisted vaginal delivery 11. Comprehensive EmOC, including Basic EmOC, safe blood transfusion, cesarean delivery, emergency hysterectomy, high dependency care/basic life support 12. Comprehensive EmOC and advanced life support
All levels
a
All levels
All levels All levels All levels II to IV II to IV II to IV II to IV II to IV III and IV IV
Definition of levels: I Community; II Basic Health Unit; III Local or District Hospital; IV University or Urban Hospital.
Abbreviations AMTSL: Active Management of the Third Stage of Labor. See joint statement FIGO/ICM PPH 2006 [1]. Basic EmOC: Basic Emergency Obstetric Care (a) antibiotics (intravenous or by injection); (b) oxytocic drugs; (c) anticonvulsants; (d) manual removal of placenta; (e) removal of retained products of conception; (f) assisted vaginal delivery. Comprehensive EmOC: Comprehensive Emergency Obstetric Care. Basic EmOC plus: (a) cesarean delivery; (b) blood transfusion. PMTCT: Prevention of mother to child transmission of HIV. Skilled Attendance: See joint statement FIGO/ICM/WHO 2004 [2]. References [1] International Confederation of Midwives and International Federation of Gynecology and Obstetrics. Prevention and treatment of post-partum haemorrhage: New advances for low resource settings. Int J Gynecol Obstet 2007;97(2):160–3. [2] World Health organization. Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM and FIGO. Geneva: WHO; 2004. Available at: http:// www.who.int/reproductive-health/publications/2004/skilled_attendant.pdf.
doi:10.1016/j.ijgo.2008.09.002
Contents lists available at ScienceDirect
International Journal of Gynecology and Obstetrics j o u r n a l h o m e p a g e : w w w. e l s e v i e r. c o m / l o c a t e / i j g o
FIGO COMMITTEE REPORT
Essential interventions for maternity care in low resource countries
The following essential interventions prepared by the FIGO Safe Motherhood and Newborn Health Committee were approved by the FIGO Executive Board in October 2007. Description
Levela
1. Prenatal visits 4 (at least 1 before 22 weeks and 1 at 36 weeks of gestation); iron and folate supplements; tetanus toxoid; antimalarial therapy 2. Skilled attendance during prenatal, intrapartum, and postpartum period for mother and newborn, to include provision of family planning and support for breastfeeding 3. Clean delivery kit, clean place of delivery 4. Active management of the third stage of labor (AMTSL) 5. Communication and referral network 6. Antenatal steroid for women in premature labor 7. Vacuum extraction for prolonged second stage 8. Safe abortion within the limits of the law. Post abortion care/uterine aspiration for incomplete and/or septic abortion 9. PMTCT and counseling for treatment of HIV positive 10. Basic EmOC, including magnesium sulfate (MgSO4) for pre-eclampsia and eclampsia; assisted vaginal delivery 11. Comprehensive EmOC, including Basic EmOC, safe blood transfusion, cesarean delivery, emergency hysterectomy, high dependency care/basic life support 12. Comprehensive EmOC and advanced life support
All levels
a
All levels
All levels All levels All levels II to IV II to IV II to IV II to IV II to IV III and IV IV
Definition of levels: I Community; II Basic Health Unit; III Local or District Hospital; IV University or Urban Hospital.
Abbreviations AMTSL: Active Management of the Third Stage of Labor. See joint statement FIGO/ICM PPH 2006 [1]. Basic EmOC: Basic Emergency Obstetric Care (a) antibiotics (intravenous or by injection); (b) oxytocic drugs; (c) anticonvulsants; (d) manual removal of placenta; (e) removal of retained products of conception; (f) assisted vaginal delivery. Comprehensive EmOC: Comprehensive Emergency Obstetric Care. Basic EmOC plus: (a) cesarean delivery; (b) blood transfusion. PMTCT: Prevention of mother to child transmission of HIV. Skilled Attendance: See joint statement FIGO/ICM/WHO 2004 [2]. References [1] International Confederation of Midwives and International Federation of Gynecology and Obstetrics. Prevention and treatment of post-partum haemorrhage: New advances for low resource settings. Int J Gynecol Obstet 2007;97(2):160–3. [2] World Health organization. Making pregnancy safer: the critical role of the skilled attendant. A joint statement by WHO, ICM and FIGO. Geneva: WHO; 2004. Available at: http:// www.who.int/reproductive-health/publications/2004/skilled_attendant.pdf.
doi:10.1016/j.ijgo.2008.09.002