PubMed · 14076347
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R M POGGIOLI. 1964. ANTEPARTUM BLEEDING.. https://pubmed.ncbi.nlm.nih.gov/14076347/
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AIM: The aim of this study was to review 4 years of hospital data on antenatal services, deliveries and maternal deaths as the baseline evaluation for a programme to improve care. METHODS: Descriptive analyses were made of data extracted from the monthly returns charts and clinical notes on all maternal deaths from January 2001 to December 2003 at the district hospital in the Kassena-Nankana district of rural northern Ghana. RESULTS: The majority (56.6%) of women first attended an antenatal clinic during the second trimester, and about 70% had haemoglobin levels of <10 g/dl. A total of 3160 deliveries were recorded. The prevalence of female genital cutting was 21.4%. Hospital and population rates of Caesarean section were 9.1 and 1.8%, respectively. Only one-third of women in need of a Caesarean section were able to access this intervention. Twenty-four maternal deaths were recorded, giving a hospital maternal mortality ratio of 759 per 100,000 live births. Complications of unsafe abortion (29.1%) and haemorrhage (20.8%) were the leading causes of death. Seventy-one percent of deaths occurred in women living within 15 km of the district hospital, and 50% occurred within 24 h of arrival. CONCLUSION: Late recourse to the health facility and complications of unsafe abortion are major contributory factors to maternal mortality in this district. A high level of unmet need for essential obstetric services, including access to contraceptive services, exists in this district. Decentralizing the availability of essential obstetric services through health centres to community level is necessary to reduce maternal mortality in developing countries.
Courts and legal tribunals increasingly decline to serve as religious or moral guardians, and require social evidence to support litigants' claims. Recent cases on emergency contraception and abortion are examined to show how judicial interpretations can take account of evidence of the impact that different understandings of the law will have for how ordinary people can plan their lives and reproductive choices. In an emergency contraception case, an interpretation was rejected that would have criminalized choices that millions of decent, law-abiding physicians, pharmacists and women routinely make. In an abortion case, three judges unanimously rejected a government ministry's defence of compliance with the law because the ministry had failed to investigate the needs within its jurisdiction for legal clarity, lawful services, and its responsibility to women returning from having lawful procedures elsewhere. In both cases, litigants prevailed who showed factual evidence that their claims better promoted reproductive health and choice.
As a member of the thrombospondin gene family, cartilage oligomeric protein (COMP) is found mainly in the extracellular matrix often associated with cartilage tissue. COMP exhibits a wide binding repertoire and has been shown to be involved in the regulation of chondrogenesis in vitro. Not much is known about the role of COMP in human cartilage tissue in vivo. With the help of immunohistochemistry, Western blot, in situ hybridization, and real-time reverse transcription-polymerase chain reaction, we aimed to elucidate the role of COMP in human embryonic, adult healthy, and osteoarthritis (OA) cartilage tissue. COMP is present during the earliest stages of human limb maturation and is later found in regions where the joints develop. In healthy and diseased cartilage tissue, COMP is secreted by the chondrocytes and is often associated with the collagen fibers. In late stages of OA, five times the COMP mRNA is produced by chondrocytes found in an area adjacent to the main defect than in an area with macroscopically normal appearance. The results indicate that COMP might be involved in human limb development, is upregulated in OA, and due to its wide binding repertoire, could play a role in the pathogenesis of OA as a factor secreted by chondrocytes to ameliorate the matrix breakdown.