Every pregnancy, in its development, has a risk of experiencing complications or complications, so that antenatal care must be carried out routinely, according to standards and integrated for quality antenatal care (Ministry of Health, 2010).

The Integrated Antenatal Minimum Service Standards (10 T) that must be provided to pregnant women consist of :

a. Weigh

Weighing at each antenatal visit is carried out to detect any disturbance of fetal growth. Weight gain that is less than 9 kilograms during pregnancy or less than 1 kilogram each month indicates a disturbance in fetal growth.

b. Measure upper arm circumference (LiLA)

LiLA measurements are only carried out at the first contact for screening pregnant women at risk of chronic energy deficiency (CED). Chronic energy deficiency here means pregnant women who are malnourished and have been going on for a long time (several months/years) where LiLA is less than 23.5 cm. Pregnant women with KEK will be able to give birth to low birth weight babies (LBW).

c. Measure blood pressure

Blood pressure measurement at each antenatal visit is performed to detect hypertension (blood pressure 140/90 mmHg) in pregnancy and preeclampsia (hypertension accompanied by edema of the face and/or lower limbs; and/or proteinuria).

d. Measure the height of the uterine fundus

Fundal height measurement at each antenatal visit is carried out to detect whether or not fetal growth is appropriate for gestational age. The measurement results if the fundal height does not match the gestational age, there is a possibility of impaired fetal growth. Standard measurements using a measuring tape after 24 weeks of gestation.

e. Count the fetal heart rate (FHR) and presentation of the fetus

DJJ assessment is carried out at the end of the first trimester and thereafter at each antenatal visit. Slow FHR less than 120/minute or fast FHR more than 160/minute indicates fetal distress. Determining fetal presentation is done at the end of the second trimester and thereafter at each antenatal visit. This examination is intended to determine the location of the fetus. The results of the examination in the third trimester, if the lower part of the fetus is not the head, or the head of the fetus has not entered the pelvis, it means that there is an abnormality, a narrow pelvis or other problems.

f. Give Tetanus Toxoid (TT) immunization

Pregnant women should receive TT immunization to prevent neonatal tetanus. Pregnant women are screened for their TT immunization status at the time of first contact. The provision of TT immunization to pregnant women is adjusted to the current immunization status of the mother.

g. Give blood tablets (iron tablets)

Every pregnant woman should receive iron tablets of at least 90 tablets during pregnancy. Iron tablets are given from the first contact to prevent iron nutritional anemia.

h. Laboratory checks (routine and special)

Laboratory examinations carried out during antenatal care include blood group examination, blood hemoglobin (Hb) level examination, protein and urine examination, blood sugar level examination, malaria blood examination in malaria endemic areas, syphilis test examination in high risk areas and pregnant women suspected of Syphilis, HIV testing, especially for areas with a high risk of HIV cases and pregnant women suspected of having HIV, and smear tests on pregnant women suspected of suffering from tuberculosis.

With a quality integrated ANC, it is hoped that all pregnancies can be well controlled. So that this breakthrough effort is expected to be one of the keys to reducing the incidence of morbidity and mortality in mothers and babies.

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