GuidelinesOther guideline
Subsequent & Referral Antenatal Visits
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
SCHEDULE FOR RETURN VISITS
The schedule shown provides a framework for visits for women attending at the hospital antenatal clinic. More frequent visits may be appropriate for certain high risk women.
Minimum schedule for return antenatal visits at hospital
| Gestational age at current visit (weeks) | Scheduled return visit |
| 6-19 | 24 weeks |
| 20-25 | 28 weeks |
| 26-28 | 30 weeks |
| 29-39 | After 2 weeks |
| 40 | 41 weeks |
CONTENT OF VISITS
- If the woman is referred from a clinic, be sure to know the reason for referral
- Ask about general health, fetal movements, danger symptoms, & problems
- For HIV infected women, ask the four screening questions for TB. Also, ensure that all aspects of HIV care are in order (CD4 testing & drugs)
- Check the BP, heart rate & colour of the mucous membranes
- Measure the SFH in cm, & palpate the pregnant uterus. Consider the possibility of breech presentation and twin pregnancy in all women ≥34 weeks. Plot the SFH on the graph against the gestational age & interpret this in accordance with the centile lines & previous measurements. Send for ultrasound scan if necessary
- Check urine test results for protein & glucose
- Repeat blood tests: Hb at 32 & 36 weeks, & HIV every 3 months
- Where appropriate, repeat information for pregnant women as for the first visit
- If the problem related to a clinic referral is resolved, tell the woman to return to her local clinic for the next visit and give her an appropriate date. Write clear notes on the antenatal record to assist the midwives at the woman’s local clinic.