Last Updated on February 3, 2023
Color Coding
- White: Low risk – level of care by nurses in clinics
- Green: Level of care by MO in Health Clinic, shared care
- Yellow: Urgent referral to hospital with O&G specialist or FMS in clinic, shared care possible
- Red: Urgent admission to the hospital
Code White : Low Risk
(A) Suitable for Delivery at Home or at Alternative Birthing Centres (ABC)
- Age 18 to 40 years old
- Married, with family support
- Height more than 145cm
- Gravida 2 – 5
- POA 37 to 41 weeks
- No past obstetric complication(s)
- No past medical complication(s)
- No antenatal complication in this pregnancy
- Estimated fetal weight 2 to 2.5kg
- Suitable home environment for delivery
(B) For Delivery at Hospital
- Age <18 years old OR >40 years old
- Single mother
- Height <145 cm
- Primigravida OR Gravida ≥6
- Birth interval <2 years OR >5 years
- Home environment not conducive for home delivery
Code Green
Maternal physical factors
- Drug addiction / smoking
- Pre-pregnancy weight / booking weight <45 kg
- Unsure of LMNP
- Current illness (including psychiatry illness & physical disability), no underlying HTN or DM
Past O&G history
- Previous gynaecological surgery
- History of 3 consecutive miscarriages
- Past obstetric history:
- Prolonged labour
- Instrumental delivery
- Caesarean section
- 3rd degree perineal tear
- Retained placenta
- PPH
- GDM / PIH / Eclampsia
- Baby’s birth weight <2.5 kg or >4 kg
- Perinatal death
Current O&G history
- Excessive weight gain of >2 kg per week
- Weight >80 kg
- Multiple pregnancy
- Hight BP (>140/90) without urine albumin
- Glycosuria: 2 episodes
- Hb <11 g/dL
- Proteinuria ≥1+
- SFH less than or more than POA/POG
- Malpresentation at 36 weeks
- Head not engaged at 37 weeks in a primigravida
Code Yellow
Refer to FMS Or Hospital with OBGYN Specialist or Nearest Hospital Within 48 Hours
- Mother HIV positive
- Mother Hepatitis B positive
- BP 140 – 160/90 – 110 mmHg, without proteinuria
- Underlying DM
- Reduced fetal movement at ≥32 weeks POA / POG
- POA / POG >41 weeks
Code Red
Maternal health condition
- Severe asthmatic attacks
- Dyspnoea on exertion
- Symptomatic heart disease
- Symptomatic anaemia at any POA or POG
- Uncontrolled DM (glycosuria ‘brick red’) with ketonuria (≥1+)
- Eclampsia
- Pre-eclampsia OR Impending eclampsia OR BP >160/110 mmHg
Maternal obstetric condition
- Antepartum haemorrhage (including miscarriages)
- PROM or PPROM
- Premature uterine contraction
Fetal condition
- FHR ≤110/min at 26 weeks
- FHR >160 at >34 weeks