Topics | Activities* by ANC visits (1st visit: gestation week (GW) 15–19; 2nd visit: GW 24; 3rd visit: GW 32; 4th visit: GW 36) |
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Rapport building | Establish rapport with pregnant women |
History taking | Current and past pregnancy, history of chronic disease, contraceptive use, and family history |
Clinical Examination | |
Maintain infection prevention measures (all visits) | |
General | |
Height | |
Weight | |
Anemia | |
Edema | |
Blood pressure | |
Abdominal | |
Fundal height (2nd, 3rd and 4th visits) | |
Fetal heart sound (2nd, 3rd and 4th visits) | |
Fetal position and presentation (3rd and 4th visits) | |
Vaginal | (restricted unless physician decides) |
Share findings | Share the clinical findings with mother and support person |
Ultrasound examination | |
Identify last menstrual period date (1st visit) | |
Fetal growth (all visits) | |
Early diagnosis of twin (1st visit) | |
Any congenital malformation (1st and 2nd visit) | |
Placental position (2nd , 3rd and 4th) | |
Amount of liquor (2nd, 3rd and 4th) | |
Mal-presentation (3rd and 4th) | |
Routine Investigations | |
Urine dip-stick – albumin and sugar | |
Routine and microscopic examination (icddr,b Hospital) | |
Blood grouping and hemoglobin estimation (icddr,b Hospital) | |
Immunization and drugs | |
Immunization against tetanus | |
Anti- helminth drug use (2nd visit) | |
Iron and folic acid supplementation and checking | |
Risk factor identification and management | |
Antibiotic use for pre-mature rupture of membrane | |
Corticosteroid treatment for women with risk or in preterm labor | |
Induction of labor for postdated pregnancy | |
Asymptomatic bacteriuria (icddr,b Hospital) | |
Anti-D for Rh-negative mother | |
Tracking | |
Tracking of women with risk factors | |
Counseling | |
Diet and rest including work sharing and hygiene practice | |
Immunization | |
Micronutrient supplementation | |
Birth preparedness (money, transport, pieces of cloths, delivery place) | |
Breast feeding | |
Preterm and/or low birth weight | |
Immediate newborn care | |
Danger signs of newborn and mother | |
Documentation | Proper documentation of all services |