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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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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: 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.
Past OB history Preconception Genetic Conceptional Malnutrition Environmental factor Medical conditions Obstetrical conditions Maternal Factors Fetus At Risk
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)
HEALTH CARE Fetal Health High risk Low risk NURSE OBGYN MIDWIFE NEONATO TEAM SONO GENETIC COMMUNITY PERINATO
Monitoring Education What can the Nurse do? Modifiable risk factors Non modifiable risk factors Prevention of complications
Best place for the baby to grow is inside the mother – every week matters
Bed Rest • pressure on vena cava • venous return • circulatory volume • Placental and renal perfusion
Mothers …… eat healthy food, exercise wisely and avoid harmful substance!!! You are protected and you are protecting your unborn
Follow up As Advised DON’T MISS YOUR CHECKUP
Fetal Health Surveillance • Screening methods • Fetal movement chart • Symphysial Fundal Height • Palpation &Auscultation • Electronic fetal monitor • Ultrasonography • Doppler velocimetry • Amniocentesis
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)
Cardiff count 10 - count 10 fetal movements • Sadovsky- feel 4 movements in 1 hour
Auscultation Fetoscope and Doppler Palpation Doppler
Non Stress Test Fetal Movement = Fetal Well Being Reactivity= 2 accelerations above baseline lasting 15 seconds within 20 minutes
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
Assessment of Fetal Well Being • Doppler Blood Flow S: D ratio - <2.6 (26 wks gestation) <3 (at term)
Amniocentesis • Chromosomes and metabolic defect • Fetal maturity - L:S ratio 2:1 - Phosphatidylglycerol - Lamellar body count < 35,000 /UL
Fetal Tachycardia Fetal heart rate above 160 beats per minute Fetal tachycardia with fetal arrhythmia
Fetal Bradycardia Baseline fetal heart rate less than 110 beats per minute
Variable Deceleration Prolonged Deceleration
THEY NEED YOU AND YOUR CARE