Emergency Obstetric Care Flashcards
Why aren’t preventive services enough to reduce maternal mortality?
Because upto 15% of pregnant women and newborns have complications which cannot be predicted
What are the major causes of maternal mortality
80% of maternal deaths are due to direct obstetric causes which include: Hemorrhagic Eclampsia Abortion complications obstructed Labour Sepsis (m- HEALS)
What are the major causes of neonatal mortality
Prematurity
Infection ( pneumonia, diarrhoea, sepsis, tetanus)
Asphyxia
(m- PIA)
What proportion of neonatal deaths occur in the first week?
3/4th
Components of BEmONC?
Admin of parenteral antibiotic Admin of parenteral uteroronic Admin of parenteral anticonvulsant Manual removal of placenta Assisted vaginal birth ( vacuum or forceps) Newborn resuscitation Care of lbw newborn Admin of parenteral antibiotic to newborn
Components of CEmONC
All BEmONC functions plus
C-section
Blood transfusion
Who needs to have BEmONC skills?
Everybody who attends a birth
When do you suspect sepsis?
Temperature of 100 F ( 38 degrees or more)
Signs of sepsis
Foul smelling discharge
Tender uterus
Antibiotic treatment of metritis
Ampicillin- every 6 hrs
Gentamicin- every 24 hrs
Metronidazole/ Clindamycin-every 8 hrs
(m- MAG)
In uncomplicated endometritis continued oral antibiotics are not required
80 % of PPH is caused by_______
Uterine atony
Name 3 uteroronics with their routes of administration
Oxytocin - Iv infusion or im
Ergometrin - im
Misoprostol- oral
Can ergometrin be given in a woman with high bp?
Never. It can precipitate eclampsia
Why is diazepam not the DOC In rx of eclampsia
High risk of neonatal respiratory depression
What is severe pre eclampsia
Dbp> 110 mm Hg
What is retained placenta?
Failure of expulsion of placenta within 30 minutes of delivery
Treatment of retained placenta?
Administer oxytocin and apply controlled cord traction
If this doesn’t work then remove manually. Infection prevention practices must be observed
Administer oxytocin after removal
An incomplete spontaneous abortion can lead to what complication?
What oral drug can be used to treat this?
Fatal haemorrhage
Misoprostol
What methods are used for removal of retained products of conception ?
- manual vacuum aspiration ( less traumatic, less painful, less uterine perforation)
- D& C
Can a vacuum extractor be used in breech presentation?
No, only in cephalic presentation
What is the advantage of using forceps for delivery?
Less cephalhematoma
Less retinal hemorrhage
What % of babies need resuscitation at birth
Upto 10 %
Is oxygen necessary for resuscitation of asphyxiated newborns?
No, Ambu bag and room air are enough
For whom is kangaroo mother care recommended?
Stable LBW and premature newborn
Pneumonia accounts for what proportion of newborn mortality
Upto 30%
What is CEmONC?
BEmONC + C- section and safe blood transfusion
what are the UN recommendations for BEmONC and CEmONC in terms of population norms?
For every 500,000 population
1 facility providing CEmONC
4facilities providing BEmONC
How will you assess quantity of EmONC services?
C- section rate
Should be between 5-15% of all births in the population
How will you assess quality of
EmONC services?
Case fatality rate
Should not be >1%
UN process indicators for EmONC
A) Number of facilities
B)Geographical distribution
c)Utilization of services ( 15% of all births in EmONC facilities )
d)Met need for EmONC (All women with complications ( estimated at 15% of births) are treated at EmONC facilities
e) Quantity of services ( C-secn rate)
f) Quaity of services ( Case Fatality Rate)
What is the duration of BEmONC and CEmONC course provided by FOGSI?
BEmONC- 3 weeks
CEmONC- 16 weeks
