Ensure Safe Motherhood for Women in Rural Nepal

by One Heart Worldwide
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal
Ensure Safe Motherhood for Women in Rural Nepal

Project Report | Jun 28, 2023
Nurse Shrijana's Fight Against Pre-Eclampsia

By Nikita Chaudhary | OHW Training/Field Supervisor, Sarlahi District

AI-generated illustration by Naresh Newar.
AI-generated illustration by Naresh Newar.

In the Haripur municipality of Sarlahi District, there was a remarkable success at the local Primary Health Center (PHC). Nurse Shrijana U. played a significant role in saving the life of Laxmi B., a 20-year-old first-time pregnant mother, using the MNH Helpline supported by One Heart Worldwide.

The story starts on July 17, 2022, when Laxmi arrived at the Haripur PHC around 4 pm. Despite her condition, she had walked for 15 minutes, enduring physical discomfort to seek medical assistance. Laxmi presented with alarming symptoms: a severe headache, blurred vision, vomiting, dizziness, and epigastric pain. Recognizing the urgency, Nurse Shrijana promptly assessed Laxmi's vital signs, noting potential danger signs for both the mother and the baby.

Using the MNH helpline at a critical time helps boost confidence among nurses.

Laxmi had arrived at the right time - the PHC had recently conducted a monthly session on Pre-Eclampsia and Eclampsia as part of the Skilled Birth Attendant Mentoring Program (SBAMP). During this session, Nurse Shrijana and her colleagues gained knowledge and skills in managing such cases. The information from the SBAMP session allowed them to identify Laxmi's condition as severe pre-eclampsia, a potentially life-threatening complication.

“Previously, we were so confused about diagnosing Pre-Eclampsia and Eclampsia, but the monthly SBAMP by our mentor, Anju T., helped us learn so much,” said Shrijana.

In a crucial decision-making moment, Nurse Shrijana and her team at Haripur PHC turned to the MNH Helpline for expert guidance. Dr. G.J., MDGP, a highly experienced doctor at the Provincial Hospital in Malangwa, promptly answered their call. Nurse Shrijana described the situation, and after a brief discussion, Dr. Jha recommended administering 10 mg of Nifedipine orally, as well as Magnesium Sulphate. He also advised transferring Laxmi to the Provincial Hospital in Janakpur due to the unavailability of NICU services at the local hospital.

With newfound confidence from the SBAMP and the guidance received from Dr. G.J. through the MNH helpline, Nurse Shrijana and her team swiftly took action. They educated Laxmi and her family about the situation, the necessary procedures, and the importance of referral. The team made all the necessary arrangements, including organizing finances and ensuring blood donor availability. Aware that severe pre-eclampsia requires delivery within 24 hours, they called an ambulance from Laxmipur Kodraha Health Post to transfer Laxmi to the Provincial Hospital in Janakpur.

A perfect example of team spirit

While waiting for the ambulance's arrival, the nursing staff mobilized their efforts to manage Laxmi's condition. One nurse prepared the loading dose of Magnesium Sulphate. Others focused on catheterization, opening an IV line, and providing counseling to Laxmi's family. During this time, they received another call from Dr. C.R.S., who further guided them on managing the case. Meanwhile, Dr. G.J. maintained contact, providing valuable follow-up support.

Upon reassessment, Laxmi's blood pressure remained at 160/100 mmHg in both arms, prompting the nursing staff to forego a second dose of Nifedipine. Ensuring meticulous documentation, they recorded the vital signs, medications administered, and the timing of the loading dose in Laxmi's ANC card and OPD card since no referral slip was available. They also verified the normality of Laxmi's blood clotting factors based on her previous lab results, avoiding the need for a bedside clotting test.

When the ambulance arrived, the nursing staff took Laxmi's vital signs and fetal heartbeat one last time before her transfer. With a blood pressure reading of 160/100 mmHg, a pulse rate of 82 beats per minute, a respiration rate of 18 breaths per minute, a temperature of 97.4°F, and oxygen saturation at 94%, they determined she was stable for the journey. They also assessed the toxicity of Magnesium Sulphate, finding no signs of adverse effects. 

At 5:30 pm, Laxmi traveled to the Provincial Hospital in Janakpur, accompanied by Nurse Shrijana's well wishes and continuous communication with Ms. Pushpa J., the nurse in charge of the Maternity Ward at the hospital. The journey lasted three and a half hours, and upon arrival, Laxmi received immediate attention from the medical staff.

A mother's gratitude towards the empowered nurses

The long night passed, and at 6 am on July 18, 2022,  Laxmi delivered a healthy, 2.75kg (6 lb.) baby girl through a cesarean section. Throughout her delivery, Laxmi remained on a maintenance dose of Magnesium Sulphate, as recommended by Dr. G.J. Both mother and baby were stable, and their condition steadily improved over the following days.  

Reflecting on this extraordinary success, Nurse Shrijana expressed her delight and gratitude for the opportunity to manage and refer the case. 

“I was so grateful that I could learn so much from the SMABP program and the MNH Helpline. Only having academic knowledge isn't enough, but we need constant, expert guidance and advice,” said Shrijana.

She added how the MNH Helpline significantly boosted her confidence, proving that knowledge alone is insufficient—expert guidance and advice can make all the difference. 

Laxmi expressed her heartfelt appreciation for the kind and helpful nursing staff at Haripur PHC, who provided medical care, ensured her emotional support, and facilitated communication with her husband overseas.

In the end, Laxmi and her baby girl overcame severe pre-eclampsia, all due to the combined efforts of Nurse Shrijana and her dedicated team at Haripur PHC. Their commitment, skill, and valuable support from the SBAMP and MNH Helpline saved two lives and gave hope to the family. 

This success story is a testament to the transformative power of knowledge and compassionate care in the face of adversity.

“I am so satisfied with the support from the nurses for saving us. I was afraid about my condition and my baby. Since my husband is working abroad, I am all alone here. They did everything for me, from arranging an ambulance to taking care of me and saving both of our lives," said Laxmi.

AI-generated illustration by Naresh Newar.
AI-generated illustration by Naresh Newar.
AI-generated illustration by Naresh Newar.
AI-generated illustration by Naresh Newar.

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One Heart Worldwide

Location: San Diego, California - USA
Website:
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Twitter: @OneHeartWW
Project Leader:
Michaela Hayes
San Francisco , California United States
$36,055 raised of $40,000 goal
 
148 donations
$3,945 to go
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