Best Practices for Maternal and Newborn Health (MNH) - Essential Guidelines
Comprehensive guidelines for maternal and newborn health practices include dos and don'ts, such as perineal shaving, delayed cord clamping, exclusive breastfeeding, and more. Key measures like controlled cord traction (CCT) in a relaxed uterus and delaying the baby's first bath play crucial roles in ensuring maternal and newborn well-being. Additionally, the significant causes of maternal mortality, like postpartum hemorrhage (PPH) and hypertensive disorders, are addressed with preventive measures and treatment approaches highlighted.
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DAKSHATA Best Practices:MNH
Dos and Dont 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 1st 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 CCT in relaxed uterus Delaying baby s 1st bath Allowing companion with mother Milking of cord
CCT in relaxed uterus Delaying baby s 1st bath Checking placenta for completeness Routine enema Allowing companion with mother Delayed clamping & cutting of cord Exclusive breastfeeding Perineal shaving 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 Single most imp measure to prevent PPH 66% (??) Steps of AMTSL 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 ? Small baby feeding well/gaining weight adequately Not suckling (after 6 hours of age) Birth weight 1500-1800g Fast breathing (more than 60 breaths per minute) Grunting No Yes Yes Yes Yes Mother known to be HIV-positive Eyes swollen and draining pus Yellow skin on face and < 24 hours old Fever Less than 10 pustules (temperature > 38 C) No Yes Yes No Yes 7
Appropriate assessment of Foetal and Maternal Conditions Taking Medical, Surgical & Obstetric history Recording Mother s Temperature Recording Mother s BP Yes Yes Yes Cleaning of perineum with antiseptic solution is not required Internal Examination should be done frequently Recording Fetal Heart Rate No Yes No 8
Essential New-Born Care (ENBC) Baby needs to be received in tray Start Inj. Vita K should only given to LBW/pre-term breastfeeding ASAP after birth Yes No No Per-term baby requires size 0 of cap with Ambu bag Skin to skin contact is required for all normal babies Suction needs to be done with every newborn Yes No Yes 9
Infection prevention How many minutes instruments should be dipped in bleaching sol for decontamination 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 10 minutes No, depends on situation
Miscellaneous In Preterm delivery Inj. Dexamethasone should be give to the new-born All pregnant woman needs to be given antibiotics (prophylactically) What is the measure to prevent deaths due to pre-tern births ANCS No No How many minutes before delivery radiant warmer should be switched on Newborn resuscitation can only be performed at NBSU/SNCU Minimum duration for KMC No 1 hour 30 minutes 11
