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BMJ. British Medical Journal. 2004; 328: p..A Roma woman who alleges she was sterilised without her consent during an emergency procedure at a Hungarian hospital is taking her case to the United Nations. Records show that the woman, then aged 28, who was undergoing labour pains and bleeding heavily, was taken by an emergency vehicle to Szatmár-Beregi Hospital in Fehérgyarmat in northeastern Hungary on 2 January 2001. Examinations determined that the placenta had ruptured and that her unborn infant had died, said Dr András Kanyó, who, with other members of the hospital's emergency team, had been alerted by emergency medical personnel to the woman's imminent arrival. "Following the ultrasound and a physical examination, I asked her about her family, and she said she had three children. I asked if she planned to have any more, and she said no," said Dr Kanyó, a gynaecologist, anaethesiologist, and intensive care specialist. (excerpt)
REVISTA PAULISTA DE MEDICINA. 1989 Jan-Feb; 107(1):47-52.In the fight against maternal mortality, the WHO recommended that developing countries adopt effective measures to reduce its high prevalence. One measure is the improvement of data about maternal deaths and major risk factors during pregnancy, delivery, and puerperium. Official figures are underreported by 50% or more, and the cause of death tends to be attributed to an immediate preceding complication. In the US, maternal mortality declined from 37/100,000 live births in 1960 to 8/100,000 in 1984; in Chile from 299 in 1960 to 45 in 1984; in Ecuador from 270 in 1960 to 189 in 1984; and in Paraguay from 327 in 1960 to 283 in 1984, a barely noticeable reduction. Strategies that improve knowledge include the keeping of statistics; epidemiological investigations (case control studies); and the formation of committees on maternal death, which are composed of highly regarded professionals (the UK, Chile, and Cuba obtained good results with them). The education of the populace by radio, television, and print media to utilize prenatal assistance is another measure. The human resources, location, and minimum instrumentation of these health centers are basic requirements. Most maternal deaths occur in hospitals of inadequate staff and material resources. The traditional birth assistant training program of Ceara state, Brazil, is a model for others. Caesareans save many lives in complicated deliveries, but in Sao Paulo state, more than 80% of some groups choose it without justification. Assistance Needs to be extended into the puerperium to monitor normal involution of the genital organs, to confirm normal lactation, and observe any pathology present during pregnancy. Cardiopathy, renal insufficiency, chronic hypertension, grand multiparity, and advanced maternal age are high risk factors for pregnancy. Postabortion deaths account for more than half of mortality in some Latin American countries. In the UK, mortality dropped from 35 in 1969, after the legalization of abortion in 1968 to 8 in 1975. The reverse was observed in Romania when abortion became outlawed. Nonetheless, abortion is a touchy issue and education about contraceptives should be stressed.