In this Study Session, you have learned:

• How to make a routine assessment of a pregnant woman at ANC visit, and identify warning signs and symptoms and the possible actions you should undertake. You have learned how to assess women for poor nutrition, pallor, shortness of breath, hypertension, fever, diabetes and vaginal infection. You have learned how to measure temperature, pulse and blood pressure. You are expected to assess properly every mother at each ANC visit for signs and symptoms of poor nutrition or iodine deficiency, including pale parts and goitre.
  
• Under normal circumstances, most women gain 9-12kg during normal pregnancy, but Weight gain is not a reliable indicator of pregnancy outcome. Sudden weight gain near the end of pregnancy is a warning of possible pre-eclampsia and for its seriousness. In such case, the woman should be referred to a health centre.
  
• Fever (a temperature of above 37.5°C) should be treated initially with fluids, paracetamol and cold sponging. Refer a pregnant woman to a health centre if her temperature stays high. She needs to be screened for infections such as malaria and other associating disease conditions.
  
• If the pulse rate rises above 100 beats per minute, it is a sign of ill health and the woman needs a referral to a health centre.
  
• Signs and symptoms of anaemia include pallor, tiredness, fast pulse and shortness of breath. Refer pregnant women with this feature.
  
• Shortness of breath is usual near the end of pregnancy as the growing baby crowds the mother's lungs. Refer her if it causes significant discomfort.
  
• If the blood pressure of a pregnant woman reaches 140/90 mmHg or higher, she has hypertension. All hypertension in pregnancy is a serious illness, which requires immediate referral to a health centre.
  
• Abnormal vaginal discharges, itching or swelling of the external genitalia, and burning or pain when urinating or during sex, are symptoms of vaginal infection, and the woman should be referred.