Dear Colleagues,
I thought you might like to see our paper on fetal monitoring by mothers during labour in Liberia which was published today in the open access journal BMC Pregnancy and Childbirth together with a blog by Dr Rhona MacDonald from MCAI.
Very low ratios of midwives to mothers in labour in maternity wards in low-resource settings, such as Liberia, often lead to high rates of birth asphyxia and intrapartum stillbirths due to a lack of fetal heart-rate monitoring.
Here is a selected summary of some of the results of this initiative:
“Four hundred sixty-one out of 474 women gave consent, of whom 431 of 461 (93%) completed the monitoring themselves. Three hundred eighty-seven of 400 women who gave comments, reported positive and 13 negative experiences. Fetal Heart Rate (FHR) changes were reported in 28 participants and confirmed in 26. Twenty-four of these 26 FHR changes were first identified by mothers. All 26 neonates were discharged home apparently well. In 2 mothers, previously unrecognized obstetric complications (cord prolapse and Bandl’s ring with obstructed labour) accompanied FHR changes that were detected. Resuscitation was needed in 8 neonates without identified FHR changes including one of birth weight 1.3 Kg who could not be resuscitated. There were no intrapartum stillbirths in participants”.
Compared with well-resourced countries, intrapartum related neonatal mortality rates are 25-fold higher and intrapartum stillbirth rates up to 50 times higher in the lowest-income countries where rehabilitation services for children with neuro-developmental impairments are poor or absent.
Here is a link to our paper: https://rdcu.be/b4UnP and a link to the blog: http://blogs.biomedcentral.com/bmcseriesblog/2020/06/15/listening-to-my-...
Best wishes
David
Professor David Southall OBE, MD, FRCPCH
Honorary Medical Director MCAI, 1 Columba Court, Laide IV22 2NL, UK
+44 (0) 7710 674003 and +44 (0)7944 632011
WhatsApp +44 7944 632011
www.mcai.org.uk, http://books.mcai.org.uk and www.ihpi.org
Registered as a SCIO (Scottish Charitable Incorporated Organisation) No. SC043467
Director, MCAI Liberia, Office within WHO in the UN One Building, and Field Office, House 13, Phebe Hospital, Liberia Enterprise Number 051730402
CHIFA profile: David Southall is a retired Professor of Paediatrics and Honorary Medical Director of the Maternal and Child Health Advocacy International, MCAI, in the UK.
(www.mcai.org.uk) He is also on the board of the International Child Health Group. director AT mcai.org.uk
