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The emphasis of the manual is on rapid assessment and decision making. The clinical action steps are based on clinical assessment with limited reliance on laboratory or other tests and most are possible in a variety of clinical settings.
The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.
Global and national confidential inquiry reports show that 60 to 80% of maternal and neonatal morbidity and mortality are due to avoidable errors. This comprehensive and illustrated second edition offers a practical guide to the management of obstetric, medical, surgical, anaesthetic and newborn emergencies in addition to organisational and training issues. The book is divided conveniently into nine sections and updated throughout in line with modern research and practice. Several new chapters cover setting up skills and drills training in maternity services to reduce avoidable harm, managing obstetric emergencies during 'home births' and in low-risk midwifery units, and minimizing maternal and fetal morbidity in failed operative vaginal delivery. Each chapter includes a practical algorithm for quick reference, the scientific basis for proposed actions, a case-based practical exercise and useful learning tools such as 'Key Pearls' and 'Key Pitfalls'. An invaluable resource for obstetricians, neonatologists, midwives, medical students, anesthesiologists and the wider perinatal team.
This handbook describes indicators that can be used to assess, monitor and evaluate the availability, use and quality of Emergency Obstetric Care. These emergency obstetric care indicators can be used to measure progress in a programmatic continuum: from the availability of and access to emergency obstetric care to the use and quality of those services.
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
This book will serve as a pocket guide, offering rapid advice on appropriate emergency care for a wide range of obstetric situations, including acute fetal hypoxia, uterine rupture, shoulder dystocia, eclampsia, amniotic fluid embolism, pulmonary thromboembolism, retention of the aftercoming head, major postpartum hemorrhage, and uterine inversion. For each emergency, the definition, diagnosis, and recommended management strategy are reviewed from a pan-European perspective. Regular review and training in obstetric emergencies is the only effective way to develop and maintain clinical competence in these rare and life-threatening situations, thus improving their management and the resulting outcomes. Healthcare professionals will find this book offers a practical and reliable source of information for dealing with dangerous and acute complications of pregnancy and childbirth.
Addresses the challenges of managing critically ill obstetric patients, with chapters authored by intensivists/anesthesiologists and obstetricians/maternal-fetal medicine specialists.
The Republic of Indonesia, home to over 240 million people, is the world's fourth most populous nation. Ethnically, culturally, and economically diverse, the Indonesian people are broadly dispersed across an archipelago of more than 13,000 islands. Rapid urbanization has given rise to one megacity (Jakarta) and to 10 other major metropolitan areas. And yet about half of Indonesians make their homes in rural areas of the country. Indonesia, a signatory to the United Nations Millennium Declaration, has committed to achieving the Millennium Development Goals (MDGs). However, recent estimates suggest that Indonesia will not achieve by the target date of 2015 MDG 4 - reduction by two-thirds of the 1990 under - 5 infant mortality rate (number of children under age 5 who die per 1,000 live births) - and MDG 5 - reduction by three-quarters of the 1990 maternal mortality ratio (number of maternal deaths within 28 days of childbirth in a given year per 100,000 live births). Although much has been achieved, complex and indeed difficult challenges will have to be overcome before maternal and infant mortality are brought into the MDG-prescribed range. Reducing Maternal and Neonatal Mortality in Indonesia is a joint study by the U.S. National Academy of Sciences and the Indonesian Academy of Sciences that evaluates the quality and consistency of the existing data on maternal and neonatal mortality; devises a strategy to achieve the Millennium Development Goals related to maternal mortality, fetal mortality (stillbirths), and neonatal mortality; and identifies the highest priority interventions and proposes steps toward development of an effective implementation plan. According to the UN Human Development Index (HDI), in 2012 Indonesia ranked 121st out of 185 countries in human development. However, over the last 20 years the rate of improvement in Indonesia\'s HDI ranking has exceeded the world average. This progress may be attributable in part to the fact that Indonesia has put considerable effort into meeting the MDGs. This report is intended to be a contribution toward achieving the Millennium Development Goals.
Provides a quick reference guide to the specialty, covering diagnoses, investigation and management in a user-friendly, accessible format. Contributors provide evidence-based guidelines which highlight the core knowledge for diagnosing and managing common problems and emergencies.
This Manual accompanies a course on the delivery of safe emergency obstetric care.