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WORKBOOK for TRAINING of MEDICAL OFFICERSin Pregnancy Care and Management of Common Obstetric Complications
000_PPP141_(08-09)_WHO India_Hal1 1 19/09/2009 11:21:36 AM
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Contents
Preface ���
Acknowledgement v
Foreword v��
ProgramOfficer’sMessage �x
Abbrev�at�onsandUn�ts x�
Tra�n�ngSess�on 1.1
CaseSheet:AntenatalCare 2.1.1
CaseSheet:IntrapartumRecord 3.1.1
CaseSheet:InstrumentalDel�very 4.1.1
CaseSheet:NewBornCare 5.1.1
CaseSheet:PostpartumCare 6.1.1
CaseSheet:Compl�cat�onsDur�ngPregnancyandPostNatalPer�od 7.1.1
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TheReproduct�veandCh�ldHealthProgrammePhase-II,aflagsh�pprogrammew�th�nNat�onalRuralHealthM�ss�on,a�mstoreducematernalmortal�tyrat�otolessthan100by2010.There is a commitment from the Government of India and also from the States and UTs for providing Essential Obstetric Care at all facilities to achieve the goal of universal Skilled Birth Attendance. With this in view, Government of India has planned to operationalize all PHCs and FRUs in handling basic and comprehensive obstetric care, respectively.
UndertheRCHPhase-II,theGovernmentofInd�aenv�sagesthatfiftypercentofthePHCsandalltheCHCs�nallthed�str�ctswouldbemadeoperat�onalas24-hourdel�verycentres,�naphasedmanner,bytheyear2010.Thesecentreswould be respons�ble for prov�d�ng Bas�c and Emergency Obstetr�c Care and Essent�al Newborn Care, �nclud�ngNewbornResusc�tat�onserv�cesroundtheclock.AlmostalltheStateshavela�demphas�s�nprov�d�ngbas�cemergencyobstetr�ccareandsk�lledattendanceatb�rth�ntheProjectImplementat�onPlans(PIP)forRCHPhase-II.
As such, theMed�calOfficers,who are �n-charge of thesehealth fac�l�t�es,would, therefore, have tobe equ�ppedenoughtohandlethecommonobstetr�cemergenc�esandprov�detherequ�s�tecaresuchasadm�n�strat�onofparenteraloxytoc�cs,ant�b�ot�csandant�-convulsantdrugs,manualremovaloftheplacenta,theconduct�onofass�stedvag�naldel�ver�es,etc.
Tra�n�ngtoolforthetra�n�ngofMed�calOfficersatPHConPregnancyCareandManagementofCommonObstet�rcCompl�cat�ons have been developed �n accordance w�th the Guidelines for Pregnancy care and Management of Common Obstetric Complications by Medical Officers�ncludeandTra�nersGu�de,HandbookandWorkbookfortheTra�nees tomanageEssent�alObstetr�cCare.These toolshavebeenpreparedbyMaternalHealthD�v�s�on �ncollaborat�onw�thJawaharlalNehruMed�calCollege,Belgaumw�th �nputs fromUNFPAandWHO.Ihope theWorkbookalongw�ththeGu�del�ne’s&Handbookw�llfac�l�tateMed�calOfficersfromPr�maryHealthCentrestobu�ldtheresk�lls�npregnancycareandmanagementofcommonobstetr�ccompl�cat�onsandhelp�nensur�ngthequal�tyandun�form�ty�nthetra�n�ngs.
Date:23.04.08 Shri Naresh Dayal,SecretaryH&FW.NewDelh�,Ind�a.
PReFACe
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ACKnoWLeDGeMent
Toach�evethegoalsforreduct�onofmaternalmortal�tyandmorb�d�ty,GoIhasacomm�tmentunderReproduct�veandCh�ldHealthProgramtoprov�dequal�tyAntenatal,PostnatalandIntranatalcaredur�ngpregnancyandch�ldb�rthbyaSk�lledB�rthAttendant.T�mely�dent�ficat�onandmanagementofobstetr�ccompl�cat�ons�sthekeytothesurv�valofmothers.
Toach�eveth�s,GovernmentofInd�aenv�sagesthatfiftypercentofthePr�maryHealthCentresandalltheCommun�tyHealthCentresshouldbeoperat�onal�sedas24-hourdel�verycentresw�thprofic�encyforprov�d�ngbas�candemergencyobstetr�c serv�ces.These centresw�ll alsobe respons�ble forprov�d�ngpre-referral emergencycare forwomenwhodevelopcompl�cat�onsdur�ngdel�very.Thetra�n�ngtools,�.e.,Tra�ners’Gu�de,Tra�nees’HandbookandWorkbookw�llhelp �n �mpart�ngknowledgeandsk�lls totheMOs,wh�chw�llhelpthem�nprov�d�ngserv�cestowomen�nlabourandobstetr�cemergenc�estherebyreduc�ngmaternalmortal�ty.
Thetra�n�ngpackagehasbeendes�gnedbythefacultyofJawaharlalNehruMed�calCollege,Belgaumpart�cularlyDr.B.S.Kodkany,Dr.KamalPat�l,Dr.M.K.SwamyandMr.K�lledar.Inputshavealsobeentakenfromprofess�onalbod�essuchasFederat�onofObstetr�candGynaecolog�calSoc�et�esofInd�a(FOGSI),espec�allyDr.C.N.PurandereandDr.HemaD�wakar,UNorgan�zat�ons,part�cularlyDr.Har�shKumarandDr.Son�aTr�khaofWHO-Ind�aandDr.D�neshAgarwalofUNFPA-Ind�a.Ithankthemallforthe�rvaluablecontr�but�ons.
Ialsotaketh�sopportun�tytoacknowledgethecontr�but�onofalltheexperts,espec�allyDr.Deok�Nandan(D�rector,NIHFW),Dr.KamalaGanesh(ExH.O.D-ObGyn,MAMC,Delh�),Dr.(Mrs)N.S.Mahanshett�andfacultyofalltheMed�calCollegesofKarnataka.IalsoacknowledgethesupportofWHO�norgan�z�ngmeet�ngs,workshopsandprov�d�ngnecessary�nputsforaccompl�sh�ngthepreparat�onofthegu�del�nes.
Thes�ncereandhardworkofDrNar�kaNamshum,Dr.H�manshuBhushan,Dr.Man�shaMalhotra,Dr.Avan�PathakandDr.RajeevAggarwalfromMaternalHealthD�v�s�on,MoHFWneedsspec�alment�on.
IhopetheHandbookalongw�ththeWorkbook&Gu�del�nesw�ll fac�l�tatemed�calofficers frompr�maryhealthcentrestobu�ldthe�rsk�lls�npregnancycareandmanagementofcommonobstet�rccompl�cat�onsandhelp�nensur�ngh�ghqual�tyoftra�n�ngs.
Date:23.04.08 Aradhana JohriJo�ntSecretary,MoHFW
NewDelh�,Ind�a
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FoReWoRD
NRHMhasacomm�tmentforreduct�onofmaternal&�nfantmortal�ty/morb�d�tysoastomeettheNat�onalandInternat�onal goals. The reduct�on of MMR �s related to qual�ty of serv�ces rendered and also handl�ng of Bas�candComprehens�veObstetr�cCareserv�cesatthehealthfac�l�t�espart�cularlyatPr�maryandSecondarylevelofthefac�l�t�es.
Nat�onalRuralHealthM�ss�onhasthegoalofreduc�ngthematernalmortal�tyrat�otolessthan100per100,000l�veb�rthsby2012&�nfantmortal�tyratetolessthan30per1000l�veb�rths.Toach�evetheseobject�ves,stepshavebeentakenunderNRHMtoappropr�atelystrengthenallPHCsandFRUs�nhandl�ngBas�candComprehens�veObstetr�cCare�nclud�ngCareatB�rth.However,forthe�mprovementofserv�cedel�very,�t�s�mportantthatmed�calofficersarere-or�entedoncaredur�ngpregnancy&ch�ldb�rthsothatfac�l�t�escanbecomeeffic�ent�nhandl�ngcompl�cat�onsrelatedtopregnancy&careofnewborn.
GoIhasalreadylaunchedthetra�n�ngofparamed�calworkers�.e.,Nurses,ANMs&LHVsformak�ngthemsk�lled�nprov�s�onofcaredur�ngpregnancy&ch�ldb�rthbutthemed�calofficers�nruralpr�marycarefac�l�t�eshavenotbeenreor�ented�nthesesk�lls.Thesemed�calofficersarealsosupposedtobethesuperv�sors&tra�nersfortheSBAtra�n�ngofNurses,ANMs&LHVs.ThereforethePHCMOsneedtoup-gradethe�rsk�lls&knowledge�nordertomanage&supportthe�rteam�nsk�llb�rthattendance.
Toach�eve th�s,GoIhasdeveloped tra�n�ng tools&gu�del�nes forMed�calOfficersatpr�maryhealth fac�l�t�es. It�ncludesTra�nersGu�deHandbookandWorkbookfortheTra�neestomanageEssent�alObstetr�cCare.ThesehavebeenpreparedbyMaternalHealthD�v�s�onof th�sM�n�stryw�th �nputs fromexperts,profess�onals,developmentpartners&leaders�nthefield.
Ihopethesetra�n�ngtoolsw�llfac�l�tatethetra�ners�nor�ent�ngthemed�calofficersfrompr�maryhealthfac�l�t�es�nprofic�entuseofessent�alproceduresdescr�bed�ntra�n�ngmanual.S�m�larly,tra�neesw�llalsobebenefittedbythehandbookandworkbookwh�chhasbeenprepared�nl�new�ththeGu�del�nesforPregnancycareandManagementofCommonObstetr�cCompl�cat�onsbyMed�calOfficers”.Ihopeth�sw�llhelp�nreduc�ngther�sk&traumaofpregnancy&ch�ldb�rth�ncommun�ty.
Date:28.08.09 (Amit Mohan Prasad)Jo�ntSecretaryH&FW
GovernmentofInd�a
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PRoGRAM oFFICeR’s MessAGe
W�th the launch of Nat�onal Rural Health M�ss�on, many pos�t�ve changes have taken place �n publ�c health,�nfrastructureandserv�cedel�verybutst�llthere�sascopefor�mprovement�nthequal�tyofserv�cesbe�ngrendered.Reduct�onofmaternaland�nfantmortal�ty�sl�nkedw�ththequal�tyofcaredur�ngpregnancyandch�ldb�rth.Sk�lledattendance�neverypregnancyanddur�ngb�rth�saprovenstrategyforensur�ngqual�tyofserv�cesandforreduc�ngmaternalmortal�ty.Tra�n�ngofm�dw�fesandor�entat�onofdoctors�sthekeystepwh�chw�llhelp�nprov�d�ngsk�lledattendancedur�ngeverypregnancyandb�rthtak�ngplaceatpubl�chealthfac�l�t�es.
To�mprovesk�llsofprov�ders,tra�n�ngofANMs/LHVs/SNsasSk�lledB�rthAttendanthasalreadybeen�nplacebuttheMed�calofficerswhoarealsothesuperv�sorsofth�stra�n�ngneedtobere-or�entedonthesk�lls.Agu�del�neonPregnancyCareandManagementofCommonObstetr�cCompl�cat�onsforMed�calofficerswork�ngatPHCandCHClevelwaspreparedforth�spurpose�ntheyear2005.However,statescouldnot�mplement�tbecausethetra�n�ngtoolswerenotava�lable.Assuch,w�ththehelpoftheexpertsanddevelopmentpartners,wehavenowdevelopedthreebooks�.e.Tra�nersGu�de,Tra�neesHandbookandWorkbookasatra�n�ngtoolforthemed�calofficers.
Therewassomedelay�nbr�ng�ngthesebookstothefinalshapebecausecerta�ntechn�calstrateg�esl�keUseofOxytoc�natallthehealthfac�l�t�esandupdatedpackageofEssent�alNewBornCareandResusc�tat�onetc.werebe�ngfirmedup.A10days’packageforMed�calofficers�snow�nplacebutthegu�del�nesareafac�l�tat�ngtool.Object�vesofthegu�del�nesw�llonlybeach�eved�fthere�sapropercoord�nat�on,plann�nganddec�s�onmak�ngamongallthekeystakeholdersw�th�nthestateforconduct�ngth�stra�n�ngandut�l�z�ngthetra�neddoctorsatproperplace.
Ihopethesetra�n�ngtoolsw�llfac�l�tateboththetra�nersandtra�nees�nreor�entat�onofknowledgeandsk�llsforcaredur�ngpregnancyandch�ldb�rthandw�llhelp�nreduc�ngther�sk&traumaofpregnancy&ch�ldb�rth�ncommun�ty.Itaketh�sopportun�tytothankeveryonewhohascontr�buted�nfram�ngthetra�n�ngpackage.
Date:02.09.09 (Dr. Himanshu Bhushan)Ass�stantComm�ss�oner
MaternalHealthD�v�s�onMOHFW
New-Delh�,INDIA
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@ Attherateof
% Percent
AMTSL Act�veManagementofTh�rdStageofLabour.
ANC Ante-natalCare
ANM Aux�l�aryNurse-m�dw�fe
APH AntepartumHaemorrhage
ASHA Accred�tedSoc�alHealthAct�v�st
BP BloodPressure
BPM BeatsPerM�nute
c/o Compla�ntof
CCT ControlledCordTract�on
CHC Commun�tyHealthCentre
CPD Cephalopelv�cD�sproport�on
D&C D�lat�onandCurettage
e.g. Forexample
EDD ExpectedDateofDel�very
ENBC Essent�alNewBornCare
Etc. Etcetra
FHR FoetalHeartRate
FHS FoetalHeartSound
FTD FullTermDel�very
FOGSI Federat�onofObstetr�csandGynecolog�calSoc�et�esofInd�a
FRU F�rstReferralUn�t
G(no.) P(no.) A(no.) L(no.) Grav�da(no.)Para(no.)Abort�on(no.)L�veB�rth(no.)
GoI GovernmentofInd�a
GPE GeneralPhys�calExam�nat�on
h/o H�storyof
Hb Haemoglob�n
Hg Mercury
HIV HumanImmunodefic�encyV�rus
HLD H�ghLevelD�s�nfect�on
i.e. That�s
IFA IronFol�cAc�d
I/o Input/output
AbbRevIAtIons AnD UnIts
00_PPP141_(08-09)_WHO India_Trai11 11 19/09/2009 11:24:25 AM
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IM Intramuscular
ICTC IntegratedCounsell�ngandTest�ngCenter
Inj. Inject�on
IUD Intrauter�neDeath
IUGR Intrauter�neGrowthRetardat�on
IV Intravenous
LLIN LongLast�ngInsect�deTreatedBednets
LBW LowB�rthWe�ght
LMP LastMenstrualPer�od
LR LabourRoom
MMR MaternalMortal�tyRat�o
MOS Med�calOfficers
MoHFW M�n�stryofHealthandFam�lyWelfare
MRP ManualRemovalofPlacenta
MTP Med�calTerm�nat�onofPregnancy
MVA ManualVacuumAsp�rat�on
N/A NotAppl�cable
NBC NewBornCare
NIHFW Nat�onalInst�tuteofHealthandFam�lyWelfare
NRHM Nat�onalRuralHealthM�ss�on
NVBDCP Nat�onalVectorBorneD�seaseControlProgramme
NSAID Non-stero�dalAnt�-�nflammatoryDrug
O/E OnExam�nat�on
OPD OutPat�entDepartment
OT Operat�onTheater
P/A PerAbdomen
P/S PerSpeculum
P/V PerVag�num
P(no.) L(no.) A(no.) Pregnancy(no.)L�ve-b�rth(no.)Abort�on(no.)
PHC Pr�maryHealthCentre
PIH PregnancyInducedHypertens�on
PIP ProjectImplementat�onPlan
PNC PostnatalCare
PPH PostpartumHaemorrhage
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PROM PrematureorPrelabourRuptureofMembranes
RL R�ngerLactate
RCH Reproduct�veandCh�ldHealth
RR Resp�ratoryRate
RPR Rap�dPlasmaReag�n
RTI Reproduct�veTractInfect�on
SBA Sk�lledB�rthAttendant
STI SexuallyTransm�ttedInfect�on
Tab Tablet
TBA Trad�t�onalB�rthAttendant
TT TetanusToxo�d
UIP Un�versalImmun�zat�onProgramme
UTI Ur�naryTractInfect�on
UNFPA Un�tedNat�onPopulat�onFundAgency
VDRL VenerealD�seaseResearchLaboratory
vs Versus
WHO WorldHealthOrgan�zat�on
ºC DegreeCent�grade
mg/mcg M�ll�gram/M�crogram
cc Cub�cCent�metre
cm Cent�metre
dl Dec�l�tre
gm Gram
IU Internat�onalUn�ts
kcal K�localor�es
kg K�logram
L L�tre
Lb Pound
mg M�ll�gram
ml M�ll�l�tre
mm M�ll�metre
U Un�ts
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1.1
Training SeSSion
Name of the Medical Officer
Name of work place
Taluka and District
Name of Training Institute
Names of the Trainers 1.
2.
3.
4.
Training Duration w.e.f. _________________________ to ______________________
Dates of Joining
Assessment (Tick any) Satisfactory/Needs re-orientation
Name and Designation of Supervisor
Signature with date
01_PPP 141_(08-09)_WHO India_Tra1 1 19/09/2009 11:26:46 AM
1.2
Training SeSSion
General Instructions to Trainees
This workbook is a compulsory component of your training. You are required to maintain record of all your learning activities and other tasks that you perform during the course. These activities are to be performed under the supervision of the supervisor initially, whose remarks will guide you in improving your skills while practising independently.
The workbook would enable your trainers to have the first hand information about various tasks performed by you and help in assessing the practical hands-on experience gained by you. This would also be very useful to you for planning your activities in advance of the actual performance of the task. This record will also be given due weightage for your final assessment. You should keep this document with you whenever you are practising a skill, complete it and show it to your supervisor for his/her remarks and suggestions.
You are expected to keep the records in this workbook whenever you carry out any procedure under the supervision of the designated supervisor. You may add more items after discussion with your supervisor, whenever required. You must show the record to your supervisor after he/she has observed the procedure and request him/her to give the remarks and suggestions regarding where you need to improve your competencies. Please be honest in completing this workbook, since this is meant to help you acquire competencies. It is very important that you know your weak areas and improve upon them during the training period.
We have also given case studies in your handbook to stimulate your analytic and decision-making skills in relation to selected essential and emergency obstetric care and newborn care which you are likely to face in the field settings. Please go through these and also discuss these with your supervisors. Please keep the workbook even after you finish your training. This would be handy in your practice later on.
Wish you the best of luck
01_PPP 141_(08-09)_WHO India_Tra2 2 19/09/2009 11:26:46 AM
1.3
Training SeSSion
Training SeSSion
Day Session Topic Time
1 1a Registration, Welcome and Introduction to problems of Maternal Health –Maternal Mortality and objectives of Medical Officers Training,Pre-test questionnaire,Orientation to the services and facilities available in hospital
2 hours
1b Care during pregnancy – Antenatal Care 1 hour2 2a Intrapartum care and partograph 2 hours
2b Active Management of Third Stage of Labour (AMTSL) 1 hour3 3a Instrumental delivery 1 hour
3b Postpartum hemorrhage and shock 1 hour4 4 Essential newborn care
Care of baby at the time of birthCare of New Born in post natal ward
a)b)
2 hours
5 5a Hypertension in pregnancy 1 hour5b Eclampsia 1 hour
6 6a Postpartum care 1 hour6b Puerperal sepsis 1 hour
7 7a Anemia 1 hour7b Other problems during pregnancy
Urinary tract infectionHyperemesis gravidumRetention of urinePremature or prelabour rupture of membranes
•
•
•
•
1 hour
8 8a Abortion 1 hour8b Antepartum hemorrhage 1 hour
9 9a Other problems during labour and deliveryProlonged and obstructed labour and partographPreterm labourFoetal distressProlapsed cordTwins
•
•
•
•
•
2 hour
9b Other problems during postpartum periodInversion of uterusProblems with breast feeding
•
•
1 hour
10 10a Prevention of infection 1 hour10b Revision of 9 days’ sessions
Post-test questionnaire and feedback from trainees2 hours
• Monitoring and assessment will be on a daily basis
• Final certification will be done on the last day of training
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1.4
Training SeSSion
recommended Client Practice by Trainee
activity observe Perform independently
1. Antenatal check-up 5 202. Identification and Management of different complications of
pregnancy5 5
3. Preparing delivery trolley/equipment 5 -4. Perform PV examination 2 55. Monitor labour, plot and interpret partograph 2 56. a) Conduct normal delivery 2 5
b) Active Management of 3rd stage of labour 2 5c) Examination of placenta, membranes, Umbilical Cord 2 5
7. ENBC procedures and assess and provide NBC including resuscitation of *new born and check weight.
2 5
8. Assist the mother to initiate and continue BF 2 59. Management of PPH* 2 110. Removal of products of conception/clots under supervision* 2 211. Identification and Management of perineal tears 2 212. Emergency management of eclampsia* 1 113. Identification and Management of other complications of labour 3 -14. Postnatal checkup 2 515. Identification and Management of complications of post partum
period2 3
16. Identification and Management of danger signs in neonate 2 217 Emergency obstetric procedure
Forceps delivery/Vacuum extraction*2 2
The trainers will ensure practising of these skills by trainees and monitor quality.Trainee should keep a daily signed Cumulative Client Practice record. This record will be utilized by Trainer for certification.
* note: In case there is no client/patient available on whom any of the above skills can be performed, the trainer should use models and innovative approaches to enable the trainees perform the requisite skills.
•
•
•
01_PPP 141_(08-09)_WHO India_Tra4 4 19/09/2009 11:26:47 AM
1.5
Training SeSSion
record/assessment Form for the Trainee
recommended Client Practice by Trainee
activity observe Perform independently
grading by Trainer
Satisfactory/Unsatisfactory
1. Antenatal check-up2. Identification and Management of different
complications of pregnancy3. Preparing delivery trolley/equipment4. Perform PV examination5. Monitor labour, plot and interpret partograph 6. a) Conduct normal delivery
b) Active Management of 3rd stage of labourc) Examination of placenta, membranes, umbilical cord
7. ENBC procedures and assess and provide NBC including Resuscitation of new born and check weight.
8. Assist the mother to initiate and continue BF 9. Management of PPH10. Removal of products of conception/clots under
supervision11. Identification and Management of perineal tears12. Emergency management of eclampsia13. Identification and Management of other complications
of labour14. Postnatal checkup15. Identification and Management of complications of post
partum period16. Identification and Management of danger signs in
neonate17 Emergency obstetric procedure
Forceps delivery/Vacuum extraction
Remarks: _________________________________________________________
Grading: Satisfactory/needs re-orientation
Name and Signature: ________________________________________________
Date: ______________
note: In the Trainers’ guide there is same form for filling and keeping record by the trainer.
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Case sheet: antenatal Care
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
2.1.1
02_PPP 141_(08-09)_WHO India_Tra1 1 19/09/2009 11:28:43 AM
Case sheet: antenatal Care
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
2.1.2
02_PPP 141_(08-09)_WHO India_Tra2 2 19/09/2009 11:28:43 AM
Case sheet: antenatal Care
2.2.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra3 3 19/09/2009 11:28:43 AM
Case sheet: antenatal Care
2.2.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra4 4 19/09/2009 11:28:43 AM
Case sheet: antenatal Care
2.3.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra5 5 19/09/2009 11:28:43 AM
Case sheet: antenatal Care
2.3.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra6 6 19/09/2009 11:28:43 AM
Case sheet: antenatal Care
2.4.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra7 7 19/09/2009 11:28:43 AM
Case sheet: antenatal Care
2.4.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra8 8 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.5.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra9 9 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.5.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra10 10 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.6.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra11 11 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.6.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra12 12 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.7.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra13 13 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.7.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra14 14 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.8.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra15 15 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.8.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra16 16 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.9.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra17 17 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.9.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra18 18 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.10.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra19 19 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.10.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra20 20 19/09/2009 11:28:44 AM
Case sheet: antenatal Care
2.11.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra21 21 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.11.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra22 22 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.12.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra23 23 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.12.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra24 24 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.13.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra25 25 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.13.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra26 26 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.14.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra27 27 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.14.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra28 28 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.15.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra29 29 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.15.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra30 30 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.16.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra31 31 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.16.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra32 32 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.17.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra33 33 19/09/2009 11:28:45 AM
Case sheet: antenatal Care
2.17.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra34 34 19/09/2009 11:28:46 AM
Case sheet: antenatal Care
2.18.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra35 35 19/09/2009 11:28:46 AM
Case sheet: antenatal Care
2.18.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra36 36 19/09/2009 11:28:46 AM
Case sheet: antenatal Care
2.19.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra37 37 19/09/2009 11:28:46 AM
Case sheet: antenatal Care
2.19.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra38 38 19/09/2009 11:28:46 AM
Case sheet: antenatal Care
2.20.1
AntenAtAl cAse record
Name : RegistrationNo:
Age : DateofExamination:
Address :
HistoryofAmenorrhoea : months days
Anycomplaints :
MenstrualHistory : Regular/IrregularCycles
LMP
EDD
ObstetricHistory : G P A L
order of delivery
Mode of delivery complication outcome of the pregnancy
1234
ContraceptiveHistory :
PastHistory :
FamilyHistory :
02_PPP 141_(08-09)_WHO India_Tra39 39 19/09/2009 11:28:46 AM
Case sheet: antenatal Care
2.20.2
GPE Weight Pulse PallorBloodPressure OedemaRR JaundiceTemperature Breasts Nipples:Normal/Inverted
SystemicExamination
CVS
RS
PerAbdomen : FundalHeight
Lie
Presentation
FHS
PreviousScar/anyotherobservation
VaginalExamination(ifnecessary)
ProvisionalDiagnosis :
Investigations : Hb
(*optional) BloodGroup&Rhtyping
UrineRoutineExamination:
RPR/VDRL*
HIV*
HBsAg*
USG*
Prophylaxis : TabIFA Inj.TT1stDose 2ndDose
Anyothertreatmentgiven :
Counselling :
Assessment Grading (satisfactory/Unsatisfactory)
NameandSignatureofTrainer/Supervisor:
02_PPP 141_(08-09)_WHO India_Tra40 40 19/09/2009 11:28:46 AM
case sheet: intrapartum record
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
3.1.1
03_PPP 141_(08-09)_WHO India_Tra1 1 19/09/2009 11:31:26 AM
case sheet: intrapartum record
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
3.1.2
03_PPP 141_(08-09)_WHO India_Tra2 2 19/09/2009 11:31:26 AM
case sheet: intrapartum record
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
3.1.3
03_PPP 141_(08-09)_WHO India_Tra3 3 19/09/2009 11:31:26 AM
case sheet: intrapartum record
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
3.1.4
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra4 4 19/09/2009 11:31:26 AM
case sheet: intrapartum record
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
3.1.5
03_PPP 141_(08-09)_WHO India_Tra5 5 19/09/2009 11:31:26 AM
case sheet: intrapartum record
3.2.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra7 7 19/09/2009 11:31:27 AM
case sheet: intrapartum record
3.2.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra8 8 19/09/2009 11:31:27 AM
case sheet: intrapartum record
3.2.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra9 9 19/09/2009 11:31:27 AM
case sheet: intrapartum record
3.2.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra10 10 19/09/2009 11:31:27 AM
case sheet: intrapartum record
3.2.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra11 11 19/09/2009 11:31:27 AM
case sheet: intrapartum record
3.3.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra13 13 19/09/2009 11:31:28 AM
case sheet: intrapartum record
3.3.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra14 14 19/09/2009 11:31:28 AM
case sheet: intrapartum record
3.3.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra15 15 19/09/2009 11:31:28 AM
case sheet: intrapartum record
3.3.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra16 16 19/09/2009 11:31:28 AM
case sheet: intrapartum record
3.3.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra17 17 19/09/2009 11:31:28 AM
case sheet: intrapartum record
3.4.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra19 19 19/09/2009 11:31:29 AM
case sheet: intrapartum record
3.4.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra20 20 19/09/2009 11:31:29 AM
case sheet: intrapartum record
3.4.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra21 21 19/09/2009 11:31:29 AM
case sheet: intrapartum record
3.4.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra22 22 19/09/2009 11:31:29 AM
case sheet: intrapartum record
3.4.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra23 23 19/09/2009 11:31:30 AM
case sheet: intrapartum record
3.5.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra25 25 19/09/2009 11:31:30 AM
case sheet: intrapartum record
3.5.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra26 26 19/09/2009 11:31:30 AM
case sheet: intrapartum record
3.5.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra27 27 19/09/2009 11:31:30 AM
case sheet: intrapartum record
3.5.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra28 28 19/09/2009 11:31:30 AM
case sheet: intrapartum record
3.5.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra29 29 19/09/2009 11:31:31 AM
case sheet: intrapartum record
3.6.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra31 31 19/09/2009 11:31:31 AM
case sheet: intrapartum record
3.6.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra32 32 19/09/2009 11:31:31 AM
case sheet: intrapartum record
3.6.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra33 33 19/09/2009 11:31:31 AM
case sheet: intrapartum record
3.6.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra34 34 19/09/2009 11:31:31 AM
case sheet: intrapartum record
3.6.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra35 35 19/09/2009 11:31:32 AM
case sheet: intrapartum record
3.7.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra37 37 19/09/2009 11:31:32 AM
case sheet: intrapartum record
3.7.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra38 38 19/09/2009 11:31:32 AM
case sheet: intrapartum record
3.7.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra39 39 19/09/2009 11:31:32 AM
case sheet: intrapartum record
3.7.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra40 40 19/09/2009 11:31:32 AM
case sheet: intrapartum record
3.7.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra41 41 19/09/2009 11:31:33 AM
case sheet: intrapartum record
3.8.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra43 43 19/09/2009 11:31:33 AM
case sheet: intrapartum record
3.8.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra44 44 19/09/2009 11:31:33 AM
case sheet: intrapartum record
3.8.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra45 45 19/09/2009 11:31:33 AM
case sheet: intrapartum record
3.8.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra46 46 19/09/2009 11:31:33 AM
case sheet: intrapartum record
3.8.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra47 47 19/09/2009 11:31:34 AM
case sheet: intrapartum record
3.9.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra49 49 19/09/2009 11:31:34 AM
case sheet: intrapartum record
3.9.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra50 50 19/09/2009 11:31:34 AM
case sheet: intrapartum record
3.9.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra51 51 19/09/2009 11:31:34 AM
case sheet: intrapartum record
3.9.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra52 52 19/09/2009 11:31:34 AM
case sheet: intrapartum record
3.9.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra53 53 19/09/2009 11:31:35 AM
case sheet: intrapartum record
3.10.1
Intrapartum record
Name: Age: RegistrationNo.
DateofAdmission :
Address :
Registered/Unregistered :
Complaints : Amenorrhea months days
PainAbdomensince:
BleedingP/V :
WaterydischargeP/V :
Anyothercomplaints :
MenstrualHistory : Regular/IrregularCycles Lmp:
edd:
ObstetricHistory : G P A L
order of delivery
mode of delivery-normal/instrumental/LScS
complicationif any
outcome of the pregnancy- live birth/stillbirth
1
2
3
PastMedicalHistory:
FamilyHistory:
GPE
Pulse Pallor
BloodPressure Oedema
RR Icterus
Temp
03_PPP 141_(08-09)_WHO India_Tra55 55 19/09/2009 11:31:35 AM
case sheet: intrapartum record
3.10.2
SystemicExamination:
CVS
RS
PerAbdomen : FundalHeight Presentation UterineContractions
FHS
Anyotherobservation
VaginalExamination : Cervicaleffacement Cervicaldilation
Statusofmembranes Absent Present
Stationofpresentingpart:
Colourofliquor
PelvicAssessment : Adequate/notadequate
Diagnosis :
Investigations : Hb Urine BloodGroup&Rh Anyother
03_PPP 141_(08-09)_WHO India_Tra56 56 19/09/2009 11:31:35 AM
case sheet: intrapartum record
3.10.3
InLatentPhase:
date & time pulse Bp contractions FHS pV advice
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra57 57 19/09/2009 11:31:35 AM
case sheet: intrapartum record
3.10.4
partoGrapH
name: W/o: age: parity: reg. no:
date & time of admission date & time of rom:
a) Foetal condition
Foetal heart rate
2001901801701601501401301201101009080
Amnioticfluid
B) Labour
cervix (cm) [plot X]
10987654
HoursTime 1 2 3 4 5 6 7 8 9 10 11 12
Alert Action
Contrac-tionsper10min
54321
c) Interventions
DrugsandIVfluidsgiven
d) maternal condition
pulse and Bp
18017016015014013012011010090807060
Temp(0C)
*PlottingofPartographtobeinitiatedfrom4cm.dilatationonwards(MANDATORY).
03_PPP 141_(08-09)_WHO India_Tra58 58 19/09/2009 11:31:35 AM
case sheet: intrapartum record
3.10.5
NeedsreferraltoFRUfor :(ifapplicable)
Dateandtimeofdelivery :
delivery notes
Mother : Modeofdelivery:Normal Assisted LSCS
IndicationincaseofInstrumentaldelivery/LSCS Date&Timeofdelivery
AMTSL : IMOxytocin10U
CCT
UterineMassage
Pulse
BP
UterusContracted&Retracted
BleedingPV
Placenta&Membranes : Complete/Incomplete Baby : Sex M F
Criedimmediately/Resuscitationneeded
Colour:Pink/Blue/Pale
Tone:Normal/Flaccid
Weight:
Urine : Passed/notpassed
Meconium : Passed/notpassed
Congenital : anomalies Yes/No
IfYes,specify
assessment Grading (Satisfactory/unsatisfactory)
NameandSignatureofTrainer/Supervisor:
Date:
03_PPP 141_(08-09)_WHO India_Tra59 59 19/09/2009 11:31:35 AM
case sheets: instrumental delivery
4.1.1
Instrumental DelIvery
Outlet Forceps Delivery/ventouse:
Name & Age :
Registration No. :
Indication :
Pre-Requisites :
Outcome of delivery :
Identification and repair of any tears/lacerations :
Post partum notes:
PR
BP
P/A tone of uterus
bleeding PV
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
04_PPP 141_(08-09)_WHO India_Tra1 1 19/09/2009 11:33:30 AM
case sheets: instrumental delivery
4.2.1
Instrumental DelIvery
Outlet Forceps Delivery/ventouse:
Name & Age :
Registration No. :
Indication :
Pre-Requisites :
Outcome of delivery :
Identification and repair of any tears/lacerations :
Post partum notes:
PR
BP
P/A tone of uterus
bleeding PV
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
04_PPP 141_(08-09)_WHO India_Tra3 3 19/09/2009 11:33:30 AM
case sheets: instrumental delivery
4.3.1
Instrumental DelIvery
Outlet Forceps Delivery/ventouse:
Name & Age :
Registration No. :
Indication :
Pre-Requisites :
Outcome of delivery :
Identification and repair of any tears/lacerations :
Post partum notes:
PR
BP
P/A tone of uterus
bleeding PV
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
04_PPP 141_(08-09)_WHO India_Tra5 5 19/09/2009 11:33:30 AM
case sheets: instrumental delivery
4.4.1
Instrumental DelIvery
Outlet Forceps Delivery/ventouse:
Name & Age :
Registration No. :
Indication :
Pre-Requisites :
Outcome of delivery :
Identification and repair of any tears/lacerations :
Post partum notes:
PR
BP
P/A tone of uterus
bleeding PV
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
04_PPP 141_(08-09)_WHO India_Tra7 7 19/09/2009 11:33:30 AM
case sheets: new born care
MANAGEMENT OF THE YOUNG INFANT AGE UP TO 2 MONTHS
IN POSTNATAl WArd
Name: __________________________________ date of Examination: _______________________________
date and time of Birth: _____________________
Birth Weight: _____________________________ Temperature: ___________°C/°F
ASK: Does the mother or infant have any problem? _____________________________________
ASSESS:
CHECK FOr FEEdING PrOBlEM Observation remarks
ASK THE MOTHEr
Have you started breast feeding the baby? Is there any difficulty in feeding the baby? Do you have any pain while breast feeding?
If yes, then look for:
Flat or inverted nipples or sore nipples Engorged breasts or breast abscess
Have you given any other foods or drinks to the baby?
If Yes, what and how?
•
•
•
•
CHECK FOr dANGEr SIGNS
Count the breaths in one minute: _____________ breaths per minuteRepeat if fast, note down ___________________ breaths per minute
•
Look for severe chest in drawing•
Look at the umbilicus. Is it red or draining pus?•
Look for skin pustules. Are there 10 or more pustules or a big boil?•
Measure axillary temperature (if not possible, feel for fever or low body temperature):
Normal (36.5–37.4o C)Mild hypothermia (36.0–36.4o C/cold feet)Moderate hypothermia (32.0o C – 36.0o C/cold feet and abdomen)Severe hypothermia (< 32o C)Fever (> 37.4o C/feels hot)
•
See if young infant is lethargic or unconscious.Look at young infant’s movements. Less than normal?•
Look for jaundice. Are the palms and soles yellow?•
Has the infant had convulsions?•
5.1.1
05_PPP 141_(08-09)_WHO India_Tra1 1 19/09/2009 11:34:22 AM
case sheets: new born care
ASSESS BrEASTFEEdING
Has the infant breastfed in the previous one hour? If infant has not fed in the previous hour, ask the mother to put her
infant to the breast. Observe the breastfeed for 4 minutes.
•
Is the infant able to attach? To check attachment, look for:•
Chin touching breast Yes____No___Mouth wide open Yes____No___Lower lip turned outward Yes____No___More areola above than below the mouth Yes____No___
Classify:No attachment at all Not well attached Good attachment
Is the infant suckling effectively (that is, slow deep sucks, sometimes pausing)?Classify:
Not suckling at all Not suckling effectively Suckling effectively
•
•
•
If not suckling well, then look for: ulcers or white patches in the mouth (thrush).
•
HAS THE YOUNG INFANT rECIEvEd
Vitamin KBCG, OPV 0, HEP-B 1
Assess other Problems:•
Advice at •
Discharge
Follow Up:
Danger Signs:
•
•
•
Assessment Grading (Satisfactory/Unsatisfactory)
Name and Signature of Trainer/Supervisor:
date:
5.1.2
05_PPP 141_(08-09)_WHO India_Tra2 2 19/09/2009 11:34:22 AM
case sheets: new born care
5.2.1
MANAGEMENT OF THE YOUNG INFANT AGE UP TO 2 MONTHS
IN POSTNATAl WArd
Name: __________________________________ date of Examination: _______________________________
date and time of Birth: _____________________
Birth Weight: _____________________________ Temperature: ___________°C/°F
ASK: Does the mother or infant have any problem? _____________________________________
ASSESS:
CHECK FOr FEEdING PrOBlEM Observation remarks
ASK THE MOTHEr
Have you started breast feeding the baby? Is there any difficulty in feeding the baby? Do you have any pain while breast feeding?
If yes, then look for:
Flat or inverted nipples or sore nipples Engorged breasts or breast abscess
Have you given any other foods or drinks to the baby?
If Yes, what and how?
•
•
•
•
CHECK FOr dANGEr SIGNS
Count the breaths in one minute: _____________ breaths per minuteRepeat if fast, note down ___________________ breaths per minute
•
Look for severe chest in drawing•
Look at the umbilicus. Is it red or draining pus?•
Look for skin pustules. Are there 10 or more pustules or a big boil?•
Measure axillary temperature (if not possible, feel for fever or low body temperature):
Normal (36.5–37.4o C)Mild hypothermia (36.0–36.4o C/cold feet)Moderate hypothermia (32.0o C – 36.0o C/cold feet and abdomen)Severe hypothermia (< 32o C)Fever (> 37.4o C/feels hot)
•
See if young infant is lethargic or unconscious.Look at young infant’s movements. Less than normal?•
Look for jaundice. Are the palms and soles yellow?•
Has the infant had convulsions?•
05_PPP 141_(08-09)_WHO India_Tra3 3 19/09/2009 11:34:22 AM
case sheets: new born care
5.2.2
ASSESS BrEASTFEEdING
Has the infant breastfed in the previous one hour? If infant has not fed in the previous hour, ask the mother to put her
infant to the breast. Observe the breastfeed for 4 minutes.
•
Is the infant able to attach? To check attachment, look for:•
Chin touching breast Yes____No___Mouth wide open Yes____No___Lower lip turned outward Yes____No___More areola above than below the mouth Yes____No___
Classify:No attachment at all Not well attached Good attachment
Is the infant suckling effectively (that is, slow deep sucks, sometimes pausing)?Classify:
Not suckling at all Not suckling effectively Suckling effectively
•
•
•
If not suckling well, then look for: ulcers or white patches in the mouth (thrush).
•
HAS THE YOUNG INFANT rECIEvEd
Vitamin KBCG, OPV 0, HEP-B 1
Assess other Problems:•
Advice at •
Discharge
Follow Up:
Danger Signs:
•
•
•
Assessment Grading (Satisfactory/Unsatisfactory)
Name and Signature of Trainer/Supervisor:
date:
05_PPP 141_(08-09)_WHO India_Tra4 4 19/09/2009 11:34:22 AM
case sheets: new born care
5.3.1
MANAGEMENT OF THE YOUNG INFANT AGE UP TO 2 MONTHS
IN POSTNATAl WArd
Name: __________________________________ date of Examination: _______________________________
date and time of Birth: _____________________
Birth Weight: _____________________________ Temperature: ___________°C/°F
ASK: Does the mother or infant have any problem? _____________________________________
ASSESS:
CHECK FOr FEEdING PrOBlEM Observation remarks
ASK THE MOTHEr
Have you started breast feeding the baby? Is there any difficulty in feeding the baby? Do you have any pain while breast feeding?
If yes, then look for:
Flat or inverted nipples or sore nipples Engorged breasts or breast abscess
Have you given any other foods or drinks to the baby?
If Yes, what and how?
•
•
•
•
CHECK FOr dANGEr SIGNS
Count the breaths in one minute: _____________ breaths per minuteRepeat if fast, note down ___________________ breaths per minute
•
Look for severe chest in drawing•
Look at the umbilicus. Is it red or draining pus?•
Look for skin pustules. Are there 10 or more pustules or a big boil?•
Measure axillary temperature (if not possible, feel for fever or low body temperature):
Normal (36.5–37.4o C)Mild hypothermia (36.0–36.4o C/cold feet)Moderate hypothermia (32.0o C – 36.0o C/cold feet and abdomen)Severe hypothermia (< 32o C)Fever (> 37.4o C/feels hot)
•
See if young infant is lethargic or unconscious.Look at young infant’s movements. Less than normal?•
Look for jaundice. Are the palms and soles yellow?•
Has the infant had convulsions?•
05_PPP 141_(08-09)_WHO India_Tra5 5 19/09/2009 11:34:22 AM
case sheets: new born care
5.3.2
ASSESS BrEASTFEEdING
Has the infant breastfed in the previous one hour? If infant has not fed in the previous hour, ask the mother to put her
infant to the breast. Observe the breastfeed for 4 minutes.
•
Is the infant able to attach? To check attachment, look for:•
Chin touching breast Yes____No___Mouth wide open Yes____No___Lower lip turned outward Yes____No___More areola above than below the mouth Yes____No___
Classify:No attachment at all Not well attached Good attachment
Is the infant suckling effectively (that is, slow deep sucks, sometimes pausing)?Classify:
Not suckling at all Not suckling effectively Suckling effectively
•
•
•
If not suckling well, then look for: ulcers or white patches in the mouth (thrush).
•
HAS THE YOUNG INFANT rECIEvEd
Vitamin KBCG, OPV 0, HEP-B 1
Assess other Problems:•
Advice at •
Discharge
Follow Up:
Danger Signs:
•
•
•
Assessment Grading (Satisfactory/Unsatisfactory)
Name and Signature of Trainer/Supervisor:
date:
05_PPP 141_(08-09)_WHO India_Tra6 6 19/09/2009 11:34:22 AM
case sheets: new born care
5.4.1
MANAGEMENT OF THE YOUNG INFANT AGE UP TO 2 MONTHS
IN POSTNATAl WArd
Name: __________________________________ date of Examination: _______________________________
date and time of Birth: _____________________
Birth Weight: _____________________________ Temperature: ___________°C/°F
ASK: Does the mother or infant have any problem? _____________________________________
ASSESS:
CHECK FOr FEEdING PrOBlEM Observation remarks
ASK THE MOTHEr
Have you started breast feeding the baby? Is there any difficulty in feeding the baby? Do you have any pain while breast feeding?
If yes, then look for:
Flat or inverted nipples or sore nipples Engorged breasts or breast abscess
Have you given any other foods or drinks to the baby?
If Yes, what and how?
•
•
•
•
CHECK FOr dANGEr SIGNS
Count the breaths in one minute: _____________ breaths per minuteRepeat if fast, note down ___________________ breaths per minute
•
Look for severe chest in drawing•
Look at the umbilicus. Is it red or draining pus?•
Look for skin pustules. Are there 10 or more pustules or a big boil?•
Measure axillary temperature (if not possible, feel for fever or low body temperature):
Normal (36.5–37.4o C)Mild hypothermia (36.0–36.4o C/cold feet)Moderate hypothermia (32.0o C – 36.0o C/cold feet and abdomen)Severe hypothermia (< 32o C)Fever (> 37.4o C/feels hot)
•
See if young infant is lethargic or unconscious.Look at young infant’s movements. Less than normal?•
Look for jaundice. Are the palms and soles yellow?•
Has the infant had convulsions?•
05_PPP 141_(08-09)_WHO India_Tra7 7 19/09/2009 11:34:22 AM
case sheets: new born care
5.4.2
ASSESS BrEASTFEEdING
Has the infant breastfed in the previous one hour? If infant has not fed in the previous hour, ask the mother to put her
infant to the breast. Observe the breastfeed for 4 minutes.
•
Is the infant able to attach? To check attachment, look for:•
Chin touching breast Yes____No___Mouth wide open Yes____No___Lower lip turned outward Yes____No___More areola above than below the mouth Yes____No___
Classify:No attachment at all Not well attached Good attachment
Is the infant suckling effectively (that is, slow deep sucks, sometimes pausing)?Classify:
Not suckling at all Not suckling effectively Suckling effectively
•
•
•
If not suckling well, then look for: ulcers or white patches in the mouth (thrush).
•
HAS THE YOUNG INFANT rECIEvEd
Vitamin KBCG, OPV 0, HEP-B 1
Assess other Problems:•
Advice at •
Discharge
Follow Up:
Danger Signs:
•
•
•
Assessment Grading (Satisfactory/Unsatisfactory)
Name and Signature of Trainer/Supervisor:
date:
05_PPP 141_(08-09)_WHO India_Tra8 8 19/09/2009 11:34:23 AM
case sheets: new born care
5.5.1
MANAGEMENT OF THE YOUNG INFANT AGE UP TO 2 MONTHS
IN POSTNATAl WArd
Name: __________________________________ date of Examination: _______________________________
date and time of Birth: _____________________
Birth Weight: _____________________________ Temperature: ___________°C/°F
ASK: Does the mother or infant have any problem? _____________________________________
ASSESS:
CHECK FOr FEEdING PrOBlEM Observation remarks
ASK THE MOTHEr
Have you started breast feeding the baby? Is there any difficulty in feeding the baby? Do you have any pain while breast feeding?
If yes, then look for:
Flat or inverted nipples or sore nipples Engorged breasts or breast abscess
Have you given any other foods or drinks to the baby?
If Yes, what and how?
•
•
•
•
CHECK FOr dANGEr SIGNS
Count the breaths in one minute: _____________ breaths per minuteRepeat if fast, note down ___________________ breaths per minute
•
Look for severe chest in drawing•
Look at the umbilicus. Is it red or draining pus?•
Look for skin pustules. Are there 10 or more pustules or a big boil?•
Measure axillary temperature (if not possible, feel for fever or low body temperature):
Normal (36.5–37.4o C)Mild hypothermia (36.0–36.4o C/cold feet)Moderate hypothermia (32.0o C – 36.0o C/cold feet and abdomen)Severe hypothermia (< 32o C)Fever (> 37.4o C/feels hot)
•
See if young infant is lethargic or unconscious.Look at young infant’s movements. Less than normal?•
Look for jaundice. Are the palms and soles yellow?•
Has the infant had convulsions?•
05_PPP 141_(08-09)_WHO India_Tra9 9 19/09/2009 11:34:23 AM
case sheets: new born care
5.5.2
ASSESS BrEASTFEEdING
Has the infant breastfed in the previous one hour? If infant has not fed in the previous hour, ask the mother to put her
infant to the breast. Observe the breastfeed for 4 minutes.
•
Is the infant able to attach? To check attachment, look for:•
Chin touching breast Yes____No___Mouth wide open Yes____No___Lower lip turned outward Yes____No___More areola above than below the mouth Yes____No___
Classify:No attachment at all Not well attached Good attachment
Is the infant suckling effectively (that is, slow deep sucks, sometimes pausing)?Classify:
Not suckling at all Not suckling effectively Suckling effectively
•
•
•
If not suckling well, then look for: ulcers or white patches in the mouth (thrush).
•
HAS THE YOUNG INFANT rECIEvEd
Vitamin KBCG, OPV 0, HEP-B 1
Assess other Problems:•
Advice at •
Discharge
Follow Up:
Danger Signs:
•
•
•
Assessment Grading (Satisfactory/Unsatisfactory)
Name and Signature of Trainer/Supervisor:
date:
05_PPP 141_(08-09)_WHO India_Tra10 10 19/09/2009 11:34:23 AM
case sheet: PostPartum care
6.1.1
PostPartum Care
Date and Registration No.
Name of the Woman & Age
Address
Presenting complaints, if any
Fever
Pain in abdomen
Type of Delivery
Place and Date of Delivery
Time of Delivery
Time of initiation of Breast Feeding
examination:
Pallor
Pulse rate
BP
Breast examination
Involution of uterus
Lochia
Perineal care
Advice
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
06_PPP 141_(08-09)_WHO India_Tra1 1 19/09/2009 11:35:24 AM
case sheet: PostPartum care
6.2.1
PostPartum Care
Date and Registration No.
Name of the Woman & Age
Address
Presenting complaints, if any
Fever
Pain in abdomen
Type of Delivery
Place and Date of Delivery
Time of Delivery
Time of initiation of Breast Feeding
examination:
Pallor
Pulse rate
BP
Breast examination
Involution of uterus
Lochia
Perineal care
Advice
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
06_PPP 141_(08-09)_WHO India_Tra3 3 19/09/2009 11:35:24 AM
case sheet: PostPartum care
6.3.1
PostPartum Care
Date and Registration No.
Name of the Woman & Age
Address
Presenting complaints, if any
Fever
Pain in abdomen
Type of Delivery
Place and Date of Delivery
Time of Delivery
Time of initiation of Breast Feeding
examination:
Pallor
Pulse rate
BP
Breast examination
Involution of uterus
Lochia
Perineal care
Advice
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
06_PPP 141_(08-09)_WHO India_Tra5 5 19/09/2009 11:35:24 AM
case sheet: PostPartum care
6.4.1
PostPartum Care
Date and Registration No.
Name of the Woman & Age
Address
Presenting complaints, if any
Fever
Pain in abdomen
Type of Delivery
Place and Date of Delivery
Time of Delivery
Time of initiation of Breast Feeding
examination:
Pallor
Pulse rate
BP
Breast examination
Involution of uterus
Lochia
Perineal care
Advice
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
06_PPP 141_(08-09)_WHO India_Tra7 7 19/09/2009 11:35:24 AM
case sheet: PostPartum care
6.5.1
PostPartum Care
Date and Registration No.
Name of the Woman & Age
Address
Presenting complaints, if any
Fever
Pain in abdomen
Type of Delivery
Place and Date of Delivery
Time of Delivery
Time of initiation of Breast Feeding
examination:
Pallor
Pulse rate
BP
Breast examination
Involution of uterus
Lochia
Perineal care
Advice
assessment Grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
Date:
06_PPP 141_(08-09)_WHO India_Tra9 9 19/09/2009 11:35:24 AM
case sheet: complications during pregnancy and post natal period
7.1.1
CompliCations during pregnanCy
(This exercise will help you to develop your skills in diagnosing obstetric complications and their management. The list of questions in history is long and covers different types of complications. By selecting the relevant ones, you will learn what to ask and look for when examining a patient. This can also be used as a ‘virtual exercise’ if enough cases of complications are not seen during your training period).
History:
During pregnancy:
Bleeding P/V- painless/with pain; duration of amenorrhea when first episode occurred; amount of bleeding; treatment taken; any blood transfused; USG done; any otherHigh BP: when first recorded as high; any pre-pregnancy hypertension; headache and blurring of vision; pain in epigastrium; urine protein absent/present; decreased urinary output; edema yes/no; Convulsions yes/no; any convulsions previously and number; treatment taken; previous h/o of epilepsy and treatment taken; unconsciousness yes/no; tongue bite yes/no; involuntary passing urine yes/no; othersBreathlessness on exertion yes/no; puffiness of face yes/no; pedal edema yes/no; Any other
During delivery
Prolonged labourSudden disappearance of labour pains (s/o uterine rupture)PPHHome delivery attended by unskilled personnel/TBA/RelativeRetained placentaAny fitsSweating, confusion, low BP; loss of consciousnessPerineal tears
Post-partum
Fever, urinary retention/incontinence; constipation/feacal incontinence; pain abdomen; foul smelling lochia; excessive bleeding p/v; breast engorgement; any other
Examination:
GE:
P/A:
P/V:
Final diagnosis
assessment grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
a.
b.
c.
d.e.
07_PPP 141_(08-09)_WHO India_Tra1 1 19/09/2009 11:36:19 AM
case sheet: complications during pregnancy and post natal period
7.2.1
CompliCations during pregnanCy
(This exercise will help you to develop your skills in diagnosing obstetric complications and their management. The list of questions in history is long and covers different types of complications. By selecting the relevant ones, you will learn what to ask and look for when examining a patient. This can also be used as a ‘virtual exercise’ if enough cases of complications are not seen during your training period).
History:
During pregnancy:
Bleeding P/V- painless/with pain; duration of amenorrhea when first episode occurred; amount of bleeding; treatment taken; any blood transfused; USG done; any otherHigh BP: when first recorded as high; any pre-pregnancy hypertension; headache and blurring of vision; pain in epigastrium; urine protein absent/present; decreased urinary output; edema yes/no; Convulsions yes/no; any convulsions previously and number; treatment taken; previous h/o of epilepsy and treatment taken; unconsciousness yes/no; tongue bite yes/no; involuntary passing urine yes/no; othersBreathlessness on exertion yes/no; puffiness of face yes/no; pedal edema yes/no; Any other
During delivery
Prolonged labourSudden disappearance of labour pains (s/o uterine rupture)PPHHome delivery attended by unskilled personnel/TBA/RelativeRetained placentaAny fitsSweating, confusion, low BP; loss of consciousnessPerineal tears
Post-partum
Fever, urinary retention/incontinence; constipation/feacal incontinence; pain abdomen; foul smelling lochia; excessive bleeding p/v; breast engorgement; any other
Examination:
GE:
P/A:
P/V:
Final diagnosis
assessment grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
a.
b.
c.
d.e.
07_PPP 141_(08-09)_WHO India_Tra3 3 19/09/2009 11:36:19 AM
case sheet: complications during pregnancy and post natal period
7.3.1
CompliCations during pregnanCy
(This exercise will help you to develop your skills in diagnosing obstetric complications and their management. The list of questions in history is long and covers different types of complications. By selecting the relevant ones, you will learn what to ask and look for when examining a patient. This can also be used as a ‘virtual exercise’ if enough cases of complications are not seen during your training period).
History:
During pregnancy:
Bleeding P/V- painless/with pain; duration of amenorrhea when first episode occurred; amount of bleeding; treatment taken; any blood transfused; USG done; any otherHigh BP: when first recorded as high; any pre-pregnancy hypertension; headache and blurring of vision; pain in epigastrium; urine protein absent/present; decreased urinary output; edema yes/no; Convulsions yes/no; any convulsions previously and number; treatment taken; previous h/o of epilepsy and treatment taken; unconsciousness yes/no; tongue bite yes/no; involuntary passing urine yes/no; othersBreathlessness on exertion yes/no; puffiness of face yes/no; pedal edema yes/no; Any other
During delivery
Prolonged labourSudden disappearance of labour pains (s/o uterine rupture)PPHHome delivery attended by unskilled personnel/TBA/RelativeRetained placentaAny fitsSweating, confusion, low BP; loss of consciousnessPerineal tears
Post-partum
Fever, urinary retention/incontinence; constipation/feacal incontinence; pain abdomen; foul smelling lochia; excessive bleeding p/v; breast engorgement; any other
Examination:
GE:
P/A:
P/V:
Final diagnosis
assessment grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
a.
b.
c.
d.e.
07_PPP 141_(08-09)_WHO India_Tra5 5 19/09/2009 11:36:19 AM
case sheet: complications during pregnancy and post natal period
7.4.1
CompliCations during pregnanCy
(This exercise will help you to develop your skills in diagnosing obstetric complications and their management. The list of questions in history is long and covers different types of complications. By selecting the relevant ones, you will learn what to ask and look for when examining a patient. This can also be used as a ‘virtual exercise’ if enough cases of complications are not seen during your training period).
History:
During pregnancy:
Bleeding P/V- painless/with pain; duration of amenorrhea when first episode occurred; amount of bleeding; treatment taken; any blood transfused; USG done; any otherHigh BP: when first recorded as high; any pre-pregnancy hypertension; headache and blurring of vision; pain in epigastrium; urine protein absent/present; decreased urinary output; edema yes/no; Convulsions yes/no; any convulsions previously and number; treatment taken; previous h/o of epilepsy and treatment taken; unconsciousness yes/no; tongue bite yes/no; involuntary passing urine yes/no; othersBreathlessness on exertion yes/no; puffiness of face yes/no; pedal edema yes/no; Any other
During delivery
Prolonged labourSudden disappearance of labour pains (s/o uterine rupture)PPHHome delivery attended by unskilled personnel/TBA/RelativeRetained placentaAny fitsSweating, confusion, low BP; loss of consciousnessPerineal tears
Post-partum
Fever, urinary retention/incontinence; constipation/feacal incontinence; pain abdomen; foul smelling lochia; excessive bleeding p/v; breast engorgement; any other
Examination:
GE:
P/A:
P/V:
Final diagnosis
assessment grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
a.
b.
c.
d.e.
07_PPP 141_(08-09)_WHO India_Tra7 7 19/09/2009 11:36:20 AM
case sheet: complications during pregnancy and post natal period
7.5.1
CompliCations during pregnanCy
(This exercise will help you to develop your skills in diagnosing obstetric complications and their management. The list of questions in history is long and covers different types of complications. By selecting the relevant ones, you will learn what to ask and look for when examining a patient. This can also be used as a ‘virtual exercise’ if enough cases of complications are not seen during your training period).
History:
During pregnancy:
Bleeding P/V- painless/with pain; duration of amenorrhea when first episode occurred; amount of bleeding; treatment taken; any blood transfused; USG done; any otherHigh BP: when first recorded as high; any pre-pregnancy hypertension; headache and blurring of vision; pain in epigastrium; urine protein absent/present; decreased urinary output; edema yes/no; Convulsions yes/no; any convulsions previously and number; treatment taken; previous h/o of epilepsy and treatment taken; unconsciousness yes/no; tongue bite yes/no; involuntary passing urine yes/no; othersBreathlessness on exertion yes/no; puffiness of face yes/no; pedal edema yes/no; Any other
During delivery
Prolonged labourSudden disappearance of labour pains (s/o uterine rupture)PPHHome delivery attended by unskilled personnel/TBA/RelativeRetained placentaAny fitsSweating, confusion, low BP; loss of consciousnessPerineal tears
Post-partum
Fever, urinary retention/incontinence; constipation/feacal incontinence; pain abdomen; foul smelling lochia; excessive bleeding p/v; breast engorgement; any other
Examination:
GE:
P/A:
P/V:
Final diagnosis
assessment grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
a.
b.
c.
d.e.
07_PPP 141_(08-09)_WHO India_Tra9 9 19/09/2009 11:36:20 AM
case sheet: complications during pregnancy and post natal period
7.6.1
CompliCations during pregnanCy
(This exercise will help you to develop your skills in diagnosing obstetric complications and their management. The list of questions in history is long and covers different types of complications. By selecting the relevant ones, you will learn what to ask and look for when examining a patient. This can also be used as a ‘virtual exercise’ if enough cases of complications are not seen during your training period).
History:
During pregnancy:
Bleeding P/V- painless/with pain; duration of amenorrhea when first episode occurred; amount of bleeding; treatment taken; any blood transfused; USG done; any otherHigh BP: when first recorded as high; any pre-pregnancy hypertension; headache and blurring of vision; pain in epigastrium; urine protein absent/present; decreased urinary output; edema yes/no; Convulsions yes/no; any convulsions previously and number; treatment taken; previous h/o of epilepsy and treatment taken; unconsciousness yes/no; tongue bite yes/no; involuntary passing urine yes/no; othersBreathlessness on exertion yes/no; puffiness of face yes/no; pedal edema yes/no; Any other
During delivery
Prolonged labourSudden disappearance of labour pains (s/o uterine rupture)PPHHome delivery attended by unskilled personnel/TBA/RelativeRetained placentaAny fitsSweating, confusion, low BP; loss of consciousnessPerineal tears
Post-partum
Fever, urinary retention/incontinence; constipation/feacal incontinence; pain abdomen; foul smelling lochia; excessive bleeding p/v; breast engorgement; any other
Examination:
GE:
P/A:
P/V:
Final diagnosis
assessment grading (satisfactory/unsatisfactory)
Name and Signature of Trainer/Supervisor:
a.
b.
c.
d.e.
07_PPP 141_(08-09)_WHO India_Tra11 11 19/09/2009 11:36:20 AM