WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-anc/ and changes regularly. See the Directory of published versions
| Active as of 2021-06-11 |
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Diagnosis and treatment<br/>\n \n \n <b>Then:</b>\n <table class=\"grid-dict\">\n \n <tr>\n <td>\n Symptom(s) of severe pre-eclampsia! Refer urgently to hospital!\nWoman has hypertension. If she is experiencing a symptom of severe pre-eclampsia, then refer urgently to the hospital for further investigation and management.\n\nProcedure\n– Give magnesium sulphate\n– Give appropriate anti-hypertensives\n– Revise the birth plan\n– Refer urgently to hospital<br/>\n \n <b>If:</b> <i>Applicability:</i> ((((((((((((((((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Severe headache&quot;))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Severe headache&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Blurred vision&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Blurred vision&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Epigastric pain&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Epigastric pain&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Dizziness&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Dizziness&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Vomiting&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Vomiting&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)) <i>(Should Refer urgently to a hospital)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Pre-eclampsia diagnosis! Refer to hospital and revise birth plan.\nWoman has pre-eclampsia – SBP of 140 mmHg or above and/or DBP of 90 mmHg or above and proteinuria 2+ and no symptom of severe pre-eclampsia.\n\nProcedure: \n– Refer to hospital \n– Revise the birth plan<br/>\n \n <b>If:</b> <i>Applicability:</i> (((((((&quot;Systolic blood pressure&quot; ≤ 140 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≤ 140 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;))\n OR ((&quot;Systolic blood pressure&quot; &gt; 160 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; &gt; 160 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))\n OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))\n OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)\n AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))\n OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (90 mmHg – &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))\n OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)\n AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)))\n OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)) <i>(Should Refer urgently to a hospital 2)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman has severe hypertension. If SBP is 160 mmHg or higher and/or DBP is 110 mmHg or higher, then refer urgently to the hospital for further investigation and management.<br/>\n \n <b>If:</b> <i>Applicability:</i> ((((&quot;Systolic blood pressure&quot; ≥ 160 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 160 mmHg)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 110 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 110 mmHg)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;)))\n OR ((&quot;Systolic blood pressure&quot; ≥ 160 mmHg)\n AND (&quot;Repeat systolic blood pressure&quot; ≥ 160 mmHg)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;None&quot;)))\n OR ((&quot;Diastolic blood pressure&quot; ≥ 110 mmHg)\n AND (&quot;Repeat diastolic blood pressure&quot; ≥ 110 mmHg)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;None&quot;)) <i>(Should Refer urgently to a hospital 3)</i><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n Woman has hypertension – SBP of 140 mmHg or higher and/or DBP of 90 mmHg or higher and no proteinuria.\n\nCounselling:\n– Advice to reduce workload and to rest\n– Advise on danger signs\n– Reassess at the next contact or in 1 week if 8 months pregnant\n– If hypertension persists after 1 week or at next contact, refer to hospital or discuss case with the doctor, if available<br/>\n \n <b>If:</b> <i>Applicability:</i> ((((&quot;Existing chronic health conditions&quot; = &quot;Hypertension&quot;)\n OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)\n AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;)))\n OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;)))\n OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)\n AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)\n AND (Urine dipstick result – protein&quot; = &quot;None&quot;)))\n OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)\n AND (&quot;Urine dipstick result – protein&quot; = &quot;None&quot;)) <i>(Should Conduct hypertension counselling)</i><br/>\n \n \n \n </td>\n </tr>\n \n </table>\n \n </td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n </table>\n</div>"
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