Maternal Health (and the three P’s)
Transcript of Maternal Health (and the three P’s)
Maternal Health (and the three P’s)
Dr Eli Medd
Consultant Obstetrician and Gynaecologist
Plymouth Hospitals NHS Trust
• Maternal mortality in the UK
• Identifying those at risk
• Working together to reduce risk and
optimise care
Per maternal death reported:
250-400 severe morbidity cases needing ICU
Who is at risk? • Existing medical conditions 66%
• Mental health problems 13%
• BMI >30 39%
• Maternal age >40 RR 3.69
• Low socioeconomic class RR 1.44
• Born outside UK RR 1.18
• African ethnicity RR 3.65
The missed opportunities
• Delayed senior medical and obstetric review with lack
of acknowledgement of risk factors
• Inappropriate interpretation of observations during
pregnancy
• Avoidance/delayed imaging
• Avoidance/delayed drug administration
• Lack of communication and advice between senior
clinicians from different specialties
Interventions
• Pre-pregnancy counselling and contraception
signposting
• Multi-disciplinary approach to decision making
• Don’t assume symptoms experienced by a pregnant
woman are due to the pregnancy
• Don’t avoid imaging to establish a diagnosis
• Think about the Three P’s in a pod…