Problems and challenges to women’s reproductive health in the 21th century

Abstract

The current high level of medical care in the world, in particular in obstetrics and gynecology, creates the preconditions for the optimal preservation of women's reproductive health and quality of life. However, in low-income countries, the quality of care for pregnant women and women after labor needs to be significantly improved. Women’s poor education, insufficient awareness of the threatening signs of a fetus during pregnancy as well as the lack of awareness of contraception lead to a large number of unplanned pregnancies, short intervals between pregnancies that negatively affects women’s health. Such patients more often suffer from the anemia of pregnant women, late gestosis, fetoplacental insufficiency, fetal growth retardation. Also, the arsenal of diagnostic methods is not wide enough, and the untimely treatment of women leads to a complicated course of pregnancy and childbirth. Currently, infections are in the fourth rank in the structure of the world’s maternal mortality and account for 11%, and in low-income countries, septic shock is one of the leading dangers, despite significant progress in the prevention and treatment of purulent-septic complications in obstetrics. In all countries, there is an increase in cases of sepsis, and its treatment is accompanied by serious costs while maintaining high mortality [1]. But at first glance, paradoxical is the fact that in high-income countries, there is a tendency to increase the incidence of postpartum purulent-inflammatory diseases, despite the extremely high level of medical care. According to the studies [2], the incidence of severe sepsis with fatal consequences increases by 10% per year. The main risk factors are: late motherhood, obesity, pregnancy with chronic diseases, the use of assisted reproductive technologies and multiple pregnancies, high frequency of cesarean sections (operative delivery increases the risk of development of postpartum purulent-septic complications in 5-20 times).