Antenatal Care (2016 WHO Model)

Clinical Description

Prioritize on person-centered health and well-being to prevent maternal and perinatal morbidity and mortality and provide a positive pregnancy experience through timely and appropriate evidence-based practices implemented throughout normal pregnancy and childbirth.

Recommended interventions:

• 1. Nutrition interventions
• 2. Maternal and fetal assessment
• 3. Preventive measures
• 4. Interventions for common physiological symptoms
• 5. Health system interventions to improve utilization and quality of ANC

Frequency and timing of contacts in the 2016 WHO ANC model

• First trimester: Up to 12 weeks
• Second trimester: 20 weeks and 26 weeks
• Third trimester: At 30, 34, 36,38 and 40 weeks.

Note: Inform the woman to return for delivery after one week if not delivered

Hemoglobin (once every 3 months), blood grouping and rhesus, VDRL, PITC (at booking visit and 3 months after), HBsAg and Hepatitis C antibody test, urine dipsticks (at each visit), at least an early USS (if not available and if necessary, then refer)

TREATMENT / MANAGEMENT

• Full history and examination
• Preventive measures: Folic acid 0.4mg PO daily (3months preconception up to 12 weeks GA), Insecticide treated net, Tetanus Vaccine (TTV) (schedule: at 0, 4weeks after 1st dose, 6 months after 2nd dose, one year after 3rd dose, one year after 4th dose), SP 3 tablets stat every 4-6 weeks, albendazole 400mg stat dose (Once off).
• 60mg Elemental Iron daily or 300mg Ferrous Sulphate or equivalent or multi- mineral supplements (MMS), single dose 1500/75mg Sulfadoxine Pyrimethamine (schedule: every month from >/= 13 weeks), single dose 400mg Albendazole or 500mg Mebendazole, COVID Vaccine
• Counsel on healthy eating and keeping physically active, early presentation if unwell