Table 2.
Interventions considered in routine ANC guidelines and number of guidelines recommending each intervention
| Screening / diagnostic procedures | Clinical interventions | Health systems | n (%) |
|---|---|---|---|
| STDs (syphilis) | 14 (93) | ||
| STDs (HIV), anaemia and pre‐eclampsia (BP + proteinuria) | 13 (87) | ||
| Routine ABO, D Rhesus testing | Supplementation: folic acid | 12 (80) | |
| Weight and BMI, infections (rubella, hepatitis B) | Advice: nutrition, exercise and/or rest, smoking cessation | 11 (73) | |
| Early ultrasound (first and second trimester), GDM and asymptomatic bacteriuria | Supplementation: iron | 10 (67) | |
| Auscultation of fetal heart, symphysis‐fundal height, Down syndrome | Advice: breastfeeding | 9 (60) | |
| Abdominal palpation, infections (bacterial vaginosis, Chlamydia) | Advice: alcohol intake, sexual intercourse, travelling. Prophylaxis: RhD | 8 (53) | |
| Infections (toxoplasmosis, hepatitis C), domestic violence | Advice: work. Management: nausea and vomiting | 7 (47) | |
| Substance use, for cervical cancer, group B streptococcus | Supplementation: vitamin D. Vaccines: tetanus | 6 (40) | |
| Breast and pelvic examination, preterm labour, postnatal depression | Advice: labour and delivery, illicit drug use and medications. Supplementation: vitamin A. Vaccines: influenza | Frequency of visits | 5 (33) |
| Fetal movement count, pelvimetry, late ultrasound and/or Doppler. tobacco use and exposure, sickle cell and thalassaemia | Advice: information on pregnancy and family planning. Management: oral health, constipation, breech presentation | 4 (27) | |
| History and physical examination, evaluation of oedema. Risk profile, fetal wellbeing and fetal anomalies. Infections (CMV), alcohol abuse and thyroid dysfunction. Antenatal cardiotocography, urinalysis | Advice: warning signs, preterm labour, prenatal screening. Prophylaxis: anti‐malarial drugs. Supplementation: calcium. Management: vaginal discharge |
Care documents Place of delivery Provider of ANC |
3 (20) |
| Infections (parvovirus B19) | Advice: course of care, hot tubs and saunas, hair treatments, HIV and other STD, vaginal birth after caesarean. Prophylaxis: steroids for women at risk of preterm birth. Management: haemorrhoids, varicose veins, backache, vaginal bleeding | First antenatal visit | 2 (13) |
| Infections (candidiasis), psycho‐social risk factors | Advice: healthy lifestyle, self‐care, emotional wellbeing, tattoos in lower back, shaken baby syndrome, cystic fibrosis, warfarin use in pregnancy. Prophylaxis: low‐dose aspirin, DVT/PTE, MTCH transmission of HIV. Vaccines: hepatitis B, rubella, varicella, pertussis, pneumococcus. Supplementation: vitamin B6, vitamin C, magnesium, zinc, multivitamins. Management: unintended pregnancy, late pregnancy symptoms, fever, swelling, heartburn, frequency of urination, palpitations, breathlessness, fatigability, syphilis, HSV, HBV, parasitosis, anaemia, carpal tunnel syndrome, depression, drug abuse, obesity, post‐term pregnancy. Vision Care Follow‐up of modifiable risk factors. |
Antenatal classes Evaluation of satisfaction Place of ANC visit |
1 (7) |
BMI, body mass index; BP, blood pressure; CMV, cytomegalovirus; DVT/PTE, deep vein thrombosis/pulmonary thromboembolism; GDM, gestational diabetes mellitus; HBV, hepatitis B virus; HSV, herpes simplex virus; MTCH, mother‐to‐child; STDs, sexually transmitted diseases.