Managing Complications in Pregnancy and Childbirth: - IAWG

Difficulty in breathingS-127MANAGEMENTSEVERE ANAEMIA• Transfuse as necessary (page C-23):- Use packed cells;- If blood cannot be centrifuged, let it hang until the cells havesettled. Infuse the cells slowly and dispose of the remainingserum;- Give frusemide 40 mg IV with each unit of packed cells.• If Plasmodium falciparum malaria is suspected, manage as severemalaria (page S-52).• Give ferrous sulfate or ferrous fumerate 120 mg by mouth PLUSfolic acid 400 mcg by mouth once daily for 6 months duringpregnancy. Continue for 3 months postpartum.• Where hookworm is endemic (prevalence of 20% or more), giveone of the following anthelmintic treatments:- albendazole 400 mg by mouth once;- OR mebendazole 500 mg by mouth once or 100 mg two timesper day for 3 days;- OR levamisole 2.5 mg/kg body weight by mouth once daily for3 days;- OR pyrantel 10 mg/kg body weight by mouth once daily for 3days.• If hookworm is highly endemic (prevalence of 50% or more), repeatthe anthelmintic treatment 12 weeks after the first dose.HEART FAILUREHEART FAILURE DUE TO ANAEMIA• Transfusion is almost always necessary in heart failure due toanaemia (page C-23):- Use packed or sedimented cells as described for severeanaemia (above);