factors are the following:
her health care provider was not able to detect that she has high blood, her husbands decision of not bringing her immediately to the hospital when she had labor pains, and the doctors in the clinic did not referred her immediately to the hospital when she developed convulsions that lead to the worsening of her condition.


What should have been done:
It was indicated in the case that she had regular antenatal check-ups then it must mean that her condition during her pregnancy should have been monitored closely, but unfortunately the health care team seems to have overlooked her condition of having a high blood. It was a neglect on the part of the health care provider. They should have given her proper antenatal care.

Her husband should have made the right decision of bringing her immediately to the hospital. If he only did that then maybe his wife would still be alive.

Also, it was a neglect on the part of the doctors for not referring her to the hospital when everything about her condition is getting out of hand. If they know that it's getting serious and that they don't have enough resources or the best interventions to help her stay alive, then they should have referred her.

one of the first factor that adds to the reason why amparali died is the decision of the husband to consult in a small clinic which is 8km away from home than to consult in the hospital which is only 5km away. The root cause of this again is poverty, the husband was bothered with the expenses of the possible hospitalization of Amparali.

The second factor is at the prenatal check-up of amparali, why is the risk factor for the high blood pressure not detected at this level? this may boiled down to system, to facilities offered in the prenatal clinic, maybe the health care professionals providing the prenatal care..

The third factor is the referral system of the small clinic of Amparali's case. As a health care delivery system, one should refer someone who is in danger if facilties were not offered in that specific institution.

ok classmates, the possible factors that we may consider in answering the case would be about hypertension in pregnancy... let us consider the possible risk factors like the delays in seeking care in relation to her condition.. can u add up more to the possible risks/explore more about the said risk?

Good evening classmates,

I will be the moderator for our first online discussion tonight. The three (3) case studies uploaded by ma'am nierras will be the topic of our discourse. The case studies have guide questions that will also help us as we go on with the discussion. Kindly follow the instructions below for the message threading.

1. Reply only to this post so that everyone can follow-up with the discussion.
2. Let us tackle one case study at a time.
3. Please follow the guide questions.
4. Everyone is free to react to others' posts.
5. Everyone is free to raise her clarifications/questions to others' post.

That's all. Let us enjoy this discussion.
Here is case one.

Amrapali’s Story

Amrapali was 22 years old and lived with
her husband and in-laws in a small village. She was registered at a health
facility and went regularly for her antenatal check-ups. Her pregnancy
proceeded smoothly until one night, during her ninth month, she developed labor
pains. Though there was a hospital only 5 km away, her husband took her to a
small health clinic, located more than 8 km away, because he feared he would
not be able to meet the expenses at the hospital.

Amrapali gave birth that night, but
immediately after delivery she developed difficulty breathing. The doctor found
that she had very high blood pressure. Soon she developed convulsions, and as
her condition worsened, the doctors referred her to the hospital. After being
admitted to the hospital, Amrapali continued to have convulsions, to the point
that her arms and legs had to be tied to the bed. Her blood pressure continued
to rise. The next morning she could not breathe properly, and she died.

Questions for Students

1. What were the social, economic, and medical
factors that contributed to Amrapali’s death?

2. What should have been done differently in
this case?