This first paper of the Lancet Series on ending preventable stillbirths reviews progress in essential areas, identified in the 2011 call to action for stillbirth prevention, to inform the integrated post-2015 agenda for maternal and newborn health. Worldwide attention to babies who die in stillbirth is rapidly increasing, from integration within the new Global Strategy for Women's, Children's and Adolescents' Health, to country policies inspired by the Every Newborn Action Plan. Supportive new guidance and metrics including stillbirth as a core health indicator and measure of quality of care are emerging. Prenatal health is a crucial biological foundation to life-long health. A key priority is to integrate action for prenatal health within the continuum of care for maternal and newborn health. Still, specific actions for stillbirths are needed for advocacy, policy formulation, monitoring, and research, including improvement in the dearth of data for effective coverage of proven interventions for prenatal survival. Strong leadership is needed worldwide and in countries. Institutions with a mandate to lead global efforts for mothers and their babies must assert their leadership to reduce stillbirths by promoting healthy and safe pregnancies.

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Anaemia is a major health problem among woman of reproductive age group, particularly in developing countries. We undertook this study to determine the maternal and perinatal outcome in patients with severe anaemia in pregnancy, with a haemoglobin concentration of < 7 g/dl. The in-hospital data were analysed for 12 months between January 2007 and December 2007 and 2.15% (n = 96) of women were found to have severe anaemia. Out of these, 18.75% had pre-term premature rupture of membranes and 5.12% of all deliveries were pre-term. Hypertensive diseases of pregnancy were seen in 17.7%; abruption in 3.12% and 9.37% had congestive cardiac failure. Postpartum haemorrhage was seen in 25.5% of the patients and 8.33% had puerperal pyrexia. Fetal distress was seen in 26% of and 33.33% had small for gestational age neonates; there were 16.66% stillbirths and 4.16% neonatal deaths. Of the 96 severely anaemic women, six died after admission. Our study shows that efforts must be taken towards safe motherhood and spreading awareness about the various consequences of anaemia, which is usually preventable with early correction.

Purpose: To compare the efficacy of ondansetron-dexamethasone combination with ondansetron alone for prevention of postoperative nausea and vomiting (PONV). Methods: This double blind, randomized study was carried out in 51 female patients, aged 20-40 yr, ASA-I physical status undergoing gynecological diagnostic laparoscopy. Group I (n = 26) received 4mg ondansetron iv and group 2 (n = 25) received a combination of 4 mg ondansetron and 8 mg dexamethasone iv soon after induction of anesthesia. Postoperatively patients were assessed hourly for four hours and then at 24 hr for nausea, vomiting, pain and post anesthetic discharge score. Vomiting occurring up to two hours was considered early vomiting and from 2-24 hr as delayed vomiting. Results: The postoperative nausea score was lower in patients receiving a combination of ondansetron and dexamethasone (3.76) than ondansetron alone (4.38) at 0 hr (P < 0.01), 2 hr (P < 0.05) and 24 hr (P < 0.0 I). In group I, 38.5% of patients had a nausea score of ~ 5 (major nausea) compared with only 12% of patients in group 2 (P < 0.025). The overall incidence of vomiting was greater in group I (35%) than in group 2 (8%) (P < 0.05). The combination group showed better control of delayed vomiting compared with the ondansetron group (4% vs 35%) (P < 0.0 I). Conclusion: The combination of ondansetron and dexamethasone provides adequate control of PONV, with delayed PONV being better controlled than early PONV. ~,.stfltats : Le score des naus6es postop&atoires 6tait plus has chez les patientes qui avaient regu une combinaison d'ondans~tron et de dexam~thasone (3,76) plut6t que de l'ondans&ron seulement (4,38) ~ 0 h (P < 0,0 I), ~ 2 h (P < 0,05) et ~ 24 h (P < 0,0 I). Darts le groupe I, 38,5 % des patientes ont pr&ent~ un score de naus~es 5 (naus~es importantes) comparativement ~ 12 % seulement des patientes dans le groupe 2 (P < 0,025). ~incidence totale de vomissements &ait plus grande darts le groupe I (35 %) que darts le groupe 2 (8 %) (P < 0,05). Le groupe ayant regu une combinaison de m~dicaments, compar~ au groupe qui a re~ju de l'ondans&ron, a pr&ent~ un meilleur contr61e des vomissements tardifs (4 % vs 35 %) (P < 0,0 I). Conclusion : La combinaison d'ondans&ron et de dexam&hasone fournit un bon contr61e des NVPO, meilleur pour les NVPO pr&oces que pour les NVPO tardifs.

Early KMC significantly increased exclusive human milk feeding and direct breastfeeding in LBW infants.