OBG 1 NOTES .pdf

OBG NOTES BY ADITYA part 1

1. ace
CONTENT OFTABLE
S.No. Content SlideNo.
Whatisdefinitionofobstetrics?
Discussabouttheterminology
includedinobstetrics?
2 6
Whatisthehistoryofmidwifery? 10
20Whataretheneedsofmidwiferyasa
profession?
Whatarethetrendsinmidwifery&
obstetrics?
22
BSC4.4.1-INTRODUCTION TO
MIDWIFERYANDOBSTETRICAL
NURSING
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2. S.No.Content SlideNo.
Discussaboutthematernal&childhealthindicators? 24
7Discussaboutthelegal&ethicalprinciples? 30
8Definethepre-conceptioncare? 39
9Whataretheneedofpre-conceptioncarc? 41
10Whichareasareincludedinpre-conceptioncare? 43
Discussabouttheroleofnurseinmidwifery&
obsterics?
11 46
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3. ObstetricswordcamefromaLatinword"OBSTETRIX"means
"MIDWIFE".
Midwifery,asknownasobstetrics,isahealthscienceandhealth
professionthatdealswithpregnancy,childbirth,andthepostpartum
periodincludingcareofthenewborn),besidessexualandreproductive
healthofwomenthroughouttheirlives.
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4. termOogy
teRinology
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5. Midwiferyistheknowledgenecessarytoperformthedutiesofmidwife.
Obstetriesisthatbranchofmedicine,whichdealswiththemanagement
ofpregnancy,laborandpuerperium.
Gynecologyisthatbranchofmedicalscience,whichtreatsdiseasesofthe
femalegenitalorgans.
Reproductionmeansprocessbywhichafullydevelopedoffspringofits
kindisproduced.
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6. Pregnancyisastateofcarryingfetusinsidetheuterusbyawomanfrom
conceptiontobirth.
Gravidaeisstateofpregnancyirrespectiveofitsduration.
Multiparareferstowomanwhohasgivenbirthmorethanonce
Nulli-paraisthewomanwhohasnotgivenbirthbefore.
Primigravidaeisawomancarryingfirstpregnancy.
Multigravidaeisawomancarryingpregnancymorethanonce
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7. Q.Branchofmedicalscience,whichtreatsdiseasesofthefemalegenital
organs....
A.Obstetrics
Gynecology.
Reproduction.
D.Nonofthem.
B.
C.
RationalGynecologyisthatbranchofmedicalscicnce,whichtreats
diseasesofthefcmalegenitalorgans.
Reference-SlideNo.7
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8. uilid
tua.
ictuc
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9. ThesituationofIndianmidwiferysetsoutinthreesections:
|
1.MidwiferyinIndiabeforeindependence.
2.MidwiferyinindependentIndia
3.PresentandfutureofmidwiferyinIndia
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10. 3.2.MIDWIFERYININDIABEFORE
INDEPENDENCE
InancientIndia,careofwomenandpracticeofmidwiferyweretotallyin
thehandsofindigenousvillage"dais'.
Theseindigenousdais,notonlyhelpedduringchildbirthbutalsoactedas
consultantsforanyconditionofthemotherrelatedtobirth
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11. Thefirsttrainingschoolfordaiswasstartedin1877byMissHewlett,an
EnglishmissionaryoftheZenanaMissionarySociety.
However,thetrainingofdaiswasnottakenupbyGovernmentofIndia
(GOI)till1900whenafundwasestablishedbyLadyCurzontoimprove
theconditionsofchildbirthinthecountry.
Butbeforethat,in1872,ahandfulofIndianChristiannursesweretrained
fortwoycarsatDelhi.
In1899theZenanaBibleandMedicalMissionstartedthetrainingof
nurses,butuntil1893therewasnogenerallyacceptcdschemeoftraining
inthehospitals.
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12. In1918withthehelpofDufferinFund,LadyReadingHealthSchoolwas
establishedtotrainAuxiliaryNurseMidwives(ANMs).
In1926theMadrasRegistrationofNursesandMidwifesActwaspassedto
promotetheroleofaregisteredmidwifeforserviceduringchildbirth.
In1936DufferinfundsanctioncedgranttoanumberofDufferinhospitals
tobuildhostels,supplyteachingmaterialsandemployqualifiedsistersin
nursingschools.
ThusDuffcrinfundhelpedinraisingthestandardsofnursingand
midwiferyinIndia.lInfactpriortoindependence,midwiferytraining
startedasaseparatecourse,inIndia.Younggirlsatthemiddleschoollevel
(8th)wereselectedtoundergothistraining
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13. 3.5MIDWIFERYININDEPENDENT
INDIA
In1946,theBhoreCommitteelaidstressonthencedforqualified
midwives,healthvisitors,andthetrainingofdais.
In1955,theShettyCommitteerecommendedthetrainingofAuxiliary
NurseMidwife(ANMs)inhcalthcentersformaternalandchildhealth
services,providedtherewereadequatehealthvisitorstosupervisethem.
In1959Bishoff,atechnicalConsultantsupportedthetrainingoftwotypes
ofnursingpersonnelANMandGeneralNurseMidwife(GNMNursing-3
ycarsandMidwifery-
1
ycar).
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14. In1947,thefirststeptheIndianNursingCounciltookafteritsinception
wastocombinethenursingandthemidwiferycoursesintoasinglccourse.
Thecoursewasdesignedtobeofthrecandahalfyearsduration,withthe
entryqualificationbeing10thclass.
In1975theKartarSinghCommitteerecommendedshorteningthetwoyear
courseofANMtooneandahalfycarsandentryafterclass10th.
TheseANMsweredesignatedasfemalehealthworkers.Theywere
speciallytrainedinmidwiferyandchildhealthcareservices.Golalso
investedheavilyinthetrainingofdais
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15. 3.7PRESENTANDFUTUREOF
MIDWIFERYININDIA
Thepresenceofaskilledmidwifeatbirthisthesinglemostimportant
factorforachievingsafemotherhood(WHO).
Thenumberofmidwivesavailableasperpopulationisanimportant
indicatorofthematernalhealthstatusinacountry.
Thematernalhealthstatusofwomenandmaternalmortalityarecloscly
relatedtothepresenceoftrainedattendantsatbirth.
Asthepercentageofbirthsattendedbytrainedpersonnelgoesup,the
maternalmortalityratiogoesdown.
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16. 3.8ININDIATHEREARETHE
FOLLOWINGCADRESOFF
MIDWIVES:
1.Thetrainednursemidwife(RN,RM):Whohasundergoneadiploma
(DiplomainGeneralNursingandMidwifery),whichisofthrecanda
halfyearsduration.OrAdegreenursewhohasdoneB.Sc.(Honors)
Nursing,whichisoffouryearsduration.
2.TheANM,whoisdesignatedastheMulti-purposehealthworker
(female),isregisteredasamidwifc.Presently,thisisatwoycarscourse
withentryclassificationbcing12thclass.Indiahasahugecadreof
ANMswhoareeducatedandtrainedinMidwifery.
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17. SkilledBirthAttendant(SBA)refersexclusivelytopeoplewith
midwiferyskills(c.g.doctors,nurses,midwives),whohavebeentraincd
togetproficiencyintheskillsnecessarytomanagenormaldeliveries,and
todiagnose,manage,orrefercomplicationstoalllevelsofhealthcare
settings.Midwiferyskillsaredeflincdasasetofcognitiveandpractical
skillsthatenabletheindividualtoprovidebasichcalthcareservices
throughoutthenatalcontinuumperiodandalsotoprovidepromptactions
incmergenciesincludinglifesavingmcasures,whenrequired.
3.
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18. 4.NEEDFORMIDWIFERY ASA
PROFESSION
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19. 1.Toachievesafemotherhood
Toavoidduplicationofservices
Togivehealthcducation
Toparticipateincountry'sconcerni.c.maternalandchildwelfare
5.
2.
3.
4.
Togetstatusandrecognitioninthesociety
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20. trends
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21. 5.TRENDSINTHEMIDWIFERY
ANDOBSTETRICALNURSING
Changesinsocialstructure,variationsinfamilylifestyle
CostContainment
OExpandedrolesfornurses
FamilyCenteredCare
AccesstoHealthCare
ShorteningHospitalStays
IncreasedUseofAlternativeTreatmentModalities
IncreascdUseofTechnology
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22. 6.
MATERNAL &CHILDBHEALTH
INDICATOR
IHealtlmlndicaTthois
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23. 6.MATERNAL &CHILDHEALTH
INDICATOR
Birthrate:Thenumberofbirthsper1,000population.
Fertilityrate:Thenumberofpregnanciesper1,000womenofchildbearing
agc.
Fetaldeathrate:Thenumberoffetaldeaths(over500g)per1,000live
births.
Neonataldeathrate:Thenumberofdeathsper1,000livebirthsoccurringat
birthorinthefirst28daysoflife.
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24. InfantMortalityRate:Thenumberofdeathsper1,000livebirths
occurringatbirthorinthefirst12monthsoflife.
ChildhoodMortalityRate:Thenumberofdeathsper1,000populationin
children,
1
to14yearsofage.
TheMaternalmortalityrate(MMR)istheannualnumberof
femalcdeathsper100,000livebirthsfromanycauserclatedtoor
aggravatedbypregnancyoritsmanagement(excludingaccidentalor
incidentalcauses).
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25. 6.3.CON...
Maternalmorbidityrate:Anydeparture,subjectiveorobjective,froma
stateofphysiologicalorpsychologicalwell-being.(duringpregnancy
childbirthandthepostpartumperiodupto42daysor
1
ycar).
Perinatalmortality:TheWorldHealthOrganizationdelinesperinatal
mortalityasthe"numberofstillbirthsanddeathsinthefirstweckoflife
per1,000totalbirths,theperinatalperiodcommencesat22completed
weeks(154days)ofgestationandendssevencompleteddaysafterbirth"
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26. Thetotalfertility_rate(TFR),sometimesalsocalledthefertilityrate,
periodtotalfertilityrate(PTFR)ortotalperiodfertilityrate(TPFR)ofa
populationistheaveragenumberofchildrenthatwouldbeborntoawoman
overherlifetimeif:
.
Sheweretoexperiencetheexactcurrentage-specificfertilityratcs
(ASFRs)throughherlifetime,and
2.Sheweretosurvivefrombirththroughtheendofherreproductivelitfe.
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27. PRACTICEQUESTION-2
Q.Theannualnumberoffemaledeathsper100,000livebirthsfromany
causerelatedtooraggravatedbypregnancyoritsmanagement....
Maternalmorbidityrate.
B.
A.
Perinatalmortality.
TheMaternalmortalityrate.
ChildhoodMortalityRate.
C.
D.
Rational:-TheMaternalmortalityrate(MMR)istheannualnumberof
femaledeathsper100,000livebirthsfromanycauserelatedtooraggravated
bypregnancyoritsmanagement(excludingaccidentalorincidentalcauses).
Reference-SlideNo.27
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28. Ethial Legal
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29. 7.LEGALANDETHICAL
PRINCIPLESINTHEPROVISION
OFHEALTHSERVICES
Informcddecisionmaking
Autonomy
Surrogacydecision
Privacy&confidentiality
Competentdeliveryservices
Safety&cflicacyofproduct
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30. Patientsorindividualswhorequirehealthcareserviceshaverighttomake
theirowndecisionabouttheopinionsfortreatmentorotherrelatedissues.
Theprocessofobtainingpermissioniscalledinformedconsent.
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31. Autonomouspersonsarethosewho,intheirthoughts,work,andactions,
areabletofollownormschosenoftheirownwithoutexternalconstraints
orcoercionbyothers.
Itistobenotedthatautonomyisnotrespectforpatient'swishagainst
goodmedicaljudgement.
Simplyput,ahealthprovidercanrefuseatreatmentoptionchosenbythe
patient,iftheoptionisofnobenefittothepatient.
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32. 7.3SURROGATEDECISION
MAKERS:
Surrogatedecisionmakers[parcents,caregivers,guardians]maytakethe
decisioniftheaffectedindividual'sabilitytomakeachoiceisdiminishedby
factorssuchasextremeyouth,mentalprocessingdifficulties,extrememedical
illnessorlossofawareness.
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33. Apatient'sfamily,fricndorspiritualguidehasnorighttomedical
informationregardingthepatientunlessauthorizedbythepatients.Thec
followingpointsofconfidentialityaretobekeptinmind:
healthcareprovidersdutiestoprotectpatient'sinformationagainst
unauthorizeddisclosures.
Patient'srighttoknowwhattheirhealthcareprovidersthinkaboutthem.
Healthcareprovider'sdutiestoensurethatpatientswhoauthorizereleases
oftheirconfidentialhealthrelatedinformationtoothers,exerciscan
adequatelyinformedandfreechoice.
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34. Everyindividualhasarighttoreceivetreatmentbyacompetenthealthcare
providerwhoknowstohandlesuchsituationsquite
wvell.Accordingtothe
laws,medicalnegligenceisshownwhenthefollowing4elementsareal
establishedbyacomplainingparty.
Alegaldutyofcaremustbeowedbyaprovidertothecomplainingparty.
Breachoftheestablishedlegaldutyofcaremustbeshown,whichmecansa
healthcareproviderhasfailedtomeetthelegallydeterminedstandardsof
care.
Damagemustbeshown.
Causationmustbeshown.
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35. Healthcareprovidersareresponsibleforanyaccidentalordeliberateuseof
productsthatdiffersfromtheirapprovedpurposesormethodsofuse,for
instance,thedosagelevelfordrugs.Lookforthedrugcontraindications,drug
expiry,damageofdilutedsterilizationsolventsetc.
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36. Q.AccordingtoWhichlegal&cthicalprinciple,thepersonisabletofollow
normschosenoftheirownwithoutexternalconstraintsorcocrcionbyothers,
isknownas.
A.Autonomy
Surrogacy.
confidentiality.
safety&efficacyofproduct.
B.
C.
D.
Rational:-Autonomouspersonsarethosewho,intheirthoughts,work,and
actions,areabletofollownormschosenoftheirownwithoutexternal
constraintsorcocrcionbyothers.
Reference-SlideNo.33
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37. Pre aringfor
ahealthy 12regnany E
ahealthy baby
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38. Preconceptioncareistheprovisionofbiomedical,behavioralandsocial
healthinterventionstowomenandcouplesbeforeconceptionoccurs.
Itaimsatimprovingtheirhealthstatus,andreducingbehaviorsand
individualandenvirommentalfactorsthatcontributetopoormaternaland
childhealthoutcomes.
Itsultimateaimistoimprovematernalandchildhealth,inboththeshort
andlongterm
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39. Page 39 of 57

40. Reducematernalandchildmortality
Preventunintendedpregnancies
Preventcomplicationsduringpregnancyanddelivery
Preventstillbirths,pretermbirthandlowbirthweight
Preventbirthdefects
Preventneonatalinfections
Preventunderweightandstunting
PreventverticaltransmissionofHIV/STIs
Lowertheriskofsomeformsofchildhoodcancers
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41. 10.LETSDISCUSSABOUTPRE
CONCEPTIONCAREPACKAGE
Prenceplion
Care
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42. 10.1AREASADDRESSEDBYTHE
PRECONCEPTION CARE
PACKAGE
Environmental Infcrtility/sub
fertility
MENTAL
Nutrition
health HEALTH
ycho
substanceuse
Genetic
condition
Interpersonal
violence
STI
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43. 10.2PRECONCEPTION CAREFOR
ALLWOOMENOFCHILDBEARING
AGE
AccesstogoodqualityhealthcareforalladolescentsVaccination(cg.
rubellaandhepatitisBvaccine)
Essentialnutritionforgirlsandwomenandworktocombatcatingdisorders
(obesityprevention),includingtheadministrationoffolicacidsupplements
Preventivemedicalconsultations,riskassessment,andpsychological
counseling(c.g.,preventionofpsychotropicsubstanceabuse,riskbehaviors)
Familyplanning,includingthepromotionofplanned,adequatelyspaced
pregnancies
Detectionandtreatmentofsexuallytransmittedinfections,especially
HIVIAIDS
Treatmentofchronicdiscases(c.g.,diabetes,hypothyroidism,malaria,
tuberculosis,andChagasdisease)._
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44. 11.LETSDISCUSSABOUTROLE
OFNURESEINMIDWIFERY&
OBSTETRICS
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45. Amidwifeisahealthcareprofessionalwhoprovidehealthcareservicesfor
womenincludinggynecologicalexaminations,contraceptivecounseling,
prescriptions,andlaboranddeliverycare.Midwifeprovidesexpertspecial
careduringlabor,deliveryandafterbirthsothatmidwifeunique
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46. Care
counselor Concerned
Manager
Giver
Adviser
Family
Planner
ROLEOF
MIDWIFE
Recordkeeper
RY
communicator
Supervisor
Coordinator
Leader Educator
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47. Thankk
You
Page 47 of 57

48. TobeuploadedonNCCPlatform.
Page 48 of 57

49. Q.Thebranchofmedicinewhichdealswithmanagementofpregnancy,labor
&puerperium...
Gynecology.
Obstetrics.
A.
B.
Reproduction.
D.Nonofthem.
C.
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50. Q.Nulliparameans..
A.Womanwhohasgivenonebirthbefore
B.Womanhasnotgivenbirthbefore.
C.Womanwhoiscarryingpregnancyfirsttime.
D.Womanwhohasgivenbirthmorethanoncc.
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51. QUESTION-3
Q.Whichcommitteelaidstressonthencedforqualifiedmidwives,health
visitor&trainingofDiasin1946.
A.Mudaliarcommitlee.
B.Bhorecommittee.
Mukhrajicommittee.
Jungalwalacommittece.
C.
D.
Page 51 of 57

52. Q.InwhichyearKartarSinghcommitteerecommendedshorteningthe2year
courseofA.N.Mto
l&halfyear...
A.1975.
B.1978.
C.1960.
D.1992.
Page 52 of 57

53. Q.Thenumberofdeathsper1000livebirthoccurringatbirthorinthefirst
28daysoflifeisknownas...
A.Fetaldeathrate.
B.Neonataldeathrate.
C.Infantdeathrate.
D.Childhooddeathrate.
Page 53 of 57

54. QUESTION-6
Q.Theaveragenumberofchildrenthatwouldbeborntoawomanoverher
lifetime,isknownas...
A.Totalfertilityrate.
B.Maternalmorbidityrate.
C.Childbirthratc.
D.Maternalbirthrate.
Page 54 of 57

55. Q.Necdforpre-conceptioncareis..
A.Reducethematernal&childmortality.
B.Preventtheneonatalinfection.
Preventthecomplicationduringpregnancy.
Allofabove.
C.
D.
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56. Q.Healthcareproviderhasfailedtomeetthelegallydeterminedstandardof
careisknownas...
Breachoflegaldutyofcare.
B.
A.
Surrogacyofdecision.
Autonomy.
Uninformeddecisionmaking.
C.
D.
Page 56 of 57

57. Q.Roleof
nursesinmidwifery&obstetricsinclude...
A.Familyplanner.
Educator.B.
C.Counsclor.
D.Allofthenm.
Page 57 of 57