For reference: Picture cards to stimulate discussion - Maternal Problems

MATERNAL PROBLEMS

1.    Maternal problem: Haemorrhage

The commonest time for severe bleeding is immediately after delivery.

However, it can occur before or during delivery.

Sometimes, the bleeding is all internal, in which case the womb is hard and very painful.

2.    Maternal problem: Anaemia

Sign & symptoms can include that the woman:

·         Is pale, tired, dizzy and weak

·         Has swollen ankles

·         Is short of breath on mild exertion

·         Gets palpitations on mild exertion

3.    Maternal problem: Malpresentation

This means that during delivery, instead of the head coming first, the hand, feet, buttocks, face, shoulder or umbilical cord come first.

4.    Maternal problem: Eclampsia, Pre-eclampsia, Pregnancy-induced hypertension

Until the problem is sever, there are usually no signs or symptoms.

The only way to know is to take the BP: it will be more than 140/90. Maybe much more

When the illness is serious, sings & symptoms can include:

·         Swollen face and swollen hands

·         Headache, blurred vision and drowsiness

·         Dizziness or even convulsions

·         Vomiting and/or abdominal pain

5.    Maternal problem: Obstructed labour

Typically labour will be more than 12 hours, sometimes much more.

The contractions are severe, frequent and utterly exhausting …

… but no progress is being made.

The woman then becomes dry and drowsy, and the contractions go weaker.

Sometimes, as the womb ruptures, extreme continuous pain supervenes.

6.    Maternal problem: Maternal infection after delivery

Sign symptoms can include that the woman:

·         Has a high temperature and shaking

·         Sometimes goes cold, pale and sweaty

·         Has continuous pain in the womb

·         Might have bleeding, sometimes severe

·         Later has a foul-smelling discharge

7.    Maternal problem: Retained placenta:

The placenta should deliver within 30 mins of birth.

Failure to do so may cause serious bleeding.

This can happen also if only part of the placenta is left inside.

MATERNAL & NEONATAL SHARED PROBLEMS

1.    Neonatal and/or maternal problem: HIV AIDS

Sign & symptoms can include:

·         Losing weight, generally unwell

·         Susceptible to infections

·         Suffering from an infection that does not respond to treatment

Note that for months or even years, there may be no symptoms, and that the only way to know for sure is to have the HIV test

                        

2.    Maternal and neonatal problem: Malnutrition

Sign symptoms can include:

·         Being thin

·         But sometimes children ae swollen, with swollen hands, feet, and tummy

·         Especially in children, the skin may have depigmentation, and the hair may turn reddish

3.    Maternal and neonatal problem: Malaria

Sign symptoms can include that the affected person:

·         Has a high fever and shaking

·         Sometimes goes cold and sweaty and feels very cold

·         Unlike uterine infection, has headache and pains in the joints or whole body

·         Feels weak and ill

·         Vomits

·         Maybe has convulsions – very similar to meningitis

If the only sign is fever, especially with headache, treat as malaria … but in neonates you might also want to treat for meningitis.