FHIR Server FHIR Server Version n/a

Resource PlanDefinition/FHIR Server from package who.fhir.anc-cds#current (62 ms)

Package

who.fhir.anc-cds

Type

PlanDefinition

FHIR Version

Source

http://fhir.org/guides/who/anc-cds/https://build.fhir.org/ig/WorldHealthOrganization/smart-anc/PlanDefinition-ANCDT17.html

Url

http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT17

Version

0.3.0

Status

active

Date

2021-06-11T23:25:04-06:00

Name

ANCDT17

Title

ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis

Experimental

False

Realm

Authority

who

Description

If the woman presents with any of the following symptoms and/or test results, conduct counselling and referral as needed

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

Note: links and images are rebased to the (stated) source

Id:

ANCDT17

Url:

ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis

Version:

0.3.0

Identifier:

value: ANC.DT.17

Name:

ANCDT17

Title:

ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis

Status:

active

Experimental:

false

Type:

system: http://terminology.hl7.org/CodeSystem/plan-definition-type

code: eca-rule

Date:

2021-06-11 23:25:04-0600

Publisher:

World Health Organization (WHO)

Description:

If the woman presents with any of the following symptoms and/or test results, conduct counselling and referral as needed

Use Context:

code

value

display

task

ANC.B10.4.

Diagnosis and treatment

Jurisdiction:

001

Libraries:

ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis

Actions:

ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis:
When: Named Event: ANC.B10.4. Diagnosis and treatment
Then:

Symptom(s) of severe pre-eclampsia! Refer urgently to hospital! Woman has hypertension. If she is experiencing a symptom of severe pre-eclampsia, then refer urgently to the hospital for further investigation and management. Procedure – Give magnesium sulphate – Give appropriate anti-hypertensives – Revise the birth plan – Refer urgently to hospital
If: Applicability: (((((((((((((((("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Severe headache")) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Severe headache"))) OR (("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Blurred vision"))) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Blurred vision"))) OR (("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Epigastric pain"))) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Epigastric pain"))) OR (("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Dizziness"))) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Dizziness"))) OR (("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Vomiting"))) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "Vomiting"))) OR (("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "None") AND ("Urine dipstick result – protein" = "++"))) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "None") AND ("Urine dipstick result – protein" = "++"))) OR (("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "None") AND ("Urine dipstick result – protein" = "+++"))) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "None") AND ("Urine dipstick result – protein" = "+++"))) OR (("Systolic blood pressure" ≥ 140 mmHg) AND ("Repeat systolic blood pressure" ≥ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "None") AND ("Urine dipstick result – protein" = "++++"))) OR (("Diastolic blood pressure" ≥ 90 mmHg) AND ("Repeat diastolic blood pressure" ≥ 90 mmHg) AND ("Symptoms of severe pre-eclampsia" = "None") AND ("Urine dipstick result – protein" = "++++")) (Should Refer urgently to a hospital)

Pre-eclampsia diagnosis! Refer to hospital and revise birth plan. Woman has pre-eclampsia – SBP of 140 mmHg or above and/or DBP of 90 mmHg or above and proteinuria 2+ and no symptom of severe pre-eclampsia. Procedure: – Refer to hospital – Revise the birth plan
If: Applicability: ((((((("Systolic blood pressure" ≤ 140 mmHg) AND ("Repeat systolic blood pressure" ≤ 140 mmHg) AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia") AND ("Urine dipstick result – protein" = "++")) OR (("Systolic blood pressure" > 160 mmHg) AND ("Repeat systolic blood pressure" > 160 mmHg) AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia") AND ("Urine dipstick result – protein" = "++"))) OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg) AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg) AND (Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia") AND ("Urine dipstick result – protein" = "++"))) OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg) AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg) AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia") AND ("Urine dipstick result – protein" = "+++"))) OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg) AND (90 mmHg – "Repeat diastolic blood pressure" < 110 mmHg) AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia") AND ("Urine dipstick result – protein" = "+++"))) OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg) AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg) AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia") AND ("Urine dipstick result – protein" = "++++"))) OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg) AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg) AND ("Symptoms of severe pre-eclampsia" = "No symptoms of severe pre-eclampsia") AND ("Urine dipstick result – protein" = "++++")) (Should Refer urgently to a hospital 2)

Woman has severe hypertension. If SBP is 160 mmHg or higher and/or DBP is 110 mmHg or higher, then refer urgently to the hospital for further investigation and management.
If: Applicability: (((("Systolic blood pressure" ≥ 160 mmHg) AND ("Repeat systolic blood pressure" ≥ 160 mmHg) AND ("Urine dipstick result – protein" = "+")) OR (("Diastolic blood pressure" ≥ 110 mmHg) AND ("Repeat diastolic blood pressure" ≥ 110 mmHg) AND ("Urine dipstick result – protein" = "+"))) OR (("Systolic blood pressure" ≥ 160 mmHg) AND ("Repeat systolic blood pressure" ≥ 160 mmHg) AND ("Urine dipstick result – protein" = "None"))) OR (("Diastolic blood pressure" ≥ 110 mmHg) AND ("Repeat diastolic blood pressure" ≥ 110 mmHg) AND ("Urine dipstick result – protein" = "None")) (Should Refer urgently to a hospital 3)

Woman has hypertension – SBP of 140 mmHg or higher and/or DBP of 90 mmHg or higher and no proteinuria. Counselling: – Advice to reduce workload and to rest – Advise on danger signs – Reassess at the next contact or in 1 week if 8 months pregnant – If hypertension persists after 1 week or at next contact, refer to hospital or discuss case with the doctor, if available
If: Applicability: (((("Existing chronic health conditions" = "Hypertension") OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg) AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg) AND ("Urine dipstick result – protein" = "+"))) OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg) AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg) AND ("Urine dipstick result – protein" = "+"))) OR ((140 mmHg ≤ "Systolic blood pressure" < 160 mmHg) AND (140 mmHg ≤ "Repeat systolic blood pressure" < 160 mmHg) AND (Urine dipstick result – protein" = "None"))) OR ((90 mmHg ≤ "Diastolic blood pressure" < 110 mmHg) AND (90 mmHg ≤ "Repeat diastolic blood pressure" < 110 mmHg) AND ("Urine dipstick result – protein" = "None")) (Should Conduct hypertension counselling)

Source

{
  "resourceType" : "PlanDefinition",
  "id" : "ANCDT17",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n    <table class=\"grid dict\">\n        \n        <tr>\n            <th scope=\"row\"><b>Id: </b></th>\n            <td style=\"padding-left: 4px;\">ANCDT17</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Url: </b></th>\n            <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-ANCDT17.html\">ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis</a></td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Version: </b></th>\n            <td style=\"padding-left: 4px;\">0.3.0</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Identifier: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                \n                <p style=\"margin-bottom: 5px;\">\n                    <b>value: </b> <span>ANC.DT.17</span>\n                </p>\n                \n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Name: </b></th>\n            <td style=\"padding-left: 4px;\">ANCDT17</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Title: </b></th>\n            <td style=\"padding-left: 4px;\">ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis</td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Status: </b></th>\n            <td style=\"padding-left: 4px;\">active</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Experimental: </b></th>\n            <td style=\"padding-left: 4px;\">false</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Type: </b></th>\n            <td style=\"padding-left: 4px;\">\n                \n                    \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>system: </b> <span><a href=\"http://hl7.org/fhir/R4/codesystem-plan-definition-type.html\">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>\n                        </p>\n                        \n                        \n                        <p style=\"margin-bottom: 5px;\">\n                            <b>code: </b> <span>eca-rule</span>\n                        </p>\n                        \n                        \n                    \n                \n                \n            </td>\n        </tr>\n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Date: </b></th>\n            <td style=\"padding-left: 4px;\">2021-06-11 23:25:04-0600</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Publisher: </b></th>\n            <td style=\"padding-left: 4px;\">World Health Organization (WHO)</td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Description: </b></th>\n            <td style=\"padding-left: 4px;\">If the woman presents with any of the following symptoms and/or test results, conduct counselling and referral as needed</td>\n        </tr>\n        \n        \n        \n        \n        <tr>\n            <th scope=\"row\"><b>Use Context: </b></th>\n            <td style=\"padding-left: 4px;\">\n                <table class=\"grid-dict\">\n                    <tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>\n                    \n                      <tr>\n                        <td>task</td>\n                        <td>ANC.B10.4.</td>\n                        <td>Diagnosis and treatment</td>\n                      </tr>\n                    \n                </table>\n            </td>\n        </tr>\n        \n        \n        <tr>\n            <th scope=\"row\"><b>Jurisdiction: </b></th>\n            <td style=\"padding-left: 4px;\">001</td>\n        </tr>\n        \n        \n        \n        \n        \n        \n        \n        \n\n        \n        <tr>\n          <th scope=\"row\"><b>Libraries: </b></th>\n          <td style=\"padding-left: 4px;\">\n            <table class=\"grid-dict\">\n              \n                <tr><td><a href=\"Library-ANCDT17.html\">ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis</a></td></tr>\n              \n            </table>\n          </td>\n        </tr>\n        \n\n        \n        <tr>\n          <th scope=\"row\"><b>Actions: </b></th>\n          <td style=\"padding-left: 4px;\">\n            <table class=\"grid-dict\">\n              \n                <tr>\n                  <td>\n                    <b> ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis:</b> <br/>\n                    <b>When:</b> <i>Named Event:</i> ANC.B10.4. Diagnosis and treatment<br/>\n                    \n                    \n                      <b>Then:</b>\n                      <table class=\"grid-dict\">\n                        \n                          <tr>\n                            <td>\n                              Symptom(s) of severe pre-eclampsia! Refer urgently to hospital!\nWoman has hypertension. If she is experiencing a symptom of severe pre-eclampsia, then refer urgently to the hospital for further investigation and management.\n\nProcedure\nâ€“ Give magnesium sulphate\nâ€“ Give appropriate anti-hypertensives\nâ€“ Revise the birth plan\nâ€“ Refer urgently to hospital<br/>\n                              \n                              <b>If:</b> <i>Applicability:</i> ((((((((((((((((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Severe headache&amp;quot;))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Severe headache&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Blurred vision&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Blurred vision&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Epigastric pain&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Epigastric pain&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Dizziness&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Dizziness&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Vomiting&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;Vomiting&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;None&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;None&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;None&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+++&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;None&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+++&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;None&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++++&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 90 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;None&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++++&amp;quot;)) <i>(Should Refer urgently to a hospital)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                          <tr>\n                            <td>\n                              Pre-eclampsia diagnosis! Refer to hospital and revise birth plan.\nWoman has pre-eclampsia â€“ SBP of 140 mmHg or above and/or DBP of 90 mmHg or above and proteinuria 2+ and no symptom of severe pre-eclampsia.\n\nProcedure: \nâ€“ Refer to hospital \nâ€“ Revise the birth plan<br/>\n                              \n                              <b>If:</b> <i>Applicability:</i> (((((((&amp;quot;Systolic blood pressure&amp;quot; â‰¤ 140 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¤ 140 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;No symptoms of severe pre-eclampsia&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++&amp;quot;))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; &amp;gt; 160 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; &amp;gt; 160 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;No symptoms of severe pre-eclampsia&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++&amp;quot;)))\n  OR ((90 mmHg â‰¤ &amp;quot;Diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (90 mmHg â‰¤ &amp;quot;Repeat diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;No symptoms of severe pre-eclampsia&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++&amp;quot;)))\n  OR ((140 mmHg â‰¤ &amp;quot;Systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (140 mmHg â‰¤ &amp;quot;Repeat systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;No symptoms of severe pre-eclampsia&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+++&amp;quot;)))\n  OR ((90 mmHg â‰¤ &amp;quot;Diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (90 mmHg â€“ &amp;quot;Repeat diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;No symptoms of severe pre-eclampsia&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+++&amp;quot;)))\n  OR ((140 mmHg â‰¤ &amp;quot;Systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (140 mmHg â‰¤ &amp;quot;Repeat systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;No symptoms of severe pre-eclampsia&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++++&amp;quot;)))\n  OR ((90 mmHg â‰¤ &amp;quot;Diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (90 mmHg â‰¤ &amp;quot;Repeat diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (&amp;quot;Symptoms of severe pre-eclampsia&amp;quot; = &amp;quot;No symptoms of severe pre-eclampsia&amp;quot;)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;++++&amp;quot;)) <i>(Should Refer urgently to a hospital 2)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                          <tr>\n                            <td>\n                              Woman has severe hypertension. If SBP is 160 mmHg or higher and/or DBP is 110 mmHg or higher, then refer urgently to the hospital for further investigation and management.<br/>\n                              \n                              <b>If:</b> <i>Applicability:</i> ((((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 160 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 160 mmHg)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+&amp;quot;))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 110 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 110 mmHg)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+&amp;quot;)))\n  OR ((&amp;quot;Systolic blood pressure&amp;quot; â‰¥ 160 mmHg)\n  AND (&amp;quot;Repeat systolic blood pressure&amp;quot; â‰¥ 160 mmHg)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;None&amp;quot;)))\n  OR ((&amp;quot;Diastolic blood pressure&amp;quot; â‰¥ 110 mmHg)\n  AND (&amp;quot;Repeat diastolic blood pressure&amp;quot; â‰¥ 110 mmHg)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;None&amp;quot;)) <i>(Should Refer urgently to a hospital 3)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                          <tr>\n                            <td>\n                              Woman has hypertension â€“ SBP of 140 mmHg or higher and/or DBP of 90 mmHg or higher and no proteinuria.\n\nCounselling:\nâ€“ Advice to reduce workload and to rest\nâ€“ Advise on danger signs\nâ€“ Reassess at the next contact or in 1 week if 8 months pregnant\nâ€“ If hypertension persists after 1 week or at next contact, refer to hospital or discuss case with the doctor, if available<br/>\n                              \n                              <b>If:</b> <i>Applicability:</i> ((((&amp;quot;Existing chronic health conditions&amp;quot; = &amp;quot;Hypertension&amp;quot;)\n  OR ((140 mmHg â‰¤ &amp;quot;Systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (140 mmHg â‰¤ &amp;quot;Repeat systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+&amp;quot;)))\n  OR ((90 mmHg â‰¤ &amp;quot;Diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (90 mmHg â‰¤ &amp;quot;Repeat diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;+&amp;quot;)))\n  OR ((140 mmHg â‰¤ &amp;quot;Systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (140 mmHg â‰¤ &amp;quot;Repeat systolic blood pressure&amp;quot; &amp;lt; 160 mmHg)\n  AND (Urine dipstick result â€“ protein&amp;quot; = &amp;quot;None&amp;quot;)))\n  OR ((90 mmHg â‰¤ &amp;quot;Diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (90 mmHg â‰¤ &amp;quot;Repeat diastolic blood pressure&amp;quot; &amp;lt; 110 mmHg)\n  AND (&amp;quot;Urine dipstick result â€“ protein&amp;quot; = &amp;quot;None&amp;quot;)) <i>(Should Conduct hypertension counselling)</i><br/>\n                              \n                                \n                              \n                            </td>\n                          </tr>\n                        \n                      </table>\n                    \n                  </td>\n                </tr>\n              \n            </table>\n          </td>\n        </tr>\n        \n    </table>\n</div>"
  },
  "url" : "http://fhir.org/guides/who/anc-cds/PlanDefinition/ANCDT17",
  "identifier" : [
    {
      "use" : "official",
      "value" : "ANC.DT.17"
    }
  ],
  "version" : "0.3.0",
  "name" : "ANCDT17",
  "title" : "ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule"
      }
    ]
  },
  "status" : "active",
  "experimental" : false,
  "date" : "2021-06-11T23:25:04-06:00",
  "publisher" : "World Health Organization (WHO)",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.who.int"
        }
      ]
    }
  ],
  "description" : "If the woman presents with any of the following symptoms and/or test results, conduct counselling and referral as needed",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "task",
        "display" : "Workflow Task"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://fhir.org/guides/who/anc-cds/CodeSystem/activity-codes",
            "code" : "ANC.B10.4.",
            "display" : "Diagnosis and treatment"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
          "code" : "001"
        }
      ]
    }
  ],
  "library" : [
    "http://fhir.org/guides/who/anc-cds/Library/ANCDT17"
  ],
  "action" : [
    {
      "title" : "ANC.DT.17 Pre-eclampsia, severe pre-eclampsia and hypertension diagnosis",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "ANC.B10.4. Diagnosis and treatment"
        }
      ],
      "action" : [
        {
          "id" : "1",
          "title" : "Refer urgently to a hospital",
          "description" : "Refer urgently to a hospital",
          "textEquivalent" : "Symptom(s) of severe pre-eclampsia! Refer urgently to hospital!\nWoman has hypertension. If she is experiencing a symptom of severe pre-eclampsia, then refer urgently to the hospital for further investigation and management.\n\nProcedure\nâ€“ Give magnesium sulphate\nâ€“ Give appropriate anti-hypertensives\nâ€“ Revise the birth plan\nâ€“ Refer urgently to hospital",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Pregnancy, childbirth, postpartum and newborn care guide (IMPAC) (2015): recommendation C3 (1)\nManaging complications guide (IMPAC) (2017): Section S-53, Table S-12 (5)"
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "((((((((((((((((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Severe headache\"))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Severe headache\")))\n  OR ((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Blurred vision\")))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Blurred vision\")))\n  OR ((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Epigastric pain\")))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Epigastric pain\")))\n  OR ((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Dizziness\")))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Dizziness\")))\n  OR ((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Vomiting\")))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"Vomiting\")))\n  OR ((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"None\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++\")))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"None\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++\")))\n  OR ((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"None\")\n  AND (\"Urine dipstick result â€“ protein\" = \"+++\")))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"None\")\n  AND (\"Urine dipstick result â€“ protein\" = \"+++\")))\n  OR ((\"Systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¥ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"None\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++++\")))\n  OR ((\"Diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Repeat diastolic blood pressure\" â‰¥ 90 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"None\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++++\"))",
                "language" : "text/cql-identifier",
                "expression" : "Should Refer urgently to a hospital"
              }
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          ]
        },
        {
          "id" : "2",
          "title" : "Refer urgently to a hospital",
          "description" : "Refer urgently to a hospital 2",
          "textEquivalent" : "Pre-eclampsia diagnosis! Refer to hospital and revise birth plan.\nWoman has pre-eclampsia â€“ SBP of 140 mmHg or above and/or DBP of 90 mmHg or above and proteinuria 2+ and no symptom of severe pre-eclampsia.\n\nProcedure: \nâ€“ Refer to hospital \nâ€“ Revise the birth plan",
          "documentation" : [
            {
              "type" : "citation",
              "label" : "Pregnancy, childbirth, postpartum and newborn care guide (IMPAC) (2015): recommendation C3 (1) \nManaging complications guide (IMPAC) (2017): Section S-52, Table S-12 (5)\nWHO pre-eclampsia and eclampsia recommendations (2011): 6, 7 (7)"
            }
          ],
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                "description" : "(((((((\"Systolic blood pressure\" â‰¤ 140 mmHg)\n  AND (\"Repeat systolic blood pressure\" â‰¤ 140 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"No symptoms of severe pre-eclampsia\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++\"))\n  OR ((\"Systolic blood pressure\" > 160 mmHg)\n  AND (\"Repeat systolic blood pressure\" > 160 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"No symptoms of severe pre-eclampsia\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++\")))\n  OR ((90 mmHg â‰¤ \"Diastolic blood pressure\" < 110 mmHg)\n  AND (90 mmHg â‰¤ \"Repeat diastolic blood pressure\" < 110 mmHg)\n  AND (Symptoms of severe pre-eclampsia\" = \"No symptoms of severe pre-eclampsia\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++\")))\n  OR ((140 mmHg â‰¤ \"Systolic blood pressure\" < 160 mmHg)\n  AND (140 mmHg â‰¤ \"Repeat systolic blood pressure\" < 160 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"No symptoms of severe pre-eclampsia\")\n  AND (\"Urine dipstick result â€“ protein\" = \"+++\")))\n  OR ((90 mmHg â‰¤ \"Diastolic blood pressure\" < 110 mmHg)\n  AND (90 mmHg â€“ \"Repeat diastolic blood pressure\" < 110 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"No symptoms of severe pre-eclampsia\")\n  AND (\"Urine dipstick result â€“ protein\" = \"+++\")))\n  OR ((140 mmHg â‰¤ \"Systolic blood pressure\" < 160 mmHg)\n  AND (140 mmHg â‰¤ \"Repeat systolic blood pressure\" < 160 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"No symptoms of severe pre-eclampsia\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++++\")))\n  OR ((90 mmHg â‰¤ \"Diastolic blood pressure\" < 110 mmHg)\n  AND (90 mmHg â‰¤ \"Repeat diastolic blood pressure\" < 110 mmHg)\n  AND (\"Symptoms of severe pre-eclampsia\" = \"No symptoms of severe pre-eclampsia\")\n  AND (\"Urine dipstick result â€“ protein\" = \"++++\"))",
                "language" : "text/cql-identifier",
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          "title" : "Refer urgently to a hospital",
          "description" : "Refer urgently to a hospital 3",
          "textEquivalent" : "Woman has severe hypertension. If SBP is 160 mmHg or higher and/or DBP is 110 mmHg or higher, then refer urgently to the hospital for further investigation and management.",
          "documentation" : [
            {
              "type" : "citation",
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            }
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                "expression" : "Should Refer urgently to a hospital 3"
              }
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        },
        {
          "id" : "4",
          "title" : "Conduct hypertension counselling",
          "description" : "Conduct hypertension counselling",
          "textEquivalent" : "Woman has hypertension â€“ SBP of 140 mmHg or higher and/or DBP of 90 mmHg or higher and no proteinuria.\n\nCounselling:\nâ€“ Advice to reduce workload and to rest\nâ€“ Advise on danger signs\nâ€“ Reassess at the next contact or in 1 week if 8 months pregnant\nâ€“ If hypertension persists after 1 week or at next contact, refer to hospital or discuss case with the doctor, if available",
          "documentation" : [
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              "type" : "citation",
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}

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