CURRENT STANDARD OPERATING PROCEDURE

OPD/DAILY CONSULTATION/PRENATAL CARE

1. Upon the arrival of the patient, the health care provider on duty will obtain patients data and vital
signs. For old patients, the health care provider will get her old record for continuation of record of
care being done to her. And for new patients, new record will be made.

2. The health care provider on duty will interview the patient regarding her current medical complaint.

3. After obtaining all the data needed, the patient will be asked to wait for her turn for consultation if
there is a waiting time needed but if there’s none, she will be directed to consultation room for
privacy and thorough examination.

6. The health care provider will diligently perform the examination and obtain the data needed like last
menstrual period (LMP), Age of gestation (AOG), Expected date of confinement (EDC), Fundic height
and Fetal heart beat (if already audible by Doppler or stethoscope). Internal examination will be done
only when necessary.

9. The health care provider will request some needed laboratory examinations like UA, CBC, BT, PELVIC
UTZ, TVS etc., only if necessary and also for monitoring of the baby’s wellbeing.

10. The health care provider will clearly discuss the danger during pregnancy to the patient. Also the
proper nutrition needed during pregnancy and some benefits of exercise.

11. The patient will be advised to get Tetanus Toxoid during her pregnancy.

12. For the patients with laboratory examination results, the health care provider will checked the result
accordingly and note if their will be danger signs to manage properly.

13. The attending physician will prescribe a medication such as MVT, iron preparation and calcium
supplement and gives further instruction as to the duration, frequency and follow up treatment.

1st month to 7th month – MONTHLY

8th month – EVERY 2 WEEKS

9th month – WEEKLY

PATIENT FOR DELIVERY

1. Patient record is taken for review of her history.

2.The attending physician/ midwife does a complete physical examination including internal
examination, if there is no contraindication.

3. Venoclysis is started, usually with D5LR 1Liter if needed.

4. Patient’s vital signs, FHT and progress of labor is monitored and recorded accordingly.
5. If the patient is in active labor she will be transferred to delivery room for further monitoring and
preparation for delivery of the baby. If no progress of labor and there’s a need for a cesarean section:
the patient will be transferred to a hospital for proper management.

6. During delivery, the patient will be attended by a qualified health care practitioner.

7. Right after the delivery, newborn care will be given and the four-time bound intervention will be
observed.

9. In case of complication like profuse/ abnormal bleeding after delivery of placenta, the patient will be
transferred to a higher facility for management.

8. If there is no any noted complication and there is laceration, the health care provider will do the
repair.

9. If there are no complications noted, the mother is transferred to the recovery room for post-partum
care while the baby is roomed-in after routine nursery care is done. Breastfeeding is advised.

10. The patient’s vital sign will be monitored. The uterus will be checked from time to time for any cause
of abdominal relaxation that may cause vaginal bleeding.

11. If the mother and the baby are in a stable condition after 24hrs, they can be discharged and asked to
comeback for follow up check up after a week.

12. Family planning will be properly discussed to encourage the patients to practice it.

Neonatal care

1. Asses the baby’s breathing and ventilate or resuscitate as needed.

2. Take steps to clear the airway and stimulate the infant if she/he does not cry or breathe
spontaneously.

3. Thoroughly dry the baby and keep it warm.

4. Properly timed cord clamping when pulsation stop.

5. Place the baby in skin – to –skin contact on the mother’s abdomen.

6. Latch baby to mother’s breast.

7. Administer eye prophylaxis (i.e. erythromycin ophthalmic ointment) and vit. K to infant after first full
breastfeed has taken place.

8. Record details of birth including:

* Date and time of delivery and sex of the baby

* anthropometric measurement

9. Perform a complete examination of the baby within the first two hours of life and inform the other
results.