Administer frusemide 80 mg intravenous stat 30 minutes before the transfusion Give oxygen Investigate and treat the underlying cause of anaemia Give ferrous sulphate 200 mg every 8 hours, PLUS folic acid 5 mg once a day for three months) If in established labour: Nurse patient in a propped-up position Obtain blood for Hb, grouping and cross-matching Insert urethral catheter Administer IV frusemide 80 mg stat Give oxygen Deliver the patient Do not allow patient to bear down with contractions Assist second stage of labour by performing vacuum extraction Do active management of third stage of labour: Give uterotonic medicine within one minute of birth. Oxytocin 10 IU IM or Misoprostol 600 microgram (DO NOT ADMINISTER ERGOMETRINE) Apply controlled cord traction while applying counter traction on the uterus. Perform uterine massage; immediate massage following delivery of placenta and palpation of uterus every 15 minutes for 2 hours Monitor vital signs every half an hour post-delivery until patient is stable Monitor input of given volume of IV fluids and urinary output per hour Monitor closely for signs of heart failure post-partum until condition is stable Investigate and treat the underlying cause of anaemia Give ferrous sulphate 200 mg every 8 hours, PLUS folic acid 5 mg once a day for three months Do not give blood transfusion while in labour Transfuse packed cells 24 hours post delivery Transfuse slowly, one unit to run for 4 hours MALARIA IN PREGNANCY MANAGEMENT OF MALARIA IN PREGNANCY DISPENSARY & HEALTH CENTRE Uncomplicated malaria Investigations Take a blood smear to test for malaria parasites Take a blood for Hb level Treatment Give quinine tablets 10 mg/kg body weight by mouth every 8 hours for 7 days Give paracetamol 1 g by mouth every 8 hours for 3 days If parasitaemia and/or clinical signs persist after 3 days of treatment with quinine and if the pregnancy is not in the first trimester:
Administer frusemide 80 mg intravenous stat 30 minutes before the transfusion Give oxygen Investigate and treat the underlying cause of anaemia Give ferrous sulphate 200 mg every 8 hours, PLUS folic acid 5 mg once a day for three months) If in established labour: Nurse patient in a propped-up position Obtain blood for Hb, grouping and cross-matching Insert urethral catheter Administer IV frusemide 80 mg stat Give oxygen Deliver the patient Do not allow patient to bear down with contractions Assist second stage of labour by performing vacuum extraction Do active management of third stage of labour: Give uterotonic medicine within one minute of birth. Oxytocin 10 IU IM or Misoprostol 600 microgram (DO NOT ADMINISTER ERGOMETRINE) Apply controlled cord traction while applying counter traction on the uterus. Perform uterine massage; immediate massage following delivery of placenta and palpation of uterus every 15 minutes for 2 hours Monitor vital signs every half an hour post-delivery until patient is stable Monitor input of given volume of IV fluids and urinary output per hour Monitor closely for signs of heart failure post-partum until condition is stable Investigate and treat the underlying cause of anaemia Give ferrous sulphate 200 mg every 8 hours, PLUS folic acid 5 mg once a day for three months Do not give blood transfusion while in labour Transfuse packed cells 24 hours post delivery Transfuse slowly, one unit to run for 4 hours MALARIA IN PREGNANCY MANAGEMENT OF MALARIA IN PREGNANCY DISPENSARY & HEALTH CENTRE Uncomplicated malaria Investigations Take a blood smear to test for malaria parasites Take a blood for Hb level Treatment Give quinine tablets 10 mg/kg body weight by mouth every 8 hours for 7 days Give paracetamol 1 g by mouth every 8 hours for 3 days If parasitaemia and/or clinical signs persist after 3 days of treatment with quinine and if the pregnancy is not in the first trimester:
guidelines_for_malawi_and_tanzania_with_foreword_20.11.13.docx