Matres Mundi Basic Perinatal Care Book

GRAPHIC TRAINING PROGRAM
BASIC B BA A S IC PERINATAL PE ATAL CARE

SOIN PERINATAL TA DE BASE
Programm me Gra aphiq que de d Formation
ATENCIN PERINATAL B BSICA

Prog grama Gr co o de e Fo Formacin
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BASIC PERINATAL CARE

Graphic Training Program
SOIN PERINATAL DE BASE

Programme Graphique de Formation
ATENCIN PERINATAL BSICA

Programa Grco de Formacin
Edited by:
MATRES MUNDI INTERNATIONAL

On initiative of:
INTERNATIONAL ACADEMY OF PERINATAL MEDICINE (IAPM) WORLD ASSOCIATION OF PERINATAL MEDICINE (WAPM)
and the nancial support of: Foundation ORDESA
General Coordination M. Dolors Chacn Supervising Committee Jos M. Carrera, Vicente Cararach, Xavier Carbonell International Scientic Supervising Asim Kurjak Illustrations Isabel Elguezabal Graphic design Annia Aragons Linguistic adaptation Pedro N. Barri Jr. Secretariat and Coordination of Edition Matres Mundi Londres 6, p. 8 08029 Barcelona, Spain Tel/fax: 0034/934190015 Design, Layaut and Prepress Baber, scp. Barcelona, Spain Printed in Spain by EGS. Barcelona, Spain
Published in Spain in 2009 by MATRES MUNDI All rights reserved Depsito legal: 28501-2009
INDEX
TABLE DE MATIRES | NDICE
FOREWORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Prof. ERICH SALING and Prof. FRANK CHERVENAK AIMS OF THE GUIDE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OBJECTIFS DE CE GUIDE OBJETIVOS DE ESTA GUA M. D. CHACN CONTRIBUTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . JOS M. CARRERA Chapter 1. Chapitre 1. Captulo 1. ANATOMY AND PHISIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . ANATOMIA ET PHISIOLOGIE ANATOMA Y FISIOLOGA
11 12
13
E. REBULL LPEZ Chapter 2. Chapitre 2. Captulo 2. PREGNANCY FOLLOW UP . . . . . . . . . . . . . . . . . . . . . . . . . . . . SUIVIE DE LA GROSSESSE CONTROL DEL EMBARAZO 19
M. D. CHACN SNCHEZ Chapter 3. Chapitre 3. Captulo 3. LABOUR AND DELIVERY ASSISTANCE . . . . . . . . . . . . . . . . . . . CONTRLE ET ASSISTANCE LACCOUCHEMENT CONTROL Y ASISTENCIA AL PARTO 43
A. FERNNDEZ PASCUAL Chapter 4. Chapitre 4. Captulo 4. CONTROL AND FOLLOW UP OF THE POSTPARTUM . . . . . . . . . . CONTRLE ET SUIVIE DU POSTPARTUM CONTROL Y CUIDADOS DEL PUERPERIO 71
L. FRANCS RIBERA Chapter 5. Chapitre 5. Captulo 5. CONTROL AND FOLLOW UP OF THE NEWBORN . . . . . . . . . . . . . CONTRLE ET SUIVIE DU NOUVEAU N CONTROL Y CUIDADO DEL RECIN NACIDO 87
M. T. TORRES COSTA
INDEX
TABLE DE MATIRES | NDICE
Chapter 6. Chapitre 6. Captulo 6.
BREASTFEEDING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 ALLAITEMENT MATERNEL LACTANCIA MATERNA
L. COLELL PALLARS Chapter 7. Chapitre 7. Captulo 7. FAMILY PLANNING. Contraceptive methods . . . . . . . . . . . . . . . 125 PLANIFICATION FAMILIALE. Mthodes contraceptives PLANIFICACIN FAMILIAR. Mtodos anticonceptivos
A. CANO PARELLADA Chapter 8. Chapitre 8. Captulo 8. SEXUALLY TRANSMITED DISEASES . . . . . . . . . . . . . . . . . . . . . 135 MALADIES DE TRANSMISSION SEXUELLE ENFERMEDADES DE TRANSMISIN SEXUAL
M. D. BAST PORTABELLA
FOREWORD
he situation of maternal and infant health remains dramatic in many parts of the globe, despite the considerable efforts made by United Nations agencies and specialist NGOs. Sub-Saharan Africa, South Asia and Latin America have the lowest ratios in the world for antenatal care coverage, delivery care coverage and skilled newborn care. As a result, these regions have some of the worlds highest rates of maternal and perinatal mortality. More than 600,000 women die every year due to complications related to pregnancy and/or childbirth. Approximately 14 million children aged under five die every year (40,000 a day), 40 % of them in the newborn stage. But what is inexcusable is that nearly 95 % of all maternal deaths and 92 % of all neonatal deaths in the world occur in Sub-Saharan Africa and South Asia due to factors that are completely avoidable in developed countries. Africa, in particular, is the continent that has the most problems in terms of maternal and infant health. Although it has 100 times more medical problems than European countries, it has 100 times fewer healthcare professionals to deal with them. Most African countries have lost around 40 % of the doctors that they had when they became independent, with more than 30,000 professionals moving to Europe and the US each year. There are more Beninese doctors in France than in Benin. And there are more doctors from Sierra Leone in Chicago than in Sierra Leone. This is the consequence of years of neglect and inaction by African governments and the international community at large. The result is that the majority of deliveries take place in humble homes, especially in rural areas (80 % of the population), and only 40 % are attended by skilled healthcare workers who are not by any means specialists (doctors or midwives) but people with no academic background who have received some form of practical training. At best, deliveries are attended by empirical midwives whose skills are based on traditional practices. This means that the only possible way to enhance antenatal care and delivery care, and thus reduce significantly the high rates of maternal and perinatal mortality, is limited in practice to improving the preparation of the so-called traditional midwives, who, although they have considerable experience, lack any formal academic training and have little schooling. It is suggested that if traditional midwives washed their hands before delivery and used simple hygiene measures during childbirth, the number of maternal deaths would be reduced by 40 %. Aware of this, the MATRES MUNDI INTERNATIONAL Cooperation agency for maternal and infant health, under the auspices of the International Academy of Perinatal Medicine (IAPM) and the World Association of Perinatal Medicine (WAPM), has decided to address the challenge of developing a Basic Perinatal Care program, designed specifically for empirical midwives (Africa) and healthcare workers (Latin America). The book that you are holding in your hands is crucial to bringing this program to fruition. It is a Guide based almost entirely on drawings, to avoid the problems of language proficiency or literacy. Written in a simple and understandable way, it provides basic information on what to do during pregnancy, delivery and postnatal recovery, with
FOREWORD
a special emphasis on identifying the risks and dangers of each stage. Moreover, it explains in a very graphic way the treatment that must be given to newborn babies, the various contraceptive methods available or the prevention of sexually transmitted diseases. The pictures are sufficiently explicit so as to be readily understood not only by traditional midwives but also by pregnant women. Through this Guide, both the IAPM and the WAPM intend to help the women and children living in developing countries, by supporting the humanitarian work of MATRES MUNDI, an aid agency for both institutions. We are grateful to Jose Maria Carrera and Matres Mundi for their tireless efforts to help pregnant, fetal, and neonatal patients. We believe that this work will potentially be life saving for the worlds most vulnerable women and children. With much love and respect, PROF. ERICH SALING President of the IAPM PROF. FRANK CHERVENAK President of the WAPM
AIMS OF THE GUIDE

OBJECTIFS DE CE GUIDE | OBJETIVOS DE ESTA GUA
his book is intended as a Guide to help primary care professionals (traditional or empirical midwives, healthcare workers, nurses, etc.) who have no academic background to learn basic skills in perinatal care and reproductive health.
Unfortunately, in many parts of the globe antenatal care, delivery care and newborn care are provided not by professionals with an adequate academic training (doctors, midwives, nurses, etc.) but by unqualified personnel with poor practical training that relies essentially on traditional knowledge. In addition, many of those healthcare workers have literacy issues. Given the difficult economic and social situation of many developing countries, limited antenatal care is bound to remain the norm for some time to come, and most women are likely to continue giving birth in their homes, attended by poorly qualified personnel. Therefore, within this context, measures to improve the care of both mother and child and reduce the high rates of maternal and perinatal mortality involve enhancing the training and preparation of empirical or traditional midwives, as well as promoting health education among women. These two objectives, however, cannot be attained using traditional academic methods (books, protocols, etc.), due to the low level of education of the population, but with tools that are adapted to the local environment. This Guide is intended to provide such a tool. Undoubtedly, images are the most powerful method of communication. For this reason, this book is made up mainly of simple and easily understandable drawings that illustrate, in a sequential and organised manner, the physiology of reproduction, obstetric controls, childbirth, puerperium, newborn baby care, breastfeeding, family planning methods, and sexually transmitted diseases. Text is kept to a minimum and available in three basic languages (English, French and Spanish). Both the pictures and the text have a common goal: explaining clearly the subject of the book, stimulating visual memory, and providing a brief reminder of the essential points that healthcare workers need to bear in mind when providing care. The book is intended to provide teachers who develop a reproductive health program aimed at empirical midwives and healthcare workers with a reliable teaching resource, thus promoting consistent healthcare guidelines. Primary care workers can use it as a reminder of everything they learned, and as a reference guide for addressing any problems they may have. The guide does not intend to make their work more difficult, but to facilitate it and improve the quality of care. Naturally, it should be adapted to each individual geographical region. In addition to this first objective, the book also aims to improve the health education of local communities in the field of maternal and infant health. In this respect, it can serve as an instrument for allowing empirical midwives to convey basic notions of hygiene during pregnancy, delivery and puerperium to their pregnant patients and provide them with information on symptoms and danger signals that require consulting a doctor, or information on how to take care of a child and the basic aspects of a childs
AIMS OF THE GUIDE

psychomotor development. It goes without saying that the explicit drawings in the book provide valuable insights into how to avoid unwanted pregnancies or sexually transmitted diseases. We hope that this small book will allow healthcare workers to alleviate suffering and improve the health of mothers and children in a world blighted by danger, scarcity and selfishness.
M. DOLORS CHACN Secretary General of Matres Mundi
objectif de cet ouvrage est de servir de guide pour aider les professionnels des soins de sant primaire (sages-femmes traditionnelles ou empiriques, agents mdicaux, aides-soignants, etc.) nayant pas reu de formation acadmique, acqurir les connaissances de base en matire de soins prnataux et de sant reproductive. Malheureusement, dans de nombreuses rgions du globe, la prise en charge des soins lis la grossesse, laccouchement et au nouveau-n nest pas assure par des professionnels ayant suivi une formation acadmique classique (mdecins, sages-femmes, infirmires, etc.), mais par des personnels non diplms dont la formation pratique irrgulire est base principalement sur des connaissances traditionnelles. De plus, une partie de ces personnels connat des problmes dalphabtisation. tant donne la difficile situation conomique et sociale de nombreux pays en voie de dveloppement, il faudra pendant encore longtemps se rsoudre ce que les soins prnataux soient limits et ce que la majorit des accouchements ait lieu au domicile de la parturiente, avec laide de personnels peu qualifis. Dans ce contexte, les mesures les plus importantes prendre pour amliorer les soins de la mre et de lenfant et rduire les taux levs de mortalit maternelle et prinatale, consistent donc amliorer la formation et la prparation des sages-femmes empiriques ou traditionnelles, mais aussi renforcer la culture sanitaire de la population fminine. Ces deux objectifs ne peuvent cependant pas tre atteints avec les mthodes acadmiques traditionnelles (livres, protocoles, etc.), en raison du faible niveau scolaire de la population, mais grce des outils adapts lenvironnement local. Ce guide a prcisment pour but de constituer un de ces outils. Limage est sans doute le vecteur de communication le plus puissant. Cest pourquoi ce livre est principalement constitu de dessins, simples et faciles comprendre, qui illustrent, de manire squentielle et intgre, la physiologie de la reproduction, les contrles obsttricaux, laccouchement, la priode suivant laccouchement, les soins du nouveau-n, lallaitement, les mthodes de planification familiale et les maladies sexuellement transmissibles. Le texte est rduit au maximum et rdig dans trois langues majeures (langlais, le franais et lespagnol). Les textes et les dessins ont un but commun: expliquer clai-
AIMS OF THE GUIDE

rement le thme trait, stimuler la mmoire visuelle et exposer brivement les points essentiels afin de servir de rappel aux professionnels de sant lorsque ceux-ci seront en exercice. Louvrage est conu comme un outil cl pour que les personnels enseignants qui dveloppent des programmes de sant reproductive destins aux sages-femmes empiriques et aux agents mdicaux, puissent disposer dun support fiable pour leurs explications, de manire promouvoir des critres de soins solides. Par la suite, les personnels de soins primaires pourront se servir de ce livre pour se rappeler tout ce quils ont appris; ce sera un ouvrage de rfrence consulter en cas de problme. Naturellement, lobjectif du guide nest pas de compliquer le travail mais de le faciliter et damliorer la qualit des prestations et, videmment, il doit tre adapt chaque milieu gographique. Une fois ce premier objectif atteint, ce guide a galement pour but damliorer la culture sanitaire des diffrentes communauts dans le domaine de la sant maternelle et infantile. cet gard, il peut reprsenter un instrument utile pour que les sages-femmes empiriques transmettent aux femmes enceintes dont elles ont la charge, les notions dhygine de base pendant la grossesse, laccouchement et la priode suivant laccouchement, les informations sur les symptmes et les signes de danger ncessitant une consultation, ainsi que les soins de lenfant et les points fondamentaux de son dveloppement psychomoteur. Il va sans dire que les dessins explicites de louvrage apportent des informations prcieuses sur la manire dviter les grossesses non dsires et de prvenir la contraction de maladies sexuellement transmissibles. Nous esprons et souhaitons que ce livre permette aux personnels de sant dapaiser les souffrances et damliorer la sant des mres et des enfants dans un monde marqu par le danger, la pnurie et lgosme.
M. DOLORS CHACN Secrtaire Gnral de Matres Mundi
l objetivo de este libro es servir de Gua para ayudar a suministrar a los profesionales de la asistencia primaria (parteras tradicionales o empricas, agentes de salud, auxiliares de enfermera, etc.), que no han recibido preparacin acadmica, los conocimientos bsicos en cuidados perinatales y salud reproductiva. Lamentablemente en extensas reas del planeta, la atencin al embarazo, el parto y el recin nacido no est en manos de profesionales con una formacin acadmica reglada (mdicos, matronas, enfermeras, etc.), sino de personal no titulado, con una formacin prctica irregular basada fundamentalmente en conocimientos tradicionales. Parte de este personal tiene, adems, problemas de alfabetizacin. Dada la difcil situacin econmica y social de muchos de los pases en curso de desarrollo, durante mucho tiempo deber aceptarse como habitual que la atencin prenatal sea limitada y que la mayora de los partos tengan lugar en el domicilio de la parturien-
10
AIMS OF THE GUIDE

ta atendidos por personal escasamente cualicado. En este escenario, las medidas ms importantes para mejorar la asistencia a la madre y al nio y reducir las altas tasas de mortalidad materna y perinatal, pasan por mejorar la formacin y preparacin de las matronas empricas o tradicionales e incrementar la cultura sanitaria de la poblacin femenina. Ambos objetivos no pueden sin embargo conseguirse, dada la escasa preparacin escolar de la poblacin, con los mtodos acadmicos tradicionales (libros, protocolos, etc.), sino con herramientas adaptadas al medio. Esta Gua es una de ellas. Sin duda la forma ms poderosa de comunicacin es la imagen. Por esta razn este libro est constituido fundamentalmente por dibujos, sencillos y fciles de interpretar, que ilustran, sucesivamente de una forma secuencial e integrada, la siologa de la reproduccin, los controles obsttricos, el parto, el puerperio, los cuidados del recin nacido, la lactancia, los mtodos de planicacin familiar y las enfermedades de transmisin sexual. El texto es el mnimo posible, y expresado en tres idiomas bsicos (ingls, francs, espaol). Ambos, guras y textos, tienen un n comn: explicar claramente el tema que se trata, despertar la memoria visual y recordar brevemente los puntos esenciales con el objetivo de retenerlos a la hora de actuar. El libro se ha concebido como una herramienta clave para que el personal docente que desarrolle un programa de salud reproductiva destinado a matronas empricas y agentes de salud, tenga un soporte seguro de sus explicaciones, promoviendo unos criterios slidos de actuacin. Posteriormente, el libro, ya en manos del personal de asistencia primaria, debe permitir el recordatorio de todo lo aprendido, y servir como punto de referencia y consulta cuando surjan problemas. Naturalmente la gua no pretende complicar el trabajo, sino facilitarlo y mejorar la calidad de las prestaciones y, por supuesto, debe adaptarse a cada mbito geogrco. Conseguido este primer objetivo, el libro tambin debera ser til para mejorar la cultura sanitaria de una determinada comunidad en el terreno de la salud materno-infantil. En este sentido, puede ser un instrumento adecuado para que las matronas empricas transmitan a las embarazadas a su cargo, las nociones bsicas de higiene durante el embarazo, parto y puerperio, la informacin sobre los sntomas y signos de peligro que deben obligarla a consultar, as como el cuidado del nio y los puntos bsicos de su desarrollo psicomotor. Y ni que decir tiene, que los explcitos dibujos de la obra proporcionan una valiosa informacin sobre cmo evitar embarazos indeseados y prevenir la adquisicin de las frecuentes enfermedades de transmisin sexual. Esperamos y deseamos que esta pequea obra sirva, en manos del personal adecuado, para aliviar sufrimientos y mejorar la salud de madres y nios en un mundo lleno de peligros, escaseces y egosmos.
M. DOLORS CHACN Secretaria General de Matres Mundi
CONTRIBUTORS
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GENERAL COORDINATION M. Dolors Chacn Snchez Associate Professor of International University of Catalonia. Barcelona-Spain. Secretary General of MATRES MUNDI. AUTHORS M. Dolors Bast Portabella Midwife. Midwife of the Sexual and Reproductive Health Care Programme (Baix Llobregat). Institut Catal de la Salut. Barcelona (Spain). Ana Cano Parellada Midwife. Full Professor of Infirmary School of San Joan de Du. Barcelona (Spain). Lourdes Colell Pallares Midwife. Resposible of Obstetric Area of the Hospital Espritu Santo. Santa Coloma de Gramanet. Barcelona (Spain). M. Dolors Chacn Snchez Midwife. Midwife of the Sexual and Reproductive Health Care Programme. El Masnou - Alella-Teia. Barcelona (Spain).
Aurora Fernndez Pascual Midwife. Responsible of Maternity Area of the Hospital of Santa Creu i Sant Pau. Barcelona (Spain). Lidia Francs Ribera Midwife. Full Professor of Unitat Docent de Llevadores de Catalunya. Infirmary School. Barcelona University (Spain). Esther Rebull Lpez Midwife. Casa Maternitat. Clinical Institut of Gynaecology, Obstetrics and Neonatology. Barcelona (Spain). M. Teresa Torres Costa Midwife. Midwife of the Sexual and Reproductive Healt Care Programme. Antoni Creus i Querol Center. Institut Catal de la Salut. Terrasa (Spain). ILLUSTRATION Isabel Elguezabal Garca Midwife. Hospital of Espritu Santo. Santa Coloma de Gramanet. Barcelona (Spain). GRAPHIC DESIGN Annia Aragons Chacn Designer. Fine Arts Student.
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ACKNOWLEDGEMENTS
MATRES MUNDI wishes to express its gratitude for the valuable sponsorship of international scientific institutions (IAPM, WAPM, Ian Donald School, etc.), the generous financial support of the Ordesa Foundation, which has made the publication of this book possible, and for all those who have given their time and energy to help us publish this book (writers, designers, artists, translators, etc.). To all Thank you!
JOS M. CARRERA President of MATRES MUNDI
ANATOMY AND PHISIOLOGY ANATOMIE ET PHISIOLOGIE ANATOMA Y FISIOLOGA

E. Rebull Lpez
ANATOMY AND PHISIOLOGY

ANATOMIE ET PHISIOLOGIE | ANATOMA Y FISIOLOGA
15
Male reproductive system Appareil reproducteur masculin | Aparato reproductor masculino
Bladder | Vessie | Vejiga Deferent duct | Conducte dphrent Conducto deferente Uretra | Urtre | Uretra Penis | Penis | Penis Testicules | Testicules | Testiculos
Continuous production of spermatozoons | Produit de spermatozodes de forme continue | Produce espermatozoides de forma continua
Female reproductive system Appareil reproducteur fminin | Aparato reproductor femenino
Pubis | Pubis | Pubis Labia majora Grandes lvres Labios mayores Clitoris | Clitoris | Cltoris Urinary meatus Meate urinaire Meato urinario Vagina | Vagin | Vagina Anus | Anus | Ano
Labia minora Petites lvres Labios menores
External genitalia | Gnitaux externes | Genitales externos
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BASIC PERINATAL CARE: Graphic Training Program SOIN PERINATAL DE BASE: Programme Graphique de Formation ATENCIN PERINATAL BSICA: Programa Grfico de Formacin
Fallopian tube Trompe de Phalopium Trompa de Falopio
Ovary | Ovaire | Ovario
Uterus | Uterus | tero Vagina | Vagin | Vagina
Internal genitalia | Gnitaux internes | Genitales internos Produces an ovule every cicle (month) | Produit un ovule chaque cicle (mois) Produce un vulo cada ciclo (mes)
Fecondation Fcondation | Fecundacin

It is the fusion of two cells, the spermatozoon and the ovule. The woman becomes pregnant and stops menstruating. Il sagit de la fusion de deux clules, le sprematozode et lovule. La femme devient enceinte et la menstruatin disparat. Es la fusin de dos clulas, el espermatozoide y el vulo. La mujer queda embarazada y deja de menstruar.
Ovule Ovule vulo
Spermatozoid Spermatozode Espermatozoide
ANATOMY AND PHISIOLOGY

ANATOMIE ET PHISIOLOGIE | ANATOMA Y FISIOLOGA
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Implantation Implantation | Implantacin

a) Fecondation | Fcondation Fecundacin b) Morula phase | Phase de Morule Fase de Mrula
c) Blastocyst | Blastocyste Blastocisto
d) Implantation | Implantation Implantacin
Embryo development Dveloppement embrionnaire | Desarrollo embrionario
4 weeks 4 semaines 4 semanas
Embryonary phase 8 weeks 8 semaines Phase embrionnaire 8 semanas Fase embrionaria
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Fetal development Dveloppement ftal | Desarrollo fetal
9 12 16
20
24
28
32
36
38
weeks semaines semanas
PREGNANCY FOLLOW UP SUIVIE DE LA GROSSESSE CONTROL DEL EMBARAZO

M. D. Chacn Snchez
PREGNANCY FOLLOW UP
SUIVIE DE LA GROSSESSE | CONTROL DEL EMBARAZO
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PREGNANCY DIAGNOSTIC DIAGNOSTIQUE DE GROSSESSE DIAGNSTICO DE EMBARAZO

Signs of possible pregnancy Signes de possibilit de grossesse | Signos de posibilidad de embarazo
22
Signs of probability Signes de probabilit | Signos de probabilidad de embarazo
Confirmation of pregnancy Signes de certitude | Signos de certeza
PREGNANCY FOLLOW UP
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PRENATAL FOLLOW UP OF NORMAL PREGNANCY CONTRLE PRNATALE DE LA GROSSESSE NORMALE CONTROL PRENATAL EN EL EMBARAZO NORMAL
4 controls are needed | Il faut faire 4 controles | Se han de realizar 4 controles 1. 2. 3. 4. ,42
Hospital admission or follow up Hospitalisation ou surveillance Ingreso o vigilancia
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Blood pressure control Contrle de la pression artrielle | Control de la tensin arterial
Max
Min
120 / 70
Weight control Contrle du poids | Control de peso
1 kg 3
PREGNANCY FOLLOW UP
25
Control of heart rate and fetal movements | Contrle des bruits du coeur et mouvements fetaux | Control del latido y movimientos fetales
Uterine height Contrle de lhauteur uterine | Control de la altura uterina
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Control of fetal growth Contrle de la croissance fetale | Control del crecimiento fetal
1 Fetal movements
Mouvements fetaux Movimientos fetales
2 Heart auscultation
Auscultation cardiaque Auscultacin cardaca
3 Position evaluation
Valoration de la position Valorar su posicin
4 Term pregnancy
Grossesse terme Embarazo a trmino
PREGNANCY FOLLOW UP
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Fetal position control Contrle de la position fetale | Control de la posicin fetal

Leopold Maneuvers | Manoeuvres de Lopold | Maniobras de Leopold
1 Uterine fundus
Fond utrin Fondo uterino
2 Position and situation of the fetus

Position et situation ftale Posicin y situacin fetal
3 Presentation
Prsentation Presentacin
4 Position and actitude

Position et attitude Posicin y actitud
Blood and urine analysis. 1st, 2nd and 3rd term ultrasound Contrle analyse de sang et urine. Ecographie de 1er, 2eme, 3eme trimestre Control anlisis de sangre y orina, y ecografa 1.er, 2.o, 3.er trimestre
1st
2nd
3rd
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Anemia control Contrle de lanmie | Control de anemia
PROPHILAXIS PROPHILAXIS PROFILAXIS

Tetanus vaccine Vaccin du ttanus | Vacuna antitetnica
PREGNANCY FOLLOW UP
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HIGIENE HIGINE HIGIENE DEL EMBARAZO

Body care Higine du corps Higiene corporal Teeth brushing Higine bucodentale Higiene bucodental
Shoes Chaussures | Calzado
u u u
e e e
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Dressing Vtements | Vestido
Rest Repos | Descanso

Walking without getting tired Marcher sans se fatiguer Caminar sin llegar a cansarse Enough rest Repos sufisant Descansar sucientemente
PREGNANCY FOLLOW UP
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PHYSICAL EXERCISE EXERCICE EJERCICIO FSICO

Moderate exercise without getting tired Raliser exercice modr (sans se fatiguer) Realizar ejercicio fsico moderado (sin llegar al cansancio) Job Travail | Trabajo
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Sexuality Sexualit | Sexualidad
Avoid sexual intercourse in case of: Eviter les rapports sexuels au cas de: Evitar relaciones coitales en caso de:
PREGNANCY FOLLOW UP
33
Toxic habits Habitudes toxiques | Hbitos txicos
FEEDING DURING PREGNANCY ALIMENTATION PENDANT LA GROSSESSE ALIMENTACIN DURANTE EL EMBARAZO

Varied and equilibrated diet Rgime vari et equilibr | Dieta variada y equilibrada
34
The diet must include: La dite doit incloure: | Ha de estar compuesta de:
Carbohidrates Carbohidrats Hidratos de carbono
Proteins Protenes Protenas
Fat Gras Grasas
Vitamins Vitamines Vitaminas
Vegetables Lgumes Hortalizas
Calcium Calcium Calcio
PREGNANCY FOLLOW UP
35
BABYS BAG SAC DU BB CANASTILLA DEL BEB
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HIGH RISK PREGNANCY GROSSESSE RISQUE EMBARAZO DE RIESGO

Reasons for hospital admission Raisons dhospitalisatons Motivos de ingreso hospitalario
Amniotic sac rupture Rompre la poche des eaux | Rotura de la bolsa de las aguas
PREGNANCY FOLLOW UP
37
Vaginal bleeding similar or higher than menses, with or without pain Saignement gnital gale ou suprieure aux rgles, avec ou sans douleur Sangrado por los genitales igual o mayor que una regla, con o sin dolor
Abdominal pain, uterine contractions Douleur au ventre, contractions utrines Dolor en el vientre, contracciones uterinas
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High fever Fivre haute | Fiebre alta
Considerable vomiting Vomissements abondants | Vmitos abundantes
PREGNANCY FOLLOW UP
39
Soreness of the face, hands, feet, with vision troubles and headache Gonflement de la figure, mains, pieds, avec troubles de vision et maux de tte Hinchazn en cara, manos, pies, con visin borrosa y dolor de cabeza
High blood pressure Hipertension | Hipertensin
140/90
40
Absence of fetal movements Si on ne sent pas de mouvements ftaux | Si no se notan movimientos fetales
Gestational diabetes Diabtes gestational | Diabetes gestacional
e u u
PREGNANCY FOLLOW UP
41
Women with physical problems or who live far Femmes avec alterations phisiques ou vivant loin Mujeres con alteraciones fsicas o que vivan muy lejos
Small sized, very young or old women Femmes de petite taille, trs jeunes ou trs ages Mujeres de baja talla, muy jvenes o muy mayores
LABOUR AND DELIVERY ASSISTANCE CONTRLE ET ASSISTANCE DE LACCOUCHEMENT CONTROL Y ASISTENCIA AL PARTO
A. Fernndez Pascual
LABOUR AND DELIVERY ASSISTANCE

CONTRLE ET ASSISTANCE DE L'ACCOUCHEMENT | CONTROL Y ASISTENCIA AL PARTO
45
WHEN THE MOMENT OF THE DELIVERY ARRIVES QUAND LE MOMENT DE LACCOUCHEMENT ARRIVE CUANDO SE PRESENTA EL MOMENTO DEL PARTO
Remove the animals from the house Fair sortir les animaux de la maison | Sacar los animales de la casa
Clean the house Nettoyer la maison | Limpiar la casa
46
Call the midwife Appeler la sage-femme Avisar a la partera (matrona)
Empirical midwife comes to the house Sage-femme empirique vient la maison Partera emprica que acude al domicilio
Evaluate fetal position Valorer la position fetale | Valorar la posicin fetal

47
Control uterine contractions Contrler les contractions uterines Controlar las contracciones uterinas
Ask the woman to urinate and defecate Demander la femme duriner et evaquer Pedir a la mujer que orine y evacue
Advise the woman to wash herself Conseiller la femme de se laver Aconsejar a la mujer una buena higiene personal
48
GETTING READY FOR THE DELIVERY PREPARATION POUR LE MOMENT LE LACCOUCHEMENT PREPARACIN PARA EL MOMENTO DEL PARTO
Wash your hands Se laver les mains | Lavado de manos
Prepare the material on the table covered with a clean sheat Prparer le matriel ncessaire sur la table, avec un drap propre, repass ou sech au soleil | Preparacin del material necesario sobre la mesa, con un mantel limpio y planchado o secado al sol

49
Boil the material Boullir le matriel | Hervir el material que se va a utilizar
Empty the water Vider leau | Vaciar el agua
Cover the material until needed Couvrir le materiel jusqau moment ou ce soit necessaire Dejar tapado el instrumental hasta el momento que se necesite
50
The woman must be comfortable, lying on the side La parturiente doit tre comfortable, allonge de ct | La embarazada permanece en la posicin ms cmoda, no en decbito supino
Wait until the delivery without touching Attendre la sortie du bb sans ne rien toucher Esperar la salida del nio sin tocar nada

51
DURING THE DELIVERY YOU MUST PENDANT LACCOUCHEMENT IL FAUT DURANTE EL PARTO SE DEBE
Listen to the babys heart Controler les bruits du coeur | Controlar los latidos del corazn del feto
Control the rupture of the membranes and the color of the fluid Controler la sortie des eaux et son couleur Controlar la salida de las aguas y su color
Control the contractions Controler le ritme des contractions Controlar el ritmo de las contracciones
52
Control de babys head before it comes out Controler la tte du bb avant sa sortie Controlar el abombamiento de la cabeza antes de la salida
Control the heart rate, blood presure and temperature Controler la frequence cardiaque, la pression et la temperature Controlar las constantes vitales

53
DEVELOPMENT OF NORMAL CHILDBIRTH EVOLUTION DE LACCOUCHEMENT NORMAL EVOLUCIN DEL PARTO NORMAL
54
ASSISTANCE TO THE DELIVERY ASSISTANCE LEXPULSIF ATENCIN AL PERIODO EXPULSIVO

Ask the woman to push when she feels pain Demander la femme de pousser quand elle a mal Pedir a la embarazada que empuje cuando tenga dolor
Ask the woman to breathe when she does not feel pain Demander la femme de respirer que elle na pas mal Pedir a la mujer que respire cuando no tenga dolor

55
Avoid vaginal exam until you see the babys head Attendre voir la tte du bb sans toucher le vagin Esperar a ver la cabeza del feto, sin efectuar tacto vaginal
u
Help the baby to come out Aider la sortie du bb quan la tte apparat Puede facilitar la salida del nio cuando se ve que abulta su cabeza
56
Protect the perineum when the head is coming out Proteger le prin quand la tte bombe Proteger el perin cuando la cabeza est a punto de salir

57
Avoid the head to come out very fast Eviter que la tte sorte trop vite Evitar que la cabeza salga muy deprisa
When the head is out, clean the babys mouth and nose Quand la tte est sortie, nettoyer la bouche et le nez du bb Cuando ha salido la cabeza, limpiar la boca y la nariz del beb
58
Grasp the baby under the arms Prendre le bb sous ses bras Coger al nio por las axilas
Grasp the baby when then buttock is coming out Tenir le bb quand les fesses sortent Sujetarlo cuando salen las nalgas
Put the baby on a table covered with a clean sheet at the height of the mother Mettre le bb sur un drap proper, de ct et au mme niveau que la mre | Poner al nio sobre una sbana limpia, de lado y al mismo nivel que la madre

59
Tie and cut the cord when the hearts stops beating with suture and sterile instruments Nouer et couper le cordon avec des fils et des instruments | Ligar y cortar el cordn cuando deje de latir con hilos y utensilios estriles
Different ways to cut the umbilical cord Differentes faons de couper le cordon Diferentes formas de cortar el cordn umbilical
60
CORD AROUND THE NECK CORDON AU TOUR DU COU CORDN ENROLLADO EN EL CUELLO DEL NIO
Cautiosly unroll the cord Drouler au tour du cou Desenrollarlo con mucho cuidado
If not possible, ligate it in two places and cut it Si on ne russit pas, le lier en deux endroits et couper au milieu Si no se consigue: atarlo por dos partes y cortarlo entre ellas

61
ASSISTANCE TO THE NEWBORN ASSISTANCE AU NOUVEAU N ATENCIN AL RECIN NACIDO

Once the baby is born: clean secretions from the nose and mouth Une fois le bb est n: nettoyer les secretions du nez et la bouche Una vez nacido el nio: limpiar las mucosidades de su nariz y boca
If necessary, aspirate secretions Si ncssaire, aspirer les secretions Si es necesario, utilizar una pera de goma para aspirar las secreciones
Put colirium in the eyes Mettre du colirium aux yeux | Poner colirio en los ojos
62
If you dont have colirium, aput lemon drops Si on na pas de colirium, mettez des gotes de citron Si no se tiene colirio, poner unas gotas de limn
PLACENTA EXPULSION DLIVRANCE DU PLACENTA EXPULSIN DE LA PLACENTA

63
Make sure the placenta is complete If faut sassurer que le placenta soit sorti compltement Hay que revisar la placenta controlando que est toda completa
If a cotyledon is missing, transfer to the hospital Sil manque un cotiledon, il faut aller lhpital Si falta algn cotiledn hay que derivar al hospital
64
RISK DELIVERY ACCOUCHEMENT RISQUE PARTO DE RIESGO

Assistance to breech delivery. If possible transfer to patient Assistance laccouchement de sige. Si possible, il vaut mieux transfrer la patiente lhpital Atencin al parto de nalgas. Siempre que se pueda hay que derivarlo al hospital
Pure breech presentation Prsentation de sige pure | Presentacin nalgas puras
Complete breech Sige complet | Presentacin nalgas completas

65
Different maneuvers Differente maneuvers | Maniobras diferentes
Manual extraction of the body Extraction manuelle du corps | Extraccin manual del cuerpo
Manual assistance Aide manuelle | Ayuda manual
66
Arm extraction Extraction des bras | Extraccin de los brazos
Head extraction Extraction de la tte | Extraccin de la cabeza

67
DELIVERY COMPLICATIONS THAT SHOULD BE TRANSFERED TO THE HOSPITAL COMPLICATIONS DE LACCOUCHEMENT QUI DOIVENT TRES TRANSFERES LHPITAL COMPLICACIONES DEL PARTO QUE DEBEN REMETIRSE AL HOSPITAL
Heavy bleeding Saignement abondant Sangrado abundante
Prolonged delivery Acouchement prolong Parto prolongado
68
Fetal distress Troubles de rythme | Sufrimiento fetal

FHR BCF FCF 160
120
Transverse presentation Prsentation transverse | Presentacin transversa
Breech presentation Prsentation de sige | Presentacin de nalgas o podlicas

69
Sickness of the mother Mauvais tat gnral de la mre | Mal estado general de la madre
Toxemia | Toxemie | Toxemia
Eclampsia. Convulsing woman Eclampsie. Femme convulsionant Eclampsia. Mujer comvulsionando
Prolapse of the umbilical cord Prolapsus du cordon | Prolapso de cordn
PUERPERIUM FOLLOW UP CONTRLE ET ASSISTANCE DU PUERPERIUM CONTROL Y CUIDADOS DEL PUERPERIO

L. Francs Ribera
PUERPERIUM FOLLOW UP
CONTRLE ET ASSISTANCE DU PUERPERIUM | CONTROL Y CUIDADOS DEL PUERPERIO
73
PUERPERIUM DEFINITION DEFINITION DE PUERPERIUM DEFINICIN DE PUERPERIO
74
PUERPERIUM STAGES TAPES DE PUERPERIUM ETAPAS DEL PUERPERIO

Inmediate puerperium (24 hours) Puerperium inmdiat (primires 24 heures) Puerperio inmediato (primeras 24 horas)
Early puerperium (from 2nd to 10th day) Puerperium prcoce (du 2me au 10me jour) Puerperio precoz (del 2.o al 10.o da)
75
Late puerperium (from the 10th day till 6 -7 weeks) Puerperium tardif (du 10me jour aux 6 -7 semaines) Puerperio tardo (del 10.o da a las 6 -7 semanas postparto)
EVALUATION OF UTERINE INVOLUTION EVALUATION DE LINVOLUTION UTERINE VALORACIN DE LA INVOLUCIN UTERINA

Control uterine height (uterine involution) Contrler lhauteur uterine (involution utrine) Controlar la altura uterina (involucin uterina) Verify uterine tonic contraction Contrler le ton utrin Controlar el tono del tero
76
EVALUATION OF THE BLOOD LOSS VALORATION DE LA PERTE DE SANG VALORACIN DE LA PRDIDA HEMTICA
Quantity control Contrle de la quantit | Control de la cantidad
500 ml
u
500 ml
Smell control Contrle de lodeur | Control del olor
77
EVALUATION OF THE WELLBING OF MOTHER AND CHILD VALORATION DE LTAT GNRAL DE LA MRE ET DU BB VALORACIN DEL ESTADO GENERAL DE LA MADRE Y DEL BEB
Vital signs control Contrle des signes vitaux | Control de constantes vitales
Daily care of the umbilical cord Soins du cordon ombilical tous les jours | Cura diaria del cordn umbilical
78
PUERPERIUM ASSISTANCE ASSISTANCE AU PUERPERIUM ATENCIN DURANTE EL PUERPERIO

High fluid intake Ingestion dabondants fluides | Ingesta de abundantes lquidos
Varied and regular diet Rgime vari et abondant | Comida variada y abundante
79
Help mothers rest Aider le repos | Facilitar el descanso
Adequate genital and personal care Correcte hygiene gnitale et personelle | Correcta higiene genital y personal
80
PERINEUM EVALUATION VALORATION DU PRIN VALORACIN DEL PERIN

Normal episiotomies Episiotomies normales Episiotomas normales In case of inflammation, use cold pads En cas dinflamation, utiliser des compresses froides Si inflamacin, poner compresas fras
Vulvoperineal hematoma Hmatome vulvo-prinal | Hematoma vulvo-perineal
81
Perineal tears Dchirure prineales | Desgarros vulvo-perineales
Rh ISOINMUNISATION ISOINMUNISATION Rh ISOINMUNIZACIN Rh

Administer Anti D Gammaglobulin in case the mother is Rh2 and the newborn Rh1 Administrer Gammaglobuline Anti D si la mre est Rh2 et le bb Rh1 Administrar Gammaglobulina Anti D si la madre es Rh2 y el recin nacido Rh1
82
PUERPERAL COMPLICATIONS THAT MUST BE TRANSFERED TO THE HOSPITAL COMPLICATIONS DU PUERPERIUM QUI DOIVENT TRE TRANSFRES LHPITAL COMPLICACIONES DEL PUERPERIO QUE DEBEN REMITIRSE AL HOSPITAL
Transfer to health care centre or hospital in case of: PUERPERAL FEVER Transfer au centre de sant ou lhpital en cas de: FIVRE PUERPERALE Trasladar al Centro de Salud o al Hospital en caso de que la mujer presente: FIEBRE PUERPERAL
Puerperal fever Fivre puerperale Fiebre y escalofros
Stinky discharge Pertes de mauvaise odeur Flujo maloliente
83
Abdominal pain Maux de ventre | Dolor en el vientre
Heavy bleeding Saignement abondant | Sangrado abundante
Important perineal tears Dchirures prineax importants | Desgarros vulvo-perineales importantes
84
ALARM SIGNS THAT NEED CONSULTATION SIGNES DALARME QUI PRCISENT CONSULTATION SIGNOS DE ALARMA QUE PRECISAN CONSULTA
Swollen episiotomy Inflamation de lepisiotomie | Inflamacin de la episiotoma
Breast lumps, inflamation or nipple scars Nodules mamaires, inflamation ou grites Bultos en las mamas, inflamacin o grietas en los pezones
Mastitis Mastite | Mastitis
85
Fever Fivre | Fiebre
Women with low milk production Femmes avec petit production de lait | Mujeres con poca leche
Flebitis Phlebite | Flebitis
86
Varicous venis Varices | Varices
Edema Edmes | Edemas
Depression Depression | Depresin
NEWBORN CARE SOINS DU NOUVEAU N CUIDADOS DEL RECIN NACIDO

M. T. Torres Costa
NEWBORN CARE
SOINS DU NOUVEAU N | CUIDADOS DEL RECIN NACIDO
89
FIRST AID PREMIERS SOINS PRIMEROS AUXILIOS

Wash your hands before touching the baby Se laver les mains avant le contact avec le bb Lavarse las manos antes del contacto con el recin nacido
Reanimation of the depressed newborn Ranimation du bb qui nat dprim Reanimacin de recin nacido que nace deprimido
90
IF THE BABY DOES NOT BREATHE SPONTANEOUSLY SI LENFANT NE RESPIRE PAS SPONTANMENT SI EL NIO NO RESPIRA ESPONTNEAMENTE
The level of the head must be below the rest of the body. Bend the legs towards the chest Il faut que la tte soit plus basse que le corps. Flexioner les jambes sur la poitrine | Hay que ponerlo con la cabeza ms baja que el cuerpo. Flexionando las piernas sobre su pecho
Pull the legs several times until normal breathing Allongez les jambes plusieurs fois jusq ce quil respire normalement Luego hay que estirar las piernas varias veces hasta que respire normalmente
NEWBORN CARE
91
IN CASE OF LOW WEIGHT EN CAS DE POIDS DIMINU SI PRESENTA BAJO PESO

Infavour skin-to-skin contact Favoriser le contacte entre la peau de la mre et du bb Favorecer el contacto piel con piel
Infavour the kangaroo method Favoriser la mtode maman kangaroo Favorecer el mtodo de la mama canguro
Daily care of the umbilical cord Faire les soins du cordon tous les jours Se ha de realizar cura diaria del cordn
92
Identify the newborn Identifier le nouveau n Identificacin del recin nacido
Weight the newborn Peser le nouveau n Pesar al recin nacido
Measure Mesurer Medir
Wash the baby with warm water Laver le nouveau n leau tide Lavar al recin nacido con agua tibia
Dress the baby and avoid cold Habiller le bb et viter le froid | Vestir al nio y abrigarlo
NEWBORN CARE
93
HOME ASSISTANCE ATTENTION DOMICILE ATENCIN DOMICILIARIA

Visit the newborn 10 days after delivery Faire une visite au nouveau n 10 jours aprs lacouchement | Se realizar una visita al recin nacido en el domicilio a los 10 das despus del parto
Evaluate the house and all thats around the baby Evaluer la maison et lentour du bb | Valorar la vivienda y el entorno del nio
94
Evaluate and advice the mother about: Evaluer et orienter la mere sur: | Valorar y orientar a la madre sobre:
Babys nutrition Nutrition du bb Nutricin del nio
Evaluate and advice the mother about the babys hygiene Evaluer et orienter la mere sur lhigine du bb Valorar y orientar a la madre sobre la higiene del beb
How to take care of the cord Comment faire les soins du cordon Como se realiza la cura del cordn
NEWBORN CARE
95
The bath Le bain El bao
Babys clothes Les vtements du bb La ropa del beb
PERIODICAL CONTROL OF THE BABY IN CONSULTATION CONTRLE PRIODIQUE DU BB EN CONSULTE CONTROL PERIDICO DEL NIO EN LA CONSULTA
1. 15 days | 15 jours | 15 das 2. 1 month | 1 mois | 1 mes 3. 2 months | 2 mois | 2 meses 4. 4 months | 4 mois | 4 meses 5. 6 months | 6 mois | 6 meses 6. 9 months | 9 mois | 9 meses 7. 12 months | 12 mois | 12 meses
First year Premire anne Primer ao
96
15 days check-up Contrle aux 15 jours | Control a los 15 das
Weigh Peser | Pesar
NEWBORN CARE
97
Measure Mesurer Medir
Measure perimeters Mesurer primetres Medir permetros
At 2, 4 and 6 months: general control and vaccination Aux 2, 4 et 6 mois: crontrle general et vaccines A los 2, 4 y 6 meses control general y vacunas
Nutrition control Contrler la nutrition | Controlar la nutricin
98
8. 15 months | 15 mois | 15 meses 9. 18 months | 18 mois | 18 meses 10. 2 years | 2 anes | 2 aos 11. 4 years | 4 anes | 4 aos
Second year Deuxime anne Segundo ao
Weigh and measure Peser et mesurer | Pesar y medir
15 month: vaccination and at 4, 6 years Vaccins: 15 mois et aux 4, 6 ans Vacunas: 15 meses y a los 4, 6 aos
Feeding control Control dalimentation Control de la alimentacin
Mouth health control Control de sant bucale Controlar la salud bucodental
NEWBORN CARE
99
VACCINATION SCHEDULE SCHMA DE VACCINES CUADRO DE VACUNACIONES

Age of vaccine administration Age dadministration des vaccines | Edad de administracin de las vacunas
an rs | s| Ea 11 13 c -12 -14 Ca h 1 da 0 y a a ns os 10 ear | a s | 1 3 os -14 Ch aq a ue os 10 an s
ese s
ese s
ese s
ese s
ese s
15 m
18 m
2m
4m
6m
is |
is |
4a
s| an rs | yea -12 11
4-6 11 13
ois
ois
ois
mo
mo
2m
4m
6m
15
18
s|
s|
4a
rs |
4-6
ns
nth
nth
rs |
ths
ths
ths
mo
mo
on
on
on
yea
2m
4m
6m
DTPa VIP VHB Hib MCC TV Td VHA 1 B Chickenpox Varicelle Varicela
uuu u u uuu u uuu uuu u u uu u u uu u u
15
18
4-6
4y
-14
ea
yea
-12
a os
100
PSICOMOTOR DEVELOPMENT DVELOPPEMENT PSICOMOTEUR DESARROLLO PSICOMOTOR

Newborn Nouveau n | Recin nacido
One month of life Un mois de vie | Un mes de vida
NEWBORN CARE
101
2 months 2 mois | 2 meses
102
NEWBORN CARE
103
104
3 years 3 ans | 3 aos
NEWBORN CARE
105
CHILDS DEVELOPMENT DVELOPPEMENT DE LENFANT DESARROLLO DEL NIO

0 to 3 months 0 3 mois | De 0 a 3 meses
Kick legs vigorously | Il gigote vigoureusement | Palalea vigorosamenle Show startle reex by noise | Il est fait sursauter par un bruit | Se sobresalta con un ruido Follow by sight | Il suit les objets avec le regard | Sigue con la mirada Lift their head | Il commence soulever la tte | Levanta la cabeza Look around for sounds by sight | Il est attentif aux bruits et les suive | Busca sonidos con la mirada Recognize their mother | Il reconnait sa mre | Reconoce a su madre

Hold their head steady by sitting | Il tient sa tte assis | Sostiene la cabeza sentado Grasp objects voluntarily | Il prend des objets a volont | Agarra objetos voluntariamente Pronounce four or more different sounds | Il prononce 4 o plus sons differents | Pronuncia 4 o ms sonidos diferentes Accept and grasps toys | Il accepte et attrape des jouets | Acepta y agarra juguetes
106

Seat without support | Il se tient assis seul | Se sienta solo sin ayuda Grasp objects using nger | Il tient des objets avec les doits | Agarra un objeto con los dedos Pronounce one word | Il prononce quelque mot | Pronuncia una palabra Imitate applauses | Il imite les applaudissements | Imita los aplausos

Crawl | Il marche quatre pattes | Gatea Look for hidden objects | Il cherche des objets cachs | Busca objetos escondidos Shake ones head | Il dit non avec la tte | Niega con Ia cabeza Drink from a cup alone | Il prend seul une tasse | Toma la taza solo

Walk alone | Il marche autonome | Camina solo Turn pages of a book | Il tourne la page dun livre | Pasa hojas de un libro Combine two words | Il utilise 2 mots ensemble | Combina 2 palabras Point to two body parts | Il identifie deux parties de son corps | Seala 2 partes de su cuerpo

Kick the ball | Il joue avec le ballon | Patea la pelota Scribble | Il dessine, il griffonne | Hace garabatos Name ve objects | Il nomme 5 objets | Nombra 5 objetos Control their urine during the day | Il contrle son urine au cours de la journe | Controla en el da su orina
NEWBORN CARE
107
Children (boys) from 0 to 27 months Enfants (garons) de 0 a 27 mois Nios de 0 a 27 meses

Weight |Poids | Peso Height |Hauteur | Talla
cm 100 16 34 90 32 30 28 26 10 24 22 20 18 8 16 7 14 6 12 10 8 6 4 5 4 3 2 3 11 10 9 15 96 92 88 84 80 76 72 68 64 12 60 56 52 48 0 3 6 9 12 15 18 21 24 27 Months | Mois | Meses
97 90 75 50 25 10 3
kg 17 97
36
75 14 50 13 35
Cranial circumference Circonference craneale en garons Circumferencia craneal en nios

64 62 60 58 56 54 52 50 48 46 44 42 40 38 36 34 32 30 24 23 22 21 20 19 18 17 16 15 14 13 12 2 4 6 8 10 12 14 16 18
12 15 18 21 24 27
2 4 6 8 10 12 14 16 18
Months | Mois | Meses
Years | Annes | Aos
108
Children (girls) from 0 to 27 months Filles de 0 a 27 mois Nias de 0 a 27 meses

Weight |Poids | Peso
97
kg 17 16
Height |Hauteur | Talla

cm 100 96 92 88 84 80 76 72 68 64 60 56 52 48
97 90 75 50 25 10 3
36 34
80 32 30 50 28 26 24 22 20 18 25 75
15 14 13 12
11 11 3 10 9 8
9 12 15 18 21 24 27 Months | Mois | Meses
16 7 14 6 12 10 8 6 4 5 4 3 2
Cranial circumference Circonference craneale en lles Circumferencia craneal en nias

64 62 60 58 56 54 52 50 48 46 44 42 40 38 36 34 32 30 24 23 22 21 20 19 18 17 16 15 14 13 12 2 4 6 8 10 12 14 16 18
12 15 18 21 24 27
2 4 6 8 10 12 14 16 18
Years | Annes | Aos
NEWBORN CARE
109
Children (boys) from 2 to 12 years Enfants (garons) de 2 a 12 ans Nios de 2 a 12 aos
cm 170 160 150 140 130 120 110 100 90 80 Age in years Age en annes Edad en aos kg 40 35 30 25 20 15 10
cm
Height Hauteur Talla
97 90 75 160 50 25 150 10 3 140

130
170
9 8 7 6 5 4 3
Weight Poids Peso
12 11 10
97 90
kg 65 60 55
75 50
50 45 40
25 10 35 3
30 25 20 15 10
110
Children (girls) from 2 to 12 years Filles de 2 a 12 ans Nias de 2 a 12 aos

cm 170 160 150 140 130 120 110 100 90 80 Age in years Age en annes Edad en aos kg 40 35 30 25 20 15 10 cm 170 160 150 140 130
Height Hauteur Talla
97 90 75 50 25 10 3
9 8 7 6 5 4 3
Weight Poids Peso
12 11 10
97 90
kg 65 60 55 50 45 40 35
75 50 25 10 3
30 25 20 15 10
NEWBORN CARE
111
ALARM SIGNS SIGNES DALARME SIGNOS DE ALARMA
Go to the healthcare centre if the baby is: Aller lhpital ou centre de sant si le bb est: Ir al hospital o centro de salud si el nio est:
Depressed Deprim Deprimido
In case of rigidity Si il prsente une rigidit Si presenta rigidez
112
Malnutrition Malnutrition | Desnutricin
Diarrea Diarre | Diarrea
Control the weigh curve Contrler la curve de poids Controlar la curva de peso
Vomiting Vomissements | Vmitos
Fever Fivre | Fiebre
BREASTFEEDING ALLAITEMENT MATERNEL LACTANCIA MATERNA

L. Colell Pallars
BREASTFEEDING
ALLAITEMENT MATERNEL | LACTANCIA MATERNA
115
BREASTFEEDING ALLAITEMENT MATERNEL LACTANCIA MATERNA

Mamary gland Glande mammaire Glndula mamaria
Areola Arole Arola
Enhance early beginning Aider le dbut prcoce Fomentar el inicio precoz
Galactophoric ducts Conductes galactophores Conductos galactferos
Nipe Mamelon Pezn
Midwife and nurse support of breasfeeding Support de la sage-femme ou linfermire pour le soutien de lallaitement Soporte de la matrona o enfermera para el mantenimiento de la lactancia materna
116
Brest evaluation Valoration des seins | Valoracin de las mamas
Breast care Soin des seins | Cuidados de las mamas

Previous massage | Massage pralable | Masaje previo
Circular massage Massage circulaire Masaje circular
Nipple stimulation Stimulation de larole Estimulacin del pezn
Help the milk coming out Facilitier la sortie du lait Facilitar la salida de leche
BREASTFEEDING
117
Positions for breastfeeding Positions pour lallaitement Posiciones para la lactancia materna
118
Ways to extract milk Formes dextraction du lait Formas de extraccin de la leche

Manual extraction | Extraction manuelle | Extraccin manual
Articial extraction | Extraction artificielle | Extraccin articial
BREASTFEEDING
119
Recomendations Recomendations | Recomendaciones

Lasting and frequency of breastfeeding Duration et frquence dallaitement Duracin y frecuencia de las mamadas
Prevention of breastfeeding problems Prevention des problmes lis lallaitement Prevencin de los problemas relativos a la lactancia
120
MOST FREQUENT PROBLEMS PROBLMES LES PLUS FRQUENTS PROBLEMAS MS COMUNES
Chap Fisures Grietas
Ingurgitation Ingurgitation Ingurgitacin
Mastitis Mastite Mastitis
Flat nipple Mamelon plan Pezn plano
Inverted nipple Mamelon invers Pezn invertido
Women with shortage of milk | Femmes avec peu de lait | Mujeres con poca leche
BREASTFEEDING
121
Recommendations Recomendations | Recomendaciones

Adequately place the baby Placer lenfant correctement Colocacin correcta del nio Local warming Chaleur Calor
Manual extraction Extraction manuelle Extraccin manual de la leche
122
Manual expression of the nipple Expression manuelle du mamelon Expresin manual del pezn
Transfer to health centre or hospital Transfert un centre de sant ou hpital Traslado al centro de salud u hospital
If fever Si fivre Si ebre
BREASTFEEDING
123
ARTIFICIAL BREASTFEEDING ALLAITEMENT ARTIFICIEL LACTANCIA ARTIFICIAL

Babys bottle preparation Prparation du biberon | Preparacin del bibern
124
FAMILY PLANNING Contraceptive methods PLANIFICATION FAMILIALE Mthodes contraceptives PLANIFICACIN FAMILIAR Mtodos contraceptivos
A. Cano Parellada
FAMILY PLANNING. Contraceptive methods

PLANIFICATION FAMILIALE. Mthodes contraceptives | PLANIFICACIN FAMILIAR. Mtodos contraceptivos
127
PRIMITIVE METHODS MTHODES PRIMITIFS MTODOS PRIMITIVOS

Lengthy breastfeeding Allaitement prolonge Lactancia materna prolongada Coitus interruptus Interruption du coitus Marcha atrs
128
NATURAL METHODS MTHODES NATURELS MTODOS NATURALES

Ogino-Knaus Ogino-Knaus | Ogino-Knaus
14
21
28 1
Basal temperature Temprature basale Temperatura basal
Cervical mucus or Billing Mucus cervical Moco cervical o Billing
e
e
C ? ? ? ? ? ? ? ? ? ? ?

129
Sintotermical (basal temperature 1 cervical mucus) Sintotermique (temprature basale 1 mucus cervical) Sintotrmico (Temperatura basal 1 Moco cervical)
130
BARRIER METHODS MTHODES DE BARRIRE MTODOS DE BARRERA

Spermicides: creams and ovules Spermicides: crmes et ovules Espermicidas: cremas y vulos Diafragm Diafragme Diafragma
Male preservatif (condom) Prservatif masculin (capote) | Preservativo masculino (condn)

131
Female preservatif Prservatif fminin | Preservativo femenino
HORMONAL HORMONAUX HORMONALES

Injectables: Monthly or Trimestrally Injectables: Mensuel ou Trimestrel | Inyectables: Mensual o Trimestral
132
Oral: Monophasic or Triphasic Oraux: Monophasique ou Triphasique | Orales: Monofsico o Trifsico
Cutaneous Cutans | Cutneos: Parches cutneos
Subcutaneous implants Implant souscutans | Implantes sub-cutneos
Intravaginal: Vaginal ring Intravaginal: Anneu vaginal | Intravaginales: Aro o Anillo vaginal

133
INTRAUTERINE DEVICE (IUD) DISPOSITIF INTRAUTRIN (DIU OU STRILET) DISPOSITIVO INTRA-UTERINO (DIU O ESTERILETE)
SURGICAL CHIRURGICALES QUIRRGICOS

Tubal ligation (female sterilisation) Ligature tubaire (strilisation fminine) | Ligadura tubrica (esterilizacin femenina)
Vasectomy Vasectomie | Vasectoma
SEXUALLY TRANSMITTED DISEASES MALADIES DE TRANSMISSION SEXUELLE ENFERMEDADES DE TRANSMISIN SEXUAL

M. D. Bast Portabella
SEXUALLY TRANSMITTED DISEASES

MALADIES DE TRANSMISSION SEXUELLE | ENFERMEDADES DE TRANSMISIN SEXUAL
137
GENITAL CONDILOMAS (WARTS) CONDILOME GNITAUX (VERRUES) CONDILOMAS GENITALES (VERRUGAS)
GENITAL CANDIDIASIS CANDIDIASE GNITALE CANDIDIASIS GENITAL

Symptoms: itch, white discharge Symptmes: demangesons, scretion blanchatre Sntomas: picor, flujo en requesn
138
GONORREA GONORRHE GONOCOCIA

Symptoms Symptmes | Sntomas
Leaking Supuration Supuracin Painful urination Douleur la miction Dolor al orinar
Vaginal discharge Scretion abondante Flujo abundante
Signs of oral infection Signes dinfection bucale Signos de infeccin en la boca
Blindness Ccit Ceguera Neonatal conjuntivitis Conjuntivite du nouveau n Conjuntivitis del R.N.

139
INGUINAL GRANULOMA GRANULOME INGUINAL GRANULOMA INGUINAL
140
HEPATITIS B HPATITE B HEPATITIS B

Intrabdominal uid Liquide dans le ventre Aumento del lquido del vientre Jaundice Jaunisse Ictericia. Coloracin amarillenta
Preterm labor Prmaturit Prematuridad
Tiredness Fatigue Cansancio
Preventive methods Mesures prventives | Medidas especficas de prevencin

141
GENITAL HERPES HERPES GNITAL HERPES GENITAL
Itch Dmangeaison Escozor y picor
Preventive methods Mesures prventives | Medidas especficas de prevencin
142
CLAMYDIA INFECTION CLAMYDIASE CLAMIDIASIS
Itch Dmangesons Escozor y picor
Neonatal conjuntivitis Conjuntivite du nouveau n Conjuntivitis del R.N.
Prematurity Prmaturit Prematuridad

143
GARDNERELLA GARDNERELLA GARDNERELLA
MYCOPLASMA MYCOPLASMA MYCOPLASMA
Disuria Disurie Disuria Bartholinitis Bartholinite Bartholinitis
Discharge Fluxe Flujo
144
Preterm labour Prmaturit Prematuridad
VENEREAL LYMPHOGRANULOMA LYMPHOGRANULOME LINFOGRANULOMA VENREO
Chancre Chancre Chancro
Vulvar edema Edme vulvaire Edema vulvar

145
PUBIC PEDICULOSIS PDICULOSE PUBIENNE PEDICULOSIS PUBIS
146
Preventives methods Mesures prventives | Medidas especficas de prevencin
SCABIES GALE SARNA
Itch Piqueur Picor

147
SYPHILIS SYPHILIS SFILIS
Primary | Primaire | Primaria
Secundary | Secundaire | Secundaria
Tertiary | Tertiaire | Terciaria Blindness Ccit Ceguera
Hydrocephalia Hidrocphal Hidrocefalia
148
TRICOMONIASIS TRICOMONIASE TRICOMONIASIS
Disuria Disurie Disuria
Yellowish discharge Scretion jaunatre Flujo amarillento
Itch Dmangeaison Escozor y picor
Preterm labour Prmaturit Prematuridad

149
HUMAN PAPILOMA VIRUS (HPV) VIRUS DU PAPILOME HUMAIN (VPH) VIRUS DEL PAPILOMA HUMANO (VPH)
150
AIDS SIDA SIDA

151
GENERAL PREVENTIVE METHODS FOR STDS AND AIDS MESURES GNRALES DE PRVENTION DES MTS ET LE SIDA MEDIDAS GENERALES DE PREVENCIN DE LAS ETS Y SIDA

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GRAPHIC TRAINING PROGRAM

BASIC B BA A S IC PERINATAL PE ATAL CARE

ATENCIN PERINATAL B BSICA

BASIC PERINATAL CARE

SOIN PERINATAL DE BASE

ATENCIN PERINATAL BSICA

MATRES MUNDI INTERNATIONAL

Chapter 6. Chapitre 6. Captulo 6.

BREASTFEEDING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 ALLAITEMENT MATERNEL LACTANCIA MATERNA

AIMS OF THE GUIDE

AIMS OF THE GUIDE

AIMS OF THE GUIDE

AIMS OF THE GUIDE

JOS M. CARRERA President of MATRES MUNDI

ANATOMY AND PHISIOLOGY ANATOMIE ET PHISIOLOGIE ANATOMA Y FISIOLOGA

ANATOMY AND PHISIOLOGY

Male reproductive system Appareil reproducteur masculin | Aparato reproductor masculino

Female reproductive system Appareil reproducteur fminin | Aparato reproductor femenino

Labia minora Petites lvres Labios menores

External genitalia | Gnitaux externes | Genitales externos

Fallopian tube Trompe de Phalopium Trompa de Falopio

Ovary | Ovaire | Ovario

Uterus | Uterus | tero Vagina | Vagin | Vagina

Fecondation Fcondation | Fecundacin

Ovule Ovule vulo

Spermatozoid Spermatozode Espermatozoide

ANATOMY AND PHISIOLOGY

Implantation Implantation | Implantacin

c) Blastocyst | Blastocyste Blastocisto

d) Implantation | Implantation Implantacin

Embryo development Dveloppement embrionnaire | Desarrollo embrionario

4 weeks 4 semaines 4 semanas

5 weeks 5 semaines 5 semanas

6 weeks 6 semaines 6 semanas

Embryonary phase 8 weeks 8 semaines Phase embrionnaire 8 semanas Fase embrionaria

Fetal development Dveloppement ftal | Desarrollo fetal

weeks semaines semanas

PREGNANCY FOLLOW UP SUIVIE DE LA GROSSESSE CONTROL DEL EMBARAZO

PREGNANCY DIAGNOSTIC DIAGNOSTIQUE DE GROSSESSE DIAGNSTICO DE EMBARAZO

Signs of probability Signes de probabilit | Signos de probabilidad de embarazo

Confirmation of pregnancy Signes de certitude | Signos de certeza

Blood pressure control Contrle de la pression artrielle | Control de la tensin arterial

Weight control Contrle du poids | Control de peso

Uterine height Contrle de lhauteur uterine | Control de la altura uterina

Fetal position control Contrle de la position fetale | Control de la posicin fetal

2 Position and situation of the fetus

4 Position and actitude

Anemia control Contrle de lanmie | Control de anemia

PROPHILAXIS PROPHILAXIS PROFILAXIS

HIGIENE HIGINE HIGIENE DEL EMBARAZO

Shoes Chaussures | Calzado

Dressing Vtements | Vestido

Rest Repos | Descanso

PHYSICAL EXERCISE EXERCICE EJERCICIO FSICO

Sexuality Sexualit | Sexualidad

Toxic habits Habitudes toxiques | Hbitos txicos

FEEDING DURING PREGNANCY ALIMENTATION PENDANT LA GROSSESSE ALIMENTACIN DURANTE EL EMBARAZO

Carbohidrates Carbohidrats Hidratos de carbono

Proteins Protenes Protenas

Fat Gras Grasas

Vitamins Vitamines Vitaminas

Vegetables Lgumes Hortalizas

Calcium Calcium Calcio

BABYS BAG SAC DU BB CANASTILLA DEL BEB