Inequalities in maternal health and pregnancy outcome among Nigerian women migrated to Italy.

Among migrant women, unfavourable health conditions and adverse obstetric events are observed more often than in native-born parturients. This observational retrospective study evaluated selected pregnancy outcomes in a Nigerian population giving birth at the University Hospital of Verona. Compared to national controls, being Nigerian was associated with preterm birth (aOR 1.

Maternal near miss and maternal deaths in Mozambique: a cross-sectional, region-wide study of 635 consecutive cases assisted in health facilities of Maputo province.

Background: Life-threatening events during pregnancy are currently used as a measure to assess quality of obstetric care. The aim of this study is to assess prevalence of near miss cases and maternal deaths, to elucidate the causes and to analyze avoidable factors based upon the three-delays approach in southern Mozambique.

Methods: Near miss cases comprised five categories: eclampsia, severe hemorrhage, severe sepsis, uterine rupture and severe malaria.

Massive Plasmodium falciparum visceral sequestration: a cause of maternal death in Africa.

Sequestration of Plasmodium falciparum-infected erythrocytes (PfIE) in the capillaries of the central nervous system (CNS) is the pathognomonic feature of cerebral malaria, a condition frequently leading to death. Sequestration of PfIE in the placental intervillous spaces is the characteristic feature of malaria in pregnancy and is associated with low birthweight and prematurity. Although both patterns of sequestration are thought to result from the expression of different parasite proteins involved in cytoadhesion to human receptors, scant information exists on whether both conditions can coexist and whether this can lead to death.

Clinico-pathological discrepancies in the diagnosis of causes of maternal death in sub-Saharan Africa: retrospective analysis.

Background: Maternal mortality is a major public-health problem in developing countries. Extreme differences in maternal mortality rates between developed and developing countries indicate that most of these deaths are preventable. Most information on the causes of maternal death in these areas is based on clinical records and verbal autopsies.

An autopsy study of maternal mortality in Mozambique: the contribution of infectious diseases.

Background: Maternal mortality is a major health problem concentrated in resource-poor regions. Accurate data on its causes using rigorous methods is lacking, but is essential to guide policy-makers and health professionals to reduce this intolerable burden. The aim of this study was to accurately describe the causes of maternal death in order to contribute to its reduction, in one of the regions of the world with the highest maternal mortality ratios.

Avoidability of maternal death in Mozambique: audit and retrospective risk assessment in 106 consecutive cases.

A maternal mortality audit identified 106 cases of maternal death in Maputo (340 per 100 000 live births), caused by haemorrhage (31%), hypertensive diseases of pregnancy (15%), puerperal sepsis (12%) and septic abortion (9%). Puerperal uterine inertia (12%) and malaria (9%), respectively, were the most prevalent causes of direct and indirect maternal death. The maternal mortality audit analyses, indicated that health services research is fruitful in a more detailed, systematic study on maternal deaths at the community level wit ensuing analyses of avoidability aspects.

Seasonal variations in maternal mortality in Maputo, Mozambique: the role of malaria.

Objective: To evaluate the impact of malaria on maternal death through the analysis of the seasonal variations of crude and malaria-specific maternal mortality rates.

Methods: All maternal deaths and live births occurring at Maputo Central Hospital, located in an urban area, between January 2001 and December 2003, were retrospectively recorded. Clinical diagnoses of the causes of death and period of the year were analysed.

Syphilis, gonorrhoea and chlamydial infection among women undergoing legal or illegal abortion in Maputo.

Our objectives were to compare the prevalence of sexually transmitted infections (STIs) in 103 women undergoing induced legal abortion (LA) and in 101 women with confirmed, recent illegal abortion (IA), in Maputo, Mozambique. For the purpose of this study, LA was considered the abortion provided in the Maputo Central Hospital with the approval of the Ministry of Health, and IA the one not provided through the approved facility, mentioned above. Women with IA were recruited in the outpatient gynaecology ward and women with LA in the emergency gynaecology ward in the Maputo Central Hospital, during the same time period.

Adolescent maternal mortality in Mozambique.

Purpose: To describe adolescent maternal mortality and analyze its avoidability.

Methods: An audit approach was used to clarify the presence of avoidable factors in 239 maternal deaths, of which 22% were among adolescents.

Results: The main causes of adolescent death were malaria, pregnancy-induced hypertension, puerperal sepsis, and septic abortion.

Malaria-related maternal mortality in urban Mozambique.

All pregnancy-related maternal deaths that occurred at the central hospital of Maputo during the 5 years between 1989 and 1993 were reviewed. The 239 maternal deaths recorded represented a maternal mortality ratio of 320/100,000 live births. Overall, 15.

Reproductive characteristics and post-abortion health consequences in women undergoing illegal and legal abortion in Maputo.

In the Maputo Central Hospital 103 women undergoing induced legal abortion (LA), 103 women with confirmed, recent illegal abortion (IA), and 100 randomly recruited antenatal clinic (AC) attenders were compared in order to find characteristic features regarding obstetric history, reproductive performance and contraceptive knowledge, attitude and practice. Women with IA were younger, had almost never undergone LA, had more often their first sexual intercourse and their first pregnancy below 20 years of age, had less knowledge of contraceptives and more often had never used contraceptives, had fewer previous spontaneous abortions and fewer previous stillbirths than LA women. There were three maternal deaths, all in the IA group.

Low-dose vaginal misoprostol for induction of labor with a live fetus.

Objective: To test the effectiveness and safety of low-dose vaginal misoprostol for induction of labor with a live fetus.

Methods: Labor was induced in 666 pregnant women with a live fetus in the cephalic position, who had no medical complications and no history of uterine surgery. One-fourth of a 200-micrograms tablet of misoprostol (50 micrograms) was placed in the posterior vaginal fornix every 12 h for a maximum of four doses or until active labor commenced.

Vaginal misoprostol as an alternative to oxytocin for induction of labor in women with late fetal death.

Background: Induction of labor in women with late fetal death is often difficult in settings with scarce resources. The purpose of this study was to assess the value of vaginal misoprostol for induction of labor in women with such fetal death.

Methods: In Maputo 156 women with late fetal death were allotted in a non-randomised way to either vaginal misoprostol or intravenous infusion of oxytocin.

A comparative study of vaginal misoprostol and intravenous oxytocin for induction of labour.

Fifty-two women who had labour induced by intravenous oxytocin were compared with 404 women in whom labour was induced by vaginal misoprostol (50-150 micrograms). The induction-to-delivery intervals in the oxytocin and misoprostol groups, respectively, had the following durations. With Bishop's score < 6, 24.

Induction of labor with intravaginal misoprostol in intrauterine fetal death.

Objective: Our purpose was to evaluate the effectiveness and safety of intravaginal misoprostol for the induction of labor in intrauterine fetal death.

Study Design: Seventy-two women at 18 to 40 weeks of pregnancy with intrauterine fetal death, without abdominal scars, were treated with 100 micrograms of intravaginal misoprostol. The dose was repeated every 12 hours until effective uterine contractions and cervical dilatation were obtained, for up to 48 hours.

Audit of uterine rupture in Maputo: a tool for assessment of obstetric care.

Records of 96 women who had rupture of the uterus in labor were audited to find circumstances significantly associated with pregnancy outcome. The prevalence was 1 rupture in 424 deliveries. In 74 cases (77.

Intrauterine infections and their association with stillbirth and preterm birth in Maputo, Mozambique.

Subclinical intrauterine infections during pregnancy in Mozambican women were studied in an attempt to elucidate their potential association with adverse pregnancy outcome, particularly stillbirth and preterm birth. A total of 39 stillbirths and 21 preterm live births were compared with 121 term live births. Extraplacental membranes and amniotic fluid were studied to ascertain the presence or absence of chorioamnionitis and of antibacterial activity in amniotic fluid.

Outcome of teenage pregnancy in Maputo, Mozambique.

Objective: To evaluate the perinatal outcome of teenage pregnancies in comparison with a population of older, high-risk women.

Method: Data about 15,207 high-risk women delivered during 1989 at the Central Hospital of Maputo, Mozambique, were collected retrospectively from the clinical records. Of these women 2185 were less than 19 years old.

Management of labour following caesarean section in a developing country.

During recent years, the observed rise of the CS rate (17% in 1989) led the medical staff of the Maputo Central Hospital to consider the opportunity of admitting to trial of labour selected pregnant patients following one previous CS. The present study retrospectively evaluates maternal and fetal outcome following the adoption of this policy. 94 (52.