- Количество слайдов: 36
Essential Elements (phases) of MCH Services in PHC Center
Specific Objectives At the end of the lecture you will be able to 1. 2. 3. 4. 5. Enumerate elements of MCH services Define components of pre-conception care. Define antenatal care. State objectives of antenatal care Describe the standard antenatal care given in the first and subsequent visits in terms of quantity and quality. 6. Use the antenatal card present in primary health care centers.
Elements of MCH • Care before conception (pre-marital care ) • Ante-natal (pre-natal) care • Delivery (natal) care • Post-natal care • Care of new born • Child health care 1 -4 maternal care 5 -6 child health care (young child clinic)
ments of MCH Pre-marital care 1. Complete family, history of consanguinity & medical history : thalasemia, sickle cell anemia, hemophilia, mental retardation, congenital anomalieas, TB, STDs…. . etc. 2. Full clinical examination including chest Xray
Elements of MCH Pre-marital care 3. v v v Laboratory investigation Serology for syphilis +HIV Rh + ABO group MCV, MCH, PCV HBs antigen Genetic assessment for thalasemia
Elements of MCH Pre-marital care v One dose of tetanus toxoid. v Health education, genetic counseling &STDs education.
Elements of MCH Antennal care (ANC) Defines as complete health supervision & routine care of pregnant women to : Maintain, protect & promote health & well being of mother, fetus & newborn infant. It includes every aspect from screening to intensive life support.
Elements of MCH Antennal care Aims & Objectives 1. To supervise health of the mother & provide advice & treatment for disorders associated with pregnancy. 2. To ensure good health for the baby & good start for life. 3. To provide opportunities for health education with respect to child’s health & wellbeing.
Elements of MCH Components of ANC 1. Monitoring of health through antenatal examination. 2. Risk screening & assessment. 3. Preventive measures. 4. Health education.
Lecture question Enumerate components of MCH services
Elements of MCH Antennal care The follow –up should be Adequate which includes quantity & quality 1. Quantity è Time of onset……. it has to start during the 1 st trimester. è No. of visits………should be at least (7) well distributed throughout pregnancy.
Elements of MCH Antennal care Quality The standard care & all information should be recorded in the maternity record: v Confirmation of pregnancy v Family, medical, past obstetrical , present pregnancy history v Physical examination v Fetal heart sound determination after the 1 st trimester v Ultrasound v Recording all the information
Elements of MCH Standards of ANC At first visit most important A: - General information Ø Preparation of pregnancy file which contains name, age, address, occupation…. . etc Ø Start by confirming pregnancy
ments of MCH Standards of ANC B- History 6 items 1. 2. 3. 4. General medical history Family history Past-obstetrical history Menstrual history
Elements of MCH Standards of ANC 5 - Present pregnancy : LMP To calculate EDD to calculate gestational age
Elements of MCH Standards of ANC 5 - Present pregnancy : nausea , vomiting , lower abdominal pain, bleeding , discharge…. etc
Elements of MCH Standards of ANC 6 - History of drug use , still lactating, sensitivity , B. T.
nts of MCH Standards of ANC C- Physical Examination q. Wt +Ht if <150 cm contracted pelvis Sudden wt gain q. Blood pressure risk of pre-eclampsia
Elements of MCH Standards of ANC Physical Examination q. Breast q. Heart q. Chest q. Teeth q. Legs abnormality caries varicosity +oedema
Elements of MCH Standards of ANC q. Abdominal Examination - Fundal height -Fetal heart sound
Elements of MCH Standards of ANC q Pelvic examination -Evaluation of bony pelvis for symmetry -Examination of cervix for infection & dilatation
Elements of MCH Standards of ANC D-Laboratory Investigation: v 1. 2. 3. GUE look for the following Pus cells UTI Protein Pre-eclampsia Bacteria UTI
ments of MCH Standards of ANC 4 - Glucose glucose urea pregnancy associated gestational diabetes or diabetes GTT could be normal elevated borderline blood glucose
Elements of MCH Standards of ANC D-Laboratory investigation v. Serology syphilis HIV Rubella antibodies
Elements of MCH Standards of ANC D-Laboratory investigation v. Serology HBs screening -History of chronic liver disease - Working in hemodialysis unit - House hold contacts -Multiple episodes of STDs -Multiple exposure to blood
Elements of MCH Standards of ANC D-Laboratory investigation v Rh ABO group v. Hb & PCV
ments of MCH Standards of ANC E- Subsequent visits v Frequency ü One visit every month , till 28 th week ü 28 th -36 th week every 2 weeks ü 36 th onward once weekly
ements of MCH Standards of ANC E- Subsequent visits v Examination ü Blood pressure each visit ü Weight is checked each visit - little increase during the 1 st 12 weeks - 16 th -28 th week 6 kgs after that 2 kgs every 4 weeks ü Ankle edema, hands, face…. .
Elements of MCH Standards of ANC E- Subsequent visits v. Examination ü Fundal height should be recorded in every visit , similarly fetal heart sound & from 32 th week onward presentation should be also checked.
Elements of MCH Standards of ANC E- Subsequent visits v Laboratory investigation ØGUE , Hb level during 2 nd 3 rd trimester. ØRh –ve mother perform Ab determination test.
Elements of MCH Standards of ANC E- Subsequent visits v Laboratory investigation Ø Repeated blood sugar estimation if there is family history of Diabetes Note : if complication arise more frequent visits are needed
usion • Elements of MCH are many started by premarital care which is directed to couples before marriage to determine their suitability to their future life. This is followed by antenatal care which is the care provided to the pregnant woman during pregnancy. It aims to Maintain, protect & promote health & well being of mother, fetus & newborn infant. It includes every aspect from screening to intensive life support.