Topic outline
Topic 1
Providing Focused Antenatal Care (FANC)
Introduction
Focused antenatal care: concepts and principles
Advantages of FANC
Failings of the traditional approach to antenatal care
Comparions of traditional and focused antenatal care
Important elements of FANC
The basic and specialised components of FANC
The first FANC visit
The second FANC visit
The third FANC visit
The fourth FANC visit
Birth preparedness, complication readiness and emergency planning
Normal birth preparedness
Birthing supplies the mother should prepare
Complication readiness and emergency planning
Causes of delay in getting emergency help
Making a referral
Topic 2
Health Promotion Issues During Pregnancy
Introduction
Nutrition during pregnancy
Eating well
Talking to women about food
Eating well with little money
Food groups and their nutrients
The five most important vitamins and minerals
Hygiene during pregnancy
Living a healthy lifestyle
Immunization against tetanus
Benefits of early and exclusive breastfeeding
Unhealthy beliefs and practices about feeding newborns
General principles of early and exclusive breastfeeding
Postpartum family planning
Breastfeeding and contraception
Benefits of birth spacing
Topic 3
Counselling on Danger Symptoms
Introduction
General principles of counselling the pregnant woman
What is special about counselling pregnant women?
What are the common danger symptoms during pregnancy?
Telling pregnant women about the danger symptoms
Advantages of husband/partner involvement in antenatal counselling
Checklist after each antenatal counselling session
Topic 4
Reduce Mother to Child Transmission of HIV
Introduction
PMTCT of HIV in antenatal care
When does HIV transmission occur from mother to baby?
Risk factors that increase the risk of HIV transmission during pregnancy
PMTCT: core interventions
Antiretroviral prophylaxis (ARP) and antiretroviral therapy (ART)
Routine HIV testing during pregnancy
Detecting HIV infection using blood tests
Opt-in and opt-out approaches
Counselling women who refuse HIV testing
Discussing HIV test results: post-test counselling
Post-test counselling for HIV-positive pregnant women
Post-test counselling for HIV-negative pregnant women
Checklist for HIV testing and counselling during the antenatal period
Additional care for the HIV-positive woman during pregnancy
Topic 5
Premature Rupture of Membranes (PROM)
Introduction
Premature rupture of membranes
Classifications of PROM
Risk factors for PROM
Infection can cause PROM
Malpresentation of the fetus
Multiple pregnancy and excess amniotic fluid
Cervical incompetence
Trauma to the abdomen
Diagnosis of PROM
Complications of PROM
Infection after PROM
Cord prolapse
Fetal hypoxia and asphyxia
Placental abruption
Preterm labour
Deformity of fetal limbs
Actions in a case of PROM
When should you conduct the delivery before referral?
When should you refer before conducting the delivery?
Topic 6
Common Medical Disorders in Pregnancy
Introduction
Malaria in pregnancy
Anaemia in pregnancy
Prevention of anaemia in pregnancy
Treatment of anaemia in pregnancy
Urinary tract infections
Prevention of UTIs
Diagnosing UTIs
Treating a bladder infection
In conclusion
Topic 7
Hypertensive Disorders of Pregnancy
Introduction
How does hypertension affect pregnancy?
Effects on blood vessels and body fluids
Effects of maternal hypertension on the fetus
Common complications of severe pre-eclampsia for the mother
Summarising maternal and fetal complications of severe pre-eclampsia
Classification of hypertension during pregnancy
Classification of pre-eclampsia
Diagnostic signs of eclampsia
Risk factors for pre-eclampsia/eclampsia
Clinical features of severe pre-eclampsia.
Headache
Blurred vision/visual disturbance
Epigastric pain
Decreased urine output
Decreased or absent fetal kick
Generalised (pathologic) oedema
Clinical features of eclampsia
Convulsions in eclampsia
What can you do if you diagnose a hypertensive disorder in a pregnant woman?
Actions if pre-eclampsia is not severe
Persuading affected women to go for medical treatment
Supportive pre-referral treatment for severe pre-eclampsia
Emergency referral for eclampsia
Topic 8
Abortion and other Causes of Early Pregnancy Bleeding
Introduction
What is early pregnancy bleeding?
Spontaneous abortion
Induced abortion
Clinical classification of abortion
Methods of provision of abortion
Goals of the post-abortion service
Important messages for women after a spontaneous or induced abortion
Follow-up care after an abortion
Pre-referral treatment in an emergency
Other causes of early pregnancy bleeding
Ectopic pregnancy
Molar pregnancy
Post-abortion family planning
When to start family planning
Topic 9
Late Pregnancy Bleeding
Introduction
What causes late pregnancy bleeding?
Placental abruption
Haemorrhagic shock
Acute renal failure
Heart failure
Placenta previa
Ruptured uterus
What to do for a woman with late pregnancy bleeding
Topic 10
Starting IV Fluid Therapy and Catheterising the Pregnant Woman
Introduction
When to start IV fluid therapy
Setting up the IV fluid therapy equipment
Sterile techniques for IV fluid therapy
Selecting the IV cannula
Selecting the venipuncture site
Inserting the IV cannula
Monitoring during IV therapy
Establishing a monitoring routine
When to stop IV infusion
Bladder catheterisation
Bladder catheterisation equipment
Steps in the catheterisation procedure
General care for the catheterised person
Removing the catheter