The phenomenon of unexpected birth and analysis of its causes, conditions, complications and resolutions in Clinical Hospital Nr. 1, Chisinau, Republic of Moldova

Abstract

Introduction: The unexpected delivery at home is a rare case but represents a particular situation, emotionally charged and often anxiety. First two previously in good health concerned, on the other hand, the prehospital care not are exceptionally familiar with this situation. Medicine of Reproductive Health is unanimously recognized by the international community as a public health problem by first intention. Worldwide daily record is 536 000 of maternal deaths, or about one maternal death every minute, 30 cases of severe maternal morbidity correspond to each maternal death. Also, 3 million neonatal deaths, 3 million stillborn and yearly, 10 million women that as a result of birth will survive, but wuth complications, some with definitive repercussions on their social life and family. Although it is expected that 90% of world population was born into medical institutions, indices of maternal and fetal mortality and morbidity, relating to births outside health facilities, hierarchy are included in the first five root causes of these pathologies. Results: In the study, we examined cases of unexpected births in Clinical Municipal Hospital N r.l, during the period 2011-2013 (in 2011 were 8300 births, of which 22 unexpected births (0,27 %); in 2012 — 8400 births, of wich 35 unexpected births (0,42 %) and in 2013 - 8450 births, 36 unexpected births (0,43 %)) analyzing the causes, major complications, ongoing process and subsequent health of mother and child. Conclusions: (1) Unplanned births phenomenon remains an actual topic of discussion and research since the incidence of the phenomenon is slowly growing and there are no large studies in this chapter. (2) Poor socio-economic conditions and ineffective health education of the population remain the main causes of this phenomenon. (3) Rates of complications and consequences for mother and child certainly remain frequent (p 0.0001 - 0.03) among unexpected births compared with normal births occurring in maternity. (4) At the moment there are no clear criteria of approach for the physician arrived unexpected in the room where the unplanned birth occurs. (5) Considering the risk for mother and baby, unplanned birth represents a real danger to maternal and child health, tending to rise steadily maternal and fetal morbidity and mortality rate.