Antenatal cards--what should they contain?

An antenatal card should be designed to facilitate the early detection of important and clearly defined conditions, which in turn can result in well-defined and beneficial actions. The home-based antenatal card is a good instrument for having relevant information accessible at various antenatal visits, and also for transmitting the information to the delivery staff. If properly designed, it could also serve as an important means to assess epidemiological characteristics of the pregnant population, necessary for deciding priorities in a public health perspective. A cross-sectional study of women giving birth in León, Nicaragua, showed that the majority of the women could be classified as high-risk pregnancies. The present paper discusses the design of the Nicaraguan antenatal card, as well as its risk factors. A revision of the antenatal card and the accompanying manual is suggested, particularly with regard to the definitions of the high-risk criteria and the proposed action.