JITRA :Antenatal COLOR Coding

An update of our earlier posting on maternal health....today was our Inspectorate general briefing.

MANAGING THE PREGNANT LADIES ACCORDING TO THE COLOUR CODING SYSTEM


RED COLOR –IMMEDIATE ADMITTANCE TO HOSPITAL

1. Eclampsia
Preeclampsia-high blood pressure with albumin content in the urine 1+ or having such symptom or BP >160/110 mmHg.
2. Chest pain during pregnancy with sign symptoms like shortness of breath and palpitation
3. Breathing difficulty during doing mild work like swiping the floor, washing dishes
4. Uncontrolled diabetes during pregnancy ( presence of ketone bodies)
5. Bleeding per vagina during pregnancy
6. Abnormal heart beat of the fetus
· FHR < 110/min at and after 26 weeks
· FHR > 160/min after 34 weeks( heart rate is raised in premature)
7. Presence of anemic symptoms regardless the gestation week
8. Premature contraction of the uterus
9. Leaking liquor without uterine contraction
10. Severe Asthmatic attack



YELLOW COLOR-REFERAL TO FAMILY MEDICINE SPECILIST /O& G CLINIC NEARBY

1. HIV positive mother

2. Hepatitis B positive mother

3. High blood pressure > 140/90 and <160/110>

4. Diabetic mother.

5. Reduced foetal movement at > 32 weeks of gestation.

6. Gestation is more than 7 days from the Estimation Date of Delivery

7. Multiple pregnancy


GREEN CODE-REFERRED TO MEDICAL OFFICER (M& HO)

1. Rhesus negative.
2. Body weight of mother before pregnancy or at booking weight is <>
3. Current health problem ( including psychiatry and handicapped) except Diabetes and Hypertension.
4. Past Gynecological operation.
5. Drug/cigarette/alcohol addiction.
6. Unsure Last Normal Menstrual Period ( LMNP).
7. Past History of continuous miscarriages ( > 3 times).
8. Past history of obstetrics.

· Caesarean

· History of Pregnancy Induced Hypertension / Eclampsia / Diabetes

· Premature Death

· History of Low birth weight of the new born -

· Third degree perineal tear.

· Sticked placenta.

· Post partum hemorrhage.

· Instrumental delivery.

· High blood pressure with urine albumin.

· Anemia.

· SFH difference of 4cm compared to gestation period.

· Head did not engage.

. Weight more than 80kg.

· Elongated labor.

· Abnormal lie.

WHITE CODE 1 – HOSPITAL DELIVERY

1.Primigravida.

2.Young or old mother.

3.Grand multi Para( 6 or more).

4.Height of less than 145cm.

5.Single mother.

6.Unsuitable home environment.

WHITE CODE 2 – ALLOWED FOR HOME DELIVERY/ ALTERNATIVE BIRTHING CENTRE

1. Gravida 2-5
   
2. No past obstetrics problem.
   
3. No medical problem.
   
4. No past antenatal complications.
   
5. Height of more than 145cm.
   
6. Child-bearing age.
   
7. Appropriate fetal size and weight.
   
8. POA is between 37 and 41 weeks.
   
9. Proper family and social support.