HEAD: 09_Che_PN_preg woman

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Chennai: A protocol for management of fever and infections in pregnant women released by the directorate of public health mandates hospital admission of these women for further tests, management and diagnosis to prevent complications and maternal deaths.
"Fever in pregnancy should not be taken lightly," said Director of Health Dr T S Selvavinayagam said.in the three-page circular sent to district health officials on Tuesday. One in twenty maternal deaths in Tamil Nadu during 2023 was attributed to fever and other infections, and most deaths occurred within three days from the onset of fever, Of the 400 maternal mortality cases registered in 2023, 20 women succumbed to fever or other infections. An analysis conducted by the Directorate of Public Health (DPH) revealed that in most cases, death occurred within three days of the onset of fever symptoms.
With the monsoon, the number of fever cases increased across the state, putting vulnerable populations, including pregnant women, at risk. "We asked health officials to do continuous surveillance and screening for early diagnosis and treatment of all pregnant women with symptoms of fever or other infections," he said.
In the set of instructions, he stated that doctors must evaluate pregnant women on the first day of fever and carry out basic investigations such as blood tests for leptospirosis, scrub typhus, sepsis, and dengue. If the mother had a fever with a cough, she should be screened for Covid-19, H1N1, and influenza. If there was jaundice, she must be tested for Hepatitis A Virus (HAV) and Hepatitis E Virus (HEV), he said. There must be no delay in treatment, he added.
Follow-up appointments within 24-48 hours must be scheduled to monitor the mother's progress. Pregnant women should be informed about warning signs that require immediate medical attention, such as persistent high fever, vaginal bleeding, severe abdominal pain, or decreased fetal movement.
These measures would help the state reduce maternal mortality, he said. At least 8.78 lakh women delivered in Tamil Nadu every year. Among them, 54 women died per 1 lakh live births due to various reasons. Maternal death audits done by the state since 2004 showed the top five causes of maternal deaths included postpartum haemorrhage (25%), hypertensive disorders (22%), sepsis (10%), heart disease (8%), and abortion (4%).
The audits showed that 80% of pregnancy-related deaths were preventable with strategic pre-birth planning, capacity building, and adequate technical and medical support. MSID:: 114080167 413 |