In this study session, you have learned that:

1. At every antenatal visit you should assess all pregnant women for signs and symptoms of poor nutrition or iodine deficiency, including pallor, lack of energy and goitre.
2. Most women gain 9-12 kg during a 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 the woman should be referred to a higher health facility.
3. Fever (a temperature of above 37.5°C) should be treated initially with fluids, paracetamol and cold sponging. Refer a pregnant woman to a higher health facility if her temperature stays high. She needs to be screened for infections such as malaria.
4. If the pulse rate rises above 100 beats per minute, it is a sign of ill health and the woman needs referral to a higher health facility.
5. Signs and symptoms of anaemia include pallor, tiredness, fast pulse and shortness of breath. Refer pregnant women with these characteristics.
6. Shortness of breath is usual near the end of pregnancy as the growing baby crowds the mother’s lungs. Refer her if it causes major discomfort.
7. 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 higher health facility.
8. Abnormal vaginal discharge, 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.