Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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• All pregnant women receive at least four focused (quality) antenatal visits.<br />
• Detection of risk factors should be modified to put the emphasis on educating the<br />
women, men, <strong>and</strong> family members about danger signs <strong>and</strong> the actions necessary to get<br />
timely access to maternal health services if the woman experiences a complication.<br />
• The so-called risk factors, instead of being considered as markers or indicators of<br />
complications, should be regarded as factors associated with complications, <strong>and</strong> their<br />
importance for each pregnancy <strong>and</strong> childbirth should be considered on a case-by-case<br />
basis.<br />
• The presence of risk factors implies a need for more careful monitoring, not because<br />
they are necessarily predictive of complications. For many of them (e.g., age), nothing<br />
can be done to alter the risk factor. However, additional care <strong>and</strong> watchfulness may<br />
prevent a complication from arising or enable its early detection <strong>and</strong> management.<br />
MATERNAL CONDITIONS AFFECTING FETAL AND NEWBORN SURVIVAL<br />
This section will discuss maternal conditions, pregnancy-related complications, <strong>and</strong> maternal<br />
infections that have an impact on fetal <strong>and</strong> newborn health <strong>and</strong> survival.<br />
Iron-deficiency Anemia<br />
Figure 3.1. Signs of iron-deficiency anemia<br />
An anemic pregnant woman has a high risk of getting<br />
ill (because of lowered resistance to infection), of<br />
having a low birth weight (LBW) infant with a birth<br />
weight of less than 2500 grams, of giving birth<br />
prematurely before 37 completed weeks of gestation,<br />
of suffering from postpartum hemorrhage <strong>and</strong> heart<br />
failure, <strong>and</strong> of dying. Many women are already anemic<br />
when they become pregnant; closely spaced<br />
pregnancies, malaria, hookworm, sickle cell anemia,<br />
<strong>and</strong> frequent <strong>and</strong> chronic infections are some of the<br />
causes of anemia.<br />
Iodine Deficiency<br />
Iodine needs increase greatly during pregnancy because iodine is essential for the development<br />
<strong>and</strong> maturation of the fetal nervous system. Iodine deficiency in the pregnant woman has been<br />
associated with: 1) in the fetus: abortion, stillbirth, retardation of cerebral development, <strong>and</strong><br />
congenital anomalies; 2) in the newborn: low birth weight, goiter, <strong>and</strong> neonatal hypothyroidism;<br />
<strong>and</strong> 3) in the adult: goiter <strong>and</strong> complications from goiters.<br />
Malnutrition<br />
<strong>Maternal</strong> undernutrition during pregnancy is associated with low birth weight. Low birth weight,<br />
in turn, has been shown to correlate with an increased incidence of the following: neonatal,<br />
infant, <strong>and</strong> child morbidity <strong>and</strong> mortality, small head circumference, mental retardation, cerebral<br />
palsy, learning problems/disabilities, visual <strong>and</strong> hearing defects, neurologic defects, <strong>and</strong> poor<br />
infant growth <strong>and</strong> development.<br />
30<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course