maternl health program MRM4.pptx

Maternal Health program Dr. Mohamed Raafat Motawea Maternal Healthcare program Components:  Antenatal care  Natal care  Postnatal care  Inter-pregnancy care Antenatal care  ANC Components 1. Registration and management. record keeping. 7. Referral services....

Maternal Health program Dr. Mohamed Raafat Motawea Maternal Healthcare program Components:  Antenatal care  Natal care  Postnatal care  Inter-pregnancy care Antenatal care  ANC Components 1. Registration and management. record keeping. 7. Referral services. 2. ANC periodic visits. 8. Home visits. 3. Health education 9. Social care. during ANC. 4. Nutritional care. 5. Tetanus toxoid. 6. Risk detection and 1- Registration & record Keeping  Booking for ANC should start within first 6 weeks after the last menstrual cycle  Delay in registration would miss the period of organogenesis  The mother should get a health card 2- ANC periodic visits & clinical Examination  Once every month till 7th month.  Once every 2 weeks till the 9th month  Once every week during the 9th month, till labor.  The mother should receive a minimum of 4 ANC visits during pregnancy  The First ANC Visit History Examination Investigations  History  Personal history  Family history  Medical and surgical history  Menstrual history  Obstetrical history  History of present pregnancy  Examination & investigations  Weight & Height measurement, clinical check up  Urine should be tested for sugar, ketones and protein.  Blood examination for blood group, RH, blood sugar, Hemoglobin ‫عشان االنيميا‬  Risk factors assessment  The return Visits History Examination Investigations History  Update the history  Listen for any problems or worries  Examination & investigations  Weight & Height measurement  Blood pressure measurement  General examination  Urine should be tested for sugar, ketones and protein.  Hemoglobin  Health Education during ANC -3  Physiological changes  Exercises and during pregnancy, relaxation Weight gain  Personal hygiene  Avoid contact with  Teeth care infectious diseases  Avoid smoking & (specially rubella) irradiation  Fresh air and sunshine  Medications  Rest and sleep  Signs of Potential  Adequate Nutrition Complications ***.Nutritional care -4 - Nutrition assessment:  Measurement of body weight  Hemoglobin estimation  Clinical examination  Dietary assessment - Nutrition Education  Focus on adequate diet  Daily consumption of fresh fruits and vegetables  Daily consumption of milk or milk product  Avoid excessive salt - Nutrition supplementation  Iron 60 mg (in non anemic mothers) o Starts at 24 weeks ‫من الشهر الرابع‬. o Extends 3-6 months after delivery.  Folic acid ‫ بيمنع‬spinal bifida o Starts 1 month before becoming pregnant. o Extends through first 3 months of pregnancy.  Calcium o Starts in 2nd trimester. Tetanus toxoid immunization -5  The 1st dose: at1st ANC visit  The 2nd dose: at least 4 weeks after the 1st dose  The 3rd dose: 6-12 months after the 2nd  Booster dose: Every 10 years  Risk Detection and Management -6  Identification of mothers who are at risk of mortality or morbidity.  Everyone is receiving a standard level of health care and more care is given to those at risk.  Risk factors are recorded in the maternal card.  ****Risk Factors in pregnancy  Age under 18 or above  Previous antepartum hge. 35.  Primigravida.  More than 6 pregnancies.  Previous caesarean  Twins. section.  Pre-eclampsia.  Vacuum, or forceps  Diabetes. delivery.  Cardiac problem.  Previous perinatal death,  Renal disease. stillbirth.  Previous Postpartum hemorrhage. 7- Referral services: Refer the at-risk mothers to hospital. 8- Home visits: o Follow up the dropouts from the ANC. o To provide health education. 9- Social care o Mother of low socioeconomic status. o Non educated women. o Women living in rural areas. Natal care  Natal care Components Birth attendants ‫اللي هيعمل العملية‬ well-trained physician or well-trained nurse. Place of Delivery ‫والمكان‬ o Hygienic. o Well equipped. o Have qualified trained persons. o These sites could be in hospitals or delivery hospitals or primary health care centers. o Natal care should be given to the newborn at the same time. Postnatal care The care given in The period of 40 d. or 6 w. after childbirth ‫فترة البوربوريم‬ Objectives  Ensure the good health of the mother and the newborn  Support for breastfeeding.  Family planning and birth spacing.  Health education on weaning and food preparation.  Inter- pregnancy care  Inter-pregnancy Care Components  Personal, medical, and family history.  Health education for lifestyle and habits.  In case of occurrence of abortion , post abortion care should be provided.  Counseling for Family Planning.  Laboratory examination (CBC, blood sugar).  Iron supplementation for 3-6 months after delivery. Thank you