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👑 A pregnant woman’s Hb remains low despite iron supplementation. According to the lecture, which condition should be investigated?
🔹A) Asthma
🔹B) Hyperthyroidism
🔹C) Thalassemia
🔹D) Gestational diabetes
507
👑 A pregnant woman at 33 weeks gestation has BP 150/100 mmHg and proteinuria. Her doctor advises against strict sodium restriction. What is the strongest explanation according to the lecture?
🔹A) Sodium restriction worsens iron absorption.
🔹B) Early-onset PE before 34 weeks may already have low cardiac output and hypoperfusion.
🔹C) Sodium restriction increases risk of gestational diabetes.
🔹D) Sodium restriction directly causes eclampsia.
507
👑 A pregnant woman has increased plasma volume that exceeds the increase in RBC mass. This leads to:
🔹A) Polycythemia
🔹B) Physiological anemia of pregnancy
🔹C) Iron overload
🔹D) Hemoconcentration
507
👑 A pregnant woman at 30 weeks gestation has Hb 6.4 g/dL with marked conjunctival pallor and breathlessness at rest. What is the most appropriate management?
🔹A) Oral iron once daily and routine follow-up
🔹B) Reassure because physiological anemia is common
🔹C) Refer urgently to hospital for further management
🔹D) Repeat Hb after delivery
507
PHC-10
🔹42 days = maternal death includes death during pregnancy or within 42 days after termination of pregnancy.
🔹9 key signal functions = show if facility can provide *EmONC.
🔹*BEmONC = 7 functions
🔹1. IV/IM antibiotics
🔹2. Oxytocic drugs
🔹3. Anticonvulsants
🔹4. Manual removal of placenta
🔹5. Removal of retained products
🔹6. Assisted vaginal delivery
🔹7. Neonatal resuscitation
🔹*CEmONC = 7 + 2
🔹8. Cesarean section
🔹9. Blood transfusion
🔹15% = about 15% of all pregnant women develop obstetric complications.
🔹6 process indicators
🔹1–2 = Access
🔹3–4 = Utilization
🔹5–6 = Quality
🔹Indicator 1: at least 5 *EmONC facilities per 500,000 population, including at least 1 comprehensive facility.
🔹Indicator 2: same standard in all subnational areas: at least 5 facilities / 500,000, including 1 comprehensive.
🔹Indicator 3: at least 15% of all births should occur in *EmONC facilities.
🔹Indicator 4: met need for *EmONC = 100% of women with major direct obstetric complications treated.
🔹Indicator 5: cesarean section rate among all births = minimum 5%, maximum 15%.
🔹Indicator 6: case fatality rate = maximum acceptable 1%.
For your information:
*EmONC = Emergency Obstetric and Newborn Care
*BEmONC = Basic Emergency Obstetric and Newborn Care
*CEmONC = Comprehensive Emergency Obstetric and Newborn Care
