, National Guidelines for Quality Obstetrics and Perinatal Care
GUIDELINES FOR QUALITY
OBSTETRIC AND PERINATAL
CARE 2025/2026.
SECTION 1:
MATERNAL HEALTH
2
, National Guidelines for Quality Obstetrics and Perinatal Care
Table of Contents
Topic Page
Acknowledgements 4
Foreword 5
Acronyms 6
How to use this guide 7
Overview of MNH services in Kenya 9
Functional Anatomy and Physiology 24
Maternal Nutrition 35
Preconception Care 56
Focused Antenatal care 60
Complications / conditions during the Antenatal Period 73
Antepartum Haemorrhage 73
Preterm Premature rupture of membranes 79
Pre-eclampsia /Eclampsia 86
Abortion 98
Ectopic Pregnancy 108
Multiple Pregnancy 112
Malaria in Pregnancy 114
Anemia in Pregnancy 120
Cardiac Disease in Pregnancy 126
Sickle Cell Disease in Pregnancy 131
Syphilis in Pregnancy 138
Tuberculosis in Pregnancy 143
Diabetes in Pregnancy 150
HIV in Pregnancy 156
Interpersonal Communication and Counselling 167
Management of Labour and delivery 172
Using the partograph 183
Induction of Labour 193
Complications of Labour and Delivery 199
Prolonged Labour / Obstructed Labour 199/202
Rupture of the Uterus 209
Foetal Distress 212
Cord Presentation and Cord prolapse 214
Malpresentations and Malpositions 217
Shoulder Dystocia 224
Vacuum Extraction 229
Caesarean Section 233
Trial of Scar 237
Targeted Postnatal care 240
Complications and Danger signs in the Puerperium 256
Post Partum haemorrhage 256
Puerperal Sepsis 264
Shock 271
Uterine inversion 277
Psychological /mental disorders 281
Community Maternal and Newborn Health 286
Infection Prevention in MNH 293
Maternal and Perinatal Death Review 305
Research in MNH 311
Monitoring, Evaluation and Supervision 312
Kenya MNH Essential Drug list 318
Millennium Development goals and targets 322
Magnesium Sulphate Monitoring sheet 323
Minimum Package of MNH services by KEPH level 326
ESSENTIAL NEWBORN CARE 328
Care of the Normal Neonate 330
Breastfeeding 341
Neonatal Resuscitation 346
Management of High Risk Neonate 358`
Neonatal emergencies 374
References 407
3
, National Guidelines for Quality Obstetrics and Perinatal Care
ACKNOWLEDGEMENTS
4
GUIDELINES FOR QUALITY
OBSTETRIC AND PERINATAL
CARE 2025/2026.
SECTION 1:
MATERNAL HEALTH
2
, National Guidelines for Quality Obstetrics and Perinatal Care
Table of Contents
Topic Page
Acknowledgements 4
Foreword 5
Acronyms 6
How to use this guide 7
Overview of MNH services in Kenya 9
Functional Anatomy and Physiology 24
Maternal Nutrition 35
Preconception Care 56
Focused Antenatal care 60
Complications / conditions during the Antenatal Period 73
Antepartum Haemorrhage 73
Preterm Premature rupture of membranes 79
Pre-eclampsia /Eclampsia 86
Abortion 98
Ectopic Pregnancy 108
Multiple Pregnancy 112
Malaria in Pregnancy 114
Anemia in Pregnancy 120
Cardiac Disease in Pregnancy 126
Sickle Cell Disease in Pregnancy 131
Syphilis in Pregnancy 138
Tuberculosis in Pregnancy 143
Diabetes in Pregnancy 150
HIV in Pregnancy 156
Interpersonal Communication and Counselling 167
Management of Labour and delivery 172
Using the partograph 183
Induction of Labour 193
Complications of Labour and Delivery 199
Prolonged Labour / Obstructed Labour 199/202
Rupture of the Uterus 209
Foetal Distress 212
Cord Presentation and Cord prolapse 214
Malpresentations and Malpositions 217
Shoulder Dystocia 224
Vacuum Extraction 229
Caesarean Section 233
Trial of Scar 237
Targeted Postnatal care 240
Complications and Danger signs in the Puerperium 256
Post Partum haemorrhage 256
Puerperal Sepsis 264
Shock 271
Uterine inversion 277
Psychological /mental disorders 281
Community Maternal and Newborn Health 286
Infection Prevention in MNH 293
Maternal and Perinatal Death Review 305
Research in MNH 311
Monitoring, Evaluation and Supervision 312
Kenya MNH Essential Drug list 318
Millennium Development goals and targets 322
Magnesium Sulphate Monitoring sheet 323
Minimum Package of MNH services by KEPH level 326
ESSENTIAL NEWBORN CARE 328
Care of the Normal Neonate 330
Breastfeeding 341
Neonatal Resuscitation 346
Management of High Risk Neonate 358`
Neonatal emergencies 374
References 407
3
, National Guidelines for Quality Obstetrics and Perinatal Care
ACKNOWLEDGEMENTS
4
