SKILL DEVELOPMENT

Skill Development



Introduction

Pregnancy is the duration between the times when there is implantation of the fertilized eggs in the uterus till the time of delivery. When one talks about pregnancy, it means the process in which there is a physiological growth and development of the fetus in the mother's womb. In basic words, pregnancy is the fetus inside the mother's womb. The nutrition of women before, during and after pregnancy is essential to have healthy children. The nutrient requirements increase significantly during pregnancy and lactation. A woman arriving malnourished in pregnancy may experience complications during this and childbirth.

Hematologic problems

Haematological problems are relatively common in newborns and can sometimes be extremely severe. Keep in mind that the blood system experiences a very early development, to meet the high oxygen demand of the growing fetus as with almost all organs and systems, neonatal hematopoiesis works to its limits, with little capacity to compensatory increases in demand (Hoffbrand, 2011). One must consider that a significant proportion of blood volume got distributed in fetal placental vessels, hence, the amount of blood that moves the fetus to the placenta or in the opposite direction of the placenta to the fetus, after delivery and before cord clamping, condition of blood volume, hematocrit and hemoglobin of the newborn.

Neonatal Anemia

The anemia of the newborn defined by concentrations of Hb / Hct vein during the first week of life, less than 14 g/dl and 42% in term infants, 13 g/dl and 39% less than 1500 g and preterm 12 g/dl Hb less than 26 weeks gestational age 187, 188. There are two types of anemia that due to their severity, are capable of endangering the life of the newborn: haemorrhagic anemia and hemolytic anemia. Anemia may be secondary to hemorrhagic bleeding ante, intra or postpartum. Chronic forms of bleeding are usually well tolerated if sufficiently severe and accompanied by hypochromia and microcytosis (Hoffbrand, 2011). By contrast, severe acute forms originate hypovolemic shock, whose clinical presentation may be indistinguishable from perinatal asphyxia, which otherwise is usually present in most infants with searing bleeding and vaginal delivery. The most recurrent causes of acute ante and intrapartum bleeding include bleeding fetomaternas, fetoplacentarias and intergemelares, malformations placental and umbilical cord or secondary to poor obstetrical technique.

Postpartum bleeding visceral includes breaks, intracranial hemorrhage, cephalohematoma massive gastrointestinal bleeding among others. The hemolytic anemias are common in the neonatal period, usually secondary to fetal-maternal incompatibility group. Fortunately the most severe forms, in connection with RH incompatibility, are becoming less frequent with the widespread use of anti-D immunoglobulin in the immediate postpartum period. Moreover, the rest of hemolytic anemia are rare in this period of life or are part of a broader clinical picture.

Complications

Maternal Complications

Concerning childbirth hemorrhage, abruption of placenta, disseminated intravascular coagulation 6%, 11% risk of HELLP, 6% neurological deficit, 7% risk of pneumonia aspiration, pulmonary edema 5%, 4% of cardiopulmonary arrest, 4 % of kidney failure and death 1%

The leading cause of maternal fatalities is cerebral hemorrhage ...