先日、まつみレディースクリニック三田の診療をお手伝いさせていただいた神戸大学産婦人科出身の竹中です。

まつみ先生に懐かしい関西弁で英語のブログを書くように依頼されました。

 

Today, I want to introduce my work in developing countries as an obstetrician gynecologist.

So far, I have worked in some developing countries with certain humanitarian organization and donor organization.

In certain countries, especially in Africa, still many pregnant women lose their lives due to the diseases of which we can save the lives most if it happened in Japan.

Among them, today I want to highlight one specific pregnancy related disease which are still common cause of maternal and fetal demise in developing countries, which is called eclampsia.

 

Eclampsia is characterized by the seizure during the pregnancy, accompanied by hypertension and proteinuria.

Historically, preeclampsia, which is the stage before the eclampsia, was called “toxemia in pregnancy”, as the pregnancy itself is the cause of the disease.

Ultimate treatment of eclampsia/preeclampsia is the termination of pregnancy.

 

In Japan, as we have consolidated system of antenatal check-up, it is extremely rare to encounter the patients of eclampsia.

We are able to detect the disease at the stage of pre-eclampsia.

Then, we can monitor the pregnancy, and terminate the pregnancy to save the lives of mother and baby if necessary.

In my 10 years of clinical practice in Japan, I have seen only two cases of eclampsia as we treat most of the case at the stage of pre-eclampsia before the pregnant women develop eclampsia.

 

Imagine if antenatal check-up system is not working, or even though there is the system, if you need to commute there six hours by car, then virtually the pregnant women have little chance to visit the antenatal service.

She may develop hypertension and proteinuria without noticing that she is developing eclampsia/pre-eclampsia, then she will have seizure at home, and finally, relatives or neighbors will bring her to the hospital.

During the transportation, she may lose her baby in utero.

In the worst-case scenario, her heart is not beating when arriving to the hospital.

 

I have seen several cases of eclampsia literally every day.

I am aware that many pregnant women have many requests to the health system in Japan.

Sometimes you need to wait for hours in the clinic/hospital.

Sometimes doctors seems to be too busy to ask questions.

 

Covid made the situation worse.

But still the Japanese health system is working relatively nicely, thanks to the efforts made by predecessors, as well as policy makers, all the clinicians and all the medical staffs.

I wish one day, anywhere in the world, high quality medical service will become available, and less lives of the mothers and babies will be lost.