Approximately 80–90% of women experience some symptoms in the premenstrual period at some point in their reproductive years. Teenagers often present with moderate to severe symptoms, while women in the fourth decade of life appear to have worse symptoms with the severity of the disease worsening with increasing age up until menopause. Obesity and smoking have also been identified as risk factors. Symptoms could be physical, psychological, emotional, environmental and/or behavioral and affect the ability to perform normal daily activities as well as adversely affect interpersonal relationships. Though several theories have been propounded, the exact cause of premenstrual syndrome is unknown. Management of this disorder requires a multi-disciplinary approach involving the general practitioner, the general gynecologist or a gynecologist with a special interest in PMS, a mental health professional (psychiatrist, clinical psychologist or counselor), physiotherapist and dietician.
Part of the book: Menstrual Cycle
Ensuring healthy lives and promoting the well-being for all at all ages is essential to sustainable development. The UN’s adoption of the sustainable development goals (SDGs) in September 2015 reaffirmed the reduction of maternal and newborn mortality as global priorities in the coming decade. The World Health Organisation Safe Childbirth Checklist has been developed to ensure the delivery of essential maternal and perinatal care practices. The Safe Childbirth Checklist aims to help frontline health workers to prevent avoidable childbirth-related mortality and morbidity. The Checklist addresses the major causes of maternal death (haemorrhage, infection, obstructed labour and hypertensive disorders), intrapartum-related stillbirths (inadequate intrapartum care), and neonatal deaths (birth asphyxia, infection and complications related to prematurity). Successful completion of checklist items by healthcare workers will help keep the woman and baby safe as the checklist catalogues a core set of practices that are proven to reduce maternal and newborn harm. The practices described in the checklist items should be conducted at every birth. This chapter utilises experiences gained in Cameroon, Ghana, Nigeria and Zambia during the Pfizer Independent Grant for Learning and Change supported Medical Women’s Association of Nigeria Improving Maternal Health in sub-Saharan Africa project to describe the checklist and how it can be used to deliver lifesaving midwifery care and enhance maternal health.
Part of the book: Selected Topics in Midwifery Care
Miscarriage also known as spontaneous abortion is the termination of pregnancy before the age of fetal viability or expulsion of fetus or embryo weighing less than 500g. It occurs naturally without any human intervention and complicates about 15–20% pregnancies globally. The age of fetal viability varies from country to country depending on the level of technological development and fetal salvage rate. The age of fetal viability in Norway is 16 weeks, in Australia its 20 weeks, 24 weeks in the UK, 26 weeks in Spain and Italy while in Nigeria the age of fetal viability is 28 weeks of gestation. Causes of miscarriage include morphologic/genetic/chromosomal abnormalities, immunological and endocrine factors, structural uterine anomalies, cervical incompetence, maternal infections and toxins. It is classified into threatened miscarriage, inevitable miscarriage, incomplete miscarriage, septic miscarriage, missed miscarriage and complete miscarriage. Miscarriage has profound and tremendous psychologic and emotional effects on mothers before or during subsequent gestations. Every effort must be made to show understanding and empathy.
Part of the book: Complications of Pregnancy