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/costateixeira/smart-anc/ and changes regularly. See the Directory of published versions
| Active as of 2021-06-11 |
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<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT17.html">ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis</a></td>
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<td style="padding-left: 4px;">0.3.0</td>
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<td style="padding-left: 4px;">ANCDT17</td>
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<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis</td>
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<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">active</td>
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<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">false</td>
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<th scope="row"><b>Type: </b></th>
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<b>system: </b> <span><a href="http://hl7.org/fhir/R4/codesystem-plan-definition-type.html">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>
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<p style="margin-bottom: 5px;">
<b>code: </b> <span>eca-rule</span>
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</td>
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<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2021-06-11 23:25:04-0600</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">World Health Organization (WHO)</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;">If the woman presents with any of the following symptoms and/or test results, conduct counselling and referral as needed</td>
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<tr>
<th scope="row"><b>Use Context: </b></th>
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<td>task</td>
<td>ANC.B10.4.</td>
<td>Diagnosis and treatment</td>
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<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 4px;">001</td>
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<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><td><a href="Library-ANCDT17.html">ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis</a></td></tr>
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</td>
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<tr>
<th scope="row"><b>Actions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td>
<b> ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis:</b> <br/>
<b>When:</b> <i>Named Event:</i> ANC.B10.4. Diagnosis and treatment<br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
<td>
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<br/>
<b>If:</b> <i>Applicability:</i> ((((((((((((((((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Severe headache&quot;))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Severe headache&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Blurred vision&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Blurred vision&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Epigastric pain&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Epigastric pain&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Dizziness&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Dizziness&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Vomiting&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;Vomiting&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 90 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;None&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)) <i>(Should Refer urgently to a hospital)</i><br/>
</td>
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<tr>
<td>
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<br/>
<b>If:</b> <i>Applicability:</i> (((((((&quot;Systolic blood pressure&quot; ≤ 140 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≤ 140 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;))
OR ((&quot;Systolic blood pressure&quot; &gt; 160 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; &gt; 160 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))
OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)
AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)
AND (Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++&quot;)))
OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)
AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))
OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)
AND (90 mmHg – &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;+++&quot;)))
OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)
AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)))
OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)
AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)
AND (&quot;Symptoms of severe pre-eclampsia&quot; = &quot;No symptoms of severe pre-eclampsia&quot;)
AND (&quot;Urine dipstick result – protein&quot; = &quot;++++&quot;)) <i>(Should Refer urgently to a hospital 2)</i><br/>
</td>
</tr>
<tr>
<td>
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/>
<b>If:</b> <i>Applicability:</i> ((((&quot;Systolic blood pressure&quot; ≥ 160 mmHg)
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AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;))
OR ((&quot;Diastolic blood pressure&quot; ≥ 110 mmHg)
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AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;)))
OR ((&quot;Systolic blood pressure&quot; ≥ 160 mmHg)
AND (&quot;Repeat systolic blood pressure&quot; ≥ 160 mmHg)
AND (&quot;Urine dipstick result – protein&quot; = &quot;None&quot;)))
OR ((&quot;Diastolic blood pressure&quot; ≥ 110 mmHg)
AND (&quot;Repeat diastolic blood pressure&quot; ≥ 110 mmHg)
AND (&quot;Urine dipstick result – protein&quot; = &quot;None&quot;)) <i>(Should Refer urgently to a hospital 3)</i><br/>
</td>
</tr>
<tr>
<td>
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<br/>
<b>If:</b> <i>Applicability:</i> ((((&quot;Existing chronic health conditions&quot; = &quot;Hypertension&quot;)
OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)
AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)
AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;)))
OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)
AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)
AND (&quot;Urine dipstick result – protein&quot; = &quot;+&quot;)))
OR ((140 mmHg ≤ &quot;Systolic blood pressure&quot; &lt; 160 mmHg)
AND (140 mmHg ≤ &quot;Repeat systolic blood pressure&quot; &lt; 160 mmHg)
AND (Urine dipstick result – protein&quot; = &quot;None&quot;)))
OR ((90 mmHg ≤ &quot;Diastolic blood pressure&quot; &lt; 110 mmHg)
AND (90 mmHg ≤ &quot;Repeat diastolic blood pressure&quot; &lt; 110 mmHg)
AND (&quot;Urine dipstick result – protein&quot; = &quot;None&quot;)) <i>(Should Conduct hypertension counselling)</i><br/>
</td>
</tr>
</table>
</td>
</tr>
</table>
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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"/>
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Managing complications guide (IMPAC) (2017): Section S-53, Table S-12 (5)"/>
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Procedure:
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Managing complications guide (IMPAC) (2017): Section S-52, Table S-12 (5)
WHO pre-eclampsia and eclampsia recommendations (2011): 6, 7 (7)"/>
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Counselling:
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– If hypertension persists after 1 week or at next contact, refer to hospital or discuss case with the doctor, if available"/>
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IG © 2019+ World Health Organization (WHO). Package who.fhir.anc-cds#0.3.0 based on FHIR 4.0.1. Generated 2024-09-10
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