1. A mother's joy begins when new life is stirring inside
A mother's joy begins when new life is stirring inside... when a tiny heartbeat is heard for the very first time, and a playful kick reminds her that she is never alone.

2. Make me safe inside & outside
Mama !
Make me
safe inside
& outside

4. High Risk Fetus:
Nurses' Role

5. Healthy Mothers and Healthy fetuses: The Vital Link.
Preventing fetal deaths begins with the health of the mother.
Cost-effective prenatal and delivery interventions that saves mothers’ lives can save most fetuses too.

6. Maternal Factors Fetus At Risk
Past OB history
Preconception
Genetic
Conceptional
Malnutrition
Environmental factor
Medical conditions
Obstetrical conditions

7. Statistics - Risk assessment
Nigeria shows 120 / 299 (40.1%) in high-risk category. (2008)
Bihar- 24/ 200 women in high risk category,74 in moderate and 101 in low risk group. (2008)
Ahmedabad % had high risk factors. (1998)

8. Fetal Health TEAM HEALTH High risk CARE Low risk NURSE OBGYN MIDWIFE
NEONATO
TEAM
SONO
GENETIC
COMMUNITY
PERINATO

9. Monitoring Education What can the Nurse do? Prevention of
Modifiable risk
factors
Non modifiable
risk factors
Prevention of
complications

10. Best place for the baby to grow is inside the mother – every week matters

11. Bed Rest pressure on vena cava venous return circulatory volume
Placental and renal
perfusion

12. Mothers …… eat healthy food, exercise wisely and avoid harmful substance!!! You are protected and you are protecting your unborn

13. ?

14. BALANCE BETWEEN CHO- PROTEIN- FAT & MIN-VIT

15. RELAX ……..

16. DON’T MISS YOUR CHECKUP
Follow up As
Advised
DON’T MISS YOUR CHECKUP

17. Fetal Health Surveillance
Screening methods
Fetal movement chart
Symphysial Fundal Height
Palpation &Auscultation
Electronic fetal monitor
Ultrasonography
Doppler velocimetry
Amniocentesis

18. One day you’re pregnant and one day you’re not: Pregnancy interruption for fetal anomalies
Quad Test
Maternal serum alpha feto protein
Unconjugated Estriol
Beta - hCG
Inhibin -A
Pregnancy associated placental protein (PAPP-A)

19. Cardiff count 10 - count 10 fetal movements
Sadovsky- feel 4 movements in 1 hour

20. Auscultation
Fetoscope and Doppler
Palpation
Doppler

21. Non Stress Test Fetal Movement = Fetal Well Being
Reactivity= 2 accelerations above baseline lasting 15 seconds within 20 minutes

22. Contraction Stress Test
Ability of fetus to tolerate stress and fetal reserve
Decrease in oxygenation with uterine contractions
Initiate 3 ucs in 10 minutes
FHR for variations

23. Investigations as advised…..

24. Assessment of Fetal Well Being
Doppler Blood Flow
S: D ratio - <2.6 (26 wks gestation)
<3 (at term)

25. Amniocentesis Chromosomes and metabolic defect Fetal maturity
- L:S ratio 2:1
- Phosphatidylglycerol
- Lamellar body count
< 35,000 /UL

26. External Fetal Monitoring

27. Internal Fetal Monitoring

28. Fetal Tachycardia Fetal heart rate above 160 beats per minute
Fetal tachycardia with fetal arrhythmia

29. Baseline fetal heart rate less than 110 beats per minute
Fetal Bradycardia
Baseline fetal heart rate less than 110 beats per minute

30. Variable Deceleration
Prolonged Deceleration

32. Sinusoidal Pattern

34. Call Health care professionals if there is a problem…

35. THEY NEED YOU
AND YOUR CARE

36. Thank You !