Id: |
ANCDT17 |
Url: |
ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis |
Version: |
0.3.0 |
Identifier: |
value: ANC.DT.17
|
Name: |
ANCDT17 |
Title: |
ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis |
Status: |
active |
Experimental: |
false |
Type: |
system: http://terminology.hl7.org/CodeSystem/plan-definition-type
code: eca-rule
|
Date: |
2021-06-11 23:25:04-0600 |
Publisher: |
World Health Organization (WHO) |
Description: |
If the woman presents with any of the following symptoms and/or test results, conduct counselling and referral as needed |
Use Context: |
code | value | display |
task |
ANC.B10.4. |
Diagnosis and treatment |
|
Jurisdiction: |
001 |
Libraries: |
|
Actions: |
ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis:
When: Named Event: ANC.B10.4. Diagnosis and treatment
Then:
Symptom(s) of severe pre-eclampsia! Refer urgently to hospital!
Woman has hypertension. If she is experiencing a symptom of severe pre-eclampsia, then refer urgently to the hospital for further investigation and management.
Procedure
– Give magnesium sulphate
– Give appropriate anti-hypertensives
– Revise the birth plan
– Refer urgently to hospital
If: Applicability: (((((((((((((((("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Severe headache"))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Severe headache")))
OR (("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Blurred vision")))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Blurred vision")))
OR (("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Epigastric pain")))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Epigastric pain")))
OR (("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Dizziness")))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Dizziness")))
OR (("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Vomiting")))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "Vomiting")))
OR (("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "None")
AND ("Urine dipstick result – protein" = "++")))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "None")
AND ("Urine dipstick result – protein" = "++")))
OR (("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "None")
AND ("Urine dipstick result – protein" = "+++")))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "None")
AND ("Urine dipstick result – protein" = "+++")))
OR (("Systolic blood pressure" ≥ 140 mmHg)
AND ("Repeat systolic blood pressure" ≥ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "None")
AND ("Urine dipstick result – protein" = "++++")))
OR (("Diastolic blood pressure" ≥ 90 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 90 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "None")
AND ("Urine dipstick result – protein" = "++++")) (Should Refer urgently to a hospital)
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Pre-eclampsia diagnosis! Refer to hospital and revise birth plan.
Woman 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.
Procedure:
– Refer to hospital
– Revise the birth plan
If: Applicability: ((((((("Systolic blood pressure" ≤ 140 mmHg)
AND ("Repeat systolic blood pressure" ≤ 140 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia")
AND ("Urine dipstick result – protein" = "++"))
OR (("Systolic blood pressure" > 160 mmHg)
AND ("Repeat systolic blood pressure" > 160 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia")
AND ("Urine dipstick result – protein" = "++")))
OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg)
AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg)
AND (Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia")
AND ("Urine dipstick result – protein" = "++")))
OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg)
AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia")
AND ("Urine dipstick result – protein" = "+++")))
OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg)
AND (90 mmHg – "Repeat diastolic blood pressure" < 110 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia")
AND ("Urine dipstick result – protein" = "+++")))
OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg)
AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia")
AND ("Urine dipstick result – protein" = "++++")))
OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg)
AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg)
AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia")
AND ("Urine dipstick result – protein" = "++++")) (Should Refer urgently to a hospital 2)
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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.
If: Applicability: (((("Systolic blood pressure" ≥ 160 mmHg)
AND ("Repeat systolic blood pressure" ≥ 160 mmHg)
AND ("Urine dipstick result – protein" = "+"))
OR (("Diastolic blood pressure" ≥ 110 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 110 mmHg)
AND ("Urine dipstick result – protein" = "+")))
OR (("Systolic blood pressure" ≥ 160 mmHg)
AND ("Repeat systolic blood pressure" ≥ 160 mmHg)
AND ("Urine dipstick result – protein" = "None")))
OR (("Diastolic blood pressure" ≥ 110 mmHg)
AND ("Repeat diastolic blood pressure" ≥ 110 mmHg)
AND ("Urine dipstick result – protein" = "None")) (Should Refer urgently to a hospital 3)
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Woman has hypertension – SBP of 140 mmHg or higher and/or DBP of 90 mmHg or higher and no proteinuria.
Counselling:
– Advice to reduce workload and to rest
– Advise on danger signs
– Reassess at the next contact or in 1 week if 8 months pregnant
– If hypertension persists after 1 week or at next contact, refer to hospital or discuss case with the doctor, if available
If: Applicability: (((("Existing chronic health conditions" = "Hypertension")
OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg)
AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg)
AND ("Urine dipstick result – protein" = "+")))
OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg)
AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg)
AND ("Urine dipstick result – protein" = "+")))
OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg)
AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg)
AND (Urine dipstick result – protein" = "None")))
OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg)
AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg)
AND ("Urine dipstick result – protein" = "None")) (Should Conduct hypertension counselling)
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