Prevention of pregnancy complications
Running head: PREVENTIVE HEALTH PROGRAM 1
PREVENTIVE HEALTH PROGRAM 2
Prevention of pregnancy complications
Author: Yusimi Fort
Professor: Antolin Maury
Introduction
The prevention of pregnancy complications is crucial to ensuring maternal and fetal health in hospital care settings. Numerous efforts have been made including the Healthy People 2020 program, to ensure that the health care configuration assesses, measures, identifies and implements interventions to ensure the health and wellbeing of all citizens. These efforts are crucial to ensuring that all individuals have equal access to adequate and affordable health care. The same holds for pregnant women and their health is just as important, as is the health and wellbeing of fetuses (Wallace et al., 2016). This paper looks into preventing pregnancy complications, policies for preventive services, developing a primary health plan, the evaluation criteria of the health plan, a preventive health program evaluation, a health problem, and pregnancy complications including preeclampsia.
Identify a health problem in your area of work, in which you can develop a preventive program.
The chosen health problem is complications during pregnancy. The goal of this plan is to attain high quality, longer lives, free of preventable disease, injury, and premature death. Specifically, to improve the health and wellbeing of families, children, infants and women (Lawrence et al., 2016). The PICOT question is as follows How can pregnancy-related health complications (Problem) be reduced by the Healthy People 2020 guidelines and other interventions(Intervention), as compared to education(Comparison), for lower-risk pregnancy and better health(Outcome), before, during and after pregnancy(Time)?
Explain how to develop and write a practical policy for preventive services
The plan based on Healthy People 2020 is as follows. The following are the before, during and after pregnancy goals of the plan.
Postpartum (After pregnancy) Behavior and Health Goals
The postpartum goals of Healthy People 2020 for pregnancy complications are as follows. Increasing the number of women who attend postpartum care visits to health workers (Hofmeyr et al., 2018). Moreover, reducing post pregnancy relapse of smoking among pregnant women who have quit smoking during pregnancy.
Preconception Behaviors and Health Goals
The preconception goals of Healthy People 2020 for pregnancy complications are as follows. To reduce the number of individuals aged eighteen to forty-four years who have impaired fenducity i.e. this is a physical hurdle preventing taking a pregnancy to term and having a pregnancy. Increasing the number of women delivering a live birth who have received services before conception care, and have practiced core recommended health behaviors for preconception. Reducing the number of women with the potential to bear children who have reduced red blood cell folate (Rasouli et al., 2019). Lastly, increasing the number of women with childbearing potential who have an intake of at least four hundred micrograms of folic acid from dietary supplements and fortified foods.
Pregnancy Behaviors and Health Goals
The during-pregnancy goals of Healthy People 2020 for pregnancy complications are as follows. To increase the number of mothers who have achieved a recommended weight gain during pregnancy (developmental). Increasing the proportion of pregnant women who have attended a series of prepared childbirth classes and sessions (developmental). Increasing abstinence from illicit drugs, cigarettes, and alcohol among pregnant women (Lawrence et al., 2016). Lastly, increasing the proportion of pregnant women who receive adequate and early prenatal care.
Mortality and Morbidity Goals
The mortality and morbidity goals of Healthy People 2020 for pregnancy complications are as follows. Reducing preterm births, very low and low birth weights. Reducing cesarean births among low-risk women. Reducing complications due to pregnancy i.e. complications during hospitalized delivery and labor and maternal illness. Reducing the rate of maternal mortality. Reducing the occurrences of young adult and adolescent deaths. Reducing the rate of child deaths. Reducing the twelve-month mortality rate for infants suffering from Down syndrome (Wallace et al., 2016). Lastly, reducing the rate of infant and fetal deaths.
Interventions
High-Risk Pregnancies
A high-risk pregnancy usually includes one of the following issues. A problem that is unique to a pregnancy and one that leads to complications including premature labor. These issues make a pregnancy high-risk. A problem with the fetus including genetic conditions and birth defects (Khanum et al., 2018). Moreover, a disease that the mother already has including high blood pressure and diabetes. Dealing with a high-risk pregnancy includes the following.
Preventing complications that have been experienced before . In a commencing pregnancy, complications that are directly related to pregnancy such as preeclampsia and preterm birth or preterm labor can be difficult to predict. However, women who have had such complications should be especially alert in later pregnancies. Pregnant women can take the following steps to prevent such complications from occurring again. If the woman has had preeclampsia, particularly when it happens early in pregnancy, she can take aspirin. It has been proven to prevent a reoccurrence of the condition. To help improve outcomes, there is a need for getting-in early and getting started on preventative treatments. If the woman has had a prior spontaneous birth, she should take progesterone (Rasouli et al., 2019). It has been proven to reduce future risk of such a complication.
Testing for genetic conditions and birth defects . Fetal problems that can complicate a pregnancy include genetic conditions and birth defects including chromosomal abnormalities. The risk of chromosomal abnormalities increases as women get older and anyone can have a child who is affected. The risk for some genetic conditions and birth defects can be increased based on the woman’s ethnic background and family history, and these must be considered. Obstetricians use noninvasive and emergent ways including blood tests and ultrasounds to detect such issues during pregnancy. The pregnant woman must consult a genetic counselor or a doctor early in their pregnancy as a way to learn about her risks and options for testing (Lawrence et al., 2016). Additionally, taking a prenatal vitamin pill, and in some instances, folic acid before and during pregnancy, can reduce the risks for numerous kinds of birth defects.
Treating the diseases that the pregnant woman already has . During pregnancy, it is crucial to address medical conditions that can affect pregnancy from the onset. Good examples include lupus, kidney disease, heart disease, high blood pressure, and diabetes. To allow for the best chance of a healthy and successful pregnancy, these conditions must be under control before the pregnancy. For a would-be mother who has a preexisting medical condition, it is important to plan on getting pregnant and having children only after they have had the underlying medical conditions treated appropriately, and have had their baseline level of health optimized. For instance, if the woman is diabetic, they should get their blood sugars under control (Rasouli et al., 2019). On the other hand, for those who have high blood pressure, they should ensure that they are being treated appropriately.
Define the steps to develop a Primary Health Plan.
Core Components of Prevention
Federal, state, local and individual efforts to prevent diseases have been successful but there are needs for an increasingly comprehensive effort. This would be useful in meeting the overall health promotion goals including those of Healthy People 2020 in the country. The following initiatives and activities can lead to a better understanding of, and the reduction of the country’s incidence of health-related issues about complications during pregnancy (Hofmeyr et al., 2018). The primary health plan should include steps on education and awareness including the following.
Proactive behavior by individuals . Activities include the following. Becoming informed on the issues and becoming proactive in the prevention initiative preventing disease and illness and promoting health. Conscientiously trying to minimize the negative behavior impact on the individual and their family (Medley et al., 2018). Choosing services and products that are healthy. Lastly, making healthy choices in terms of lifestyles.
Improvement of the health system at the local, state and federal levels . Activities include the following. Collaboration with regulatory agencies and developing an effective and competent public health workforce. Improving and building long term additional resources, and commitments by all stakeholders and strategic partnerships (Rasouli et al., 2019). Lastly, revitalizing and enhancing the health system, at all levels.
Hazard evaluation at the local, state and federal levels. Activities include the following. Facilitating reduction to exposure such as preventing second-hand smoking. Quantifying and identifying hazardous agents (Hill et al., 2019). Additionally, responding to high-risk situations and implementing hazard assessments as required.
Surveillance in all areas . Activities include the following. Implementing widespread surveillance to assist in identifying the relationships between health concerns and hazards. Developing measures to track issues. Identifying community, state and national health issues related to pregnancy and pregnancy complications (Lawrence et al., 2016). Monitoring risk situations or areas and determining the prevalence of pregnancy-related health outcomes.
Research . Activities include the following. Supporting and identifying pregnancy complications health research agenda at the national level. Such research would address knowledge gaps related to emergent links between exposure to risk factors and health outcomes.
Establishing programs to proactively distribute information to targeted groups including those at high risk for pregnancy complications and issues. Activities include the following. Working with the media to highlight public health pregnancy-related issues. Educating workers in and out of the health field who may have daily contact with pregnant women and working in care facilities that deal with pregnancy. These individuals are well-posed to contribute to the education of the community, screen for certain pregnancy-related health risks, and encourage healthy behaviors such as cessation of smoking during pregnancy (Wallace et al., 2016). Providing information on the effectiveness of interventions as a way to inform policies. Lastly, educating and informing individuals, health care providers, public health practitioners and decision-makers on the science-based health prevention approaches that will have the greatest impact and benefit on public health.
Explain the evaluation criteria of a primary health plan.
Primary Care Actions to Prevent Pregnancy-Related Complications
Research indicates that there is effectiveness in public policies that promote the health care of women comprehensively. These focus on the management of health outcomes and care at highly complex and medium care levels. The metrics for such policies include the integration of the pregnant woman and her family in the fight against pregnancy-related issues, municipal management, and professional training. For professionals to be fully equipped and skilled to address and recognize pregnancy risk factors, they should receive adequate training as part of a lifelong policy on training (Lawrence et al., 2016). The policy which could entail pedagogical concepts pertinent to teaching health workers on social control and management should be aimed at supporting work processes related to organization and planning.
Home visits are envisaged as a strategy for health promotion for pregnant women. When these visits are conducted during the postpartum period, they can be an efficient way for professionals to monitor the postpartum and prenatal periods as well as interact with the pregnant woman’s family. Such visits provide opportunities for the professional to observe the social and family context that the woman lives in and for the woman to indicate to the professional their actual living conditions (Medley et al., 2018). These can be essential in the facilitation of humanized and genuine action.
Health Education
Health education as a strategy for reducing pregnancy-related issues and promoting health can have a positive effect by promoting the empowerment and autonomy of social groups and individuals. Additionally, by reducing health issues. As such, health education is a crucial aspect and should be considered in reducing pregnancy-related risks. Education is also relevant to the interdisciplinary and multi-disciplinary work of healthcare professionals (Mohseni et al., 2018). This is due to education enabling them to analyze and detect numerous variables including social health determinants that are potential pregnancy-related health risk factors.
Occupation, income, and education are closely linked and can determine social opportunities and access to assets. As such, they play an important role in the success of health actions including reducing pregnancy-related complications and reproductive planning (Hofmeyr et al., 2018). Inadequate income and financial independence can also act as determinants of other issues such as pregnancy planning.
Research indicates that the causes of pregnancy-related complications can be unevenly distributed. Moreover, that this uneven distribution can be attributed to social health determinants and the deficiencies of the health system, necessitating the Healthy People 2020 guidelines (Scheres et al., 2017). As such, the risk of pregnancy-related complications can be increased in populations that are socially disadvantaged as women in such populations are likely to lack insurance and adequate healthcare, as compared to those with greater social and financial resources.
The education levels of women can have a significant effect on their maternal health. As a result, education acts a social health determinant that can enhance strategies for bolstering individual health. This is due to increased demand for health and social rights due to higher education levels, leading to equal and increased opportunities for care and prevention against pregnancy-related complications. The education level of pregnant women is a crucial factor for consideration in the health care context. Generally, women with increased levels of education are more likely to seek preventive care. This contributes significantly to the reduction of pregnancy-related complications.
Numerous women experience health issues during pregnancy. Such compilations can involve the health of the fetus or the mother. Even women who are healthy before pregnancy can undergo complications. These complications could lead to a pregnancy being categorized as high-risk (Khanum et al., 2018). Getting regular and early prenatal care can assist reduce the risk for issues by enabling providers of health care to manage, treat, and diagnose conditions before they become serious.
Explain the commonly used methods for evaluating a preventive health program.
Evaluation
Disease prevention and health promotion programs collect data to evaluate the effectiveness of and to document changes. Effective evaluations track changes over time through the collection of data at the beginning and end of the implementation of the program. In the identification of evaluation measures for disease prevention and health promotion programs, it is crucial to consider the training available, the time frame provided, the needs of the funders and the stakeholders and, the focus of the program (Scheres et al., 2017).
An evaluation may also utilize measures geared towards population health. Measures utilized in prevention programs for pregnancy-related complications include the following. Community or participant outcome measures can assess the following (Medley et al., 2018). Skills and knowledge, environmental conditions, policies, healthcare costs, the prevalence of risk factors, healthy behaviors, biometric markers, and perceived health status.
Program process measures can assess the following. The cost to complete program-related activities. The types of contributions and resources provided by stakeholder groups. The degree to which activities are implemented according to the plan for the program. The characteristics and number of staff offering the program. The types of program settings and activities. The number of policies developed. The number of people that intend to take action and are aware of program messaging. The number of stakeholders involved in the program. The types and numbers of educational materials produced for the program. The number of patients enrolled in pregnancy-related complications prevention and health promotion programs. The number of participants that follow up and receive referrals. The number of participants taking part in skill activities and health education development. The number of participants taking part in risk assessments or screenings for complications (Mohseni et al., 2018). Lastly, the number of participants who complete the program.
Participant data includes metrics as follows. Knowledge including feedback on program implementation, perceived risk, and health concerns. Medical history including hospitalizations, doctor’s visits, and medication use. Health status including perceived health status, disability, stress, injury, and disease or conditions. Biological markers including skin circumference, cholesterol, blood pressure, body mass index, weight and height (Neiger, 2017). Lastly, demographic data including the primary language, educational attainment income, ethnicity or race, and age.
Identify a health problem in which it is important to develop a preventive health program.
Preeclampsia
Preeclampsia is a complication during pregnancy that is characterized by signs of damage to another organ system including kidneys and liver, and high blood pressure. The condition usually commences after five months of pregnancy in women who have had normal blood pressure. The causes of this abnormal development include certain genes, issues with the immune system, blood vessel damage and insufficient blood flow to the uterus. In rare instances, the condition develops after the delivery of the baby and is referred to as postpartum preeclampsia. A diagnosis of this condition too early in the pregnancy, before the baby can be delivered, can be particularly challenging (Hill et al., 2019). The baby needs time to mature and there is a need for the pregnant woman to avoid putting themselves or their unborn child at risk of serious complications.
If the condition is left untreated, it can lead to serious or fatal complications for both the baby and the mother. The most effective intervention for the condition is delivering the baby. Even after delivery, it can take time for the mother to recuperate.
Signs and Symptoms
The symptoms and signs for this condition include the following. Shortness of breath due to fluid in the lungs and impaired liver function. A reduced level of platelets in the blood or thrombocytopenia and decreased urine output, vomiting, and nausea. Abdominal pain usually on the right side under the ribs and changes in vision including sensitivity to light, a vision that is blurred, and temporary vision loss (Scheres et al., 2017). Other symptoms include severe headaches and excess protein in urine or proteinuria, or additional signs of kidney issues.
Primary Prevention
The most effective way to deal with a disease is through prevention and this can only be achieved if its cause is known and if it is feasible to manipulate or avoid the causes. The pathogenesis of preeclampsia includes the inappropriate cell activation of endothelial cells, a severe inflammatory response, and spinal arteries’ shallow endovascular cytotrophoblast invasion. However, the mechanisms behind these features are unknown (Hill et al., 2019). As such, contraception or delivering the baby is the only way to avoid the condition. Primary prevention of this condition touches on the following.
Smoking
Smoking cigarettes is linked to a thirty to forty percent decrease in the risk of the condition. However, this benefit is curtailed by the significant negative effects of smoking on general health, the risk for placental abruption and its effects on fetal growth (Khanum et al., 2018). However, knowledge on the prevention effects of smoking on the condition could assist in discovering important aspects of the condition’s pathophysiology.
Age, Paternal Factors and Sperm Exposure
These variables point to potential primary prevention approaches as they can be manipulated. A popular theory on the causes of the condition is the maladaptation of the immune system (Mohseni et al., 2018). Proponents of this theory come from epidemiological studies that indicate the increased frequency of the condition after oocyte donation and donor insemination, the effect of a change in partners and the preventive effect of sperm exposure.
Secondary Prevention
The Availability of Early Detection Approaches
Numerous tests have emerged and are envisaged as predictors of later development of preeclampsia. Some of the approaches could be easily introduced or are already used in most hospital care settings. Measuring the second trimester mean arterial pressure or blood pressure is not effective in the early diagnosis of the condition. Increases in these measurements predict gestational hypertension, however, and not the condition with its associated mortality and morbidity. Additionally, gains in weight cannot be utilized to predict the development of pregnancy-induced hypertension disorders. Moreover, excess gain in weight alone does not give any significant prognosis to perinatal outcome. Numerous women with such a disorder show no symptoms, which is a crucial aspect of the rationale for regular and consistent antenatal visits during late pregnancy (Neiger, 2017). Laboratory tests have been extensively utilized for monitoring, diagnosis and the prediction of the progression of the disease. The diagnosis of the condition is also based on laboratory tests.
Tertiary Prevention
Undoubtedly, proper antenatal care is crucial as part of the tertiary prevention of the condition. The intervention and screening, as part of timed delivery that comes with organized antenatal care, has been the main reason for the reduction in serious morbidity and maternal mortality. There need to be efforts to develop antenatal care configurations that allow easy referral and close vigilance for all at-risk pregnant women. There should be increased attention to look for patients portraying risk factors for the condition. The objective of treating the condition is the prevention of complications. Experts agree that medication treatment of severe hypertension during pregnancy is beneficial and necessary. The contentious issue, however, touches on the role of pharmacological treatment for conservative treatment, when the condition is severe. This is aimed at dealing with the effect of treatment on maternal and fetal outcomes, the ability of this treatment to change the progression of the underlying systemic disorder and, the prolongation of the pregnancy (Mohseni et al., 2018).
Conclusion
The prevention of pregnancy complications including preeclampsia is crucial to ensuring maternal and fetal health in hospital care settings. The goal of this plan is to attain high quality, longer lives free of preventable disease, injury, and premature death. In a commencing pregnancy, complications that are directly related to pregnancy such as preeclampsia and preterm birth or preterm labor can be difficult to predict. Obstetricians use noninvasive and emergent ways, including blood tests and ultrasounds, to detect issues of this nature during pregnancy. Federal, state, local and individual efforts to prevent diseases have been successful but there are needs for an increasingly comprehensive effort. Home visits are envisaged as a strategy for health promotion for pregnant women. Preeclampsia is a complication during pregnancy that is characterized by signs of damage to another organ system including kidneys and liver, and high blood pressure. Proper antenatal care is crucial as part of tertiary prevention of the condition (Neiger, 2017). This paper looks into preventing pregnancy complications, policies for preventive services, developing a primary health plan, the evaluation criteria of the health plan, evaluating a preventive health program, and a health problem necessitating a preventive plan, as well as pregnancy complications including preeclampsia.
References
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