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Mama ! Make me safe inside & outside

A mother's joy begins when new life is stirring inside... when a tiny heartbeat is heard for the very first time, and a playful kick reminds her that she is never alone. Mama ! Make me safe inside & outside. High Risk Fetus: Nurses' Role. Healthy Mothers and Healthy fetuses:

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Mama ! Make me safe inside & outside

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  1. A mother's joy begins when new life is stirring inside... when a tiny heartbeat is heard for the very first time, and a playful kick reminds her that she is never alone.

  2. Mama ! Make me safe inside & outside

  3. High Risk Fetus: Nurses' Role

  4. Healthy Mothers and Healthy fetuses: The Vital Link. • Preventing fetal deaths begins with the health of the mother. • Cost-effective prenatal and delivery interventions that saves mothers’ lives can save most fetuses too.

  5. Past OB history Preconception Genetic Conceptional Malnutrition Environmental factor Medical conditions Obstetrical conditions Maternal Factors Fetus At Risk

  6. Statistics - Risk assessment • Nigeria shows 120 / 299 (40.1%) in high-risk category. (2008) • Bihar- 24/ 200 women in high risk category,74 in moderate and 101 in low risk group. (2008) • Ahmedabad - 81.66% had high risk factors. (1998)

  7. HEALTH CARE Fetal Health High risk Low risk NURSE OBGYN MIDWIFE NEONATO TEAM SONO GENETIC COMMUNITY PERINATO

  8. Monitoring Education What can the Nurse do? Modifiable risk factors Non modifiable risk factors Prevention of complications

  9. Best place for the baby to grow is inside the mother – every week matters

  10. Bed Rest • pressure on vena cava • venous return • circulatory volume • Placental and renal perfusion

  11. Mothers …… eat healthy food, exercise wisely and avoid harmful substance!!! You are protected and you are protecting your unborn

  12. ?

  13. BALANCE BETWEEN CHO- PROTEIN- FAT & MIN-VIT

  14. RELAX ……..

  15. Follow up As Advised DON’T MISS YOUR CHECKUP

  16. Fetal Health Surveillance • Screening methods • Fetal movement chart • Symphysial Fundal Height • Palpation &Auscultation • Electronic fetal monitor • Ultrasonography • Doppler velocimetry • Amniocentesis

  17. One day you’re pregnant and one day you’re not: Pregnancy interruption for fetal anomalies Quad Test • Maternal serum alpha feto protein • Unconjugated Estriol • Beta - hCG • Inhibin -A • Pregnancy associated placental protein (PAPP-A)

  18. Cardiff count 10 - count 10 fetal movements • Sadovsky- feel 4 movements in 1 hour

  19. Auscultation Fetoscope and Doppler Palpation Doppler

  20. Non Stress Test Fetal Movement = Fetal Well Being Reactivity= 2 accelerations above baseline lasting 15 seconds within 20 minutes

  21. Contraction Stress Test • Ability of fetus to tolerate stress and fetal reserve • Decrease in oxygenation with uterine contractions • Initiate 3 ucs in 10 minutes • FHR for variations

  22. Investigations as advised…..

  23. Assessment of Fetal Well Being • Doppler Blood Flow S: D ratio - <2.6 (26 wks gestation) <3 (at term)

  24. Amniocentesis • Chromosomes and metabolic defect • Fetal maturity - L:S ratio 2:1 - Phosphatidylglycerol - Lamellar body count < 35,000 /UL

  25. External Fetal Monitoring

  26. Internal Fetal Monitoring

  27. Fetal Tachycardia Fetal heart rate above 160 beats per minute Fetal tachycardia with fetal arrhythmia

  28. Fetal Bradycardia Baseline fetal heart rate less than 110 beats per minute

  29. Variable Deceleration Prolonged Deceleration

  30. Sinusoidal Pattern

  31. Call Health care professionals if there is a problem…

  32. THEY NEED YOU AND YOUR CARE

  33. Thank You !

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