Case study: Newborn and child health—Introduction

21-year-old Nasir Ali arrived at the small hospital in her rural home in Somalia.

She was in her first pregnancy with regularly occurring contractions. Her pregnancy to date had been relatively unremarkable.

Nasir did have several bouts of fevers

that were assumed to be malaria based on previous experience with the illness. The traditional healer in her community gave her some medicinal plants for treatment, and she seemed to improve.

Ton Rulkens. CC BY-SA 2.0.

When the nurse at the hospital reviewed the dates of pregnancy with Nasir, she calculated that the pregnancy had gestational age of 42 weeks. However, the fundal height was that of a 35-week pregnancy. For this reason, it was recommended that she go to nearest hospital with more resources, which was 30 miles away.

She was transferred by ambulance

to the hospital for access to its operating room, blood bank, and services for an at-risk infant (e.g., incubators and oxygen, which were not available at the local hospital).

Aamin ambulance. UNSOM. Public domain.

At the referral hospital, the labor and delivery nurse examined Nasir

and discovered meconium-stained amniotic fluid. Fetal monitoring is unavailable in this hospital, so Nasir was taken to the operating theater, where a cesarean section was performed, and the baby was born.

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Case study: Newborn and child health—Introduction

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