This topic contains introduction of vital statistics, list of important statistics, birth rate, death rate, specific death rates, infant mortality rate, neonatal mortality rate, under five mortality rate, maternal mortality rate (detailed), perinatal mortality rate (detailed), expectation of life, general fertility rate and still births.
This document discusses trends in midwifery and obstetrical nursing. It begins by defining midwifery and obstetrics. It then outlines several trends, including economic issues like rising costs of childcare; technological advances in fertility treatments and testing; demographic shifts to urban areas; changes in healthcare settings like managed care and shorter hospital stays. It also discusses trends toward patient involvement and self-care. Current problems discussed are shorter hospital stays, higher patient acuity, lack of rural facilities, and changes to maternal-newborn nursing models.
Role of nurse midwifery and obstetric careSujata Sahu
The document discusses the roles of a nurse midwife throughout the four stages of childbearing: adolescence, antenatal, intranatal, and postnatal. In each stage, the nurse midwife acts as a caregiver, counselor, teacher, and clinician. During adolescence, the midwife provides education on puberty, sexuality, and marriage. In the antenatal stage, the midwife provides prenatal care, screening for risk factors, and education. In labor and delivery, the midwife supports the mother, monitors labor, and teaches about the birthing process. After birth, the midwife assesses mother and baby, counsels on parenting and family planning, and teaches about newborn and
This document presents information on abruption placenta from a nursing college presentation. It defines abruption placenta as premature separation of a normally situated placenta after 28 weeks of gestation. It discusses the incidence, risk factors like maternal age and hypertension, signs and symptoms like vaginal bleeding and abdominal pain, diagnosis using ultrasound and coagulation tests, and management including fluid replacement, blood transfusion, and sometimes c-section. Nursing care focuses on monitoring maternal and fetal vital signs and blood loss, providing comfort, and watching for complications of abruption placenta like shock.
Current trends in midwifery &; obstetrical nursingAbhilasha verma
The document discusses current trends in midwifery and obstetrical nursing. It outlines goals to reduce maternal mortality, fetal and infant death, preterm birth, and cesarean sections among low-risk women. New trends discussed include the WHO near-miss approach, maternal waiting homes, postpartum butterfly device, transvaginal Bakri balloon, wireless fetal monitoring, non-invasive prenatal testing, vaginal seeding, cervical cerclage, treating intrauterine infections, and improving nutrition. The document also discusses robotic gynecological surgery, the Vita HEAT device during labor, using virtual reality to relieve labor pains, Clearblue digital pregnancy tests, My Peri Tens devices, and an
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
This document provides information about antenatal assessment and examination. It defines antenatal care as the systematic examination and advice given to pregnant women at regular intervals starting from the beginning of pregnancy until delivery. The aims of antenatal care are to ensure a normal pregnancy and delivery for both mother and baby. Components of antenatal care include registration, history taking, investigations, physical examination, and health education. The document describes how to set up an antenatal clinic and the equipment needed. It outlines the process for history taking, investigations, and the abdominal and vaginal examinations performed during antenatal visits.
This document discusses trends in midwifery and obstetrical nursing. It begins by defining midwifery and obstetrics. It then outlines several trends, including economic issues like rising costs of childcare; technological advances in fertility treatments and testing; demographic shifts to urban areas; changes in healthcare settings like managed care and shorter hospital stays. It also discusses trends toward patient involvement and self-care. Current problems discussed are shorter hospital stays, higher patient acuity, lack of rural facilities, and changes to maternal-newborn nursing models.
Role of nurse midwifery and obstetric careSujata Sahu
The document discusses the roles of a nurse midwife throughout the four stages of childbearing: adolescence, antenatal, intranatal, and postnatal. In each stage, the nurse midwife acts as a caregiver, counselor, teacher, and clinician. During adolescence, the midwife provides education on puberty, sexuality, and marriage. In the antenatal stage, the midwife provides prenatal care, screening for risk factors, and education. In labor and delivery, the midwife supports the mother, monitors labor, and teaches about the birthing process. After birth, the midwife assesses mother and baby, counsels on parenting and family planning, and teaches about newborn and
This document presents information on abruption placenta from a nursing college presentation. It defines abruption placenta as premature separation of a normally situated placenta after 28 weeks of gestation. It discusses the incidence, risk factors like maternal age and hypertension, signs and symptoms like vaginal bleeding and abdominal pain, diagnosis using ultrasound and coagulation tests, and management including fluid replacement, blood transfusion, and sometimes c-section. Nursing care focuses on monitoring maternal and fetal vital signs and blood loss, providing comfort, and watching for complications of abruption placenta like shock.
Current trends in midwifery &; obstetrical nursingAbhilasha verma
The document discusses current trends in midwifery and obstetrical nursing. It outlines goals to reduce maternal mortality, fetal and infant death, preterm birth, and cesarean sections among low-risk women. New trends discussed include the WHO near-miss approach, maternal waiting homes, postpartum butterfly device, transvaginal Bakri balloon, wireless fetal monitoring, non-invasive prenatal testing, vaginal seeding, cervical cerclage, treating intrauterine infections, and improving nutrition. The document also discusses robotic gynecological surgery, the Vita HEAT device during labor, using virtual reality to relieve labor pains, Clearblue digital pregnancy tests, My Peri Tens devices, and an
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
This document provides information about antenatal assessment and examination. It defines antenatal care as the systematic examination and advice given to pregnant women at regular intervals starting from the beginning of pregnancy until delivery. The aims of antenatal care are to ensure a normal pregnancy and delivery for both mother and baby. Components of antenatal care include registration, history taking, investigations, physical examination, and health education. The document describes how to set up an antenatal clinic and the equipment needed. It outlines the process for history taking, investigations, and the abdominal and vaginal examinations performed during antenatal visits.
The third stage of labor involves the separation and expulsion of the placenta after childbirth. The placenta separates from the uterine wall due to uterine contraction. The uterus then contracts further to aid the descent and expulsion of the placenta through the birth canal. Midwives monitor for signs of separation and use techniques like controlled cord traction or fundal pressure to deliver the placenta if needed. Oxytocic drugs may also be used to aid delivery or prevent hemorrhage. Care of both mother and newborn continues for at least an hour after completion of the third stage to ensure uterine contraction and monitor for complications.
OBG Research | Obstetrical Gynecology | Problem statements MontuLimja
This document contains summaries of presentations on various topics related to nursing. It includes summaries of 4 different problem statements and objectives for proposed studies on:
1. Assessing knowledge of exclusive breastfeeding among new and experienced mothers in Durg, Chhattisgarh, India.
2. Evaluating knowledge of childbirth preparedness among first-time mothers in Durg.
3. Determining the effectiveness of a planned teaching program on knowledge of family planning among 3rd year nursing students in Durg.
4. Assessing knowledge of danger signs of newborn illness among pregnant women in Durg.
The document provides information on the presenters, principal, vice principal and guide for the presentations
This document provides a historical review of midwifery from ancient times to modern developments. It discusses evidence of midwifery from 5000 BC and references to midwives in the Old Testament. It then outlines key figures and developments in midwifery from Hippocrates and Aristotle in ancient Greece to modern innovations like specialized obstetric tools, antenatal clinics, and advances in reducing maternal mortality. It also briefly discusses the development of maternity services in India and the UK as well as current trends and challenges in maternal health nursing.
PRECONCEPTION CARE &PARENTHOOD PREPARATION.pptxBRITO MARY
This document provides an overview of preconception care presented by Mrs. John Britto Mary. It defines preconception care as interventions that aim to identify and modify risks to a woman's health or pregnancy outcome. The goals of preconception care are to optimize the woman's health, minimize risks to her and the fetus, and provide information to make informed decisions about future reproduction. The need for preconception care is to improve pregnancy outcomes and identify risks before pregnancy. Key components include early risk detection and prevention, managing high-risk factors before conception, and creating awareness. Elements addressed include nutrition, genetics, maternal age, environmental hazards, and medical history. The roles of midwives are also outlined.
This document discusses preconception care, which aims to maximize maternal and child health by providing health interventions to women and couples before conception. It outlines the aims of preconception care as improving health status, reducing risk factors, and preventing diseases and complications. The key components covered include nutrition, genetics, environment, infertility, STIs, violence, mental health, and substance use. Steps to improve health before pregnancy for both women and men are also presented.
Screening and assessment of high-risk pregnancies involves identifying women at increased risk of complications through non-invasive tests like ultrasounds, NSTs and CSTs. Diagnostic tests then establish or rule out conditions and include invasive procedures like amniocentesis and cord blood sampling. Ultrasounds provide fetal images and assess growth while NSTs and CSTs monitor the fetal heart rate during rest and contractions. Amniocentesis analyzes amniotic fluid for genetic disorders while cord blood sampling draws fetal blood for similar tests when earlier methods were inconclusive. Both invasive procedures have a risk of miscarriage but can diagnose many conditions affecting the developing baby.
This document discusses preconception care, including its definition, components, elements, benefits, and the role of midwives. Preconception care involves providing health interventions to women and couples before conception to detect risks, manage health conditions, promote nutrition and family planning. Key elements addressed include nutritional needs, genetic history, maternal age, environmental hazards and maternal history. The benefits of preconception care are reducing unintended pregnancy and birth defects, as well as promoting healthy behaviors and pregnancy outcomes. Midwives play an important role in educating and screening women to identify risks and plan interventions.
The human placenta is a discoid, haemochorial organ that develops during pregnancy to connect the developing fetus to the uterine wall for nutrient/waste exchange. At term, the placenta is a circular disc about 15-20cm in diameter and 2.5cm thick that weighs around 500g. It has both a fetal side covered by amnion/umbilical cord and a rough, spongy maternal side with lobes. The placenta facilitates gas/nutrient exchange between maternal and fetal blood supplied by the umbilical cord and establishes a connection between the mother and developing fetus.
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
This document summarizes minor disorders that can occur in newborns. It defines a newborn as an infant from birth until 28 days old. It then describes and provides treatment recommendations for common minor issues newborns may experience such as stuffy nose, sticky eyes, skin rashes, oral thrush, jaundice, engorgement of the breast, vomiting, diarrhea, hiccups, sneezing, failure to pass urine or meconium, excessive crying, excessive sleepiness, caput succedaneum, umbilical granuloma, pink eye, baby acne, and genital issues. The document stresses the importance of not neglecting minor health problems in newborns.
1. Subinvolution, breast engorgement, mastitis, breast abscess, and thrombophlebitis are common postpartum complications that can occur.
2. Subinvolution occurs when the involution of the uterus after delivery is impaired or delayed. Breast engorgement is swelling of the breasts due to increased blood and lymph supply before lactation begins.
3. Mastitis is an inflammation of the breast tissue that is usually caused by bacterial infection during breastfeeding. Left untreated it can develop into a breast abscess, which is a localized collection of pus in the breast that requires drainage.
This document discusses the physiology and management of the second stage of labor. It defines the second stage as beginning with full cervical dilation and ending with delivery of the fetus. Key points include: the second stage has two phases - propulsive and expulsive; normal duration is 2 hours for primiparous and 30 minutes for multiparous women; physiological changes include descent, uterine contractions, membrane rupture, and soft tissue displacement; management aims for a normal delivery with minimal maternal effects and early detection of abnormalities. Assessment includes monitoring contractions, descent, fetal heart rate, and progressing through the mechanisms of labor.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
A registered midwife is someone who has completed an approved midwifery education program, is registered to practice midwifery, and maintains competency. The scope of midwifery practice includes providing care during pregnancy, labor, birth and postpartum, as well as family planning advice and newborn care. Midwifery practice is underpinned by values of empowering women and respecting their decisions, and sees birth as a normal process where midwives are the primary caregivers. An individual midwife's scope may change based on their experience and training, practice guidelines, and the needs of the woman and baby.
This document discusses nursing care of newborns. It defines the neonatal period as the first 28 days after birth. Newborn care includes immediate care at birth such as ensuring warmth, clearing airways, clamping the umbilical cord, and initiating breastfeeding. Later newborn care in the postnatal ward focuses on maintaining warmth, observing for signs of illness, preventing infections, and providing parental education. Key elements of newborn care are establishing breathing, feeding, cord and eye care, and maintaining hygiene and skin care. The document also explains Apgar scoring, which assesses a newborn's condition at 1 and 5 minutes after birth.
This document provides guidance on nursing care during the first stage of labour. It discusses assessing vital signs, positioning, diet, bladder and bowel care, pain management techniques, monitoring labour progress using a partogram, and infection control measures. The partogram is a graph used to monitor parameters like cervical dilation, fetal heart rate, uterine contractions and helps detect any abnormalities in labour progression. It is initiated once active labour begins and involves regularly assessing and plotting these parameters to identify delays.
1) The document discusses abortion, which is the ending of a pregnancy by removing or expelling the fetus or embryo before 20 weeks of gestation.
2) It defines abortion according to different authors and provides statistics on the incidence of abortion worldwide and in India.
3) The causes of abortion are discussed as maternal causes, fetal causes, and other causes.
4) The document outlines the nursing management of abortion and different methods for medical termination of pregnancy.
vital statistics related to maternal health in indIA.pptxAnju Kumawat
This document discusses vital statistics and various rates used to measure population health, including birth rate, death rate, infant mortality rate, and maternal mortality rate. It provides definitions and current statistics for India and other countries for each rate. Key causes of infant, neonatal, and perinatal mortality are also examined. Improving antenatal care, nutrition, institutional deliveries, and addressing socioeconomic factors are identified as important for reducing mortality rates.
maternal mortality and neonatal mortality.pptxiceatashna
Maternal and neonatal mortality and morbidity are defined. The leading causes of maternal death are severe bleeding, infections, high blood pressure during pregnancy, and complications during delivery. Nearly 75% of maternal deaths are due to these complications. Skilled care before, during, and after childbirth can prevent many maternal and neonatal deaths by managing and treating complications in a timely manner. However, many women in developing countries do not receive this essential care due to issues of poverty, distance from facilities, lack of information, and inadequate healthcare services. International efforts like the Sustainable Development Goals aim to reduce maternal mortality worldwide by improving access to quality maternal healthcare.
The third stage of labor involves the separation and expulsion of the placenta after childbirth. The placenta separates from the uterine wall due to uterine contraction. The uterus then contracts further to aid the descent and expulsion of the placenta through the birth canal. Midwives monitor for signs of separation and use techniques like controlled cord traction or fundal pressure to deliver the placenta if needed. Oxytocic drugs may also be used to aid delivery or prevent hemorrhage. Care of both mother and newborn continues for at least an hour after completion of the third stage to ensure uterine contraction and monitor for complications.
OBG Research | Obstetrical Gynecology | Problem statements MontuLimja
This document contains summaries of presentations on various topics related to nursing. It includes summaries of 4 different problem statements and objectives for proposed studies on:
1. Assessing knowledge of exclusive breastfeeding among new and experienced mothers in Durg, Chhattisgarh, India.
2. Evaluating knowledge of childbirth preparedness among first-time mothers in Durg.
3. Determining the effectiveness of a planned teaching program on knowledge of family planning among 3rd year nursing students in Durg.
4. Assessing knowledge of danger signs of newborn illness among pregnant women in Durg.
The document provides information on the presenters, principal, vice principal and guide for the presentations
This document provides a historical review of midwifery from ancient times to modern developments. It discusses evidence of midwifery from 5000 BC and references to midwives in the Old Testament. It then outlines key figures and developments in midwifery from Hippocrates and Aristotle in ancient Greece to modern innovations like specialized obstetric tools, antenatal clinics, and advances in reducing maternal mortality. It also briefly discusses the development of maternity services in India and the UK as well as current trends and challenges in maternal health nursing.
PRECONCEPTION CARE &PARENTHOOD PREPARATION.pptxBRITO MARY
This document provides an overview of preconception care presented by Mrs. John Britto Mary. It defines preconception care as interventions that aim to identify and modify risks to a woman's health or pregnancy outcome. The goals of preconception care are to optimize the woman's health, minimize risks to her and the fetus, and provide information to make informed decisions about future reproduction. The need for preconception care is to improve pregnancy outcomes and identify risks before pregnancy. Key components include early risk detection and prevention, managing high-risk factors before conception, and creating awareness. Elements addressed include nutrition, genetics, maternal age, environmental hazards, and medical history. The roles of midwives are also outlined.
This document discusses preconception care, which aims to maximize maternal and child health by providing health interventions to women and couples before conception. It outlines the aims of preconception care as improving health status, reducing risk factors, and preventing diseases and complications. The key components covered include nutrition, genetics, environment, infertility, STIs, violence, mental health, and substance use. Steps to improve health before pregnancy for both women and men are also presented.
Screening and assessment of high-risk pregnancies involves identifying women at increased risk of complications through non-invasive tests like ultrasounds, NSTs and CSTs. Diagnostic tests then establish or rule out conditions and include invasive procedures like amniocentesis and cord blood sampling. Ultrasounds provide fetal images and assess growth while NSTs and CSTs monitor the fetal heart rate during rest and contractions. Amniocentesis analyzes amniotic fluid for genetic disorders while cord blood sampling draws fetal blood for similar tests when earlier methods were inconclusive. Both invasive procedures have a risk of miscarriage but can diagnose many conditions affecting the developing baby.
This document discusses preconception care, including its definition, components, elements, benefits, and the role of midwives. Preconception care involves providing health interventions to women and couples before conception to detect risks, manage health conditions, promote nutrition and family planning. Key elements addressed include nutritional needs, genetic history, maternal age, environmental hazards and maternal history. The benefits of preconception care are reducing unintended pregnancy and birth defects, as well as promoting healthy behaviors and pregnancy outcomes. Midwives play an important role in educating and screening women to identify risks and plan interventions.
The human placenta is a discoid, haemochorial organ that develops during pregnancy to connect the developing fetus to the uterine wall for nutrient/waste exchange. At term, the placenta is a circular disc about 15-20cm in diameter and 2.5cm thick that weighs around 500g. It has both a fetal side covered by amnion/umbilical cord and a rough, spongy maternal side with lobes. The placenta facilitates gas/nutrient exchange between maternal and fetal blood supplied by the umbilical cord and establishes a connection between the mother and developing fetus.
Many women experience some minor disorders during pregnancy.
Every system of the body may be affected during pregnancy. These disorders, however , are not minor to the pregnant woman.
This document summarizes minor disorders that can occur in newborns. It defines a newborn as an infant from birth until 28 days old. It then describes and provides treatment recommendations for common minor issues newborns may experience such as stuffy nose, sticky eyes, skin rashes, oral thrush, jaundice, engorgement of the breast, vomiting, diarrhea, hiccups, sneezing, failure to pass urine or meconium, excessive crying, excessive sleepiness, caput succedaneum, umbilical granuloma, pink eye, baby acne, and genital issues. The document stresses the importance of not neglecting minor health problems in newborns.
1. Subinvolution, breast engorgement, mastitis, breast abscess, and thrombophlebitis are common postpartum complications that can occur.
2. Subinvolution occurs when the involution of the uterus after delivery is impaired or delayed. Breast engorgement is swelling of the breasts due to increased blood and lymph supply before lactation begins.
3. Mastitis is an inflammation of the breast tissue that is usually caused by bacterial infection during breastfeeding. Left untreated it can develop into a breast abscess, which is a localized collection of pus in the breast that requires drainage.
This document discusses the physiology and management of the second stage of labor. It defines the second stage as beginning with full cervical dilation and ending with delivery of the fetus. Key points include: the second stage has two phases - propulsive and expulsive; normal duration is 2 hours for primiparous and 30 minutes for multiparous women; physiological changes include descent, uterine contractions, membrane rupture, and soft tissue displacement; management aims for a normal delivery with minimal maternal effects and early detection of abnormalities. Assessment includes monitoring contractions, descent, fetal heart rate, and progressing through the mechanisms of labor.
Preparation for delivery of mother, baby and midwife and equipmentsDR MUKESH SAH
In addition to their delivery bags, midwives “carry” many other invaluable tools ... family planning, delivery preparation, postnatal counseling and breastfeeding. ... With this equipment, we can recover 80% of newborns. ... “Midwifery feels good when both the mother and baby come out of the labor ward alive.
A registered midwife is someone who has completed an approved midwifery education program, is registered to practice midwifery, and maintains competency. The scope of midwifery practice includes providing care during pregnancy, labor, birth and postpartum, as well as family planning advice and newborn care. Midwifery practice is underpinned by values of empowering women and respecting their decisions, and sees birth as a normal process where midwives are the primary caregivers. An individual midwife's scope may change based on their experience and training, practice guidelines, and the needs of the woman and baby.
This document discusses nursing care of newborns. It defines the neonatal period as the first 28 days after birth. Newborn care includes immediate care at birth such as ensuring warmth, clearing airways, clamping the umbilical cord, and initiating breastfeeding. Later newborn care in the postnatal ward focuses on maintaining warmth, observing for signs of illness, preventing infections, and providing parental education. Key elements of newborn care are establishing breathing, feeding, cord and eye care, and maintaining hygiene and skin care. The document also explains Apgar scoring, which assesses a newborn's condition at 1 and 5 minutes after birth.
This document provides guidance on nursing care during the first stage of labour. It discusses assessing vital signs, positioning, diet, bladder and bowel care, pain management techniques, monitoring labour progress using a partogram, and infection control measures. The partogram is a graph used to monitor parameters like cervical dilation, fetal heart rate, uterine contractions and helps detect any abnormalities in labour progression. It is initiated once active labour begins and involves regularly assessing and plotting these parameters to identify delays.
1) The document discusses abortion, which is the ending of a pregnancy by removing or expelling the fetus or embryo before 20 weeks of gestation.
2) It defines abortion according to different authors and provides statistics on the incidence of abortion worldwide and in India.
3) The causes of abortion are discussed as maternal causes, fetal causes, and other causes.
4) The document outlines the nursing management of abortion and different methods for medical termination of pregnancy.
vital statistics related to maternal health in indIA.pptxAnju Kumawat
This document discusses vital statistics and various rates used to measure population health, including birth rate, death rate, infant mortality rate, and maternal mortality rate. It provides definitions and current statistics for India and other countries for each rate. Key causes of infant, neonatal, and perinatal mortality are also examined. Improving antenatal care, nutrition, institutional deliveries, and addressing socioeconomic factors are identified as important for reducing mortality rates.
maternal mortality and neonatal mortality.pptxiceatashna
Maternal and neonatal mortality and morbidity are defined. The leading causes of maternal death are severe bleeding, infections, high blood pressure during pregnancy, and complications during delivery. Nearly 75% of maternal deaths are due to these complications. Skilled care before, during, and after childbirth can prevent many maternal and neonatal deaths by managing and treating complications in a timely manner. However, many women in developing countries do not receive this essential care due to issues of poverty, distance from facilities, lack of information, and inadequate healthcare services. International efforts like the Sustainable Development Goals aim to reduce maternal mortality worldwide by improving access to quality maternal healthcare.
The maternal mortality rate is the number of maternal deaths in a population divided by the number of women of reproductive age. It captures the likelihood of both becoming pregnant and dying during pregnancy (including deaths up to six weeks after delivery).
Vital statistics provide important health indicators like birth and death rates. Maternal and child health is assessed through measurements of mortality and morbidity. Common indicators include maternal morbidity and mortality rates, fertility rates, and mortality rates for infants and children like neonatal mortality rate and infant mortality rate. Causes of maternal and child mortality and morbidity include obstetric issues, social factors like education and poverty, and lack of access to maternal healthcare services. Prevention efforts include improving access to maternal services, nutrition, sanitation, family planning, and socioeconomic development.
MORTALITY IN INFANCY AND CHILDHOOD (2).docxSambaSukanya
Mortality rates in infancy and childhood are indicators of health and socioeconomic development. Medical advances have substantially reduced childhood mortality. Mortality is commonly analyzed in periods including perinatal, neonatal, post-neonatal, infant, and under-5. Causes and rates of mortality differ in each period. Preventive measures aim to improve nutrition, healthcare access, and socioeconomic conditions to further reduce mortality rates.
Health index in contrast of maternal healthNehaNupur8
Health index
Characteristics of maternal indicators
Commonly used maternal health indicators
Maternal mortality rate
Fertility rate
Perinatal mortality rate
Neonatal mortality rate
Postneonatal mortality rate
Infant mortality rate
Health index also called health indicators depending on the measure, a health indicators may be defined for a specific population, place, or geographic area.
Indicators are defined as “variable which help to measure changes
Definition and components of reproductive health?
Demographic trends and fertility determinants
Family planning
Impact of reproductive patterns on child health
Impact of reproductive patterns on women health
Mechanisms to reduce morbidity and mortality
This document defines and discusses vital statistics, which are numerical records of life events like births, deaths, marriages, and sickness in a population. It provides definitions of key vital statistics like birth rate, maternal mortality rate, and infant mortality rate. It discusses how these statistics are calculated and their importance for evaluating community health, developing public health policies and programs, and conducting research. The roles of nurses include collecting, analyzing, and communicating vital statistics data to assess health issues and plan interventions in communities.
This document summarizes a case study on infant mortality rate (IMR) and malnourishment in Satna, Madhya Pradesh, India. It begins with definitions of IMR from organizations like UNICEF and WHO. It then provides background on worldwide and Indian IMR trends, noting that Satna has a higher IMR than most other Indian states and countries globally. The document describes conducting surveys of local officials and residents in Satna to understand factors contributing to high IMR and malnourishment. Key factors identified include lack of access to healthcare, sanitation issues, and poverty. The document concludes by suggesting steps like improving nutrition programs and healthcare access to help reduce IMR and malnourishment in Satna.
ReferencesHoltz, C. (2017). Global health care Issues and polic.docxaudeleypearl
References
Holtz, C. (2017). Global health care: Issues and policies (3rd ed.). Burlington, MA: Jones & Bartlett.
· Chapter 11, “Global Use of Complementary and Integrative Health Approaches” (pp. 287-320)
· Chapter 17, “Global Health in Reproduction and Infants” (pp. 465-493)
· Chapter 21, “Health and Health Care in Mexico” (pp. 579-590)
Levine, R. (2007). Case studies in global health: Millions saved. Sudbury, MA: Jones & Bartlett.
· Case 6, “Saving Mothers’ Lives in Sri Lanka” (pp. 41–48)
Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M., Lauderdale, J., … Purnell, L. (2014). Guidelines for implementing culturally competent nursing care. Journal of Transcultural Nursing, 25(2), 109–121.
Yeager, K. A., & Bauer-Wu, S. (2013). Cultural humility: Essential foundation for clinical researchers. Applied Nursing Research, 26(4), 251–256.
Saving MotherS’ LiveS in Sri Lanka �
T
he reduction in deaths during pregnancy and
delivery has long been held out as a major
international public health goal, but many
countries have had difficulties making prog-
ress toward it. Most observers now agree that there are
no quick fixes, and that the solution will come with the
strengthening of now-failing health systems in many
poor countries, building up the training of professional
and paraprofessional health workers, improving access
to both basic and higher-level services, and ensuring the
availability of basic medical supplies and medications to
deal with obstetric problems. The case of Sri Lanka dem-
onstrates how rapidly progress can occur when those
fundamental building blocks are in place.
Mothers Shouldn’t Die in Childbirth
Pregnancy and childbirth are natural events and typi-
cally require little or no medical intervention for either
mother or baby. But in about 15 percent of all preg-
nancies, a severe complication affects the woman—for
example, maternal diabetes or dangerously high blood
pressure sets in, excessive bleeding occurs during child-
birth, or the mother suffers from a serious postpartum
Case 6
Saving Mothers’ Lives in Sri Lanka
Geographic area: Sri Lanka
Health condition: in the �950s, the maternal mortality ratio in Sri Lanka was estimated at between 500
and 600 per �00,000 live births.
Global importance of the health condition today: Pregnancy-related complications annually claim the lives
of 585,000 women. Some 99 percent of these deaths take place in developing countries, where women
have a � in 8 chance of dying in their lifetime due to pregnancy-related causes, compared with the � in
4,800 chance in Western europe.
Intervention or program: Beginning in the �950s, the government of Sri Lanka made special efforts to ex-
tend health services, including critical elements of maternal health care, through a widespread rural health
network. Sri Lanka’s success in reducing maternal deaths is attributed to broad access to maternal health
care, which is built upon a ...
This document summarizes a presentation on improving maternal mortality through policy perspectives. It discusses the high maternal mortality ratio in countries like Sierra Leone compared to low ratios in countries like Grenada. The root causes of maternal mortality are identified as inequality, low socioeconomic status, lack of healthcare access, and cultural practices. Effective policies to reduce mortality ratios include increasing access to skilled healthcare workers, emergency services, transportation, and community health programs.
This document provides an overview of key concepts in maternal and child health epidemiology. It defines various reproductive and perinatal outcomes such as low birth weight, preterm birth, fetal death, birth defects, and maternal morbidity and mortality. It also discusses risk factors that can influence these outcomes, including individual health, behaviors, psychosocial factors, access to healthcare, and structural factors. Data sources for measuring outcomes like infant mortality and maternal death in the United States are described.
Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination of pregnancy from pregnancy-related causes. The three main causes of maternal death globally are hemorrhage, sepsis, and hypertensive disorders. In India, maternal mortality rates are highest in rural areas where access to healthcare is limited. The three delay model explains that maternal deaths are often due to delays in seeking care, reaching care, and receiving adequate care. Reducing maternal mortality requires improving access to emergency obstetric care, family planning services, and addressing social determinants like gender inequality and poverty.
Module IIIMaternal Health ______________________________________.docxmoirarandell
Module III
Maternal Health _______________________________________________
Introduction
In the Module we will explore maternal health paying particular attention to global disparities in the support and care mothers around the world get, the factors that promote such disparities, causes of maternal mortality and morbidity, the impact of reproductive patterns on the health of children, and mechanisms to reduce maternal morbidity and mortality, particularly in low-and –middle income countries.
At the end of this Module you should be able to articulate the following:
Critical Skills
1. Explain the global trends in maternal health.
2. Identify the key players and they play in promoting maternal health.
3. Be able to identify the causes of maternal mortality and morbidity in the U.S and other countries, particularly developing nations.
4. Explain mechanisms used to reduce maternal morbidity and mortality.
5. Be familiar with at least two development organizations/NGOs and their work around maternal health.
Maternal Health at a Glance
Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. While most women look forward to motherhood (and their spouses to fatherhood), for too many women, motherhood is a torturous experience associated with suffering, ill-health and even death. It is estimated that about 800 women die from pregnancy- or childbirth-related complications around the world every day. Consider the following few facts about maternal health (WHO):
· Every day, approximately 800 women die from preventable causes related to pregnancy and childbirth – about 287 000 women in 2010 alone. Most of them died due to preventable cause like not being able to access skilled routine and emergency care.
· The FOUR main maternal mortality causes are: severe bleeding, infections, unsafe abortion, and hypertensive disorders (pre-eclampsia and eclampsia). After delivery bleeding is very serious condition, if unattended, it can kill even a healthy woman within two hours.
· Of the more than 136 million women who give birth a year, about 20 million of them experience pregnancy-related illness after childbirth.
· About 16 million girls aged between 15 and 19 give birth each year, accounting for more than 10% of all births. Complications from pregnancy and childbirth are the leading cause of death among girls 15-19 in developing nations.
· The state of maternal health mirrors the gap between the rich and the poor. Less than 1% of maternal deaths occur in high-income countries. The lifetime risk of dying from complications in childbirth or pregnancy for a woman in the developing world is an average of one in 150 compared to one in 3800 in developed countries. Of the 800 women who die every day,440 live in sub-Saharan Africa, 230 in Southern Asia and five in high-income countries.
· Most maternal deaths can be prevented through skilled care at childbirth and access to emergency obstetric c ...
Maternal mortality is defined as the death of a woman during pregnancy or within 42 days of termination of pregnancy. The three main causes of maternal death are hemorrhage, infection, and hypertensive disorders, which together account for 75-80% of direct maternal deaths. India accounts for 25% of global maternal deaths despite having only 16% of the world's population. Every year approximately 8 million women suffer from pregnancy related complications worldwide and over half a million die. Maternal mortality can be greatly reduced by ensuring access to quality emergency obstetric care services and family planning programs.
The document discusses reproductive health services and changes in technologies and costs. It covers definitions of maternal death and perinatal mortality. The leading global causes of maternal death are postpartum hemorrhage, sepsis, hypertensive disorders, and obstructed labor. Reproductive health services include adolescent care, premarital care, preconception care, antenatal care, natal care, and postnatal and post-abortion care. Premarital screening aims to reduce the transmission of genetic disorders and infectious diseases.
Infant mortality is defined as the death of an infant before their first birthday. The infant mortality rate is the number of infant deaths per 1,000 live births. Leading causes of infant mortality include preterm birth, low birth weight, congenital abnormalities, Sudden Infant Death Syndrome, infectious diseases, malnutrition, and lack of access to basic healthcare. Factors that contribute to higher infant mortality rates include socioeconomic challenges, environmental conditions like air pollution, and lack of policies supporting maternal health and early childhood development. Reducing infant mortality requires improved access to prenatal care, nutrition, sanitation, immunizations, and social support systems.
The document provides an agenda for a workshop on reproductive, maternal and child health. It includes objectives to provide an overview of global maternal mortality trends, describe the Millennium Development Goals related to reproductive health, and identify causes and strategies to prevent maternal mortality. The agenda also involves interactive activities to define key terms and review what is known about the Millennium Development Goals.
Maternal mortality refers to the death of a woman during pregnancy, childbirth or within 42 days of termination of pregnancy. Some key points:
- Causes of maternal mortality include hemorrhage, sepsis, unsafe abortion, obstructed labor, eclampsia, and complications from existing medical conditions.
- Maternal mortality is highest in Sub-Saharan Africa, where 1 in 16 women face the risk of dying from pregnancy or childbirth-related causes.
- In India, an estimated woman dies every seven minutes from pregnancy or childbirth complications. The maternal mortality ratio in India is around 200 per 100,000 live births.
- Prevention strategies focus on increasing access to antenatal
Similar to Vital statistics related to maternal health in india (20)
The document summarizes the processes of gametogenesis and fertilization. It describes how primary oocytes develop into mature eggs through meiosis and follicular maturation in females, and how spermatogonia develop into spermatozoa through spermatogenesis and meiosis in males. It then explains the processes of capacitation, acrosome reaction, ovulation, fertilization, pronuclear formation, and early embryonic cleavage that occur for successful conception and the formation of a zygote.
This topic includes menstruation:- its definition, anatomical aspects- follicular growth and atresia, germ cells, premodial follicle; menstrual cycle/ ovarian cycle:- definition, phases- recruitment of groups of follicles (premature phase), selection of dominant follicle and its maturation, ovulation, follicular atresia; Endometrial cycle:- division of endometrium- basal zone, functional zone and its phases- stage of regeneration, stage of proliferation, secretory phase, menstrual phase, mechanism of menstrual bleeding, role of prostaglandins, hormones in relation to ovarian and menstrual cycle, ovulation, luteal-follicular shift, menstrual symptoms, menstrual hygiene, anovular menstruation, artificial postponement; cervical cycle, vaginal cycle and general changes in follicular and luteal phase.
This topic includes difference between female and male pelvis, various pelvis types, general description of pelvis bones, division of pelvis, landmarks of pelvis, plane, axis, sacral angle, diameters of inlet, cavity and outlet.
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This topic contains anticonvulsants used in obstetrics such as magnasium sulphate, diazepam, phenytoin and anticoagulants such as heparin and warfarin.
The document discusses the basic concepts of chemistry and the composition of matter. It explains that all matter is made up of chemical elements, which can exist in solid, liquid, or gas states. The human body contains 26 main elements that are classified into major elements, minor elements, and trace elements. Major elements like oxygen, carbon, hydrogen, and nitrogen make up 96% of body mass, while minor elements like calcium and phosphorus make up 3.8%. The remaining 0.2% consists of trace elements that have important functions, though some of their functions remain unknown.
This topic contains Meaning and definitions of midwifery, obstetrics, obstetrical nursing, midwife, scope of midwifery, basic competencies of a midwife, history of midwifery in nursing and development of maternity services in India.
This topic contains definition, instruments, indications, contraindications, prerequisites, advantages, procedure, complications and hazards of ventouse or vaccum delivery.
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This topic contains detail about genital prolapse in pregnancy, It's definition, incidence, types, stages, causes, risk factors, clinical features, effect of prolapse, effect on pregnancy, effect during labour and puerperium, prevention, treatment and nursing management during pregnancy, labour and puerperium.
Uterine inversion is a rare complication where the uterus turns inside out, and can be partial or complete. It occurs in around 1 in 20,000 deliveries and is usually acute and complete. There are three degrees - first involves dimpling of the fundus, second passes through the cervix into the vagina, and third is complete outside the vulva. Treatment involves urgent manual replacement or hydrostatic replacement under anesthesia to prevent shock, hemorrhage, infection and other complications. Proper management of the third stage of labor can prevent induced inversions.
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TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14...Donc Test
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
TEST BANK For Brunner and Suddarth's Textbook of Medical-Surgical Nursing, 14th Edition (Hinkle, 2017) Verified Chapter's 1 - 73 Complete.pdf
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Receptor Discordance in Breast Carcinoma During the Course of Life
Definition:
Receptor discordance refers to changes in the status of hormone receptors (estrogen receptor ERα, progesterone receptor PgR, and HER2) in breast cancer tumors over time or between primary and metastatic sites.
Causes:
Tumor Evolution:
Genetic and epigenetic changes during tumor progression can lead to alterations in receptor status.
Treatment Effects:
Therapies, especially endocrine and targeted therapies, can selectively pressure tumor cells, causing shifts in receptor expression.
Heterogeneity:
Inherent heterogeneity within the tumor can result in subpopulations of cells with different receptor statuses.
Impact on Treatment:
Therapeutic Resistance:
Loss of ERα or PgR can lead to resistance to endocrine therapies.
HER2 discordance affects the efficacy of HER2-targeted treatments.
Treatment Adjustment:
Regular reassessment of receptor status may be necessary to adjust treatment strategies appropriately.
Clinical Implications:
Prognosis:
Receptor discordance is often associated with a poorer prognosis.
Biopsies:
Obtaining biopsies from metastatic sites is crucial for accurate receptor status assessment and effective treatment planning.
Monitoring:
Continuous monitoring of receptor status throughout the disease course can guide personalized therapy adjustments.
Understanding and managing receptor discordance is essential for optimizing treatment outcomes and improving the prognosis for breast cancer patients.
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Understanding Atherosclerosis Causes, Symptoms, Complications, and Preventionrealmbeats0
Definition: Atherosclerosis is a condition characterized by the buildup of plaques, which are made up of fat, cholesterol, calcium, and other substances, in the walls of arteries. Over time, these plaques harden and narrow the arteries, restricting blood flow.
Importance: This condition is a major contributor to cardiovascular diseases, including coronary artery disease, carotid artery disease, and peripheral artery disease. Understanding atherosclerosis is crucial for preventing these serious health issues.
Overview: We will cover the aims and objectives of this presentation, delve into the signs and symptoms of atherosclerosis, discuss its complications, and explore preventive measures and lifestyle changes that can mitigate risk.
Aim: To provide a detailed understanding of atherosclerosis, encompassing its pathophysiology, risk factors, clinical manifestations, and strategies for prevention and management.
Purpose: The primary purpose of this presentation is to raise awareness about atherosclerosis, highlight its impact on public health, and educate individuals on how they can reduce their risk through lifestyle changes and medical interventions.
Educational Goals:
Explain the pathophysiology of atherosclerosis, including the processes of plaque formation and arterial hardening.
Identify the risk factors associated with atherosclerosis, such as high cholesterol, hypertension, smoking, diabetes, and sedentary lifestyle.
Discuss the clinical signs and symptoms that may indicate the presence of atherosclerosis.
Highlight the potential complications arising from untreated atherosclerosis, including heart attack, stroke, and peripheral artery disease.
Provide practical advice on preventive measures, including dietary recommendations, exercise guidelines, and the importance of regular medical check-ups.
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2. Vital statistics are the statistics on principal
events in the life of an individual.
They are usually gathered at the time of an
event, i.e. birth, marriage, death vital
statistics are commonly complied from
records of vital events registered through
offices that are organized as part of vital
registration system.
3. Birth rate
Death rate
Specific death rate
Infant mortality rate
Neonatal mortality rate
Perinatal mortality rate
Under five mortality rate
Maternal mortality rate
Expectation of life
General fertility rate
4. “The Birth rate is defined as the number of live
births during a year per 1000 estimated mid-
year population.”
Birth rate= Number of live births during the year x 1000
Estimated mid year population
Currently the birth rate in India is about 17.5
per 1000 population.
In the developed countries, the birth rate is
less than 15.
The aim of the family planning programme in
India is to reduce the birth rate to at least 2.1
by 2025.
5. “The Death rate is defined as the number of
deaths per 1000 estimated mid-year population
in one year.”
Death rate= Number of deaths during the year x 1000
Estimated mid year population
Currently the death rate in India is about 8.5
per 1000 population.
In USA and other developed countries, the
death rate is less than 9.
6. The Death rate due to:
Specific causes, e.g. Cholera
In specific groups like age, gender,
occupation, social class
Specific periods, annual, weekly, monthly
are called specific death rates.
7. 1. Specific Death rate due to Cholera=
Number of deaths from Cholera during the year x 1000
Mid year population
2. Specific Death rate for males=
Number of deaths among male during the year x 1000
Mid year population
3. Specific Death in 2001=
Number of deaths in 2001 x 1000
Mid year population
8. “It is the number of deaths under one year of
age per 1000 live births in one year.”
IMR= Number of deaths under one year of age x 1000
Total live births in the year
Currently the IMR is about 69 per 1000 live
births.
In developed coutries, it is about 6.
Infant mortality rate is regarded as a most
sensitive index of the health of the community.
9. “Deaths occuring within 4 weeks or 28 days of
birth are called neonatal deaths.”
Neonatal Mortality Rate=
Number of deaths under 28 days of age x 1000
Total live births
The importance of neonatal mortality rate is
beacuase the total infant deaths, nearly 50 %
occur during the first 4 weeks.
10. The causes of infant mortality are:
Pre maturity
Birth injury and asphyxia
Neonatal infections, i.e. Diarrhea, Broncho-
pneumonia
Congenital abnormalities
Hemorrhagic disease.
In India, the neonatal mortality rate was 30.9
in 2019.
11. “It is the annual number of deaths of children
aged under 5 years, expressed as a rate per
1000 live births.”
Under Five Mortality Rate=
Number of deaths of children
less than 5 years of age in a given year x 1000
Number of live births in the same year
Currently the under five mortality rate in India is
about 96 per 1000 live births.
In developed countries it is less than 7.
12. Death of a woman who is pregnant or within
42 days of termination of pregnancy
irrespective of the duration and the site of
pregnancy from any cause related to or
aggravated by the pregnancy or its
management but not from accidental or
incidental causes.
13. The MMR is expressed in terms of such
maternal deaths per 1,00,000 live births.
In most of the developed countries, the MMR
varies from 4-40 per 1,00,000 live births.
In the developing countries, it varies from
100-700 with India having about 408 per
1,00,000 live births.
15. Direct obstetric deaths are those resulting
from complication of pregnancy, delivery or
their management such conditions are
abortion, ectopic gestation, pre-eclampsia,
eclampsia, antepartum and post-partum,
hemorrhage and puerperal sepsis.
16. Conditions present before or developed during
pregnancy but aggravated by the physiological
effects of pregnancy and strain of labour.
These are anemia, cardiac disease, diabetes,
thyroid disease, etc.
Of which anemia is the most important single
cause in the developing countries.
Viral hepatitis when endemic, contributes
significantly to maternal deaths.
Include accidents, malaria, typhoid and
infectious diseases.
18. The optimum reproductive efficiency appears
to be between 20-25 years.
In the young adolescent pregnancy carries
higher risk due to pre-eclapsia,
cephalopelvic disproportion and uterine
inertia.
In women aged 35 years or above the risk is
3-4 times higher.
19. The risk is slightly more in primigravidae but
it is 3 times greater in para 5 or above where
post-partum hemorrhage, malpresentations
and rupture uterus are more common.
The risk is lowest in the second pregnancy.
20. Mortality ratio are higher in women
belonging to low socio-economic status as
these women are likely to be less privileged
in the field of nutrition, housing, education
and antenatal care.
21. The most significant factor affecting maternal
mortality is the availability of antenatal care
and its acceptance by the community.
Unfortunately, those very groups which have
the highest mortality, like grand multiparae or
the patient's of lower socio-economic status
are the women who least often avail
themselves of this facility.
22. It is partinent at finding out the circumstances
in which the deaths occur and whether the
particular deaths are avoidable rather than to
know what is the immediate cause of death.
An avoidable factor is a departure from the
best current clinical practice preceeding a
maternal death.
Even in the advanced countries where the
death rate had been lowered to an almost
irreducible minimum, about 40-45 % of the
deaths have got avoidable factors.
24. Policy initiatives:
Utmost efforts are to be made from all levels.
government and private agencies, so that the
upgraded health care delivery system should
be accessible to most if not all pregnant
women.
The government must make maternal mortality
a priority public health issue and periodically
evaluate the programmes in an effort to prevent
or minimize maternal deaths.
About 70 % of maternal death in India is
preventable.
25. Programme initiatives:
Improvement of nutritional status and literacy
rate without discrimination against women.
65 % of the girls in India within 14 years are
anemic. 70 % of pregnant women suffer from
iron deficiency anemia.
Early registration of pregnancy.
Provision to identify the high risk cases and
their references to appropriate referral
hospitals where the ideal antenatal care
cannot be enforced, atleast a minimum of 3
visits should be carried out the first at 2nd
trimester, second at 32 weeks and third one at
36 weeks of gestation.
26. Family planning counselling:
Family planning is the first line of defence
against unwanted pregnancy and illegal
abortion.
It will prevent pregnancies that are too early,
too closely spaced, too many or too late.
It is estimated that about 25-40 % of the
maternal deaths from unwanted pregnancies
could be avoided if methods of
contraceptives were made available and
used.
27. In the third world countries, about half of the
estimated 4,50,000 annual maternal deaths
could be avoided if all the pregnancies
occurred to women between the ages of 18-
35, if the interval of pregnancies were at least
2 years and if no woman had more than 4
children.
Essential obstetric care:
It is to be provided either by a field staff at
the door step of a pregnant woman or
preferably at the first referred level hospital.
28. Efforts are not only made to upgrade the
hospital care and to refer the high risk
women as early as possible but services
need to be designed to provide conveyance
and/or to reduce the distance between the
pregnant mothers and the place of care they
required.
About 80 % of the rural mothers delivered at
home and majority are attended by untrained
birth attendants.
29. The quickest and cheapest means to provide
safe delivery services to mother in these
areas are to train the traditional birth
attendants, to upgrade the health centres, to
make all kinds of government vehicle
available in emergencies and all out increase
in number of health care providers such as
midwives, health visitors, social workers and
other auxiliary personnel.
Integration of domiciliary, rural and
institutional services with efficient refferal
system.
30. More maternal deaths could be prevented
when care is provided at the first refferal level
hospital by trained staff compared to that by
field staff.
Frequent joint consultation amongst specialist
in the management of medical disorders of
pregnancy particularly anemia, diabetes,
hypertension and cardiac disease.
Provision for good anesthetic facilities, blood
transfusion services and senior resident in
labour room for decision making regarding the
routine of delivery atleast in state hospitals.
31. Maternal mortality conferences with frank
discussions regarding the causes of deaths
and to find out whether it was avoidable.
Annual reports of such enquity committees
are to be published for necessary preventive
measures.
Periodic refresher course for continuing
education of general practitioners,
obstetricians, midwives and auxiliary staff to
highlight the preventable factors.
32. Perinatal mortality is defined as deaths
among fetuses weighing over 1000 gm at
birth who die before and during delivery or
within the first 7 days of delivery.
The perinatal mortality rate is expressed in
terms of such deaths per 1000 total births.
33. The Perinatal mortality closely reflects both the
standards of medical care and effectiveness of
social and public health measures.
However, for international acceptance the limit
of viability is brought down to a fetus weighing
500 gm or more.
During the past few decades, there has been a
phenomenal decrease in perinatal mortality
rate with the fall in maternal deaths.
The major contribution towards this has come
from socio-economic changes, improvement in
health care, decrease in family size and a move
forwards hospital delivery.
34. But where as the perinatal mortality is less
than 10 per 1000 total births in the developed
countries, it is much higher in the developing
countries.
The major health problems in this part of the
globe arises from the synergistic effects of
malnutrition, infection and unregulated fertility
combined with lack of adequate obstetric care
and poor communication.
35. “It is the mortality of infants occuring during
the period from the 28th week of pregnancy to
7 days after birth per 1000 total births.”
In other words it includes still births + deaths
under one week.
Perinatal Mortality=
Number of deaths occuring during
28 weeks or more or under one week after birth x 1000
Total live + still births
In India, perinatal mortlity rate is about 44 per
1000 live births.
In developed countries, it is less than 10 per
1000 total births.
37. Age over 30 years, parity above 5, low socio-
economic condition, poor maternal nutritional
status, etc all adversly affects the pregnancy
outcome.
In anemia with (Hb % <8g/dl), diabetes
mellitus, syphilis, acute fever and infection.
The total risk of death increases due to
hypoxia, intrauterine growth restrictions,
prematurity and infection.
Hypertensive disorders of pregnancy.
38. Antepartum hemorrhage particularly abruptio
placenta is responsible for about 10 % of
perinatal deaths due to severe hypoxia.
Pre-exlampsia, eclampsia is associated with
high perinatal loss either due to placental
insufficiency or prematurity- spontaneous or
induced.
Cervical incompetence, premature effacement
and dilatation of cervix between 24-36 weeks is
responsible for significant perinatal deaths
from prematurity.
39. Dystocia from disproportion, malpresentation,
abnormal uterine action, premature rupture of
membranes may result in asphyxia, amnionitis
and birth injuries contributes to perinatal
deaths.
40. Multiple pregnancy most often leads to
premature delivery and usual complications.
Congenital malformation is responsible for
8-10 % of perinatal deaths, the lethal
malformations are mostly related to nervous,
cardiovascular or gastrointestinal system.
Intrauterine growth restriction and low birth
weight babies.
41. Apart from preterm delivery, intra uterine
nutritional deficiency may be responsible for
such low weight babies which are more
vulnerable to biochemical, neurological and
respiratory complications resulting in high
perinatal deaths of about 50 % when the birth
weight is less than 2 kg.
Pre-term labour and pre-term rupture of the
membranes are known leading causes of
prematurity.
42. Related clinical conditions
In about 25 % deaths are related to prolonged
and difficult labour, in about 20 % related to
pregnancy complications and in about 40 %
deaths remain undermined.
Direct causes of death as revealed by autopsy
About 80 % of the perinatal deaths are related
to perinatal hypoxia, low birth weight,
infection and intracranial hemorrhage.
The undetermined group is reduced to 15 %.
43. Thus autopsy study is essential in any
perinatal mortality study when the real cause
of death can only be ascertained so that
preventive measures can be taken to prevent
its occurence.
44. As every mother has the right to conclude her
pregnancy safely so also has the baby got a
right to be born alive, safe and healthy.
Many of the perinatal deaths are preventable
with proper care and good organizational set
up.
It should be emphasized that in the developing
countries, high proportion of perinatal death is
accounted for by socio-biological factors
acting long before delivery.
As such, improvement of obstetric service
only around delivery, will not minimize
perinatal deaths appreciably.
45. Simultaneous demographic and social changes
help in reduction of perinatal mortality.
The measures are easy to outline but difficult to
implement in practice in the developing world.
Pre-pregnancy health care counseling
Genetic counseling in high risk cases and the
role of prenatal diagnosis to detect genetic,
chromosomal or structural abnormalities are
essential.
Termination of an affected fetus is a positive
step in reduction of deaths due to congenital
malformations.
46. Regular antenatal care, with advice regarding
health, diet and rest.
Improvement of maternal nutrition.
Detection and correction of anemia and
prevention in multiple pregnancy.
Immunization against tetanus should be done
as a routine.
Screening of high risk patients those of poor
socio-economic status or high parity and very
young and twins, etc and their mandatory
hospital delivery.
Risk approach to MCH care is essential.
47. Careful monitoring in labor and avoidance of
traumatic vaginal delivery.
To minimize sepsis, atleast three formalities
are to be taken- clean hands, clean surface
where delivery takes place and to cut the cord
clean.
Providing an efficient neonatal service specilly
to look after the preterm babies.
Health care education of the mother about the
care of the newborn.
Educating the public to utilize family planning
aids and also to utilize the available maternity
and child health services.
48. Autopsy studies of perinatal deaths.
Continued studies of perinatal mortality
poblems by demographic studies, regular
clinically allied interdepartmental meetings
and pathological research.
49. Life expectancy is a statistical measure of
how long an organism may live based on the
year of their birth, their current age and other
demographic factors including gender.
In the year 1950-1955 the combined life
expectancy at birth for both genders was
46.5 years.
Five decades later by 2008 it was 69 years an
increase of 22.5 years.
50. GFR represents the number of children that
would be born to a woman if she were to live
to the end of her childbearing years and bear
children in accordance with current age
specific fertility rates, i.e., the GFR is the
total number of live births per 1000 women of
reproductive age (15-49 years) in population
per year.
GFR=
Number of live births in an area during the year x 1000
Mid-year female population age 15-44/49 in
the same area in the same year
51. “A still birth is a birth of a newborn after 28th
completed week when the baby does not
breath or show any sign of life after
delivery.”
Such deaths include antepartum deaths and
intrapartum deaths.
Still birth rate is the number of such deaths
per 1000 births.
52. Acute fetal distress
Traumatic vaginal delivery leading to
asphyxia or intracranial hemorrhage.
Asphyxia- premature babies are more
vulnerable.
Congenital malformation of the fetus.
About half of the still births are related to
preterm babies.