Maternal Care
A health professional’s guide to pregnancy and childbirth
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- Acknowledgements
- Introduction
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1 Antenatal care
- Objectives
- Goals of good antenatal care
- Diagnosing pregnancy
- The first antenatal visit
- Determining the duration of pregnancy
- Side-room and special screening investigations
- The second antenatal visit
- Assessing the results of the screening investigations
- Grading the risk
- Subsequent visits
- The visit at 26 weeks
- The visits at 30, 34 and 36 weeks
- The visit at 40 weeks
- Managing pregnant women with HIV infection
- Case studies
- 1a Skills: General examination at the first antenatal visit
- 1b Skills: Examination of the abdomen in pregnancy
- 1c Skills: Vaginal examination in pregnancy
- 1d Skills: Screening tests for syphilis
- 1e Skills: Screening tests for HIV
- 1f Skills: Examination of the breasts
- 2 Assessment of fetal growth and condition during pregnancy
- 2a Skills: Routine use of the antenatal record
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3 Hypertensive disorders of pregnancy
- Objectives
- The hypertensive disorders of pregnancy
- The classification of hypertension during pregnancy
- Pre-eclampsia
- Patients at increased risk of pre-eclampsia
- The management of pre-eclampsia
- The emergency management of pre-eclampsia with severe features
- The management of eclampsia
- The further management of pre-eclampsia with severe features at the referral hospital
- Gestational hypertension
- Chronic hypertension
- Postpartum hypertension
- Case studies
- 3a Skills: Measuring blood pressure and proteinuria
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4 Antepartum haemorrhage
- Objectives
- Antepartum haemorrhage
- The initial emergency management of antepartum haemorrhage
- Diagnosing the cause of the bleeding
- Antepartum bleeding caused by abruptio placentae
- Antepartum bleeding caused by placenta praevia
- Antepartum haemorrhage of unknown cause
- Referral of a patient with an antepartum haemorrhage
- A blood-stained vaginal discharge
- Case studies
- 5 Preterm labour and preterm rupture of the membranes
- 6 Monitoring the condition of the mother during the first stage of labour
- 7 Monitoring the condition of the fetus during the first stage of labour
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8 Monitoring and managing the first stage of labour
- Objectives
- The diagnosis of labour
- Management of suspected labour
- The two phases of the first stage of labour
- Monitoring of the first stage of labour
- Management of a patient in the latent phase of the first stage of labour
- Management of a patient in the active phase of the first stage of labour
- Poor progress in the active phase of the first stage of labour
- Cephalopelvic disproportion
- Inadequate uterine action
- The referral of patients with poor progress during the active phase of the first stage of labour
- Prolapse of the umbilical cord
- Women living with HIV
- Case studies
- 8a Skills: Examination of the abdomen in labour
- 8b Skills: Vaginal examination in labour
- 8c Skills: Recording observations on the partogram
- 9 The second stage of labour
- 9a Skills: Performing and repairing an episiotomy
- 10 Managing pain during labour
- 11 The third stage of labour
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12 The puerperium
- Objectives
- The normal puerperium
- Management of the puerperium
- The six week postnatal visit
- Puerperal pyrexia
- Genital tract infection
- Urinary tract infections
- Thrombophlebitis
- Respiratory tract infection
- Puerperal psychiatric disorders
- Secondary postpartum haemorrhage
- Self-monitoring
- HIV positive mothers
- Case studies
- 13 Medical problems during pregnancy, labour and the puerperium
- 14 Family planning after pregnancy
- 15 Regionalised perinatal care
- Appendix
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