DAKSHATA Best Practices MNH Dos and Dont Perineal
DAKSHATA Best Practices: MNH
Do’s and Don’t • • • Perineal shaving Routine enema Restriction on diet Exclusive breastfeeding Delayed clamping & cutting of cord Checking placenta for completeness CCT in relaxed uterus Milking of cord Delaying baby’s 1 st bath Allowing companion with mother Do’s Don’t Exclusive breastfeeding Perineal shaving Delayed clamping & cutting of cord Routine enema Checking placenta for completeness Restriction on diet Delaying baby’s 1 st bath CCT in relaxed uterus Allowing companion with mother Milking of cord
Delaying baby’s 1 st bath Exclusive breastfeeding CCT in relaxed uterus Checking placenta for completeness Routine enema Perineal shaving Allowing companion with mother Delayed clamping & cutting of cord Do’s Don’t Milking of cord Restriction on diet
PPH … Single Most Important Cause of Maternal Mortality What % of maternal deaths due to PPH can be averted 66% (? ? ) Single most imp measure to prevent PPH AMTSL Steps of AMTSL 1. Oxytocin in 1 min 2. CCT 3. Ut message
Hypertensive Disorder of Pregnancy What % of maternal deaths occur due to severe PE/E Single most effective treatment in severe PE What are the criterias for Assessment of PE/E 14% Inj Mag Sulfate 1. BP> 140/90 2. Proteinuria 3. Danger sign/Convulsion
Obstructed Labour Can we prevent obstructed labor? When HWs should start filling partograph Simple tool to prevent Obstructed Labor Yes Cx dilatation >=4 cm Partograph
Danger Signs ? Birth weight 1500 -1800 g Not suckling (after 6 hours of age) Small baby feeding well/gaining weight adequately Fast breathing (more than 60 breaths per minute) Grunting Yes No Yes Eyes swollen and draining pus Yellow skin on face and < 24 hours old Less than 10 pustules Fever (temperature > 38° C) Yes No Mother known to be HIV-positive No Yes 7
Appropriate assessment of Foetal and Maternal Conditions Taking Medical, Surgical & Obstetric history Yes Recording Mother’s BP Yes Recording Fetal Heart Rate Internal Examination should be done frequently Yes No Recording Mother’s Temperature Yes Cleaning of perineum with antiseptic solution is not required No 8
Essential New-Born Care (ENBC) Baby needs to be received in tray Start breastfeeding ASAP after birth Inj. Vita K should only given to LBW/pre-term No Yes No Suction needs to be done with every newborn Per-term baby requires size 0 of cap with Ambu bag Skin to skin contact is required for all normal babies No Yes 9
Infection prevention How many minutes instruments should be dipped in bleaching sol for decontamination 10 minutes Six cleans PV examination should be performed every hour 1. Hands 2. Surface 3. Perineum 4. Cord cutting instruments 5. Cord tie 6. Clean Cord No, depends on situation
Miscellaneous All pregnant woman needs to be given antibiotics (prophylactically) What is the measure to prevent deaths due to pre-tern births In Preterm delivery Inj. Dexamethasone should be give to the new-born No ANCS No Minimum duration for KMC How many minutes before delivery radiant warmer should be switched on Newborn resuscitation can only be performed at NBSU/SNCU 1 hour 30 minutes No 11
- Slides: 11