RESUMO
PIP: In Africa the future mother and the mother in labor continue to be very much at risk. Thus far it has been impossible to obtain accurate maternal death rates. The results of hospital practice limited to the West African Sahel (Senegal, Mauritania, Niger) for more than 10 years is the focus. Attention is on 2 types of emergency - major dystocia and ruptured uterus - because of their frequency and their sequelae. These emergencies are resented by surgeons who believe that obstetrics should not be a matter of last resort hysterectomies and futile attempts to repair torn bladders and rectums. In developing countries these emergencies should be a major concern of the health service, because of the extent to which they continue to be a threat to mother and child. These emergencies are discussed at length in terms of dealing with them at the curative level, at the preventive level, and the obstetric risks. At the curative level they require prompt surgical care in easily reached centers with good equipment and staff. At the preventive level there is greater chance of effective prevention by screening and systematic antenatal supervision. The obstetric risks could be reduced in all African mothers if a suitable action program was adopted.^ieng
