1. The Silent Cry Dr. Pushpa Nusair Assist. Professor
Obstetric and Gynecology
Department of Medical Sciences
College of Medicine Nursing and Health Sciences
Fiji National University

2. Outline A case study : An unbooked mother
Audit of unbooked mothers at CWM hospital (maternity Unit) from 2010 to June, 2013

3. Introduction Global statistics Developing countries studies
Local: None located

4. Case Study

5. Case study Name: MS Age: 32 years (December, 1979) Ethnicity: iTaukei
Marital Status: Single
Gravida 2, Para 1
Social background: living with parents/disabled mother

6. Case Study Had a previous cesarean delivery in May, 2011
Presented on 26/12/12 at 00:35 hours
Delivered to a very foul smelling fetus (birth weight : 3.2 kg), and placenta infarcted 400g
Denied sexual intercourse
Refused to acknowledge her pregnancy

7. Case Study All bloods including coagulation and blood cultures
Broad spectrum antibiotics
Awaiting coagulation profile
Collapsed midday informed by nurse
Active resuscitation ABC
Anesthetic and medical informed

8. Case Study
D.I.C
Intensive care unit jointly managed by obstetrics, anesthetics and medical
Massive blood transfusion, FFP and Cryo
Multi-organ failure and irreversible D.I.C
Despite all measures, patient DIED on 26/12/12 at 11.30pm

9. AUDIT

10. Methods Descriptive audit Yearly stats: 2010 - June, 2013
Monthly stats :
2012 (Oct - Dec)
2013 (Jan – June)

11. Methods Characteristics of unbooked mothers: Age Ethnicity
Marital status
Gravida
Parity
Gestation
Mode of delivery

12. Results
Percentage of unbooked mothers at CWM Hospital, Suva, Fiji %

13. Results
Percentage of unbooked mothers by ethnicity %

14. Results
Percentage of unbooked mothers by ethnicity and month %

15. Unbooked mother for Oct-Dec 2012 by age groups

16. Marital Status of unbooked mothers between Oct-Dec 2012

17. Gravidity at Parity of unbooked mothers from Oct-Dec 2012

18. Conclusion How do we hear the silent cry?
What can we do for these women?

19. Thank You!