Record antenatal visits and act on alerts

Available to

Midwives, obstetricians, nurses.

At each antenatal visit you record the measurements and tests. The system checks them against safety limits and raises an alert when one needs action.

Record a visit

Open Maternity → Antenatal Visits and select New, or use the Antenatal Visits tab of the episode.
Choose the Pregnancy and check the Visit Date. Gestation is calculated from the LMP.
Enter Weight, BP Systolic and BP Diastolic, Fundal Height and Fetal Heart Rate.
Choose the Presentation and Fetal Movements.
Under tests and symptoms record Urine Protein, Urine Glucose, Haemoglobin and Oedema. Enter any Danger Symptoms Reported (headache, visual disturbance, bleeding, leaking fluid, severe abdominal pain).
Enter the Next Visit Date and notes, then save. Any alert appears in a banner at the top.

A visit with an urgent alert: hypertension with proteinuria.

Alerts and when they are raised

Alert	Level	Raised when
Severe hypertension	Urgent	Systolic 160 or more, or diastolic 110 or more.
Hypertension with proteinuria (possible pre-eclampsia)	Urgent	Systolic 140 or more or diastolic 90 or more, with urine protein 1+ or more, at 20 weeks or later.
Raised blood pressure	Review	Systolic 140 or more or diastolic 90 or more without proteinuria.
Fetal movements absent	Urgent	Fetal movements recorded as absent. Reduced movements are a review alert.
Fetal heart rate outside 110 to 160	Urgent	A heart rate is entered outside that range.
Danger symptoms reported	Urgent	Anything is entered under danger symptoms.
Fundal height differs by more than 3 cm	Review	At 24 weeks or later, fundal height differs from gestation in weeks by more than 3.
Anaemia	Review	Haemoglobin below 11 g/dL.
Glycosuria	Review	Urine glucose positive.
Non-cephalic presentation	Review	Breech or transverse at 36 weeks or later.

Antenatal Alerts lists visits with an alert so that none is missed.

Postnatal visits

Postnatal visits (Maternity → Postnatal Visits) record the mother's blood pressure, temperature, pulse, uterus, lochia, wound, breastfeeding, an EPDS depression screening score (0 to 30), and contraception counselling. Alerts are raised for raised blood pressure, fever, abnormal lochia, wound infection signs, abnormal uterus findings and an EPDS score of 13 or more.

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