中低收入国家的产妇高度护理和重症监护病房

IF 3.9 2区 医学 Q1 OBSTETRICS & GYNECOLOGY Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2024-02-15 DOI:10.1016/j.bpobgyn.2024.102474
José Rojas-Suarez , Fathima Paruk
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引用次数: 0

摘要

尽管近几十年来在最大限度降低孕产妇死亡率方面取得了显著进步,但高收入国家与中低收入国家之间仍然存在着明显的差距,尤其是在对孕妇和产后妇女的强化护理和高度护理方面。这种差异是多因素造成的,受多种因素的影响,如社区孕产妇保健服务的可用性和可及性、预防性护理的质量、获得医院或重症监护的及时性、资源的可用性以及配备先进干预措施的设施等。包括人体免疫缺陷病毒(HIV)、不安全堕胎、产褥败血症在内的各种并发症,尤其是 COVID-19 大流行病,加剧了这些挑战的复杂性。在应对这些挑战和探讨潜在解决方案的过程中,我们希望能为正在进行的有关低收入国家孕产妇医疗保健的讨论做出贡献,最终努力实现公平的医疗保健环境,让每一位母亲,无论其地理位置或社会经济地位如何,都能获得她们所需和应得的医疗保健服务。利用传统和创新方法来实现充分的知识、适当的技能、适用资源的定位以及强有力的领导力是至关重要的。通过实施和加强这些战略,资源有限的环境可以优化现有资源,及时识别产科患者的病情严重程度,确保为母亲和儿童提供及时、适当的干预。此外,可显著改善这种状况的策略还包括增加医疗基础设施投资、有效的资源管理、提高供应链效率以及开发和使用低成本、高质量的设备。通过有针对性的投资、创新、有效的资源管理和国际合作,有可能确保每一个孕产妇重症监护室和ICU病房,无论其地理位置或社会经济地位如何,都能获得高质量的重症监护,以提供挽救生命的护理。
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Maternal high-care and intensive care units in low- and middle-income countries

Despite notable advancements in minimizing maternal mortality during recent decades, a pronounced disparity persists between high-income nations and low-to middle-income countries (LMICs), particularly in intensive and high-care for pregnant and postpartum individuals. This divergence is multifactorial and influenced by factors such as the availability and accessibility of community-based maternity healthcare services, the quality of preventive care, timeliness in accessing hospital or critical care, resource availability, and facilities equipped for advanced interventions. Complications from various conditions, including human immunodeficiency virus (HIV), unsafe abortions, puerperal sepsis, and, notably, the COVID-19 pandemic, intensify the complexity of these challenges. In confronting these challenges and deliberating on potential solutions, we hope to contribute to the ongoing discourse around maternal healthcare in LMICs, ultimately striving toward an equitable health landscape where every mother, regardless of geographic location or socioeconomic status, has access to the care they require and deserve. The use of traditional and innovative methods to achieve adequate knowledge, appropriate skills, location of applicable resources, and strong leadership is essential. By implementing and enhancing these strategies, limited-resource settings can optimize the available resources to promptly recognize the severity of illness in obstetric individuals, ensuring timely and appropriate interventions for mothers and children. Additionally, strategies that could significantly improve the situation include increased investment in healthcare infrastructure, effective resource management, enhanced supply chain efficiency, and the development and use of low-cost, high-quality equipment.

Through targeted investments, innovations, efficient resource management, and international cooperation, it is possible to ensure that every maternal high-care and ICU unit, regardless of geographical location or socioeconomic status, has access to high-quality critical care to provide life-saving care.

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来源期刊
CiteScore
9.40
自引率
1.80%
发文量
113
审稿时长
54 days
期刊介绍: In practical paperback format, each 200 page topic-based issue of Best Practice & Research Clinical Obstetrics & Gynaecology will provide a comprehensive review of current clinical practice and thinking within the specialties of obstetrics and gynaecology. All chapters take the form of practical, evidence-based reviews that seek to address key clinical issues of diagnosis, treatment and patient management. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. Management will be described in practical terms so that it can be applied to the individual patient.
期刊最新文献
Post pregnancy family planning in Latin America and the Caribbean analysis and strengths in training on immediate contraception post obstetric event by CLAP/PAHO Fetal therapies – (Stem cell transplantation; enzyme replacement therapy; in utero genetic therapies) Ethical considerations in prenatal genomic testing Prenatal detection of copy number variants Impact of prenatal genomics on clinical genetics practice
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