OBSTETRICS
MANAGEMENT PROTOCOL
For Hospitals
,JANUARY 2021
,
, TABLE OF CONTENTS
TABLE OF CONTENTS ........................................................................................................................ i
FOREWORD..................................................................................................................................... iii
ACRONYMS ..................................................................................................................................... iv
ACKNOWLEDGMENT ...................................................................................................................... vi
LIST OF CONTRIBUTORS................................................................................................................. vii
LIST OF TABLES................................................................................................................................ ix
LIST OF ANNEXES ............................................................................................................................ ix
LIST OF FIGURES............................................................................................................................... x
1. RESPECTFUL MATERNITY CARE..................................................................................................... 1
2. RAPID INITIAL ASSESSMENT AND EMERGENCY MANAGEMENT..................................... 6
3. TRIAGE .....................................................................................................................................................10
LIAISON ..........................................................................................................................................12
4. PRECONCEPTION CARE ....................................................................................................................16
5. ANTENATAL CARE ..............................................................................................................................19
6. ECTOPIC PREGNANCY .......................................................................................................................30
7. MOLAR PREGNANCY ..........................................................................................................................36
8. HYPEREMESIS GRAVIDARUM.........................................................................................................39
9. ANTEPARTUM HEMORRHAGE.......................................................................................................44
PLACENTAL ABRUPTION ................................................................................................................44
PLACENTA PREVIA..........................................................................................................................46
ADHERENT PLACENTA ...................................................................................................................47
10. MULTIPLE PREGNANCY....................................................................................................................49
11. PREMATURE / PRELABOR RUPTURE OF MEMBRANE (PROM)................................55
12. LABOR AND DELIVERY......................................................................................................................60
MANAGEMENT DURING 1st STAGE...............................................................................................62
nd
MANAGEMENT DURING 2 STAGE .............................................................................................66
13. THIRD STAGE OF LABOR ..................................................................................................................69
14. NEWBORN CARE AT THE TIME OF BIRTH................................................................................71
ESSENTIAL NEWBORN CARE (ENC) ................................................................................................71
NEONATAL RESUSCITATION ..........................................................................................................76
15. POSTPARTUM / POSTNATAL CARE .............................................................................................80
ROUTINE POSTPARTUM / POSTNATAL CARE ................................................................................80
PUERPERAL FEBRILE MORBIDITIES ................................................................................................84
MANAGEMENT ..............................................................................................................................86
PSYCHOLOGICAL MORBIDITIES DURING PUERPERIUM.................................................................90
16. ABNORMAL LABOR.............................................................................................................................93
MANAGEMENT OF FIRST STAGE ABNORMALITIES........................................................................94
MANAGING SECOND STAGE ABNORMALITIES ..............................................................................95
17. PRETERM LABOR.................................................................................................................................97
18. UMBLICAL CORD PROLAPSE........................................................................................................ 101
Obstetrics Management Protocol for Hospitals. MOH, i
MANAGEMENT PROTOCOL
For Hospitals
,JANUARY 2021
,
, TABLE OF CONTENTS
TABLE OF CONTENTS ........................................................................................................................ i
FOREWORD..................................................................................................................................... iii
ACRONYMS ..................................................................................................................................... iv
ACKNOWLEDGMENT ...................................................................................................................... vi
LIST OF CONTRIBUTORS................................................................................................................. vii
LIST OF TABLES................................................................................................................................ ix
LIST OF ANNEXES ............................................................................................................................ ix
LIST OF FIGURES............................................................................................................................... x
1. RESPECTFUL MATERNITY CARE..................................................................................................... 1
2. RAPID INITIAL ASSESSMENT AND EMERGENCY MANAGEMENT..................................... 6
3. TRIAGE .....................................................................................................................................................10
LIAISON ..........................................................................................................................................12
4. PRECONCEPTION CARE ....................................................................................................................16
5. ANTENATAL CARE ..............................................................................................................................19
6. ECTOPIC PREGNANCY .......................................................................................................................30
7. MOLAR PREGNANCY ..........................................................................................................................36
8. HYPEREMESIS GRAVIDARUM.........................................................................................................39
9. ANTEPARTUM HEMORRHAGE.......................................................................................................44
PLACENTAL ABRUPTION ................................................................................................................44
PLACENTA PREVIA..........................................................................................................................46
ADHERENT PLACENTA ...................................................................................................................47
10. MULTIPLE PREGNANCY....................................................................................................................49
11. PREMATURE / PRELABOR RUPTURE OF MEMBRANE (PROM)................................55
12. LABOR AND DELIVERY......................................................................................................................60
MANAGEMENT DURING 1st STAGE...............................................................................................62
nd
MANAGEMENT DURING 2 STAGE .............................................................................................66
13. THIRD STAGE OF LABOR ..................................................................................................................69
14. NEWBORN CARE AT THE TIME OF BIRTH................................................................................71
ESSENTIAL NEWBORN CARE (ENC) ................................................................................................71
NEONATAL RESUSCITATION ..........................................................................................................76
15. POSTPARTUM / POSTNATAL CARE .............................................................................................80
ROUTINE POSTPARTUM / POSTNATAL CARE ................................................................................80
PUERPERAL FEBRILE MORBIDITIES ................................................................................................84
MANAGEMENT ..............................................................................................................................86
PSYCHOLOGICAL MORBIDITIES DURING PUERPERIUM.................................................................90
16. ABNORMAL LABOR.............................................................................................................................93
MANAGEMENT OF FIRST STAGE ABNORMALITIES........................................................................94
MANAGING SECOND STAGE ABNORMALITIES ..............................................................................95
17. PRETERM LABOR.................................................................................................................................97
18. UMBLICAL CORD PROLAPSE........................................................................................................ 101
Obstetrics Management Protocol for Hospitals. MOH, i
