Anda di halaman 1dari 26

..

..
1

1-12


Pre-eclampsia
ecclampsia



low risk pregnancy

The WHO multicentre trial

: ANC ANC
:

Argentina, Cuba, Saudi Arabia


primary outcome

Severe anemia, pre-eclampsia, UTI, LBW

maternal/fetal death eclampsia

VS

(median) 5 8
Refer rate 13.4% 7.3%
Admit rate, diagnosis, admission time, LBW, postpartum anemia, UTI

LBW (15%)
Pre-eclampsia 1.7% 1.4%
Hypertension 2.3% 3.9%
Ecclampsia
,

stillbirth 1
3
< 2,500 g
>4,500 g
, pre-eclampsia/eclampsia,

Myomectomy, uterine septum, cone biopsy, cervical cerclage, classical C/S

()

17 ( EDC)
35 ( EDC)
Rh negative


Diastolic BP > 90 mmHg

()

Insulin-dependent DM

( )

, , SLE,

(/ , pregnancy test, Beta-hCG)


, EDC (LMP + 7 3 )
( 12 )

, -

, heart & lung, ( + pap smear)
Hb (Hb < 9)

()

BP
,
Syphilis test (VDRL, RPR), anti-HIV
Multiple urine dipstick (for asymptomatic bacteriuria)
ABO Blood group Rh
Hct, Hb, OF ( MCV) DCIP
, ,

()

Tetanus toxoid
+ folic acid


, , ,

20

(20 )

, BP, BW, GA, uterine height, fetal heart rate, (PV)




multiple urine dipstick, urine protein/sugar
Fe/Folic acid/calcium supplement, tetanus toxoid
Ultrasound , ,
Complete antenatal card
, , 26

(26 )

, BP, BW, GA, uterine height, fetal heart rate, , -


Hb test (), multiple urine dipstick, protein/sugar
Fe/Folic acid/calcium supplement, tetanus toxoid

IUGR
, , , ,
,

32

(32 )

, BP, BW, GA, uterine height, fetal heart rate, , -


Hb/Hct, Syphilis, anti-HIV (lab 2), multiple urine dipstick, protein/sugar
Fe/Folic acid/calcium supplement

IUGR
, , , ,
,

, 38

(38 )

, BP, BW, GA, uterine height, fetal heart rate, , -


Urine protein/glucose

Breech presentation external cephalic version


oblique lie C/S

, IUGR
290

, , PROM,

, ,

Checklist
1 ................................ ( 12 )
1

classifying form

, ,

, , ,

multiple urine dipstick, protein, sugar, asymptomatic bacteriuria

( 2 )

Hb/Hct/OF/DCIP (), VDRL, anti-HIV, blood gr, Rh,


HBsAg

tetanus toxoid 1

/ folic acid iodine

10 hotline

<12 20

26

32

38

Checklist ()

2 ................................ (20 )
1

( 1)

()

, iodine

Tetanus toxoid 2 ( 1

<12 20

26

32

38

Checklist ()

3 ................................ (26 )
1

protein, sugar

, ,

: , ,

, iodine

<12 20

26

32

38

Checklist ()
4 ................................ (32 )
1

Hb/Hct, VDRL, anti-HIV

, , ,

5 ................................ (38 )
ECV

41

<12 20

26

32

38


24 .

, ,


,

//

, pap smear

Support


2-9 (%)
1 social support

32

24

21

10