MAJOR CAUSES OF DEATH DURING PREGNANCY

1. Ectopic pregnancy - It occurs when a pregnancy implants outside of the uterine

cavity. If left untreated, it can cause major internal bleeding and death.
2. Hypertension - If untreated, severe gestational hypertension may cause
dangerous seizures (eclampsia) and even death in the mother and fetus. Because of
these risks, it may be necessary for the baby to be delivered early, before 37 weeks
gestation
PIH – pregnancy induced hypertension
3. Hemorrhage- uterine atony(relax) - Postpartum hemorrhage is a serious and
potentially fatal condition. With PPH, you can lose large amounts of blood very
quickly. It causes a sharp decline in blood pressure, which can restrict blood flow to
your brain and other organs. This is called shock, and it can lead to death.
4. Embolism - A PE restricts blood flow to your lungs, lowers oxygen levels in your
lungs and increases blood pressure in your pulmonary arteries. Without quick
treatment, a pulmonary embolism can cause heart or lung damage and even death.
5. Infection – GBS : This is the most common cause of life-threatening infections in
the newborn and possibly the mother. Infections that may occur include sepsis,
pneumonia, or meningitis. Universal screening at 35 to 37 weeks of gestation, and
intrapartum antibiotic prophylaxis are the key prevention strategies for GBS.

Group B streptococcus (also called Group B strep or GBS) is a common type of bacteria
(tiny organisms that live in and around your body) that can cause infection. Usually
GBS is not serious for adults, but it can hurt newborns. Many people carry Group B
strep bacteria and don't know it
6. Anesthesia-related complications such as intrapartum cardiac arrest

Surgery and anesthesia can affect uterine activity and placental perfusion, and
therefore fetal oxygenation and fetal heart rate. Fetal heart rate can also be affected
directly by medications that readily cross the placenta or indirectly by their influence
on maternal hemodynamics.

7. An important focus of all prenatal visits, therefore, in addition to education about

pregnancy, is to screen for danger signs that might reveal any of these conditions
ANTEPARTUM SCREENING:

a. Health history (extensive)

· Demographic Data –
name, age, address, contact numbers
religion and health insurance.
· Chief Concern –
she thinks she is pregnant;
LMP; pregnancy test; signs of pregnancy;
discomforts of pregnancy; wanted pregnancy
· Family profile –
marital status; support people;
size of house; financial status; jobs
· History of Past Illnesses –
past conditions can become active during/immediately following pregnancy –
kidney, heart disease; HPN; STIs; Diabetes; Hepa B; HIV; Thyroid
problem; UT; TB ; Asthma ; Seizures ; Varicella -chickenpox ; mumps

· History of Family illnesses –

cardiovascular; renal diseases; cognitive impairment; blood
disorders; genetically inherited diseases.
· Day History/Social Profile –
current nutrition; elimination; recreation and interpersonal interactions
· Gynecological History – reproductive system problem; menstrual history;
perineal self-examination; BSE (breast self-examination); Surgery on the
reproductive tract; reproductive planning method used; stress incontinence-
Kegel’s exercise
Obstetric History –
Don’t assume that the current pregnancy is a woman’s first pregnancy simply
because she is very young or says she has only recently been married. She may
have had an adolescent pregnancy or this could be a second marriage. For each
previous pregnancy, document the child’s sex and the place and date of birth.
What is a birth plan?
A birth plan is a document that lets your medical team know your preferences for
things such as how to manage labor pain.

Sample of a Birth Plan: MLG

Birth Attendant: AC, MD, or nurse-midwife KD, whoever is on call for the big day.
Birth Setting: DR at SPMC
Support Person: Husband P (if out of town, my sister A).
Activities During Labor:
• I want to walk around or rock in the rocking chair or play Monopoly.
• I want to wear my own nightgown, and listen to a Garth Brooks CD.
• I want to eat “anything chocolate” during labor.
• I want an epidural for pain management.
Birth:
• Position for birth: on my side.
• No episiotomy
• Husband wants to cut cord and videotape the birth.
• I want my son to watch if he wants to.
Postpartum:
• I want to breastfeed immediately.
• I want to use skin-to-skin care to keep baby warm.
• I want to room in.
• Husband wants to sleep over on bedside
INTRAPARTUM - The intrapartum period refers to the time
of pregnancy from the onset of labor to delivery of the
newborn and the placenta.
CARDINAL SIGNS OF LABOR
PHARMACOLOGY
Vitamin K is needed to form blood clots and to stop bleeding. Babies are
born with very small amounts of vitamin K stored in their bodies, which
can lead to a serious bleeding problem known as vitamin K deficiency
bleeding (VKDB). VKDB can lead to brain damage and death. Bleeding
from vitamin K deficiency is a risk during the first 6 months of life. VKDB
is preventable with a one-time intramuscular shot of vitamin K at birth.
Credé procedure is the practice of washing a newborn's eyes
with a 2% silver nitrate solution to protect against neonatal
conjunctivitis caused by Neisseria gonorrhoeae. Credé's
prophylaxis.