Table 1 Contents of antenatal care (ANC) package in icddr,b area, Matlab, Bangladesh

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