Women’s – Maternal and Children’s Health Care

In 2000 the Millennium Development Goals (MDGs) were passed by the United Nations. MDG No. 5 set the target of reducing maternal mortality by three-quarters (to 5.5%) by 2015. However, this goal has not been achieved worldwide. Percentage wise, even the industrialized countries, or so-called first world countries, have not achieved this goal either. Numerically, there is an urgent need for action, especially in the so-called developing countries. For example, in 2010, maternal mortality was highest in South Sudan, with 2,054 deaths per 100,000 live births, while Estonia was the world leader with just 2 / 100,000. Germany was ranked 164 out of 184 countries with 7 / 100,000 and Sierra Leone fourth highest with 890 / 100,000.

Gestational diabetes is a glucose tolerance disorder that occurs during pregnancy. The pathophysiology of gestational diabetes corresponds to a large extent to that of type 2 diabetes. On the basis of a genetic predisposition, obesity and the lifestyle (diet, exercise) of the women play a major role.
Preeclampsia and its variations HELLP syndrome and eclampsia are high blood pressure disorders that occur during pregnancy.
Both categories preeclampsia and gestational diabetes are associated with endothelial damage to the blood vessels – both of the placenta and of the maternal blood vessels.

It therefore makes sense that the EVFM is dedicated to these two pregnancy-related diseases and is committed to prevention programs.

Preeclampsia and Gestational diabetes can present a serious health risk to mother and child. Due to complications such as foetal macrosomia, stillbirth, retro-placental hematoma, disseminated intravascular coagulation, postpartum haemorrhage, intrauterine foetal death, intrauterine foetal growth restriction and iatrogenic preterm birth, together make them the most common causes of maternal mortality and prenatal morbidity and mortality worldwide.

Only through optimal prenatal care programs and high-tech medicine (laboratory medicine, ultrasound sonography, Doppler examination, intensive care medicine and neonatology) can the complications of these pregnancy disorders be kept in check in western countries. By ensuring this medical care in industrialized countries the public perception of these serious illnesses as a threat takes a back seat. Pregnancy is no longer perceived as a potentially life-threatening condition, but as a life event.
However, the fact remains that even in Germany most of the complications in pregnancy can be traced back to the categories of preeclampsia and gestational diabetes. Preterm birth or caesarean sections are just two examples of this.

The EFVM is involved in various accompanying measures for mothers and children’s health. The main focus here is also on so-called non-metropolitan regions in Germany, as well as low-resource settings of the sub-Saharan zone.
In collaboration with the Princess Christian Maternity Hospital in Freetown, Sierra Leone, a Gestational Diabetes Registry and a Preeclampsia Registry is to be established through a study nurse program. In addition, an exchange and training program for young assistant physicians of gynaecology and obstetrics was launched between Germany and Sierra Leone.