EINC

Question 1

Too many mothers and newborns are dying every year. GLOBALLY

Answer 1

560,000 mothers
4,000,000 (4million) newborns

Question 2

Too many mothers and newborns are dying every year. PHILIPPINES

Answer 2

4,600 mothers
33,620 newborns

Question 3

•To detect diseases which may complicate pregnancy
•To educate women on danger and emergency signs & symptoms
•To prepare the woman and her family for childbirth

Answer 3

Antenatal Care

Question 4

To detect diseases which may complicate pregnancy. SCREEN:

Answer 4

Anemia
Pre-eclampsia
Diabetes Mellitus
Syphilis

Question 5

To detect diseases which may complicate pregnancy. TO PREVENT:

Answer 5

• Ferrous and folic acid supplementation
• Tetanus toxoid immunization
• Corticosteroids for preterm labor

Question 6

To detect diseases which may complicate pregnancy. TO DETECT:

Answer 6

PROM
Preterm Labor

Question 7

To detect diseases which may complicate pregnancy. TREATMENT:

Answer 7

• Ferrous sulfate for anemia
• Antihypertensive meds and
Magnesium sulfate for SEVERE preeclampsia
• REFER

Question 8

all patients who are at risk for preterm delivery
• with preterm labor between 24-34 weeks
AOG
or with any of the following prior to term:
• Antepartal hemorrhage/bleeding
• Hypertension
• (preterm) Pre-labor rupture of membranes

Answer 8

Administer ANTENATAL STEROIDS

Question 9

Overall reduction in neonatal death
Reduction in RDS
Reduction in cerebroventricular hemorrhage
Reduction in sepsis in the first 48 hours of life

Answer 9

Antenatal Steroids:
Betamethasone 12 mg IM q 24 hrs x 2 doses OR DEXAMETHASONE 6 mg IM q 12 x 4 doses

Question 10

2ml ampules: 4mg/ml
6 mg - 1.5 ml injected intramuscularly
Even a single dose of 6 mg IM before delivery is beneficial
emergency drug should be available at the OPD and ER

Answer 10

DEXAMETHASONE
PHOSPHATE

Question 11

DANGER SIGNS and SYMPTOMS

Answer 11

Vaginal bleeding
Headache
Blurring of vision
Abdominal Pain
Severe difficulty breathing
Dangerous fever (T°>38, weak)
Burning on urination

Question 12

INTRAPARTUM CARE
1. Admission to labor when the parturient is alread in the active phase.

Answer 12

•Active phase labor:
- 2-3 contractions in 10 minutes
- Cervix is 4 cm dilated

Question 13

•Active phase labor:

Answer 13

• 2-3 contractions in 10 minutes
• Cervix is 4 cm dilated

Question 14

Recommended Practices During Labor:
Admit when the parturient is already in ACTIVE LABOR

Answer 14

No difference in Apgar score
— need for Cesarean Section by 82%
No difference in need for labor augmentation

Question 15

Recommended Practice During Labor

Answer 15

1. Admission to labor when the parturient is already in the active phase.
2. Continuous maternal support

Question 16

Continuous maternal support

Answer 16

•⬇️Need for pain relief by 10%
•Duration of labor SHORTER by half an hour
•⬆️spontaneous vaginal delivery by 8%
•⬇️Instrumental vaginal delivery 10%
•5 minute Apgar < 7 ⬇️ by 30%

Question 17

Having a LABOR COMPANION can result in:

Answer 17

• Less use of pain relief drugs -> Increased alertness of baby
• Baby less stressed, uses less energy
- Reduced risk of infant hypothermia
- Reduced risk of hypoglycemia
• Early and frequent breastfeeding
• Easier bonding with the baby

Question 18

Recommended Practices During
Labor

Answer 18

1. Admission to labor when the parturient is already in the active phase.
2. Continuous maternal support
3. Upright position during first stage of labor

Question 19

Freedom of movement

Answer 19

• distract mothers from the discomfort of labor, release muscle tension, and give a mother the sense of control over her labor

Question 20

First stage of labor shorter by about 1 hour
Need for epidural analgesia ⬇️ by 17%

No difference in rates of SVD , CS, and Apgar score < 7 at 5 minutes

Answer 20

UPRIGHT POSITION DURING LABOR