Preconception Care PPT PDF
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Hana I. (MRHN)
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Summary
This presentation covers preconception care, outlining its definition, components, and importance in reducing maternal and child mortality and morbidity in Ethiopia. It examines key elements like nutrition, family planning, and environmental factors influencing pregnancy outcomes. The presentation also explores interventions and assesses risk factors.
Full Transcript
PRECONCEPTION CARE BY: Hana I. (MRHN) Outlines Definition of preconception care Components of preconception care Objectives At the end of the session the learners will be able to Define preconception care Discuss components of preconception care ...
PRECONCEPTION CARE BY: Hana I. (MRHN) Outlines Definition of preconception care Components of preconception care Objectives At the end of the session the learners will be able to Define preconception care Discuss components of preconception care Brainstorming What is preconception care ? Preconception care A set of interventions to identify & modify risks that affects the women’s health or pregnancy outcome through prevention and management. It’s a set of interventions that aim to identify and modify biomedical, behavioral, and social risks to improve pregnancy outcomes through risk assessment, health education, and management. Conti… It is given during pre-conception and inter-pregnancy periods. It is now included in continuum maternal care. Brainstorming Who should get preconception care? Why Preconception care is needed There is a growing recognition that embryonic period is critical for the outcome of pregnancy. Pre-conceptional risks are underweight, overweight, anemia, unintended pregnancy, alcohol intake, smoking, chronic medical conditions, STI, malaria and so on. Conti… To prevent or lower risk of adverse birth outcomes like miscarriage, preterm birth, low birth weight, birth defects, and antepartum hemorrhage, neonatal and maternal deaths. Our country faces a high number of maternal and child deaths, and having a good utilization of PCC decreased maternal and child mortality by 57% and maternal and child morbidity by 73%. Why ANC is not adequate? most APOs happen before the early periods of conception and the median antenatal attendance for Ethiopian women is around 16 weeks of gestation, investing solely in antenatal care is not adequate for improving pregnancy and birth outcomes. Components of preconception care majorly classified in to the following I. Assessment Identification of risk factors related to poor pregnancy out comes. All reproductive age group couples/ woman should be asked for their pregnancy plan and those who planned within the coming 3 months needed to be assessed for pre-conceptional care. Conti… II. Intervention Treating identified risk factors and complications Preconception care intervention includes: counseling, treatment and linkage or referral. Core Components of Preconception care (PCC) 1. Family planning 9. Infectious disease 2. Nutrition 10. Vaccine Preventable 3. Folic acid supplementation Diseases 4. Sexual Health and 11. Genetic risks Violence 12. Chronic medical 5. Environmental exposure condition or Occupational hazards 6. Medicines with adverse 13. Substance use effect on pregnancy 14. Reproductive organ outcome anomalies 7. Mental health 8. Oral health 15. Cervical cancer 1. Family planning and contraceptive FP - is an action taken by individuals or couples to decide the no and timing of children in family. Modern FP includes pills, injectable, IUCD whereas traditional include abstinence, withdrawal, calendar methods. Emergency contraception includes IUCD, and COC and pop FP is an important and fundamental component of preconception care, which reduces adolescent pregnancy rates, and promotes spacing between pregnancies. Conti… Reproductive planning has the potential to considerably reduce maternal, newborn, infant and child deaths. Globally it decreases 71% of unwanted pregnancies, thereby eliminating 22 million unplanned births, 25 million induced abortions and 7 million miscarriages. It also reduces sexual transmission of HIV through correct and consistent condom use What do we assess? Reproductive life plan (Are you planning to be pregnant , with in three months’ time)? Assess history of APOs (unintended pregnancy, abortion..) Assess medications, health conditions, and activities that may affect fertility Intervention Counsel and provide information on family planning for those who desire pregnancy but needed to delay pregnancy for medical reason. Return of fertility following discontinuation of contraceptive methods should be informed to the couples wishing to postpone conception. Counsel women about birth spacing and girls to delay teenage pregnancy. Conti… Counsel to use modern contraception Link or refer the clients to family planning unit for family planning service utilization 2. Nutrition an underweight or overweight woman, a short woman, or women with micronutrient deficiencies during pregnancy contribute to increase complications for mother and fetus. In Ethiopia, 22% of women of reproductive age are thin, 8% are overweight or obese and 24% are anemic. Conti… Additionally, 29% pregnant and lactating women were also anemic. Maternal under nutrition and iron- deficiency anemia account for at least 20% of maternal mortality. Conti… Women of reproductive age do have increased requirements for certain micronutrients such as folic acid, iron, iodine, calcium and zinc which can be found either by consuming diversified and fortified food or by supplement which are essential for positive pregnancy and health outcomes Nutritional Assessment Assess the ABCD of nutrition Anthropometric factors e.g. BMI (18.5-24.9) Biochemical factors e.g. anemia Clinical assessment- identify s/s that indicate nutritional deficiency e.g. conjunctiva pallor – iron deficiency Dietary assessment- Assess dietary practice, diversity, healthy food choice Intervention Nutritional Counseling Iron-folic acid supplementation Micronutrient Supplementation(Iodine fortified salt) Deworming Prevention of anemia Promoting healthy weight during preconception Nutritional Counseling Provide nutrition counseling for women during preconception period to engage their couples to consume adequate and diversified foods. Counsel to consume 100–200 grams of various fruits and vegetables each day, such as tomatoes, carrots, and papayas. Counsel to consume every day, include animal-sourced items in your meals, such as eggs, meat (60 grams), and dairy products (300–400 grams). Advice to drink 8–10 large glasses of clean water every day and to limit the intake of sugar, sweets, and soft drinks to below 30 grams per day. Counsel to get some exercise every day for at least 30 minutes. Advice intake of calcium rich foods such as dairy products (yoghurt, milk, and cheese), eggs, fish,, beef and rice so on Advice to take zinc rich foods such as meat, fish, eggs, whole grains… Conti… Counseling on intake of iodine through use of iodized salt for all women of reproductive age. Counsel on avoiding caffeine consumption (inhibitors of iron/zinc/calcium absorption) within one hour before or after eating, promote increased intake of absorption enhancers, vitamin C-rich foods such as oranges, tangerines, mangoes etc. Counsel and educate on limiting consumption of processed, junk foods and other sugar containing drinks to prevent overweight and chronic diseases. Iodine Supplementation Iodine deficiency disorders (IDD) can result in adverse maternal and fetal outcomes. Neurodevelopmental deficits in fetal brain are the most significant irreversible effect of IDD during early pregnancy. Conti… In Ethiopia, 80% of pregnant women had insufficient iodine intake. therefore Counsel the woman to take iodized salts Advice to take iodine supplement 150microgrm daily Deworming Advice to deworm annually or bi- annually with albendazole (400 mg) or mebendazole (500 mg), to control and/or prevent anemia in women reproductive age group. Advice to keep proper hygiene and sanitation practices Prevention of Anemia Anemia during pregnancy increases the risk of maternal mortality, perinatal(20 wks of gestation-28 days after birth) mortality, low birth weight (LBW), and preterm birth. All women during the preconception period should be screened for anemia by checking their hemoglobin levels. Conti… All preconception women diagnosed with anemia as per the national protocol receive increased daily elemental iron to 120 mg until their Hgb concentration becomes normal (Hb12 g/L or higher). Counsel for the intake of foods rich in iron, such as meat, fish, and poultry Link or refer if the anemia is not manageable Promoting Healthy Weight during Preconception A non pregnant reproductive women’s nutritional status should be assessed is classified based on their BMI as presented in the table below Nutritional BMI (Kg/m2) status/Classification Underweight < 18.5 Normal weight 18.5-24.9 Overweight 25-29.9 Obese >= 30 Conti… For women with a low pre-pregnancy BMI (