An early arrival

Antenatal care
1. Routine Investigations and Physical examinations
  1. Urine
    1. Asymptomatic bacteriuria
    2. proteinuria
    3. Glycosuria
  2. Blood Pressure
  3. Abdominal Examination
  4. Ultrasound
2. Anomaly Scan
  1. done any time between 18 weeks and 20 weeks plus six days to check if the baby is developing normally and the location of the placenta.
3. High Vaginal Swab
  1. taken at the first visit, at 30 weeks and before the birth.
Stages of labour
Management of preterm labour
1. Goals of treatment
  1. inhibit strength and frequencies of contractures
    1. Mg sulfate (tocolytic)
  2. optimize fetal status before preterm delivery
    1. corticosteriods
    2. intensive care and resuscication team
    3. Group B strep. prophylaxis
Complications of prematurity
1. Short-term complications
  1. Breathing problems
  2. Heart problems
  3. Brain problems
  4. Temperature control problems
  5. Gastrointestinal problems
  6. Blood problems
  7. Metabolism problems
  8. Immune system problems
2. Long-term complications
  1. Cerebral palsy
  2. Impaired learning
  3. Vision problems
  4. Hearing problems
  5. Dental problems
  6. Behavioral and psychological problems
  7. Chronic health issues
Effects of prematurity on mother-infant relationship
1. parents of preterm infants reported less bonding problems compared to parents of full-terms
Examination of the newborn
1. Baby Reflexes
  1. Root Reflex
  2. Suck Reflex
  3. Moro Reflex
  4. Tonic Neck Reflex
  5. Grasp Reflex
  6. Babinski Reflex
  7. Step Reflex
challenges in the immediate neonatal period
1. The earlier in a pregnancy that babies are born, the less prepared their bodies are for the outside world. challenges are:
  1. Staying warm
  2. Feeding
  3. Breathing
  4. Infections
  5. bleeding in the brain
  6. eyes are not ready for the outside world
Lactation
1. Estrogen stimulates growth of the ductal system of the breasts
2. growth hormone, prolactin, the adrenal glucocorticoids, and insulin → Protein metabolism
3. Progesterone Is Required for Full Development of the Lobule-Alveolar System (final development).
breastfeeding
1. Advantages
  1. babies
    1. Stronger immune systems
    2. Less diarrhea, constipation, gastroenteritis
    3. Fewer colds and respiratory illnesses
    4. Fewer ear infections
    5. Better vision
    6. Lower rates of infant mortality
    7. Lower rates of SIDS
  2. mothers
    1. physically
      1. faster weight loss after birth
      2. Stimulates the uterus to contract and return to normal size
      3. Less postpartum bleeding
      4. Fewer UTI
      5. Less chance of anemia
      6. Less risk of postpartum depression
    2. emotionally
      1. produces the naturally oxytocin and prolactin promote stress reduction
      2. Increased confidence and self-esteem
      3. Increased calmness
      4. Breastfeeding makes travel easier
      5. Physical/emotional bonding
    3. for life
      1. Lower risk of breast cancer
      2. Lower risk of ovarian cancer
      3. Lower risk of RA & lupus
      4. Less endometriosis
      5. Less osteoporosis with age
      6. Less diabetes
      7. Less hypertension
      8. Less CVD
2. contraindications
  1. baby has galactosaemia
  2. Mother has active untreated tuberculosis
  3. Mother is receiving therapeutic radio- active isotopes
  4. Mother is receiving antimetabolites
  5. Mother is receiving chemotherapeutic agents
  6. Mother has herpes simplex lesions on a breast
  7. Mother is HIV positive
  8. Mother is abusing drugs
Postnatal follow up
1. For all mothers
2. For all Newborns
Pap smear
1. a method of cervical screening used to detect potentially pre-cancerous and cancerous processes in the cervix
2. It is recommended from 21 years of age until the age of 65
3. It has a screening of once every 3-5 years depending on the sexual behavior of the patient
4. If results are abnormal, then a pap smear should be taken every 6-12 months depending on the severity of the abnormality
Preventive medical initiatives for women and promoting a health campaign
1. Well woman preventive visits
2. Screening for gestational DM
3. Cervical cancer screening
4. Counseling for STIs
5. Screening for HIV
6. Breastfeeding services and equipment
7. Breast cancer screening
Fatima, 32yrs old came for antenatal care in 12wks pregnancy. had cone biopsy revealed CIN. in past 24hrs she had backache and abdominal cramps that intensified in the past six hours. She had a vaginal delivery of a male infant weighing 2kg about 26 hours after admission

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An early arrival

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Medienanhänge

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	Erstellt von mahmoud eladl vor mehr als 6 Jahre