Perinatal mort

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  • 1. PERINATAL MORTALITY PRESENTATION Baby of NFMZ By Dr. N KK DR
  • 2. Mother’s history  Name :NFMZ  Age : 32  G4P3  Bld group : O +ve  VDRL & HIV : non reactive  Occupation : Teacher at XXXX  PAST OBS HX : Uneventful Summary of Visits  Booking done at 8/52 POA @ GP X  4 Antenatal check ups at GP X  First visit to KK Desarhu @ 31/52 POA  Visit to KK 3 times  Visit to MO 2 times  H/o hospital admission x 3 ( 1 referred from GP X, 2 REFERRED BY KK DR)
  • 3. 1ST BOOKING@ GP X (& subsequent follow ups) Date POA BP W=k g Alb SFH 30/7 8w3d 106/65 94 - - 18w6 d 119/74 98 N 18 23/11 25w 98/60 100 N 24 3/1 30w4 d 150/60 110 +++ 30 Ix : FBC - hb 10.8 mch 26 Blood Group : O+ve HIV : Non reactive Hb Remarks - 10.8 Fh US : S CRL 12mm 7w6d Follow date Show n Request MGTT Show n MGTT 4.5/4.6 Referal to GH STAT
  • 4. First Admission To GOV HOSP (3/1/2014 5/1/2014)  Referred from GP X  Patient admitted for 2 days.  Dx as Late Onset of PIH with UTI  Plan :  EOD BP at nearest KK 2/52  TCA ANC in 2/52 (22nd January 2014)  To complete Unasyn 375 mg BD for 2/52  Not for anti hypertensive medication
  • 5. First Booking At KK DR At 6/1/2014 at 30/52 POA ANC : Late PIH in pregnancy not on RX Previous ANC claimed uneventful During examination , no fresh complain noted edema both legs BP 150/100 repeated 160/100 Urine Albumin 3+  S/T Specialist O+G on call  For T. Nifedifine 10mg TDS  For Admission STAT
  • 6. 2nd Admission to Hospital (6/1/2014 – 7/1/2014)  Diagnosis upon discharge as PIH  Plan Upon Discharge  EOD BP at KK 2/52  NOT for medication
  • 7. 2nd Visit to MO in KK DR (after discharged from ward) 10 January 2014 BP noted 1)140/100 2)140/90 Otherwise patient asymptomatic Urine Alb : NIL S/T Specialist O+G on call Plan : - Start on T. Labetolol 100mg TDS - Cont EOD BP 2/52 - For PE Profile - TCA ANC at given date (22/1/2014)
  • 8. Summary Of F/u at KK DR Date POA Weigh t BP 6/1/14 30w 106.5 10/1/14 31w5d 12/1/14 32w SFH Hb Remarks 150/10 3+ 0 160/110 30cm 10.6 ADMITTED til 7th Jan 140/10 0 140/90 - 31cm - Started on T.Labetolol 100mg TDS 30cm - HomeVisit (Sunday) 2nd BP on L Lateral 140/90 120/80 Alb NIL
  • 9. 13th Jan 2014( POA 32 w 1 day)  Pt went to work as usual , no symptom of labor , FM good.  At 11am, pt felt severe backpain and noted trickling of per vaginal     bleed by12pm Ambulance called from workplace(Sekolah XX) at her school and pt was sent to Hosp at 1230pm , strong contraction felt and was sent to Labour room straight BP was 156/116 and urine alb 2+ , patient was transferred to OICW Ultrasound done : Fetal heart not detected Induced at 2pm and delivered at 4.06pm  Baby girl delivered 1.7kg 0’ 0” no resuscitation done  ?Baby passed away at 1606pm at OICW , HTJ  MOTHER was discharged on 17th January 2014  COD : Fresh still birth secondary to abruptio placenta complicated with primary PPH, severe pre eclampsia
  • 10. Discharged on 17th January 2014 Plan Upon Discharge : 1. EOD BP and review HB level postpartum Postnatally Patient plan to insert IUCD (not yet) Hb level 10.0 BP MONITORING – 120-130/80-90 , Not on medication since delivery Patient recuperating well.