Postpartum Hemorrhage
| Definition | Blood loss after vaginal or cesarean delivery (Smith, 2018). |
| Prevalence | “2%-4% after vaginal delivery; 6% after cesarean delivery; PPH stands as 25% of maternal deaths” (National Health Portal of India, 2017). |
| Risk Factors | Obesity; Infection; Multiple baby pregnancy; High blood pressure of pregnancy (Stanford Children’s Health, n.d.). |
| Signs and Symptoms | Heavy blood loss, and can lead to hypovolemic shock (Smith, 2018). |
| Management/Treatment | Resuscitation, and the management of obstetric hemorrhaging and/or hypovolemic shock; identifying & managing the cause of the hemorrhage (Smith, 2018). |
| Possible Interventions | “Administration of Pitocin, carboprost tromethamine, a blood transfusion, and/or oxygen” (Belleza, 2017). |
| Challenges to Overcome | Early identification (Wisconsin Association for Perinatal Care, n.d.) |
Maternal Sepsis
| Definition | “A life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs” (WHO, 2018). |
| Prevalence | In 2017, there were 145 deaths per 100,000 lives (WHO, 2019). |
| Risk Factors | Caesarean section; Overcrowded and poorly resourced healthcare facilities; Unawareness of the signs & symptoms (WHO, 2018) |
| Signs and Symptoms | Fever and shivering; altered mental status; difficulty breathing; increased heart rate (WHO, 2018) |
| Management/Treatment | Antimicrobial and early fluid resuscitation (WHO, 2018). |
| Possible Interventions | Promotion of hand-washing; safe food preparation; sanitation improvement (WHO, 2018) |
| Challenges to Overcome | “Achieving universal prevention, diagnosis, and management” (WHO, 2018) |
Abortion Complications
| Definition | Unexpected outcomes in the intentional termination of a woman’s pregnancy by death of an embryo |
| Prevalence | Guttmacher Institute (2017) finds that 15.6 million abortions occur every year, and of that, it was determined by HMIS that “ten women reportedly die due to unsafe abortions every day in India” (Law Corner, 2019). |
| Risk Factors | Economic precariousness; Level of education; Celibacy [in terms of marital status]; Family/friend influence (Gènéthique, 2017) |
| Signs and Symptoms | Hemorrhaging; sepsis; peritonitis; and trauma to the cervix, vagina, uterus, and the abdominal organs (WHO, n.d.) |
| Management/Treatment | Antibiotic treatment of infections; treatment of hemorrhaging; and health care to the “genital tract and/or internal organs” (WHO, 2019) |
| Possible Interventions | Blood loss measurement; renal function measurement; assessment of vital signs (Belleza, 2017) |
| Challenges to Overcome | Reduction, until total elimination, of the stigma associated with this condition (Faundes et al., 2020) |
Pregnancy Induced Hypertension
| Definition | Condition in which a woman has high blood pressure during pregnancy (Belleza, 2017) |
| Prevalence | Indian literature hasn’t documented well the prevalence of this condition, according to the Indian Journal of Community Medicine (2015); However, in a study they conducted, 6.9% was found to be the prevalence of a total of 931 pregnant woman in this study (2015). |
| Risk Factors | Obesity; Family history of condition; Alcohol; Heart Failure; Stroke; Smoking (Tebeu et al., 2011) |
| Signs and Symptoms | Hypertension; Proteinuria; Edema (Belleza, 2017) |
| Management/Treatment | Condition can only be managed to combat eclampsia, the highest form of pregnancy hypertension, using drug prescriptions (Carson, 2018) |
| Possible Interventions | Promotion of bed rest, proper nutrition, and emotional support (Belleza, 2017) |
| Challenges to Overcome | Lack of access to quality antenatal health care and blood pressure measurement within the country (Mehta et al., 2015) |
References
Anibal Faundes, Rodica Comendant, Berna Dilbaz, Guyo Jaldesa, Robert Leke, Basab Mukherjee, Marina Padilla de Gil, Luis Tavara,
Preventing unsafe abortion: Achievements and challenges of a global FIGO initiative, Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 62, 2020, Pages 101-112, ISSN 1521-6934, https://doi.org/10.1016/j.bpobgyn.2019.05.016. (http://www.sciencedirect.com/science/article/pii/S1521693419300793)
Belleza, M., (2017, January 19). Abortion. Retrieved from https://nurseslabs.com/abortion/
Belleza, M. (2017, January 19). Postpartum Hemorrhage. Retrieved from https://nurseslabs.com/postpartum-hemorrhage/
Belleza, M. (2017, January 19). Pregnancy Induced Hypertension. Retrieved from https://nurseslabs.com/pregnancy-induced-hypertension/
Carson, M. (2018, June 12). Hypertension and Pregnancy. Retrieved from https://emedicine.medscape.com/article/261435-overview
Gènéthique. (2017, July 20). Precariousness, family situation, contraception…risk factors for abortion. Retrieved from http://www.genethique.org/en/precariousness-family-situation-contraception-risk-factors-abortion-67991.html#.XjewyxNKjs0
Guttmacher Institute. (2017, December 11). National estimate of abortion in India released. Retrieved from https://www.guttmacher.org/news-release/2017/national-estimate-abortion-india-released
Law Corner. (2019, October 18). Abortion law in India. Retrieved from https://lawcorner.in/abortion-law-in-india/
Mehta B, Kumar V, Chawla S, Sachdeva S, Mahopatra D. Hypertension in Pregnancy: A Community-Based Study. Indian J Community Med. 2015;40(4):273–278. doi:10.4103/0970-0218.164403
National Health Portal of India. (2017, March 16). Postpartum haemorrhage. Retrieved from https://www.nhp.gov.in/disease/gynaecology-and-obstetrics/postpartum-haemorrhage
Smith, J. R. (2018, June 27). Postpartum Hemorrhage. Retrieved from https://emedicine.medscape.com/article/275038-overview
Stanford Children’s Health. (n.d.). Postpartum Hemorrhage. Retrieved from https://www.stanfordchildrens.org/en/topic/default?id=postpartum-hemorrhage-90-P02486
Tebeu, P. M., Foumane, P., Mbu, R., Fosso, G., Biyaga, P. T., & Fomulu, J. N. (2011). Risk factors for hypertensive disorders in pregnancy: a report from the maroua regional hospital, cameroon. Journal of reproduction & infertility, 12(3), 227–234.
Wisconsin Association for Perinatal Care. (n.d.). Postpartum hemorrhage: The challenges. Retrieved from https://www.perinatalweb.org/major-initiatives/postpartum-hemorrhage/the-challenges
World Health Organization. (n.d.). Abortion. Retrieved from https://www.who.int/health-topics/abortion#tab=tab_2
World Health Organization. (2018). Maternal sepsis. Retrieved from https://www.who.int/reproductivehealth/maternal-sepsis/en/
World Health Organization. (2019, June 26). Preventing unsafe abortion. Retrieved from https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion
World Health Organization. (2018, April 19). Sepsis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/sepsis
World Health Organization. (2018, January 26). Sexual and reproductive health: Maternal sepsis. Retrieved from https://www.who.int/reproductivehealth/maternal-sepsis/en/
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