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The Silent Cry

The Silent Cry . Dr. Pushpa Nusair Assist. Professor Obstetric and Gynecology Department of Medical Sciences College of Medicine Nursing and Health Sciences Fiji National University . Outline . A case study : An unbooked mother

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The Silent Cry

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  1. The Silent Cry Dr. Pushpa Nusair Assist. Professor Obstetric and Gynecology Department of Medical Sciences College of Medicine Nursing and Health Sciences Fiji National University

  2. Outline • A case study : An unbooked mother • Audit of unbooked mothers at CWM hospital (maternity Unit) from 2010 to June, 2013

  3. Introduction • Global statistics • Developing countries studies • Local: None located

  4. Case Study

  5. Case study • Name: MS • Age: 32 years (December, 1979) • Ethnicity: iTaukei • Marital Status: Single • Gravida 2, Para 1 • Social background: living with parents/disabled mother

  6. Case Study • Had a previous cesarean delivery in May, 2011 • Presented on 26/12/12 at 00:35 hours • Delivered to a very foul smelling fetus (birth weight : 3.2 kg), and placenta infarcted 400g • Denied sexual intercourse • Refused to acknowledge her pregnancy

  7. Case Study • All bloods including coagulation and blood cultures • Broad spectrum antibiotics • Awaiting coagulation profile • Collapsed midday informed by nurse • Active resuscitation ABC • Anesthetic and medical informed

  8. Case Study • D.I.C • Intensive care unit jointly managed by obstetrics, anesthetics and medical • Massive blood transfusion, FFP and Cryo • Multi-organ failure and irreversible D.I.C • Despite all measures, patient DIED on 26/12/12 at 11.30pm

  9. AUDIT

  10. Methods • Descriptive audit • Yearly stats: 2010 - June, 2013 • Monthly stats : • 2012 (Oct - Dec) • 2013 (Jan – June)

  11. Methods • Characteristics of unbooked mothers: • Age • Ethnicity • Marital status • Gravida • Parity • Gestation • Mode of delivery

  12. Results Percentage of unbooked mothers at CWM Hospital, Suva, Fiji %

  13. Results Percentage of unbooked mothers by ethnicity %

  14. Results • Percentage of unbooked mothers by ethnicity and month %

  15. Unbooked mother for Oct-Dec 2012 by age groups

  16. Marital Status of unbooked mothers between Oct-Dec 2012

  17. Gravidity at Parity of unbooked mothers from Oct-Dec 2012

  18. Conclusion • How do we hear the silent cry? • What can we do for these women?

  19. Thank You!

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