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Checklist For WLT
Checklist For WLT
1. Do a hemoglobin test (1st visit, then at about 28 weeks, then 34-36 weeks and or when
needed based on signs and symptoms):
• If hemoglobin is <7 g/dL, blood transfusion is indicated. If in-house facility not available,
refer woman to higher centre for it.
• If hemoglobin is between 7–11 g/dL, manage as per the management protocol for anemia
in pregnancy.
2. Do an RPR test /VDRL (first visit):
• If result is positive, refer woman for treatment of syphilis.
• Plan to treat newborn.
• Encourage woman to bring sexual partner for treatment.
• Advise on correct and consistent use of condom to prevent reinfection after treatment.
3. Test for blood group and Rh,. If Rh negative, woman has to be evaluated for the need of
anti-D immune globulin.
4. Test for HBsAg, HCV
5. Inform woman that HIV testing is recommended for all pregnant women, but that she may
choose not to have the test (opt out councelling). If she chooses to be tested, refer her to
counseling and testing services for HIV:
6. Inform about the universal screening needed for gestational diabetes, blood sugar should
be tested by glucometer 2 hours post 75 gram glucose load irrespective of meals . If blood
sugar ≥ 140 mg/dl , treat her as having gestational diabetes (DIPSI criteria)
Do this test at:
• 1st visit/1st Trimester.
• 2nd test at 24-28 weeks – at least 4 weeks after first test
• 3rd test at 32-34 weeks – may be done in high risk cases
7. If she is at high risk of hypothyroidism, recommend serum TSH
8. Urine (Routine and microscopic examination to be done.
9. Obstetric USG (Standard recommendation)
• 1st – 11-14 weeks for NT/NB scan
• 2nd TIFFA at 18-20 weeks (Level –II) for gross congenital malformation
• 3rd at any other time as per indication
If limited facility & only one ultrasound to be done it should be done at 18-20 weeks
Checklist For History Taking In Pregnant Women
GETTING READY
1. Greet the woman and her companion respectfully and with kindness, introduce yourself,
and offer the woman a seat.
2. Encourage her to ask questions, and listen to what she has to say.
HISTORY
Personal Information (First Visit)
1. Ask the woman’s name, age, address, and phone number (if available).
2. Ask if she has access to reliable transportation.
3. Ask what are her/her family’s sources of income/financial support.
4. Ask if she is having a medical, obstetric, social, or personal problem or other concern,
and if she has had any problems during this pregnancy.
5. Ask if she has received care from another caregiver during this pregnancy.
6. Any History of consanguinity.
Interim History (Return Visits). Remember that the questions about her present pregnancy
should be asked at every ANC visit.
1. Ask if she is having a medical, obstetric, social, or personal problem or other concerns.
2. Ask if she has had any problems or significant changes since her last visit.
3. Ask her about quickening or fetal movement.
4. Ask if she has received care from another caregiver since her last visit. If so, ask who
provided the care, what care was provided and what the outcome of care was.
5. Ask if any of her personal information has changed since her last visit.
6. Ask if her daily habits or lifestyle (workload, rest, dietary intake) changed since her last
visit.
7. Ask if there has been a change in her medical history since her last visit.
8. Ask if she has taken drugs/medications prescribed and followed the dvice/
recommendations provided at her last visit.
9. Ask if she has had any reactions to or side effects from immunizations or
drugs/medications given at her last visit.
Checklist for calculation of EDD and Period of Gestation
Checklist for how will you calculate the EDD
1. Ask the date of 1st day of last menstrual period.
2. Ask about her menstrual cycles – whether regular or irregular and of how many days.
3. Calculate EDD by adding 9 months and 7 days to the date of first day of last menstrual
period (known as Naegele’s Formula). e.g. if LMP is 4/4/2020 her EDD will be
11/1/2021.
4. This is true for cycles of 28-30 days.
5. If cycles are prolonged or shortened then it must be documented with the EDD, as the
actual EDD will be later or earlier respectively.
There may be some cases where the woman in not able to tell LMP, so the approximate EDD
can be calculated with the help of:
For Example:
1. If the LMP is 5/1/2020, EDD will be 12/10/2020.
Now to calculate gestational age on 13/4/2020, the LMP is nearer, so period of gestation
becomes 26 days of January + 29 days of February + 31 days of March + 13 days of
April = 99 days
So period of gestation is 14 weeks 1 day.
1. Fever
2. Persistent vomiting
3. Convulsions
4. Severe Headache, blurring of vision
5. Generalied swelling of the body and puffiness of face
6. Palpitation, easy fatigability and breathlessness at rest
7. Continuous severe pain in abdomen
8. Vaginal bleeding
9. Decreased urinary output / or burning sensation during micturation.
10. Decreased or absent fetal movements at >28 week.
11. Yellowish discoloration in eyes & palms.
12. Leaking of watery fluid P/V.
13. Itching all over the body.
Checklist for Birth Preparedness
Definition: