New Trends in Maternity and

Newborn Health Nursing

Dr. Reda Mohamed Nabil Aboushady

Lecturer of Maternal and Newborn Health
Nursing
Faculty of Nursing – Cairo University.
 Outlines
 Introduction.
 New trends in Maternal &Newborn Health Nursing.
 New technology in Maternal & Newborn health
Nursing.
 Conclusion.
 References.
New Trends in Maternal and Newborn Health Nursing.

Nursing
practice

Nursing Midwifery Nursing

Research Nursing Education
 Reduce the rate of Maternal mortality.
 Reduce the rate of fetal and infant death.
 Reduce preterm birth.
 Reduce cesarean births among low risk
women. 4
 I- To Reduce the rate of maternal
.mortality
Through……..
 The WHO near-miss approach.
 Maternal Waiting home.
 Post partum butterfly.
 Transvaginal Bakri Balloon replacement.
 The Automated External Defibrillator (AED)
&LUCAS External Cardiac Compressor.
 II- To Reduce the rate of fetal and infant
death

 Wireless fetal monitoring using smart phone.

 Non invasive prenatal testing (Cell-free DNA
screening).
Vaginal seeding .
 III- To Reduce preterm births
 WHO approach To reduce preterm.
(Omega-3 fatty acid)

IV- To Reduce cesarean section birth

 WHO Robson Classification.

 New Technology in Maternity & Newborn
Health Nursing.
 Robotic Gynecological Surgery.
 The Vita HEAT during labour .
 Virtual reality( VR) relieve Labor Pains.
 Massaging Bra (The Lilu ).
 Clearblue Digital pregnancy test.
 My Peri Tens device .
 A contraceptive computer chip (by Remote control)
New Trends in Education of Maternal and
Newborn Health Nursing.

 Telecommunication in maternity.
(telenursing – smart phone)
 Mind map & Concept map.
 Introduction
 New Trends in Maternity's & Midwifery Nursing is
rapidly changing the world, that required professionals
to remain up-to-date in order to react to new any
developments as they occur.

 High-quality of care, evidence based practice is a key

strategy for improving maternal and newborn health
and a critical component in the continuum of care.
 REDUCE THE RATE OF MATERNAL
MORTALITY
 The WHO Near-Miss Approach.
 Maternal Waiting home.
Post partum butterfly.
Transvaginal Bakri Balloon
replacement.
 The Automated External Defibrillator
(AED) &LUCAS External Cardiac
Compressor.
 Near-miss approach

The WHO (2011) developed a standard approach for

monitoring the implementation of critical interventions in
maternal health care and proposes a systematic process for
assessing the quality of care.
 Who are responsible for the quality of
maternal health care within a health care
facility??????

 Health care provider

 Programme
manager
 Policy-maker

Near miss approach is intended for …..

 According to (Pattinson., et al 2009),
implementation of MNM approach in health service
will serve to….

 Determine the frequency of severe maternal

complications, maternal near-miss cases and maternal
deaths (Pattinson., et al 2009).
 Evaluate a health-care facility’s or the health system’s
performance.
 Determine the frequency of use of key interventions for
the prevention and management of severe complications
related to pregnancy and childbirth.
 Raise awareness regarding quality-of-care issues and
foster changes towards the improvement of maternal
health care (Pattinson., et al 2009).
 PURPOSE OF THE NEAR-MISS APPROACH

 To improve clinical practice and reduce preventable

morbidity and mortality through the use of best evidence-
based practices (WHO, 2011).

 Used to monitoring and evaluating quality of obstetric care,

decrease maternal death & improve maternal health (WHO,
2011).
 MATERNAL WAITING HOME

Three delays….
 Delay in seeking appropriate medical help
 Delay in reaching an appropriate facility.
 Delay in receiving adequate care.
 Delay in reaching an appropriate facility.

According to WHO, Maternity waiting home is offer a low –

cost way to bring women closer to needed obstetric care .
 To reduce barriers for accessing facility birth (skilled birth
attendance), go to the hospital during labor/delivery or in
pregnancy if complications occur on appropriate time
(Dadi, et al., 2018).
Waiting home have exist in Northern Europe, Canada and the
United States (Dadi, et al., 2018). To improve maternal and
neonatal health.

Maternity witting home are residential facilities, located

near a qualified medical facility, where women defined as
“high risk” can wait their delivery and be transferred to a
nearby medical facilty (Braat et al., 2018).
According to WHO criteria for Admitted
maternal waiting home……

 Parity 0 or >6
 History of perinatal death.
 History of operative or
complicated delivery.
 Height < 150 cm.
 Hypertension.
 Diabetes & Anemia.
 Hydraminos.
 Preeclampsia toxemia.
 Non-cephalic presentation.
 Multiple pregnancy.
 Maternity waiting home services…..
(Dadi, et al., 2018)

Health Services Other services

 Pre and postnatal
Education  Food&
care.
 Childbirth Laundary.
 Physical exams.
classes.  Recreational
 Laboratory tests.
 Newborn care activities.
 24 hrs. nursing
 Breast feeding.  Child care.
care.  Ambulance
 Treatment of  Nutrition.
 Family planning. services.
illness.  Income
 Uncomplicated  Skills training.
generation.
deliver.
 Post partum Haemorrhage Butterfly

It is a novel device designed to treat PPH through uterine

compression (Cunningham et al., 2017). It is less invasive and
less tiring than traditional Bimanual compression.
Safe, cost-effectiveness need little
training, effective intervention that can
be used by midwives could be a major
advance in reducing maternal mortality
from PPH, especially in low resource
settings where the majority of deaths Stephen Padilla, 2017

occur (Cunningham et al., 2017).

  Transvaginal Bakri Balloon replacement

The Bakri balloon is non-surgical

option, an intrauterine device indicated
to reduce or control PPH temporarily
when conservative treatment is
warranted (Abraham, 2017). https://obgyn.onlinelibrary.wiley.com/doi/pd
f/10.1111/j.1600-0412
 Cardiac pulmonary arrest
The Automated LUCAS EXTERNAL
External Defibrillator – CARDIAC
(AED) COMPRESSOR

https://www.usa.philips.com/.../philip Aufderheide , et al. (2011)Standard cardiopulmonary

s-heartstart-home-defibrillator resuscitation versus active compression-decompression
cardiopulmonary resuscitation :a randomised trial.
 REDUCE THE RATE OF
FETAL AND INFANT
DEATH

Through Mobile (wireless)

continuous &
intermittent fetal
monitoring.
Non invasive prenatal
testing
Vaginal seeding
Wireless Fetal Heart Rate Monitoring
or Novii Wireless Patch System
 Continuous
monitoring Intermittent
Wearable device monitoring
provide Novii Wireless
continuous fetal Fetal Heart
monitoring. Rate Monitor

https://www.foxnews.com/health/wearable- www.monicahealthcare.com/products
device-provides-continuous
  Non-invasive prenatal testing (NIPT).

 Cell-free DNA Genetic screening is a new

genetic test that uses cell-free circulating fetal
DNA in the maternal serum to screen for the
more common aneuploidies: trisomy 21
(Down syndrome), trisomy 18 (Edwards
syndrome), trisomy 13 (Patau syndrome) and
monosomy X (Turner syndrome)( Caramins
& Chopra, 2014).
 Vaginal seeding (vaginal microbe)

Vaginal seeding, is a procedure

whereby vaginal fluids (vaginal microbe) are applied
to a new-born child delivered by CS. the increase in
the rate of cesarean delivery, increase in the
frequency of, atopic disease, and risk of autoimmune
disorders,(eczema, asthma and rhino conjunctivitis,
obesity , diabetes and others) (Nierenberg, 2016).
Vaginal seeding refers to the practice of inoculating a
cotton gauze or a cotton swab with vaginal fluids to
transfer the vaginal normal flora to the mouth, nose, or
skin of a the body for newborn infant have been born by
-C-section. To reduces the risk of developing allergy,
asthma, autoimmune disorders.
 Reduce cesarean
section birth among
low-risk women

Robson
Classification
“WHO proposes the Robson Classification system as a
global standard for assessing, monitoring and comparing
caesarean section rates within healthcare facilities over
time, and between facilities”.
ROBSON’ 10-GROUP CLASSIFICATION.
Reduce preterm births

WHO approach
To reduce preterm
 New approach to reduce incidence of
preterm birth.
Maternal progesterone
supplementation.
Cerclage.
Treatment of intra-uterine
infection.
Prevent exposure to cigarette
smoking.
Improvement of maternal
nutrition.
Lifestyle modification to
ameliorate maternal stress.
Omega-3 for reducing Research has confirmed that
preterm birth adding Omega-3 to the diet of
pregnant women has a positive
effect on visual and
cognitive development of the
baby. Studies have also shown that
higher consumption of omega-3
may reduce the risk of allergies in
infants (National Institute of
Health, 2018).
 THE THREE MAIN OMEGA-3 FATTY
ACIDS

Alpha-linolenic acid )ALA(

Eicosapentaenoic acid ) EPA(
Docosahexaenoic acid )DHA(
II- New Trends in Education of Maternal and
Newborn Health Nursing.

 Telecommunication in maternity.
 Mind Map & concept map.
Telecommunication for day-to-day during high-risk pregnancy tests and
steps, including:

● Electronic medical record (EMR) consultations: Reviewing and making

recommendations for care based on a patient’s medical history and test
results, all of which are detailed in the EMR.
● Genetic counseling: Talking with patients about their risk factors for
passing genetic conditions to their babies.
● Videoconferencing: The doctor and patient can discuss findings during
ultrasound examinations face-to-face over video.
● Virtual rounding: Being at an inpatient’s bedside across the state through
mobile device technology.
Nurses who deliver, manage and coordinate care and services using
telecommunication technology are determined to be providing tele-
nursing. Tele-nursing may occur via interactive video discussions enabling
visualization of the person to determine the appropriate care or education
required. People receiving care are able to stay in their own home, limiting
the need for nurses to travel significant distances to see clients
 Mind Map

 Mind map is a diagram used to visually organize

information. A mind map is hierarchical and
shows relationships among pieces of the
whole. ... Mind maps can also be drawn by hand,
either as "rough notes" during a lecture, meeting
or planning session.
Concept Map Mind Map
 New Technology in Maternity & Newborn
Health Nursing
 Robotic Gynecological Surgery.
 The Vita HEAT during labor .
 Virtual reality( VR) Eases Labor Pains.
 Massaging Bra (The Lilu ).
 Clearblue Digital pregnancy test.
 My Peri Tens device
 A contraceptive computer chip(Remote
control)
 Robotic Gynecological Surgery

 Robotics is a new field in surgery especially in

complex operations where movement is critical
(Shazly, et al., 2015).
  Capable of taking a patient's vitals, medical
history and updating medical records.
 The robotic nurse plays an essential role in a successful robotic
surgery. As part of the robotic surgical team, Each one of the
robotic nursing team “nurse coordinator, scrub-nurse and
circulating-nurse” has a certain job description to ensure
maximum patient's safety and robotic surgical efficiency.
 Well-structured training programs should be offered to the
robotic nurse to be well prepared, feel confident, and maintain
high-quality of care.
Uses
 Hysterectomy & tubal ligations.
 Removal of fibroid tumors &
Myomectomy.
 Removal of ovarian cysts & ovarian
tumors.
 Infertility surgery
 Endometriosis surgery
 Genital Prolapse surgery.
 The Vita HEAT during labor

 The Vita HEAT is a portable system that moves with the woman
throughout entire labour and delivery process.

 Portable, under-body system delivers warmth and helps improve women

satisfaction &comfort. Also, use as non-pharmacology pain relieve.
 VIRTUAL REALITY( VR) EASES LABOR PAINS

 Virtual reality (VR) is one of

the newest non-
pharmacological labor pain
management (Frey et al.,
2018).
 VR is a new the technology can help patients learn pain
management skills like breathing exercises, meditation,
and visualization.

 Using VR to distract from the pain is completely drug-

free, and research has proven effectiveness of VR during
labor.
 Can Virtual Reality help women
?cope with childbirth

A study done by Pratiw et al., (2017) to determine

the effect of Virtual Reality using smart phone on
pain reduction in primiparity
women during labor process. They concluded that
Virtual reality is an effective
complementary nonpharmacological method to
reduce pain during labor process
 Auto Kegel technology
My Peri Tens device in Yarlap device

- Kegel exerciser and muscle stimulator for

women to strengthen pelvic floor.
- It is new pelvic floor muscle trainer to help
women with post-partum complications
and incontinence.

https://www.amazon.com/Exerciser-
Stimulator-Strengthen-Alternative-
Postpartum/dp/B01N7K06HW.
 Benefits of the My Prei Tens

PELVIC FLOOR TRAINERS: helps women prevent

bladder leaks, urges to urinate, urinary incontinence, and
other pelvic floor issues.
BETTER BLADDER CONTROL: Regain and maintain
bladder control women of all ages and sizes can avoid
bladder leaks.
EASY-TO-USE MUSCLE TONERS: It is stimulator technology
will do the pelvic exercises automatic. Apply lubricant onto the
stimulator and place device comfortably inside the vagina, with the
silver parts facing toward their hips. Only 20 minutes a day can
help women get results effortlessly and proven results.
INTIMATE HEALTH: After childbirth, women’s pelvic floor
muscles may have lost tone from atrophy or strain.
 MASSAGING BRA (THE LILU )
 Massaging Bra helps to move more milk into
breast pump. The milk is collected in a specially
designed bag that fits inside the unit.
 It is used to stimulate milk glands and help to
achieve let down by using the wireless, re-
chargable remote (Thomas, Chhugani, &
Rahma, 2017).
https://www.wearlilu.com/
 The Lilu is a powered bra that
has a built-in massager. It used
to prevent blocked milk
ducts. The Lilu is on of
strategies to relief breast
engorgement (Medgadget,
https://www.medgadget.com/2017/09/massaging-
bra-helps-move-milk-breast-pump-alleviating-
2018).
clogged-ducts.html
 Clearblue Digital pregnancy test

Clearblue Digital Pregnancy Test is a

highly effective and advanced digital
pregnancy test. It is more than 99%
accurate at detecting fertility (Johnson et
al., 2015). https://www.google.com.sa/url?
sa=t&rct=j&q=&esrc=s&source.
Clearblue is the first one-step home ovulation test, enabling
women to measure their surge in Luteinising Hormone (LH) to
determine their most fertile days.
 Remote control
A contraceptive computer chip

 A contraceptive computer chip that can

be controlled by remote control has been
developed (Dave Lee, 2018). 
 The chip is implanted under a woman's
skin, releasing a small dose of
.
levonorgestrel daily.
 Safe, effective, long-term birth control. https://iapp.org/news/a/contraceptive-computer-
chip-may-hit-the-market-in-2018/
 A small electric charge melts an ultra-thin seal around the
levonorgestrel, releasing the 30 mcg dose into the body for 16
year.
 The device measures 20mm x 20mm x 7mm and will be
"competitively priced“ (Dave Lee, 2018).
 Conclusion

In conclusion, it is important for maternity nurses to

recognize that new technology help to improve maternal
and new-born health. Building skills, continuous training
is very important to improve maternal health and
improve quality of care.
 References

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Lavender, T., Fisher, T., Weeks., A.(2017). PPH Butterfly: a novel device to treat
postpartum haemorrhage through uterine compression . BMJ Innov 2017;3:45–54.
doi:10.1136/bmjinnov-2016-000144
2-WHO Handbook for Guideline Development (second edition). Geneva:
World Health Organization; 2014.
3-Abraham, C. (2017). Bakri balloon placement in the successful
management of postpartum hemorrhage in a bicornuate uterus: A case
report. International journal of surgery case reports, 31, 218-220.
4-Cunningham, C., Watt, P., Aflaifel, N., Collins, S., Lambert, D., Porter,
J., ... & Weeks, A. (2017). PPH Butterfly: a novel device to treat postpartum
haemorrhage through uterine compression. BMJ innovations, bmjinnov-
2016.
.
5- Braat, F., Vermeiden, T., Getnet, G., Schiffer, R., van den Akker, T., & Stekelenburg, J. (2018).
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Suckling speed.
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