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 2025-06-24 |
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<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT03.html">ANC.DT.03 Check symptoms and follow up</a></td>
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<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.3.0</td>
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<b>
Official
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<span>ANC.DT.03</span>
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<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.03 Check symptoms and follow up</td>
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<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
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<b>system: </b> <span><a href="http://terminology.hl7.org/6.4.0/CodeSystem-plan-definition-type.html">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>
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<b>code: </b> <span>eca-rule</span>
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<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2025-06-24 13:58:48-0600</td>
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<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">World Health Organization (WHO)</td>
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<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>Depending on current and/or persistant symptoms, physiological symptoms counselling may be required</p>
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<th scope="row"><b>Use Context: </b></th>
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<td style="padding-left: 4px;">001</td>
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<th scope="row"><b>Actions: </b></th>
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<td>
<b> ANC.DT.03 Check symptoms and follow up:</b>
<br/>
<b>When:</b>
<i>Named Event:</i> ANC.B7 Check symptoms and follow up
<br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
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Ginger, chamomile, vitamin B6 and/or acupuncture are recommended for the relief of nausea in early pregnancy, depending on a woman’s preferences and available options. Women should be informed that symptoms of nausea and vomiting usually resolve in the second half of pregnancy.
<br/>
<b>If:</b>
<i>Applicability:</i>
"Current physiological symptoms" = "Nausea and vomiting"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message))</i>
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Pharmacological treatments for nausea and vomiting, such as doxylamine and metoclopramide, should be reserved for those pregnant women experiencing distressing symptoms that are not relieved by non-pharmacological options, under the supervision of a medical doctor
<br/>
<b>If:</b>
<i>Applicability:</i>
"Persistent physiological symptoms" = "Nausea and vomiting"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 2)</i>
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<td>
Advice on diet and lifestyle is recommended to prevent and relieve heartburn in pregnancy. Antacid preparations can be offered to women with troublesome symptoms that are not relieved by lifestyle modification.
<br/>
<b>If:</b>
<i>Applicability:</i>
"Current physiological symptoms" = "Heartburn"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 3)</i>
<br/>
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<td>
Antacid preparations can be offered to women with troublesome symptoms that are not relieved by lifestyle modification. Magnesium carbonate and aluminium hydroxide preparations are probably unlikely to cause harm in recommended dosages.
<br/>
<b>If:</b>
<i>Applicability:</i>
"Persistent physiological symptoms" = "Heartburn"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 4)</i>
<br/>
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<td>
Non-pharmacological therapies, including muscle stretching, relaxation, heat therapy, dorsiflexion of the foot, and massage can be used for the relief of leg cramps in pregnancy
<br/>
<b>If:</b>
<i>Applicability:</i>
"Current physiological symptoms" = "Leg cramps"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 5)</i>
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<td>
If leg cramps are not relieved with non-pharmacological measures, then give 300–360 mg magnesium per day in two or three divided doses; give calcium 1 g twice daily for two weeks
<br/>
<b>If:</b>
<i>Applicability:</i>
"Persistent physiological symptoms" = "Leg cramps"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 6)</i>
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<td>
Regular exercise throughout pregnancy is recommended to prevent low back and pelvic pain. There are a number of different treatment options that can be used, such as physiotherapy, support belts and acupuncture, depending and based on a woman’s preferences and available options.
<br/>
<b>If:</b>
<i>Applicability:</i>
(((("Current physiological symptoms" = "Low back pain")
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OR (("Current physiological symptoms" = "Pelvic pain")
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<i>(Should Conduct counselling on physiological symptoms)</i>
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<b>Then:</b> <i>Additional sub-actions not displayed</i>
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<td>
Dietary modifications to relieve constipation include promoting adequate intake of water and dietary fibre (found in vegetables, nuts, fruits and whole grains)
<br/>
<b>If:</b>
<i>Applicability:</i>
"Current physiological symptoms" = "Constipation"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 7)</i>
<br/>
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<td>
Wheat bran or other fibre supplements can be used to relieve constipation, if dietary modifications are not enough, and if they are available and appropriate
<br/>
<b>If:</b>
<i>Applicability:</i>
"Persistent physiological symptoms" = "Constipation"
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 8)</i>
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<td>
Non-pharmacological options, such as compression stockings, leg elevation and water immersion, can be used for the management of varicose veins and oedema in pregnancy, depending and based on a woman’s preferences and available options
<br/>
<b>If:</b>
<i>Applicability:</i>
(((("Current physiological symptoms" = "Varicose veins")
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OR (("Current physiological symptoms" = "Oedema")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness")))
OR (("Persistent physiological symptoms" = "Varicose veins")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness")))
OR (("Persistent physiological symptoms" = "Oedema")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness"))
<i>(Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 9)</i>
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Please investigate any possible complications or onset of labour, related to low back and pelvic pain
<br/>
<b>If:</b>
<i>Applicability:</i>
((("Current physiological symptoms" = "Contractions")
OR (Current physiological symptoms" = "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))
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<i>(Should Conduct counselling on physiological symptoms 2)</i>
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<b>Then:</b> <i>Additional sub-actions not displayed</i>
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Woman has dysuria – please investigate urinary tract infection and treat if positive
<br/>
<b>If:</b>
<i>Applicability:</i>
("Current physiological symptoms" = "Pain during urination (dysuria)")
OR ("Persistent physiological symptoms" = "Pain during urination (dysuria)")
<i>(Should Conduct laboratory tests and imaging)</i>
<br/>
<b>Then:</b> <i>Additional sub-actions not displayed</i>
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<td>
Please investigate any possible complications, including thrombosis, related to varicose veins and oedema
<br/>
<b>If:</b>
<i>Applicability:</i>
((("Current physiological symptoms" = "Leg pain")
OR ("Current physiological symptoms" = "Leg redness"))
OR ("Persistent physiological symptoms" = "Leg pain"))
OR ("Persistent physiological symptoms" = "Leg redness")
<i>(Should Conduct counselling on physiological symptoms 3)</i>
<br/>
<b>Then:</b> <i>Additional sub-actions not displayed</i>
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Please investigate any possible complications, including thrombosis, related to varicose veins and oedema
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<b>If:</b>
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<i>(Should Follow-up steps/investigations: clinician's discretion)</i>
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<parameter>
<name
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 5"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 6"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct counselling on physiological symptoms 3"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct counselling on physiological symptoms 2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 9"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Should Conduct laboratory tests and imaging"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="encounter"/>
<mustSupport value="encounter.reference"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet value="http://smart.who.int/anc/ValueSet/anc-b7-de43"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="encounter"/>
<mustSupport value="encounter.reference"/>
<mustSupport value="value"/>
<codeFilter>
<path value="code"/>
<valueSet value="http://smart.who.int/anc/ValueSet/anc-b7-de18"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString value="Persistent physiological symptoms"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B7.DE18 Persistent physiological symptoms
@activity: ANC.B7 Symptoms & Follow-up
@description: Which of the following physiological symptoms persist? Select which of the following physiological symptoms persist after being reported during last contact
*/
define "Persistent physiological symptoms":
[Observation: Cx."Persistent physiological symptoms"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
and Last(Split(O.encounter.reference, '/')) = Last(Split(encounter, '/'))
return O.value as FHIR.CodeableConcept"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 3"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Current physiological symptoms" = "Heartburn"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 3":
ContactData."Persistent physiological symptoms" in Cx."Current physiological symptoms - Heartburn Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 4"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Persistent physiological symptoms" = "Heartburn"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 4":
ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Heartburn Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString value="Current physiological symptoms"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B7.DE43 Current physiological symptoms
@activity: ANC.B7 Symptoms & Follow-up
@description: The physiological symptoms that the woman is experiencing right now: select "None" if she is experiencing none of these symptoms
*/
define "Current physiological symptoms":
[Observation: Cx."Current physiological symptoms"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
and Last(Split(O.encounter.reference, '/')) = Last(Split(encounter, '/'))
return O.value as FHIR.CodeableConcept"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms"/>
</extension>
<extension url="statement">
<valueString
value="/*
((("Current physiological symptoms" = "Low back pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))
OR (("Current physiological symptoms" = "Pelvic pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))
OR (("Persistent physiological symptoms" = "Low back pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)")))
OR (("Persistent physiological symptoms" = "Pelvic pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))
*/
define "Should Conduct counselling on physiological symptoms":
(
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Low back Choices"
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Contractions Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - during urination (dysuria) Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Extreme pelvic pain Choices")
) or
(
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Pelvic Choices"
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Contractions Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - during urination (dysuria) Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Extreme pelvic pain Choices")
) or
(
ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Pain - Low back Choices"
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Contractions Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - during urination (dysuria) Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Extreme pelvic pain Choices")
) or
(
ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Pain - Pelvic Choices"
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Contractions Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - during urination (dysuria) Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Extreme pelvic pain Choices")
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Persistent physiological symptoms" = "Nausea and vomiting"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 2":
ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Nausea and Vomiting Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 7"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Current physiological symptoms" = "Constipation"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 7":
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Constipation Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Follow-up steps/investigations: clinician's discretion"/>
</extension>
<extension url="statement">
<valueString
value="/*
((((((((((((((((((("Current physiological symptoms" = "Abnormal vaginal discharge")
OR ("Current physiological symptoms" = "Breathing difficulty"))
OR ("Current physiological symptoms" = "Breathless during routine activities"))
OR ("Current physiological symptoms" = "Cough lasting more than 3 weeks"))
OR ("Current physiological symptoms" = "Fever"))
OR ("Current physiological symptoms" = "Gets tired easily"))
OR ("Current physiological symptoms" = "Headache"))
OR ("Current physiological symptoms" = "Vaginal bleeding"))
OR ("Current physiological symptoms" = "Vaginal discharge"))
OR ("Current physiological symptoms" = "Visual disturbance"))
OR ("Persistent physiological symptoms" = "Abnormal vaginal discharge"))
OR ("Persistent physiological symptoms" = "Breathing difficulty"))
OR ("Persistent physiological symptoms" = "Breathless during routine activities"))
OR ("Persistent physiological symptoms" = "Cough lasting more than 3 weeks"))
OR ("Persistent physiological symptoms" = "Fever"))
OR ("Persistent physiological symptoms" = "Gets tired easily"))
OR ("Persistent physiological symptoms" = "Headache"))
OR ("Persistent physiological symptoms" = "Vaginal bleeding"))
OR ("Persistent physiological symptoms" = "Vaginal discharge"))
OR ("Persistent physiological symptoms" = "Visual disturbance")
*/
define "Should Follow-up steps/investigations: clinician's discretion":
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Abnormal vaginal discharges Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Breathing difficulty Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Breathless during routine activities Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Cough lasting more than 3 weeks Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Fever Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Gets tired easily Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Headache Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Vaginal bleeding Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Visual disturbance Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Abnormal vaginal discharge Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Breathing difficulty Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Breathless routine activities Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Cough lasting more than 3 weeks Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Fever Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Gets tired easily Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Headache Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Vaginal bleeding Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Visual disturbance Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 8"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Persistent physiological symptoms" = "Constipation"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 8":
ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Constipation Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Current physiological symptoms" = "Nausea and vomiting"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message)":
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Nausea and Vomiting Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 5"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Current physiological symptoms" = "Leg cramps"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 5":
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Leg cramps Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 6"/>
</extension>
<extension url="statement">
<valueString
value="/*
"Persistent physiological symptoms" = "Leg cramps"
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 6":
ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Leg cramps Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms 3"/>
</extension>
<extension url="statement">
<valueString
value="/*
((("Current physiological symptoms" = "Leg pain")
OR ("Current physiological symptoms" = "Leg redness"))
OR ("Persistent physiological symptoms" = "Leg pain"))
OR ("Persistent physiological symptoms" = "Leg redness")
*/
define "Should Conduct counselling on physiological symptoms 3":
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Leg Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Leg redness Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Pain - Leg Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Leg redness Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
((("Current physiological symptoms" = "Contractions")
OR (Current physiological symptoms" = "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))
OR ("Persistent physiological symptoms" = "Contractions"))
OR (Persistent physiological symptoms" = "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)")
*/
define "Should Conduct counselling on physiological symptoms 2":
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Contractions Choices"
or ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Extreme pelvic pain Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Contractions Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Pain - Extreme pelvic pain Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 9"/>
</extension>
<extension url="statement">
<valueString
value="/*
(((("Current physiological symptoms" = "Varicose veins")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness"))
OR (("Current physiological symptoms" = "Oedema")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness")))
OR (("Persistent physiological symptoms" = "Varicose veins")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness")))
OR (("Persistent physiological symptoms" = "Oedema")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness"))
*/
define "Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 9":
(
(ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Varicose veins Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Leg Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Leg redness Choices")
)
or (
(ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Oedema Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Leg Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Leg redness Choices")
)
or (
(ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Varicose veins Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Leg Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Leg redness Choices")
)
or (
(ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Oedema Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - Leg Choices")
and not (ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Leg redness Choices")
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT03"/>
</extension>
<extension url="name">
<valueString value="Should Conduct laboratory tests and imaging"/>
</extension>
<extension url="statement">
<valueString
value="/*
("Current physiological symptoms" = "Pain during urination (dysuria)")
OR ("Persistent physiological symptoms" = "Pain during urination (dysuria)")
*/
define "Should Conduct laboratory tests and imaging":
ContactData."Current physiological symptoms" in Cx."Current physiological symptoms - Pain - during urination (dysuria) Choices"
or ContactData."Persistent physiological symptoms" in Cx."Persistent physiological symptoms - Pain - during urination (dysuria) Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="15"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value ObservationStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="16"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToBoolean"/>
</extension>
<extension url="statement">
<valueString
value="define function ToBoolean(value boolean): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="17"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="ModifierExtension"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the single WHO core modifier extension (if present) on the given resource with the specified id.
@comment: This function uses singleton from to ensure that a run-time exception is thrown if there
is more than one extension on the given resource with the specified url.
*/
define function ModifierExtension(domainResource DomainResource, id String):
singleton from ModifierExtensions(domainResource, id)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="18"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="ModifierExtensions"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns any WHO core modifier extensions defined on the given resource with the specified id.
@comment: NOTE: Extensions are not the preferred approach, but are used as a way to access
content that is defined by extensions but not yet surfaced in the
CQL model info.
*/
define function ModifierExtensions(domainResource DomainResource, id String):
domainResource.modifierExtension E
where E.url = ('http://fhir.org/guides/who/core/StructureDefinition/' + id)
return E"/>
</extension>
<extension url="displaySequence">
<valueInteger value="19"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="20"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value string): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="21"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="22"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="23"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements" id="effective-data-requirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
<valueReference>🔗
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<url value="http://smart.who.int/anc/PlanDefinition/ANCDT03"/>
<identifier>
<use value="official"/>
<value value="ANC.DT.03"/>
</identifier>
<version value="0.3.0"/>
<name value="ANCDT03"/>
<title value="ANC.DT.03 Check symptoms and follow up"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="eca-rule"/>
</coding>
</type>
<status value="active"/>
<experimental value="false"/>
<date value="2025-06-24T13:58:48-06:00"/>
<publisher value="World Health Organization (WHO)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.who.int"/>
</telecom>
</contact>
<description
value="Depending on current and/or persistant symptoms, physiological symptoms counselling may be required"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="task"/>
<display value="Workflow Task"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://smart.who.int/anc/CodeSystem/activity-codes"/>
<code value="ANC.B7"/>
<display value="Check symptoms and follow up"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<library value="http://smart.who.int/anc/Library/ANCDT03"/>
<action>
<title value="ANC.DT.03 Check symptoms and follow up"/>
<trigger>
<type value="named-event"/>
<name value="ANC.B7 Check symptoms and follow up"/>
</trigger>
<action id="1">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<textEquivalent
value="Ginger, chamomile, vitamin B6 and/or acupuncture are recommended for the relief of nausea in early pregnancy, depending on a woman’s preferences and available options. Women should be informed that symptoms of nausea and vomiting usually resolve in the second half of pregnancy."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.1. Nausea and vomiting (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Current physiological symptoms" = "Nausea and vomiting""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
</expression>
</condition>
</action>
<action id="2">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 2"/>
<textEquivalent
value="Pharmacological treatments for nausea and vomiting, such as doxylamine and metoclopramide, should be reserved for those pregnant women experiencing distressing symptoms that are not relieved by non-pharmacological options, under the supervision of a medical doctor"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.1. Nausea and vomiting (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Persistent physiological symptoms" = "Nausea and vomiting""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 2"/>
</expression>
</condition>
</action>
<action id="3">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 3"/>
<textEquivalent
value="Advice on diet and lifestyle is recommended to prevent and relieve heartburn in pregnancy. Antacid preparations can be offered to women with troublesome symptoms that are not relieved by lifestyle modification."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.2. Heartburn (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Current physiological symptoms" = "Heartburn""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 3"/>
</expression>
</condition>
</action>
<action id="4">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 4"/>
<textEquivalent
value="Antacid preparations can be offered to women with troublesome symptoms that are not relieved by lifestyle modification. Magnesium carbonate and aluminium hydroxide preparations are probably unlikely to cause harm in recommended dosages."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.2. Heartburn (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Persistent physiological symptoms" = "Heartburn""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 4"/>
</expression>
</condition>
</action>
<action id="5">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 5"/>
<textEquivalent
value="Non-pharmacological therapies, including muscle stretching, relaxation, heat therapy, dorsiflexion of the foot, and massage can be used for the relief of leg cramps in pregnancy"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.3. Leg cramps (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Current physiological symptoms" = "Leg cramps""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 5"/>
</expression>
</condition>
</action>
<action id="6">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 6"/>
<textEquivalent
value="If leg cramps are not relieved with non-pharmacological measures, then give 300–360 mg magnesium per day in two or three divided doses; give calcium 1 g twice daily for two weeks"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.3. Leg cramps (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Persistent physiological symptoms" = "Leg cramps""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 6"/>
</expression>
</condition>
</action>
<action id="7">
<title value="Conduct counselling on physiological symptoms"/>
<description value="Conduct counselling on physiological symptoms"/>
<textEquivalent
value="Regular exercise throughout pregnancy is recommended to prevent low back and pelvic pain. There are a number of different treatment options that can be used, such as physiotherapy, support belts and acupuncture, depending and based on a woman’s preferences and available options."/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.4. Low back and pelvic pain (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="(((("Current physiological symptoms" = "Low back pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))
OR (("Current physiological symptoms" = "Pelvic pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)")))
OR (("Persistent physiological symptoms" = "Low back pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)")))
OR (("Persistent physiological symptoms" = "Pelvic pain")
AND (Current physiological symptoms" ≠ "Contractions" OR "Pain during urination (dysuria)" OR "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms"/>
</expression>
</condition>
<action>
<title value="Conduct counselling on physiological symptoms"/>
</action>
<action>
<title
value="Counselling on regular exercise, physiotherapy, support belts and acupuncture to relieve low back and pelvic pain"/>
</action>
</action>
<action id="8">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 7"/>
<textEquivalent
value="Dietary modifications to relieve constipation include promoting adequate intake of water and dietary fibre (found in vegetables, nuts, fruits and whole grains)"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.5. Constipation (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Current physiological symptoms" = "Constipation""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 7"/>
</expression>
</condition>
</action>
<action id="9">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 8"/>
<textEquivalent
value="Wheat bran or other fibre supplements can be used to relieve constipation, if dietary modifications are not enough, and if they are available and appropriate"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.5. Constipation (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value=""Persistent physiological symptoms" = "Constipation""/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 8"/>
</expression>
</condition>
</action>
<action id="10">
<title
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message)"/>
<description
value="Conduct counselling on physiological symptoms (see Annotations for pop-up message) 9"/>
<textEquivalent
value="Non-pharmacological options, such as compression stockings, leg elevation and water immersion, can be used for the management of varicose veins and oedema in pregnancy, depending and based on a woman’s preferences and available options"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): D.6. Varicose veins and oedema (3)
WHO consolidated self-care interventions guidelines (2019) (4)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="(((("Current physiological symptoms" = "Varicose veins")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness"))
OR (("Current physiological symptoms" = "Oedema")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness")))
OR (("Persistent physiological symptoms" = "Varicose veins")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness")))
OR (("Persistent physiological symptoms" = "Oedema")
AND (Current physiological symptoms" ≠ "Leg pain" OR "Leg redness"))"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms (see Annotations for pop-up message) 9"/>
</expression>
</condition>
</action>
<action id="11">
<title value="Conduct counselling on physiological symptoms"/>
<description value="Conduct counselling on physiological symptoms 2"/>
<textEquivalent
value="Please investigate any possible complications or onset of labour, related to low back and pelvic pain"/>
<documentation>
<type value="citation"/>
<label value="Managing complications guide (IMPAC) (2017): C-3 (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="((("Current physiological symptoms" = "Contractions")
OR (Current physiological symptoms" = "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)"))
OR ("Persistent physiological symptoms" = "Contractions"))
OR (Persistent physiological symptoms" = "Extreme pelvic pain, cannot walk (symphysis pubis dysfunction)")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms 2"/>
</expression>
</condition>
<action>
<title value="Conduct counselling on physiological symptoms"/>
</action>
<action>
<title
value="Investigate any possible complications or onset of labour"/>
</action>
</action>
<action id="12">
<title value="Conduct laboratory tests and imaging"/>
<description value="Conduct laboratory tests and imaging"/>
<textEquivalent
value="Woman has dysuria – please investigate urinary tract infection and treat if positive"/>
<documentation>
<type value="citation"/>
<label
value="Managing complications guide (IMPAC) (2017): S-114 (5)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Current physiological symptoms" = "Pain during urination (dysuria)")
OR ("Persistent physiological symptoms" = "Pain during urination (dysuria)")"/>
<language value="text/cql-identifier"/>
<expression value="Should Conduct laboratory tests and imaging"/>
</expression>
</condition>
<action>
<title value="Conduct laboratory tests and imaging"/>
</action>
<action>
<title value="Urine test required"/>
</action>
</action>
<action id="13">
<title value="Conduct counselling on physiological symptoms"/>
<description value="Conduct counselling on physiological symptoms 3"/>
<textEquivalent
value="Please investigate any possible complications, including thrombosis, related to varicose veins and oedema"/>
<documentation>
<type value="citation"/>
<label
value="Managing complications guide (IMPAC) (2017): S-128 (5)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="((("Current physiological symptoms" = "Leg pain")
OR ("Current physiological symptoms" = "Leg redness"))
OR ("Persistent physiological symptoms" = "Leg pain"))
OR ("Persistent physiological symptoms" = "Leg redness")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct counselling on physiological symptoms 3"/>
</expression>
</condition>
<action>
<title value="Conduct counselling on physiological symptoms"/>
</action>
<action>
<title
value="Investigate any possible complications, including thrombosis, related to varicose veins and oedema"/>
</action>
</action>
<action id="14">
<title value="Follow-up steps/investigations: clinician's discretion"/>
<description
value="Follow-up steps/investigations: clinician's discretion"/>
<textEquivalent
value="Please investigate any possible complications, including thrombosis, related to varicose veins and oedema"/>
<documentation>
<type value="citation"/>
<label value="Managing complications guide (IMPAC) (2017): S-9 (5)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="((((((((((((((((((("Current physiological symptoms" = "Abnormal vaginal discharge")
OR ("Current physiological symptoms" = "Breathing difficulty"))
OR ("Current physiological symptoms" = "Breathless during routine activities"))
OR ("Current physiological symptoms" = "Cough lasting more than 3 weeks"))
OR ("Current physiological symptoms" = "Fever"))
OR ("Current physiological symptoms" = "Gets tired easily"))
OR ("Current physiological symptoms" = "Headache"))
OR ("Current physiological symptoms" = "Vaginal bleeding"))
OR ("Current physiological symptoms" = "Vaginal discharge"))
OR ("Current physiological symptoms" = "Visual disturbance"))
OR ("Persistent physiological symptoms" = "Abnormal vaginal discharge"))
OR ("Persistent physiological symptoms" = "Breathing difficulty"))
OR ("Persistent physiological symptoms" = "Breathless during routine activities"))
OR ("Persistent physiological symptoms" = "Cough lasting more than 3 weeks"))
OR ("Persistent physiological symptoms" = "Fever"))
OR ("Persistent physiological symptoms" = "Gets tired easily"))
OR ("Persistent physiological symptoms" = "Headache"))
OR ("Persistent physiological symptoms" = "Vaginal bleeding"))
OR ("Persistent physiological symptoms" = "Vaginal discharge"))
OR ("Persistent physiological symptoms" = "Visual disturbance")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Follow-up steps/investigations: clinician's discretion"/>
</expression>
</condition>
</action>
</action>
</PlanDefinition>