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INTRAPARTUM CARE OBSERVATION TOOLPID 27
My Projects Project Home Project Setup Online Designer Data Dictionary Codebook

The Codebook is a human-readable, read-only version of the project's Data Dictionary and serves as a quick reference for viewing the attributes of any given field in the project without having to download and interpret the Data Dictionary. Note: Checkbox fields have their coded values displayed both in the format defined by users in the Online Designer/Data Dictionary as well as in the extended format seen in data imports and exports (i.e., field___code).

Data Dictionary Codebook 07/05/2025 1:40am
Field finder: — When viewing this page, collapse:
Data Dictionary Codebook
INTRAPARTUM CARE OBSERVATION TOOL (PID: 27)
07/05/2025 1:40am
Instruments
Instrument Form Name
Form 1 form_1
# Variable / Field Name Field Label
Field Note
 Field Attributes (Field Type, Validation, Choices, Calculations, etc.)
Instrument:Form 1(form_1)
1 [record_id] Record ID text
2 [name_of_field_officer] Name of field officer text
Field Annotation: @HIDEBUTTON @APPUSERNAME-APP
3 [nam_of_the_observer] (A.GENERAL DETAILS) Name of the Observer   text, Required
4 [date_of_observation] Date of observation text (date_dmy), Required
5 [district_name] District name radio, Required
1Sangrur
2Any other specify
6 [any_other_specify_dist]
Show the field ONLY if:
[district_name] = '2'
Any other specify text
7 [block_name] Block name radio, Required
1Sangrur
2Sunam
3Dhuri
4Bhawanigrah
5Moonak
6Other
8 [other_block]
Show the field ONLY if:
[block_name] = '6'
Other text
9 [type_of_facility] Type of facility radio, Required
1PHC
2CHC
3SDH/DH
4Other
10 [specify_other_facility]
Show the field ONLY if:
[type_of_facility] = '4'
Specify other text
11 [level_of_facility] Level of facility radio, Required
1L1
2L2
3L3
4Other
12 [specify_other_level_facility]
Show the field ONLY if:
[level_of_facility] = '4'
Specify other text
13 [observation_start_time] Observation start time text (time), Required
14 [name_of_the_pregnant_women] Name of the Pregnant Women text, Required
15 [age_of_the_pregnant_women] Age of the Pregnant Women text (number), Required
16 [mcts_rch_id_of_pregnant_wo] MCTS/RCH ID of Pregnant Women text (number), Required
Field Annotation: @PLACEHOLDER = '12'
17 [full_address_of_pregnant_women] Full address of Pregnant Women text, Required
18 [contact_number_of_pregnant] Contact number of Pregnant Women text (number, Min: 1000000000, Max: 9999999999), Required
Field Annotation: @PLACEHOLDER='10 Digits Number' @FORCE-MINMAX
19 [how_did_she_get_to_the_hos] How did she get to the hospital (Mode of transport)? radio, Required
1By ambulance from another facility
2By ambulance from home
3By own transport
4By hired transport
5By public transport
6Other specify
20 [specify_other_mode_of_transport]
Show the field ONLY if:
[how_did_she_get_to_the_hos] = '6'
Specify other text
21 [did_asha_accompany_the_pre] Did ASHA accompany the Pregnant Woman? yesno, Required
1Yes
0No
22 [was_she_referred_from_another_facility] Was she referred from another facility? yesno, Required
1Yes
0No
23 [if_yes_how_long_after_refe]
Show the field ONLY if:
[was_she_referred_from_another_facility] = '1'
If yes, how long after referral did she reach the current facility? (HH:MM) (write NA if not referred) text, Required
24 [if_referred_what_was_the_rason_for_referral]
Show the field ONLY if:
[was_she_referred_from_another_facility]='1'
If referred, what was the reason for referral? checkbox, Required
1if_referred_what_was_the_rason_for_referral___1No reason, no complication evident
2if_referred_what_was_the_rason_for_referral___2Bleeding PV
3if_referred_what_was_the_rason_for_referral___3Pre-eclampsia/eclampsia
4if_referred_what_was_the_rason_for_referral___4Preterm labour/PROM/PPROM
5if_referred_what_was_the_rason_for_referral___5Other specify
25 [other_specify_1]
Show the field ONLY if:
[if_referred_what_was_the_rason_for_referral(5)] = '1'
Other, specify text, Required
26 [first_person_to_attend_pregn_women] Who was the first person to attend to the Pregnant Women? radio, Required
1SN/ANM
2Doctor
3Other mention
27 [other_mention_2]
Show the field ONLY if:
[first_person_to_attend_pregn_women] = '3'
Other, mention text, Required
28 [stage_of_labour_at_the_tim] Stage of labour at the time of arrival radio, Required
1Stage I (Latent)
2Stage I (Active)
3Stage II
4Stage III
5Stage IV
29 [section_b_admission_and_tr] SECTION B. ADMISSION AND TRIAGING descriptive
30 [time_of_arrival_of_pregnan] Time of arrival of Pregnant Woman to the healthcare facility (HH:MM) text (time), Required
31 [where_was_the_initial_asse_condcted] Where was the initial assessment conducted? radio, Required
1OPD/ANC room
2Triage room
3Labour room
4Other place, mention
32 [other_place_assessment]
Show the field ONLY if:
[where_was_the_initial_asse_condcted] = '4'
Other place text
33 [time_of_entry_of_pregnant_triaging_area]
Show the field ONLY if:
[where_was_the_initial_asse_condcted] = '2'
Time of entry of Pregnant Women in the Triaging area (HH:MM) text (time), Required
34 [overall_environment_of_the] 1.Overall environment of the triage area descriptive
35 [waiting_time_for_the_pregn_to_be_attended_at_triage_area] Waiting Time for the Pregnant Women to be attended at the triage area radio, Required
1Less than 10 minutes
2More than 10 minutes
36 [wheel_chair_stretcher_for_preg_wmn] Wheelchair / Stretcher for the Pregnant Women (only in respect to the given patient radio, Required
1Available and functional
2Available but non-functional
3Not available
37 [befor_initiating_the_process_of_history_and_examination] 2. Before initiating the process of History and Examination descriptive
38 [a_privacy_confidentiality] a. Privacy & confidentiality descriptive
40 [behaviour_and_communicat] b. Behavior and Communication
(Factors) 		descriptive
41 [listening_to_pregnant_women] Listening to Pregnant Women yesno, Required
1Yes
0No
42 [listening_to_care_provider] Listening to care provider yesno, Required
1Yes
0No
43 [explains_instructions_clear_and_pregnant_women] Explains instructions clearly and makes the Pregnant Women understand including repeating the explanation yesno, Required
1Yes
0No
44 [explains_instructions_clear_and_makes_to_careprovider] Explains instructions clearly and makes the care provider understand including repeating the explanation yesno, Required
1Yes
0No
45 [tone_towards_pregnant_wome] Tone towards Pregnant Women radio, Required
1Polite/ sensitive
2Rude
46 [tone_towards_care_provider] Tone towards care provider radio, Required
1Polite/ sensitive
2Rude
47 [process_of_history_taking] 3. Process of History Taking (record if the health care provider asks and documents the following) descriptive
48 [checks_antenatal_card_mcp] Checks Antenatal Card (MCP Card) radio, Required
1Available and filled
2Available but not filled
3Not available
49 [check_ask_lmp] Check/ ask LMP yesno, Required
1Yes
0No
50 [calculate_edd] Calculate EDD yesno, Required
1Yes
0No
51 [past_obseteric_hst] Past Obstetric History descriptive
52 [no_of_pregnancy] No. of Pregnancy text, Required
53 [previous_live_births] Previous Live births yesno, Required
1Yes
0No
54 [abortions] Abortions yesno, Required
1Yes
0No
55 [dilation_curettage] Dilation & Curettage yesno, Required
1Yes
0No
56 [miscarriages] Miscarriages yesno, Required
1Yes
0No
57 [still_births] Still births yesno, Required
1Yes
0No
58 [ectopic_tubal_pregnancies] Ectopic/ Tubal Pregnancies yesno, Required
1Yes
0No
59 [vaginal_delivery] Vaginal Delivery yesno, Required
1Yes
0No
60 [caesarean_delivery]
Show the field ONLY if:
[vaginal_delivery]='0'
Caesarean Delivery yesno, Required
1Yes
0No
61 [severe_anemia] (Assess for high-risk pregnancy)Severe anemia yesno, Required
1Yes
0No
62 [elderly_multipara_35_years] Elderly Multipara > 35 Years yesno, Required
1Yes
0No
63 [gestational_diabetes_mellitus] Gestational Diabetes mellitus yesno, Required
1Yes
0No
64 [pih_pre_eclampsia_eclampsia] PIH - Pre-Eclampsia/ Eclampsia yesno, Required
1Yes
0No
65 [rh_disease] Rh Disease yesno, Required
1Yes
0No
66 [antepartum_haemorrhage] Antepartum Haemorrhage yesno, Required
1Yes
0No
67 [twin_multiple_pregnancies] Twin/Multiple Pregnancies yesno, Required
1Yes
0No
68 [teenage_pregnancy] Teenage Pregnancy yesno, Required
1Yes
0No
69 [hydramnios_oligo_poly] Hydramnios (Oligo/Poly) yesno, Required
1Yes
0No
70 [short_stature_140cm] Short Stature (< 140CM) yesno, Required
1Yes
0No
71 [examination_4] 4. Examination (tick on the appropriate box - assessed and normal, assessed and abnormal, not assessed, assessed and follow up actions taken)   descriptive
72 [a_checked_vital_signs_blood_pressure] (a. Checked vital signs)
Blood Pressure 		radio, Required
1Normal
2Abnormal
3Not assessed
73 [follow_up_action4_1] Follow Up action text
74 [checked_vital_sings_temperature] Temperature radio, Required
1Normal
2Abnormal
3Not assessed
75 [follow_up_action4_2] Follow Up action text
76 [checked_vital_pulse] Pulse radio, Required
1Normal
2Abnormal
3Not assessed
77 [follow_up_action4_3] Follow Up action text
78 [checked_vital_respirations] Respirations radio, Required
1Normal
2Abnormal
3Not assessed
79 [follow_up_action4_4] Follow Up action text
80 [checked_vital_pelvic_abdominal_pain] Pelvic/ abdominal pain radio, Required
1Normal
2Abnormal
3Not assessed
81 [follow_up_action4_5] Follow Up action text
82 [number_of_anc_visits] Number of ANC visits radio, Required
11
22
33
44
5other
6Not asked
83 [other_anc_visit]
Show the field ONLY if:
[number_of_anc_visits] = '5'
Other text, Required
84 [checked_for_danger_signs_hiv_positive] (b. Checked for danger signs)
HIV Positive 		radio, Required
11 Yes, present
22 No, not present
33 Not assessed
85 [follow_up_actions5_1] Follow up/Actions text, Required
86 [checked_danger_signs_bleeding] Bleeding radio, Required
1Yes present
2No not present
3Not assessed
87 [follow_up_actions5_2] Follow up/Actions text, Required
88 [checked_danger_signs_leaking_of_fluid] Leaking of fluid radio, Required
1Yes present
2No not present
3Not assessed
89 [follow_up_actions5_3] Follow up/Actions text, Required
90 [checked_danger_signs_headache] Headache radio, Required
1Yes present
2No not present
3Not assessed
91 [follow_up_actions5_4] Follow up/Actions text, Required
92 [checked_danger_signs_dizziness_blurry_vision] Dizziness/Blurry vision radio, Required
1Yes present
2No not present
3Not assessed
93 [follow_up_actions5_5] Follow up/Actions text, Required
94 [checked_danger_signs_decreased_fetal_movement] Decreased fetal movement radio, Required
1Yes present
2No not present
3Not assessed
95 [follow_up_actions5_6] Follow up/Actions text, Required
96 [checked_for_fetal_well_fetal_hrt_rt] (c. Checked for fetal wellbeing)
Fetal heart rate 		radio, Required
1Normal
2Abnormal
3Not assessed
97 [follow_up_actions6_1] Follow up/Actions text, Required
98 [checked_fetal_position] Fetal Position radio, Required
1Cephalic
2Transverse lie
3Complete breech
4Frank beech
5Footling breech
99 [frequency_of_contractions] (Conducted abdominal examination)Frequency of contractions *per 10 mintues * text, Required
100 [duration_of_contractions_o] Duration of contractions* Of seconds * text, Required
101 [strength_by_palpation] Strength (by palpation) radio, Required
1Mild
2Moderate
3Strong
102 [fetal_position_checked_by] Fetal position checked by abdominal grips yesno, Required
1Yes
0No
103 [washed_hands_and_wore_gloves] e. Conducted vaginal examinationWashed hands and wore gloves before examination yesno, Required
1Yes
0No
104 [cleaned_the_perineum_befor_exami] Cleaned the perineum before examination yesno, Required
1Yes
0No
105 [cervical_dilation_in_cm] Cervical dilation in CM text (number), Required
106 [fetal_descent_5] Fetal descent
( /5) 		text (number), Required
107 [status_of_membranes] Status of membranes radio, Required
1Intact
2Ruptured
108 [amniotic_fluid] Amniotic Fluid radio, Required
1Clear
2Bloody
3Cloudy
4Meconium
109 [partograph_plotting_initia] Partograph plotting initiated yesno, Required
1Yes
0No
110 [identification_of_complication] ( 5. Steps for Management of complications after examination)Identification of complication yesno, Required
1Yes
0No
111 [consultation_with_gynaecol] Consultation with Gynecologist / Medical officer radio, Required
1Yes
2No
3Not applicable (initial assessment done by doctor)
112 [next_steps] Next Steps radio, Required
1Management at facility
2Referral
113 [pre_labour_rupture_of_membranes]
Show the field ONLY if:
[next_steps] = '1'
Management at Facility (mark the appropriate steps)
a) Pre-labour rupture of membranes (induced) 		yesno, Required
1Yes
0No
114 [b_oxytocin_iv_tablets]
Show the field ONLY if:
[next_steps] = '1'
b) Oxytocin (IV / Tablets) yesno, Required
1Yes
0No
115 [c_fluid_iv]
Show the field ONLY if:
[next_steps] = '1'
c) Fluid (IV) yesno, Required
1Yes
0No
116 [d_antibiotics_oral_iv]
Show the field ONLY if:
[next_steps] = '1'
d) Antibiotics (oral / IV) yesno, Required
1Yes
0No
117 [e_management_of_gdm_insuli]
Show the field ONLY if:
[next_steps] = '1'
e) Management of GDM (Insulin IV / Oral) yesno, Required
1Yes
0No
118 [f_management_of_hypertensi]
Show the field ONLY if:
[next_steps] = '1'
f) Management of Hypertension (IV/ Oral) yesno, Required
1Yes
0No
119 [g_administration_of_steroiod_preterm]
Show the field ONLY if:
[next_steps] = '1'
g) Administration of steroid of preterm labour (IV) yesno, Required
1Yes
0No
120 [a_any_other_action]
Show the field ONLY if:
[next_steps] = '1'
h) Any other action yesno, Required
1Yes
0No
121 [specify_6]
Show the field ONLY if:
[a_any_other_action] = '1'
Specify text, Required
122 [time_of_exit_of_pregnant_women_from_triage] Time of exit of Pregnant Woman from triage (HH:MM) text (time), Required
123 [place_referred_to] Place referred to radio, Required
1ANC ward
2Labour room
3HRP labour room
4Maternity OT
5Out-facility referral
124 [c_labour_management] C. LABOUR MANAGEMENT descriptive
125 [provide_switches_on_the_radiant_warmer] (Pre-delivery preparation)Provider switches on the radiant warmer / heat source at least half an hour prior to delivery yesno, Required
1Yes
0No
126 [provider_prepares_delivery_tray] Provider Prepares delivery tray and baby tray yesno, Required
1Yes
0No
127 [newborn_care_corner_with_all_essential_equipment_and_supplies] Provider prepares newborn care corner with all essential equipment and supplies yesno, Required
1Yes
0No
128 [provider_loads_utero_tonic_prior] Provider loads utero-tonic prior to conducting the delivery yesno, Required
1Yes
0No
129 [pt_shftd_at_appropriate_tm] Was the patient shifted at appropriate time to the labour room yesno, Required
1Yes
0No
130 [birth_companion_allowed_inside_the_lbr] Is birth companion allowed inside the labour room? yesno, Required
1Yes
0No
131 [procedure_during_delivery] (Procedure during delivery - 1st stage)Is gestational age of pregnant woman assessed? yesno, Required
1Yes
0No
132 [confirmed_that_true_labor_pain] Is it confirmed that it is true labor pain? yesno, Required
1Yes
0No
133 [initial_partograph_reviwed] Is the initial partograph reviewed? yesno, Required
1Yes
0No
134 [are_vital_signs_measured] Are vital signs measured? (Pulse rate/ BP/ Temperature/ Respiratory rate/ Fetal Heart Rate) yesno, Required
1Yes
0No
135 [partograph_filled_real_time] Is Partograph filled in real time? yesno, Required
1Yes
0No
136 [cervical_dilatation_noted_when_is_4cm] Is cervical dilatation noted when it is 4 cm and above on the alert line along with the time? yesno, Required
1Yes
0No
137 [following_plotted_half_hour] Are the following plotted every half hour: (Check multiple) checkbox, Required
1following_plotted_half_hour___1Frequency and duration of uterine contractions,
2following_plotted_half_hour___2Fetal heart rate,
3following_plotted_half_hour___3Condition of the membranes,
4following_plotted_half_hour___4Color of amniotic fluid and maternal pulse
138 [following_plotted_four_hours] Are the following plotted every four hours: (Check multiple) checkbox, Required
1following_plotted_four_hours___1Cervical dilatation
2following_plotted_four_hours___2Descent of head or presenting part,
3following_plotted_four_hours___3Maternal temperature,
4following_plotted_four_hours___4Blood pressure and urinalysis (should be performed every time the woman passes urine).
139 [given_medication_administration_recored_photograph] Are medications given/IV Fluid administration recorded in the partograph? yesno, Required
1Yes
0No
140 [procedure_during_delivery2] Procedure during delivery - 2nd stage descriptive
141 [hcp_ensure_newborn_care_corner] Does HCP ensure that the newborn care corner is prepared and equipment for neonatal resuscitation are ready? yesno, Required
1Yes
0No
142 [hcp_place_clean_plastic_sheet] Does the HCP place clean plastic sheet from the delivery kit under the woman's buttocks? yesno, Required
1Yes
0No
143 [hcp_wash_hands_soap_dry] Does the HCP wash hands thoroughly with soap and water, air dries them? yesno, Required
1Yes
0No
144 [hcp_wear_sterile_glove] Does the HCP wear sterile gloves on both the hands? yesno, Required
1Yes
0No
145 [hcp_clean_the_perinealarea_from_above_downward] Does the HCP clean the perineal area from above downward with cotton swabs dipped in antiseptic lotion? yesno, Required
1Yes
0No
146 [cervical_dilatation_assessed] Is cervical dilatation assessed as part of vaginal examination? yesno, Required
1Yes
0No
147 [cervical_effacement_assessed] Is cervical effacement assessed as part of vaginal examination? yesno, Required
1Yes
0No
148 [the_presenting_part_determined] Is the presenting part determined and recorded? (vertex, face, brow, breech) yesno, Required
1Yes
0No
149 [episiotom_done] (Delivery of head) Episiotomy done yesno, Required
1Yes
0No
150 [local_anaesthesia_given_before_episitomy] Local Anaesthesia given before episiotomy yesno, Required
1Yes
0No
151 [hcp_provides_perineal_supp] HCP provides perineal support yesno, Required
1Yes
0No
152 [hcp_tells_the_mother_to_take_deep] HCP tells the mother to take deep breath and to bear down only during a contraction yesno
1Yes
0No
153 [encouraging_the_women_to_push_on_urge] Encouraging the women to push on urge yesno, Required
1Yes
0No
154 [delivery_of_head_head_flexion_done] Delivery of head - head flexion done yesno, Required
1Yes
0No
155 [suction_of_baby_after_delivery] Suction of baby after delivery of head done yesno, Required
1Yes
0No
156 [assisted_the_delivery_of_shoulders_body] (Delivery of shoulders and body)   Assisted the delivery of shoulders and body yesno
1Yes
0No
157 [the_baby_is_placed_on_mother_sabdomen] The baby is placed on mother's abdomen for skin-to-skin contact yesno, Required
1Yes
0No
158 [medication_describe] Medication
(Describe the drugs and injections provided to the pregnant women with their doses)
 descriptive
159 [oxytocin_administration_du] Oxytocin administration (During which Stage of labour) radio
1First stage
2Beginning of second stage
3After delivery of anterior shoulder
4After delivery of placenta
160 [procedure_during_delivery_3rd] Procedure during delivery - 3rd stage descriptive
161 [time_of_initiation_of_thir] Time of Initiation of third stage of delivery (Time of child delivery) text (time), Required
162 [time_of_placenta_delivery] Time of Placenta Delivery text (time), Required
163 [palpates_abdomen_to_rule_out_presence_of_foetal_part] Palpates abdomen to rule out the presence of foetal part / second baby yesno, Required
1Yes
0No
164 [delivers_the_placenta_by_controlled_cord] Delivers the placenta by Controlled Cord traction yesno
1Yes
0No
165 [placed_the_placenta_in_the] Placed the placenta in the tray yesno
1Yes
0No
166 [gave_uterine_massage] Gave uterine massage yesno
1Yes
0No
167 [examination_of_placental_membrane_and_umbilical_cord] Examination of placental membrane and umbilical cord done yesno
1Yes
0No
168 [proper_examination_of_perineum_cervix_and_vaginal] Proper examination of perineum, cervix and vaginal done yesno
1Yes
0No
169 [observation_for_uterine_contraction] Observation for uterine contractions yesno
1Yes
0No
170 [management_when_placenta_d] Management when placenta does not descend (> 30 min) descriptive
171 [consultation_with_doctor] Consultation with doctor yesno
1Yes
0No
172 [utero_tonic_drugs] Utero tonic Drugs yesno
1Yes
0No
173 [antibiotics] Antibiotics yesno
1Yes
0No
174 [manual_removal_of_placenta] Manual Removal of placenta yesno
1Yes
0No
175 [in_case_still_no_descent_n] In case still no descent, next step taken(specify) text
176 [procedure_during_delivery_4th] Procedure during delivery - 4th stage descriptive
177 [documenting_the_weight_and_abnormality] Documenting the weight and any abnormality in placenta yesno
1Yes
0No
178 [bleeding_per_vaginum] Bleeding Per Vaginum (observation for any bleeding) yesno
1Yes
0No
179 [examination_of_vulva_perin] Examination of vulva, perineum and vagina yesno
1Yes
0No
180 [repairing_of_tears] Repairing of tears yesno
1Yes
0No
181 [measurement_of_amount_of_blood_loss] Measurement of amount of blood loss yesno
1Yes
0No
182 [stay_in_labour_room_after_delivery] Stay in Labour room after delivery of placenta radio
1< 30 minutes
2> 30 minutes
183 [monitoring_for_bleeding_pv] Monitoring for bleeding PV done yesno
1Yes
0No
184 [monitoring_for_vitals_done] Monitoring for vitals done yesno
1Yes
0No
185 [outcome_determined_during] Outcome determined during labour by delivery in-charge descriptive
186 [normal_uncomplicated_labou] Normal uncomplicated labour text
187 [pre_eclampsia] Pre-eclampsia text
188 [fever] Fever text
189 [abnormal_bleeding] Abnormal bleeding text
190 [dystocic_labour] Dystocic labour text
191 [fetal_distress] Fetal distress text
192 [other_specify] Other: Specify text
193 [d_active_management_of_com] D. ACTIVE MANAGEMENT OF COMPLICATIONS descriptive
194 [pregnant_woman_with_bleeding_pv] Pregnant woman with bleeding PV yesno, Required
1Yes
0No
195 [was_iv_fluids_given_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Was IV fluids given yesno
1Yes
0No
196 [nst_cardiotocography_connected_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Was NST / Cardiotocography connected, or monitoring done yesno
1Yes
0No
197 [was_fhr_noted_bleeding]
Show the field ONLY if:
[nst_cardiotocography_connected_bleeding] = '1'
Was FHR noted? radio
1Yes
2No
3Not applicable
198 [value_fhr]
Show the field ONLY if:
[was_fhr_noted_bleeding] = '1'
Value text (number)
199 [were_decelerations_recorde_bleeding]
Show the field ONLY if:
[nst_cardiotocography_connected_bleeding] = '1'
Were decelerations recorded radio
1Yes
2No
3Not-applicable
200 [record]
Show the field ONLY if:
[were_decelerations_recorde_bleeding] = '1'
Record radio
1Early
2Late
3Variable
201 [were_contractions_monitore_bleeding]
Show the field ONLY if:
[nst_cardiotocography_connected_bleeding] = '1'
Were contractions monitored radio
1Yes
2No
3Not applicable
202 [were_vitals_checked_and_documented_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Were vitals checked and documented yesno
1Yes
0No
203 [were_pulse_rate_noted_bleeding]
Show the field ONLY if:
[were_vitals_checked_and_documented_bleeding] = '1'
were pulse rate noted radio
1Yes
2No
3Not applicable
204 [value_pluse_bleeding]
Show the field ONLY if:
[were_pulse_rate_noted_bleeding] = '1'
Value text (number)
205 [was_blood_pressure_noted_bleeding]
Show the field ONLY if:
[were_vitals_checked_and_documented_bleeding] = '1'
Was blood pressure noted radio
1Yes
2No
3Not applicable
206 [value_sbp]
Show the field ONLY if:
[was_blood_pressure_noted_bleeding] = '1'
Value (SBP) text (number, Min: 60, Max: 200)
Field Annotation: @FORCE-MINMAX
207 [value_dbp]
Show the field ONLY if:
[was_blood_pressure_noted_bleeding] = '1'
Value (DBP) text (number, Min: 60, Max: 150)
Field Annotation: @FORCE-MINMAX
208 [was_temperature_noted_bleeding]
Show the field ONLY if:
[were_vitals_checked_and_documented_bleeding] = '1'
Was temperature noted radio
1Yes
2No
3Not applicable
209 [value_temprature]
Show the field ONLY if:
[was_temperature_noted_bleeding] = '1'
Value temperature text (number)
210 [blood_test_performed_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Was blood test performed? yesno
1Yes
0No
211 [was_clotting_time_checked_bleeding]
Show the field ONLY if:
[blood_test_performed_bleeding] = '1'
Was clotting time checked radio
1Yes
2No
3Not applicable
212 [value_clotting_time_bleeding]
Show the field ONLY if:
[was_clotting_time_checked_bleeding]='1'
Value (Clotting time) text
213 [was_bleeding_time_checked_bleeding]
Show the field ONLY if:
[blood_test_performed_bleeding] = '1'
Was bleeding time checked radio
1Yes
2No
3Not applicable
214 [value_bleeding_time_bleeding]
Show the field ONLY if:
[was_bleeding_time_checked_bleeding] ='1'
Value (bleeding time) text
215 [was_hb_checked_bleeding]
Show the field ONLY if:
[blood_test_performed_bleeding]='1'
Was Hb checked radio
1Yes
2No
3Not applicable
216 [value_hb_bleeding]
Show the field ONLY if:
[was_hb_checked_bleeding] ='1'
Value (HB) text
217 [blood_product_given_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Was blood or blood products given to woman radio
1Yes
2No
3Not applicable
218 [artificial_rupture_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Was artificial rupture of membrane performed and documented yesno
1Yes
0No
219 [time_rapture_bleeding]
Show the field ONLY if:
[artificial_rupture_bleeding]='1'
Time text (time)
220 [date_raptue_bleeding]
Show the field ONLY if:
[artificial_rupture_bleeding]='1'
Date text (date_dmy)
221 [was_labour_augmented_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Was labour augmented? yesno
1Yes
0No
222 [augmentation_started_time_bleeding]
Show the field ONLY if:
[was_labour_augmented_bleeding]='1'
when was augmentation started - Time text (time)
223 [date_of_start_of_augmentat_bleeding]
Show the field ONLY if:
[was_labour_augmented_bleeding]='1'
Date of start of augmentation text (date_dmy)
224 [name_of_drugs_bleeding]
Show the field ONLY if:
[was_labour_augmented_bleeding]='1'
Name of drugs text
225 [dosage_of_the_drug_bleeding]
Show the field ONLY if:
[was_labour_augmented_bleeding]='1'
Dosage of the drug text
226 [other_medication_gvn_bleeding]
Show the field ONLY if:
[pregnant_woman_with_bleeding_pv]='1'
Was any other medication given yesno
1Yes
0No
227 [other_medicine_bleeding]
Show the field ONLY if:
[other_medication_gvn_bleeding]='1'
Name of the medicine text
228 [other_dosage_of_medicine_bleeding]
Show the field ONLY if:
[other_medication_gvn_bleeding]='1'
Dosage of medicine text
229 [pregnant_woman_with_fever] Pregnant Woman with Fever yesno, Required
1Yes
0No
230 [was_iv_fluids_given_fever]
Show the field ONLY if:
[pregnant_woman_with_fever]='1'
Was IV fluids given yesno, Required
1Yes
0No
231 [was_nst_cardiotocography_fever]
Show the field ONLY if:
[pregnant_woman_with_fever]='1'
Was NST / Cardiotocography connected, or monitoring done yesno, Required
1Yes
0No
232 [was_fhr_noted_fever]
Show the field ONLY if:
[was_nst_cardiotocography_fever] = '1'
Was FHR noted radio, Required
1Yes
2No
3Not applicable
233 [value_of_fhr_fever]
Show the field ONLY if:
[was_fhr_noted_fever]='1'
Value text (number)
234 [were_accelerations_recorde_fever]
Show the field ONLY if:
[was_nst_cardiotocography_fever] = '1'
Were accelerations recorded radio, Required
1Yes
2No
3Not applicable
235 [record_fever]
Show the field ONLY if:
[were_accelerations_recorde_fever] = '1'
Record radio
1Early
2Late
3Variable
236 [were_contractions_monitore_fever]
Show the field ONLY if:
[was_nst_cardiotocography_fever] = '1'
Were contractions monitored radio, Required
1Yes
2No
3Not applicable
237 [were_vitals_checked_and_do_fever]
Show the field ONLY if:
[pregnant_woman_with_fever]='1'
Were vitals checked and documented yesno
1Yes
0No
238 [were_pulse_rate_noted_fever]
Show the field ONLY if:
[were_vitals_checked_and_do_fever] = '1'
Were pulse rate noted radio
1Yes
2No
3Not applicable
239 [value_fever]
Show the field ONLY if:
[were_pulse_rate_noted_fever] = '1'
Value text (number)
240 [was_blood_pressure_noted_fever]
Show the field ONLY if:
[were_vitals_checked_and_do_fever] = '1'
Was blood pressure noted radio
1Yes
2No
3Not applicable
241 [sbp_fever]
Show the field ONLY if:
[was_blood_pressure_noted_fever] = '1'
SBP text (number)
242 [dbp_fever]
Show the field ONLY if:
[was_blood_pressure_noted_fever] = '1'
DBP text (number)
243 [was_temperature_noted_fever]
Show the field ONLY if:
[were_vitals_checked_and_do_fever] = '1'
Was temperature noted radio
1Yes
2No
3Not applicable
244 [value_tem_fever]
Show the field ONLY if:
[was_temperature_noted_fever] = '1'
Value text (number)
245 [urine_microscopy_fever]
Show the field ONLY if:
[pregnant_woman_with_fever]='1'
Was urine microscopy done? yesno, Required
1Yes
0No
246 [result_of_urine_microscopy]
Show the field ONLY if:
[urine_microscopy_fever]='1'
Result of urine microscopy text
247 [was_artificial_rupture_of_membraned_fever]
Show the field ONLY if:
[pregnant_woman_with_fever]='1'
Was artificial rupture of membrane performed and documented yesno, Required
1Yes
0No
248 [time_bleeding_fever]
Show the field ONLY if:
[was_artificial_rupture_of_membraned_fever] = '1'
Time text (time)
249 [date_fever]
Show the field ONLY if:
[was_artificial_rupture_of_membraned_fever] = '1'
Date text (date_dmy)
250 [was_foul_smelling_vaginal_fever]
Show the field ONLY if:
[was_artificial_rupture_of_membraned_fever]='1'
Was foul smelling vaginal discharge noted radio
1Yes
2No
3Not applicable
251 [labour_augmented_fever]
Show the field ONLY if:
[pregnant_woman_with_fever]='1'
Was labour augmented? yesno, Required
1Yes
0No
252 [augmentation_start_tm_fever]
Show the field ONLY if:
[labour_augmented_fever]='1'
When was augmentation started - Time text (time)
253 [date_of_start_of_augmentat_fever]
Show the field ONLY if:
[labour_augmented_fever]='1'
Date of start of augmentation text (date_dmy)
254 [name_drug_used_fever]
Show the field ONLY if:
[labour_augmented_fever]='1'
Name drug used text
255 [dosage_fever]
Show the field ONLY if:
[labour_augmented_fever]='1'
Dosage text
256 [other_drugs_given_fever]
Show the field ONLY if:
[pregnant_woman_with_fever]='1'
Was any other drugs given yesno, Required
1Yes
0No
257 [name_of_the_drugs_fever]
Show the field ONLY if:
[other_drugs_given_fever]='1'
Name of the drugs text
258 [dosage_of_drugs_fever]
Show the field ONLY if:
[other_drugs_given_fever]='1'
Dosage of drugs text
259 [pregnant_woman_with_pre_eclampsia] Pregnant Woman with Pre- eclampsia / Eclampsia yesno, Required
1Yes
0No
260 [iv_fluids_given_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Was IV fluids given yesno, Required
1Yes
0No
261 [was_mgso4_given_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Was MgSO4 given yesno, Required
1Yes
0No
262 [dosage_of_mgso4_eclampsia]
Show the field ONLY if:
[was_mgso4_given_eclampsia]='1'
Dosage of MgSO4 text
263 [antihypertensive_given_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Was antihypertensive given yesno, Required
1Yes
0No
264 [name_of_drug_eclampsia]
Show the field ONLY if:
[antihypertensive_given_eclampsia]='1'
Name of drug text
265 [dosage_of_drug_eclampsia]
Show the field ONLY if:
[antihypertensive_given_eclampsia]='1'
Dosage of drug text
266 [cardiotocography_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Was NST / Cardiotocography connected, or monitoring done yesno, Required
1Yes
0No
267 [was_fhr_noted_eclampsia]
Show the field ONLY if:
[cardiotocography_eclampsia]='1'
Was FHR noted radio, Required
1Yes
2No
3Nat applicable
268 [value_fhr_eclampsia]
Show the field ONLY if:
[was_fhr_noted_eclampsia]='1'
Value text
269 [accelerations_recorded_eclampsia]
Show the field ONLY if:
[cardiotocography_eclampsia]='1'
Were accelerations recorded radio
1Yes
2No
3Not applicable
270 [recorded_eclampsia]
Show the field ONLY if:
[accelerations_recorded_eclampsia]='1'
Recorded radio
1Early
2Late
3Varibale
271 [contractions_monitore_eclampsia]
Show the field ONLY if:
[cardiotocography_eclampsia]='1'
Were contractions monitored radio, Required
1Yes
2No
3Not applicable
272 [vitals_checked_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Were vitals checked and documented yesno, Required
1Yes
0No
273 [pulse_rate_noted_eclampsia]
Show the field ONLY if:
[vitals_checked_eclampsia]='1'
Were pulse rate noted radio
1Yes
2No
3Not applicable
274 [value_pulse_eclampsia]
Show the field ONLY if:
[pulse_rate_noted_eclampsia]='1'
Value text
275 [blood_pressure_eclampsia]
Show the field ONLY if:
[vitals_checked_eclampsia]='1'
Was blood pressure noted radio, Required
1Yes
2No
3Not applicable
276 [value_of_sbp_eclampsia]
Show the field ONLY if:
[blood_pressure_eclampsia]='1'
Value of SBP text (number, Min: 50, Max: 200)
Field Annotation: @FORCE-MINMAX
277 [value_of_dbp_eclampsia]
Show the field ONLY if:
[blood_pressure_eclampsia]='1'
Value of DBP text (number, Min: 50, Max: 140)
Field Annotation: @FORCE-MINMAX
278 [temperature_noted_eclampsia]
Show the field ONLY if:
[vitals_checked_eclampsia]='1'
Was temperature noted radio
1Yes
2No
3Not applicable
279 [value_temp_eclampsia]
Show the field ONLY if:
[temperature_noted_eclampsia]='1'
Value of temperature text (number)
280 [reflexes_checked_for_mgso4_eclampsia]
Show the field ONLY if:
[vitals_checked_eclampsia]='1'
Reflexes checked for MgSO4 toxicity radio
1Yes
2No
3Not applicable
281 [was_artificial_rupture_of_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Was artificial rupture of membrane performed and documented yesno
1Yes
0No
282 [time_eclampsia]
Show the field ONLY if:
[was_artificial_rupture_of_eclampsia] = '1'
Time text (time)
283 [date_eclampsia]
Show the field ONLY if:
[was_artificial_rupture_of_eclampsia] = '1'
Date text (date_dmy)
284 [was_labour_augmented_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Was labour augmented? yesno
1Yes
0No
285 [when_was_augmentation_started_eclampsia]
Show the field ONLY if:
[was_labour_augmented_eclampsia] = '1'
when was augmentation started - Time text (time)
286 [date_of_start_of_augmentat_eclampsia]
Show the field ONLY if:
[was_labour_augmented_eclampsia] = '1'
Date of start of augmentation text (date_dmy)
287 [name_the_drug_eclampsia]
Show the field ONLY if:
[was_labour_augmented_eclampsia] = '1'
Name the drug text
288 [dosage_eclampsia]
Show the field ONLY if:
[was_labour_augmented_eclampsia] = '1'
Dosage text
289 [was_any_other_medication_given_eclampsia]
Show the field ONLY if:
[pregnant_woman_with_pre_eclampsia]='1'
Was any other medication given yesno
1Yes
0No
290 [name_of_drugs_eclampsia]
Show the field ONLY if:
[was_any_other_medication_given_eclampsia] = '1'
Name of drugs text
291 [dosage_other_eclampsia]
Show the field ONLY if:
[was_any_other_medication_given_eclampsia] = '1'
Dosage text
292 [pregnant_woman_with_preter] Pregnant Woman with Preterm labour/PROM/PPROM yesno, Required
1Yes
0No
293 [was_iv_fluids_given_preterm_labour]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Was IV fluids given yesno
1Yes
0No
294 [antenatal_corticoster_prom]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Were antenatal corticosteroids given yesno, Required
1Yes
0No
295 [name_of_drug_prom]
Show the field ONLY if:
[antenatal_corticoster_prom]='1'
Name of drug text
296 [dosage_prom]
Show the field ONLY if:
[antenatal_corticoster_prom]='1'
Dosage text
297 [antibiotics_given_prom]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Was antibiotics given yesno, Required
1Yes
0No
298 [name_of_antibiotic_prom1]
Show the field ONLY if:
[antibiotics_given_prom]='1'
Name of antibiotic text
299 [dosage_of_antibiotic_prom1]
Show the field ONLY if:
[antibiotics_given_prom]='1'
Dosage of antibiotic text
300 [name_of_antibiotic_prom2]
Show the field ONLY if:
[antibiotics_given_prom]='1'
Name of antibiotic text
301 [dosage_antibiotic_prom2]
Show the field ONLY if:
[antibiotics_given_prom]='1'
Dosage of antibiotic text
302 [tocolytics_given_prom]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Were tocolytics given yesno, Required
1Yes
0No
303 [tec_name_drug_prom]
Show the field ONLY if:
[tocolytics_given_prom]='1'
Name of drug text
304 [tec_dosage_prom]
Show the field ONLY if:
[tocolytics_given_prom]='1'
Dosage text
305 [cardiotocography_connected_prom]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Was NST / Cardiotocography connected, or monitoring done yesno, Required
1Yes
0No
306 [fhr_noted_prom]
Show the field ONLY if:
[cardiotocography_connected_prom] ='1'
Was FHR noted radio
1Yes
2No
3Not applicable
307 [value_fhr_prom]
Show the field ONLY if:
[fhr_noted_prom]='1'
Value text (number)
308 [accelerations_recorde_prom]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Were accelerations recorded radio, Required
1Yes
2No
3Not applicable
309 [record_prom]
Show the field ONLY if:
[accelerations_recorde_prom]='1'
Record radio
1Early
2Late
3Variable
310 [were_contractions_monitore_preterm_labour]
Show the field ONLY if:
[cardiotocography_connected_prom] ='1'
were contractions monitored radio
1Yes
2No
3Not applicable
311 [colour_of_amniotic_fluid_noted_preterm_labour]
Show the field ONLY if:
[cardiotocography_connected_prom] ='1'
colour of amniotic fluid noted radio
1Yes
2No
3Not applicable
312 [color_preterm_labour]
Show the field ONLY if:
[colour_of_amniotic_fluid_noted_preterm_labour] = '1'
Color radio
1Meconium
2Clear
3Bloody
313 [were_vitals_checked_and_do_preterm_labour]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Were vitals checked and documented yesno
1Yes
0No
314 [were_pulse_rate_noted_preterm_labour]
Show the field ONLY if:
[were_vitals_checked_and_do_preterm_labour] = '1'
were pulse rate noted radio
1Yes
2No
3Not applicable
315 [value_pulse_preterm_labour]
Show the field ONLY if:
[were_pulse_rate_noted_preterm_labour] = '1'
Value text (number)
316 [was_blood_pressure_noted_preterm_labour]
Show the field ONLY if:
[were_vitals_checked_and_do_preterm_labour] = '1'
Was blood pressure noted radio
1Yes
2No
3Not applicable
317 [sbp_value_preterm_labour]
Show the field ONLY if:
[was_blood_pressure_noted_preterm_labour] = '1'
SBP Value text (number)
318 [dbp_value_preterm_labour]
Show the field ONLY if:
[was_blood_pressure_noted_preterm_labour] = '1'
DBP value text (number)
319 [was_temperature_noted_preterm_labour]
Show the field ONLY if:
[were_vitals_checked_and_do_preterm_labour] = '1'
Was temperature noted radio
1Yes
2No
3Not applicable
320 [value_temp_preterm_labour]
Show the field ONLY if:
[was_temperature_noted_preterm_labour] = '1'
Value text (number)
321 [was_labour_augmented_preterm_labour]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Was labour augmented? yesno
1Yes
0No
322 [when_was_augmentation_started_preterm_labourr]
Show the field ONLY if:
[was_labour_augmented_preterm_labour] = '1'
when was augmentation started - Time text (time)
323 [date_of_start_of_augmentat_preterm_labour]
Show the field ONLY if:
[was_labour_augmented_preterm_labour] = '1'
Date of start of augmentation text (date_dmy)
324 [name_of_the_drug_agumention_preterm_labour]
Show the field ONLY if:
[was_labour_augmented_preterm_labour] = '1'
Name of the drug text
325 [dosage_agumention_preterm_labour]
Show the field ONLY if:
[was_labour_augmented_preterm_labour] = '1'
Dosage(drops/minute) text
326 [any_other_medication_given_preterm_labour]
Show the field ONLY if:
[pregnant_woman_with_preter]='1'
Was any other medication given yesno
1Yes
0No
327 [name_of_medicine_preterm_labour]
Show the field ONLY if:
[any_other_medication_given_preterm_labour] = '1'
Name of medicine text
328 [dosage_anyother_preterm_labour]
Show the field ONLY if:
[any_other_medication_given_preterm_labour] = '1'
Dosage text
329 [pregnant_woman_with_other] Pregnant Woman with Other Obstetric or Fetal Complications yesno, Required
1Yes
0No
330 [was_iv_fluids_given_fetal_complications]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Was IV fluids given yesno
1Yes
0No
331 [was_nst_cardiotocography_connected_fetal_complications]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Was NST / Cardiotocography connected or monitoring done yesno
1Yes
0No
332 [was_fhr_noted_fetal_complications]
Show the field ONLY if:
[was_nst_cardiotocography_connected_fetal_complications] = '1'
Was fhr noted radio
1Yes
2No
3Not applicable
333 [value_fhr_fetal_complications]
Show the field ONLY if:
[was_fhr_noted_fetal_complications] = '1'
Value text (number)
334 [were_accelerations_recorde_fetal_complications]
Show the field ONLY if:
[was_nst_cardiotocography_connected_fetal_complications] = '1'
were accelerations recorded radio
1Yes
2No
3Not applicable
335 [record_of_acceleration_fetal_complications]
Show the field ONLY if:
[were_accelerations_recorde_fetal_complications] = '1'
Record radio
1Early
2Late
3Variable
336 [were_contractions_monitore_fetal_complications]
Show the field ONLY if:
[was_nst_cardiotocography_connected_fetal_complications] = '1'
were contractions monitored radio
1Yes
2No
3Not applicable
337 [colour_of_amniotic_fluid_noted_fetal_complications]
Show the field ONLY if:
[was_nst_cardiotocography_connected_fetal_complications] = '1'
colour of amniotic fluid noted radio
1Yes
2No
3Not applicable
338 [color_amniotic_fluid_noted_fetal_complications]
Show the field ONLY if:
[colour_of_amniotic_fluid_noted_fetal_complications] = '1'
color amniotic fluid noted radio
1Meconium
2Clear
3Bloody
339 [was_labour_care_guide]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Was Labour Care Guide / Partograph used yesno
1Yes
0No
340 [was_poor_progress_of_labou]
Show the field ONLY if:
[was_labour_care_guide] = '1'
Was poor progress of labour noted radio
1Yes
2No
3Not applicable
341 [was_caput_noted]
Show the field ONLY if:
[was_labour_care_guide] = '1'
Was Caput noted radio
1Yes
2No
3Not applicable
342 [was_molding_noted]
Show the field ONLY if:
[was_labour_care_guide] = '1'
Was molding noted radio
1Yes
2No
3Not applicable
343 [was_position_of_fetus_ment]
Show the field ONLY if:
[was_labour_care_guide] = '1'
Was position of fetus mentioned as radio
1Yes
2No
3Not applicable
344 [was_cpd_suspected]
Show the field ONLY if:
[was_labour_care_guide] = '1'
Was CPD suspected radio
1Yes
2No
3Not applicable
345 [duration_of_first_stage_of]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Duration of first stage of labour text
346 [duration_of_second_stage_of_labour]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Duration of second stage of labour text
347 [were_vitals_checked_and_documented_fetal_complications]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Were vitals checked and documented yesno
1Yes
0No
348 [were_pulse_rate_noted_fetal_complications]
Show the field ONLY if:
[were_vitals_checked_and_documented_fetal_complications] = '1'
were pulse rate noted radio
1Yes
2No
3Not applicable
349 [value_pluse_fetal_complications]
Show the field ONLY if:
[were_pulse_rate_noted_fetal_complications] = '1'
Value text (number)
350 [was_blood_pressure_noted_fetal_complications]
Show the field ONLY if:
[were_vitals_checked_and_documented_fetal_complications] = '1'
Was blood pressure noted radio
1Yes
2No
3Not applicable
351 [value_sbp_fetal_complications]
Show the field ONLY if:
[was_blood_pressure_noted_fetal_complications] = '1'
Value SBP text (number)
352 [value_dbp_fetal_complications]
Show the field ONLY if:
[was_blood_pressure_noted_fetal_complications] = '1'
Value DBP text (number)
353 [was_temperature_noted_fetal_complications]
Show the field ONLY if:
[were_vitals_checked_and_documented_fetal_complications] = '1'
Was temperature noted radio
1Yes
2No
3Not applicable
354 [value_temp_fetal_complications]
Show the field ONLY if:
[was_temperature_noted_fetal_complications] = '1'
Value text (number)
355 [was_labour_augmented_fetal_complications]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Was labour augmented? yesno
1Yes
0No
356 [when_was_augmentation_started_time_fetal_complications]
Show the field ONLY if:
[was_labour_augmented_fetal_complications] = '1'
when was augmentation started (time) text (time)
357 [date_of_start_of_augmentation_fetal_complications]
Show the field ONLY if:
[was_labour_augmented_fetal_complications] = '1'
Date of start of augmentation text (date_dmy)
358 [name_of_drug_used_augmenta_fetal_complications]
Show the field ONLY if:
[was_labour_augmented_fetal_complications] = '1'
Name of drug used augmentation text
359 [dose_of_drugs_augumention_fetal_complications]
Show the field ONLY if:
[was_labour_augmented_fetal_complications] = '1'
Dose text
360 [was_any_other_medication_given_fetal_complications]
Show the field ONLY if:
[pregnant_woman_with_other]='1'
Was any other medication given yesno
1Yes
0No
361 [name_of_other_drug_fetal_complications]
Show the field ONLY if:
[was_any_other_medication_given_fetal_complications] = '1'
Name of other drug text
362 [dosage_of_other_drug_fetal_complications]
Show the field ONLY if:
[was_any_other_medication_given_fetal_complications] = '1'
Dosage text
363 [pregnant_woman_with_medica] Pregnant Woman with Medical Conditions yesno, Required
1Yes
0No
364 [was_iv_fluids_given_medical_condition]
Show the field ONLY if:
[pregnant_woman_with_medica]='1'
Was IV fluids given yesno
1Yes
0No
365 [was_nst_cardiotocography_connected_medical_condition]
Show the field ONLY if:
[pregnant_woman_with_medica]='1'
Was NST / Cardiotocography connected or monitoring done yesno
1Yes
0No
366 [was_fhr_recorded_medical_condition]
Show the field ONLY if:
[was_nst_cardiotocography_connected_medical_condition] = '1'
was FHR recorded radio
1Yes
2No
3Not applicable
367 [value_fhr_medical_condition]
Show the field ONLY if:
[was_fhr_recorded_medical_condition] = '1'
Value text (number)
368 [were_accelerations_recorde_medical_condition]
Show the field ONLY if:
[was_nst_cardiotocography_connected_medical_condition] = '1'
were accelerations recorded radio
1Yes
2No
3Not applicable
369 [record_of_accelaration_medical_condition]
Show the field ONLY if:
[were_accelerations_recorde_medical_condition] = '1'
Record radio
1Early
2Late
3Variable
370 [were_contractions_monitore_medical_condition]
Show the field ONLY if:
[was_nst_cardiotocography_connected_medical_condition] = '1'
were contractions monitored radio
1Yes
2No
3Not applicable
371 [were_vitals_checked_and_do_medical_condition]
Show the field ONLY if:
[pregnant_woman_with_medica]='1'
Were vitals checked and documented yesno
1Yes
0No
372 [were_pulse_rate_noted_medical_condition]
Show the field ONLY if:
[were_vitals_checked_and_do_medical_condition] = '1'
were pulse rate noted radio
1Yes
2No
3Not applicable
373 [value_pluse_medical_condition]
Show the field ONLY if:
[were_pulse_rate_noted_medical_condition] = '1'
Value text (number)
374 [was_blood_pressure_noted_medical_condition]
Show the field ONLY if:
[were_vitals_checked_and_do_medical_condition] = '1'
was blood pressure noted radio
1Yes
2Not
3Not applicable
375 [sbp_value_medical_condition]
Show the field ONLY if:
[was_blood_pressure_noted_medical_condition] = '1'
SBP Value text (number)
376 [dbp_value_medical_condition]
Show the field ONLY if:
[was_blood_pressure_noted_medical_condition] = '1'
DBP Value text (number)
377 [was_temprature_noted_medical_condition]
Show the field ONLY if:
[were_vitals_checked_and_do_medical_condition] = '1'
was temperature noted radio
1Yes
2No
3Not applicable
378 [value_temp_medical_condition]
Show the field ONLY if:
[was_temprature_noted_medical_condition] = '1'
Value text (number)
379 [was_labour_augmented_medical_condition]
Show the field ONLY if:
[pregnant_woman_with_medica]='1'
Was labour augmented? yesno
1Yes
0No
380 [when_was_augmentation_started_medical_conditionr]
Show the field ONLY if:
[was_labour_augmented_medical_condition] = '1'
when was augmentation started - Time text (time)
381 [date_of_start_of_augmentat_medical_condition]
Show the field ONLY if:
[was_labour_augmented_medical_condition] = '1'
Date of start of augmentation text (date_dmy)
382 [name_drug_used_medical_condition]
Show the field ONLY if:
[was_labour_augmented_medical_condition] = '1'
Name drug used text
383 [dosage_medical_condition]
Show the field ONLY if:
[was_labour_augmented_medical_condition] = '1'
Dosage(Drops/Min) text
384 [was_any_other_medication_given_medical_condition]
Show the field ONLY if:
[pregnant_woman_with_medica]='1'
Was any other medication given yesno
1Yes
0No
385 [name_of_drug_other_medical_condition]
Show the field ONLY if:
[was_any_other_medication_given_medical_condition] = '1'
Name of drug text
386 [dosage_other_drug_medical_condition]
Show the field ONLY if:
[was_any_other_medication_given_medical_condition] = '1'
Dosage text
387 [e_observation_of_pre_opera] E. OBSERVATION OF PRE-OPERATIVE PERIOD AND MATERNITY OT descriptive
388 [women_referred_ot_time] (Pre-operative preparedness and process)   If woman is referred to OT, time pregnant women received in pre-operative ward text (time), Required
389 [blood_cross_matching_done] Blood cross-matching done yesno, Required
1Yes
0No
390 [documentation_of_the_surgi] Documentation of the surgical checklist radio, Required
1Real time
2Delayed (> 4 hours from activity)
3Not filled
391 [pre_anesthetic_check_up] Pre-anesthetic check-up radio, Required
1Anaesthetic checklist available and used
2Anaesthetic checklist available and not used
3Anaesthetic checklist not available
392 [documenting_the_anaesthetic] Documenting the anesthetic checklist radio, Required
1Real time
2Delayed (> 4 hours from activity)
3Not filled
393 [finalising_ot_list_timely_conveying_ot_display] Finalising OT list/ timely conveying to the OT and display radio, Required
1Done/ one day in advance
2Done/ not in advance
3Not done
394 [prioritising_emergency_cas] Prioritising emergency cases radio, Required
1Done
2Not done
395 [ot_protocol] Adherence to protocol: OT protocol radio, Required
1Available and followed
2Available and not followed
3Not available
396 [p_informing_concerned_auth] Informing concerned authorities on rescheduled list radio, Required
1Done
2Not done
397 [shifting_plan_being_follow] Shifting plan being followed? radio, Required
1Yes
2Not
3Not applicable
398 [patient_preparation] Patient preparation (can tick on multiple options) checkbox, Required
1patient_preparation___1Enema
2patient_preparation___2Bath
3patient_preparation___3Dressing
4patient_preparation___4Shaving
5patient_preparation___5Clipping of hair on private parts
399 [placement_of_requisitions] Placement of requisitions checkbox, Required
1placement_of_requisitions___1Blood testing
2placement_of_requisitions___2Medications
3placement_of_requisitions___3Fluids
400 [ambulation_of_pregnsnt_womn_to_maternity_ot] Ambulation of pregnant woman to Maternity Operation Theatre (MOT) radio, Required
1Done by stretcher
2Done by wheelchair
3Walking
401 [verification_of_patient] Verification of patient radio, Required
1Done
2Not done
402 [evaluation_of_vitals_and_doc] Evaluation of vitals and documentation radio, Required
1Real time
2Delayed
3Not done
403 [shifting_to_mot] Shifting to MOT radio, Required
1Done under supervision
2Not done under supervision
405 [maternity_ot] Maternity OT descriptive
406 [time_pregnant_women_shifted_in_mot] Time pregnant women shifted in maternal operation theatre text (time), Required
407 [preparedness_of_maternity] Preparedness of maternity OT radio, Required
1Surgical checklist available and utilised
2Surgical checklist available and not utilised
3Surgical checklist not available
408 [listening_to_beneficiary] (Behavior of healthcare provider) a. Listening to beneficiary yesno, Required
1Yes
0No
409 [let_the_beneficiary_speak] b. Let the beneficiary speak yesno, Required
1Yes
0No
410 [c_explains_instructions_clearly] c. Explains instructions clearly and makes the beneficiary understand including repeating the explanation yesno, Required
1Yes
0No
411 [d_tone] d. Tone radio
1Polite
2Rude
3Yelling/ Abusive
412 [maintain_confidentiality] e. Maintain confidentiality and privacy yesno, Required
1Yes
0No
413 [physically_abusive] a. Physically abusive yesno, Required
1Yes
0No
414 [induction_of_anaesthesia] Induction of anaesthesia yesno, Required
1Yes
0No
415 [antacid_is_given] Antacid is given to reduce stomach acid in case there is aspiration. yesno, Required
1Yes
0No
416 [urinary_catheterization] Urinary catheterization yesno, Required
1Yes
0No
417 [surgical_site_preparation] Surgical site preparation yesno, Required
1Yes
0No
418 [lines_for_iv_fluid] Lines for IV-fluid yesno, Required
1Yes
0No
419 [incision_type] Incision type radio, Required
1Low transverse
2Low vertical
3High vertical
420 [final_management_of_delive] Final management of delivery radio, Required
1Managed in OT
2Shifted to ICU (if available)
3Referred to higher centre
421 [monitoring_of_bp_and_other_vitals] (Status of management of following complications) a. monitoring of blood pressure and other vitals radio, Required
1Done
2Not Done
422 [management_of_post_partum] b. management of post-partum haemorrhage radio, Required
1Done
2Not done
3Not applicable
423 [management_of_any_reaction_to_anaesthesia] c. management of any reaction to anaesthesia radio, Required
1Done
2Not done
3Not applicable
424 [drugs_and_doses_iv_oral] d. drugs and doses (iv/oral) radio, Required
1Done
2Not done
3Not applicable
425 [management_of_gestationa] e. management of gestational diabetes radio, Required
1Done
2Not done
3Not applicable
426 [management_of_pre_eclamp] f. management of pre-eclampsia / eclampsia cases radio, Required
1Done
2Not done
3Not applicable
427 [time_pregnant_women_shifted_to_post_operative_ward] Time pregnant women shifted to post-operative ward text (time)
428 [essential_newborn_care] ESSENTIAL NEWBORN CARE descriptive
429 [health_care_provider_perform_essential_newborn_care] Did the health care provider perform essential newborn care? yesno
1Yes
0No
430 [performed_essential_newborn_care]
Show the field ONLY if:
[health_care_provider_perform_essential_newborn_care] = '1'
what were the steps of essential newborn care performed? checkbox
1performed_essential_newborn_care___1Baby delivered on mother's abdomen
2performed_essential_newborn_care___2Dried immediately using clean towel
3performed_essential_newborn_care___3Cut the cord with sterile scissors/ surgical blade)
4performed_essential_newborn_care___4Cord cut after 1-3 minutes from birth
5performed_essential_newborn_care___5Skin to skin care initiated
6performed_essential_newborn_care___6Breastfeeding initiated within half an hour
431 [towel_cloth_provid] Was the towel/ cloth provided by the facility? yesno, Required
1Yes
0No
432 [healthcare_provide_et_newborn] Did the healthcare provider weigh the newborn? yesno, Required
1Yes
0No
433 [administer_vi_k1_to_newborn] Did the health care provider administer vitamin K1 to the newborn? yesno
1Yes
0No
434 [neonatal_resuscitation_if] NEONATAL RESUSCITATION (if baby did not cry/breathe) descriptive
435 [immediate_resuscitation] Immediate resuscitation promptly initiated as per guidelines upon assessment? yesno
1Yes
0No
436 [time_when_newborn_resuscit] Time when newborn resuscitation is decided to be given text (time)
437 [who_is_undertaking_the_active_managment] Who is undertaking the active management of situation (resuscitation)? checkbox
5who_is_undertaking_the_active_managment___5SN/ANM
6who_is_undertaking_the_active_managment___6Doctor
7who_is_undertaking_the_active_managment___7Paediatrician
Otherswho_is_undertaking_the_active_managment___othersmention
8who_is_undertaking_the_active_managment___8NA
438 [other_rescuve_active_managment]
Show the field ONLY if:
[who_is_undertaking_the_active_managment(Others)] = '1'
Other text
439 [steps_follow_resucitation] What were the steps followed by the staff for resuscitation of the baby? checkbox
1steps_follow_resucitation___1Clamps and cuts the cord immediately
2steps_follow_resucitation___2Keeps the newborn clean, dry and warm (transfers the baby under pre-heated radiant warmer)
3steps_follow_resucitation___3Performs PSSR (Position, Suction, Stimulation and Reposition) and monitoring
4steps_follow_resucitation___4Provides bag and mask ventilation
5steps_follow_resucitation___5Assesses for cord pulsation (pulsation in 6 seconds * 10 = heart rate)
6steps_follow_resucitation___6Assesses breathing and starts oxygen if condition does not get stable
440 [suction_is_repeated_if_nec] Suction is repeated if necessary yesno
1Yes
0No
441 [tactile_stimulation_is_giv] Tactile stimulation is given if necessary yesno
1Yes
0No
442 [reposition_is_done_if_nece] Reposition is done if necessary yesno
1Yes
0No
443 [irregular_breathing] If still no / irregular breathing and HR > 100/ minute start ventilation if necessary yesno
1Yes
0No
444 [mask_is_placed_to_cover] Mask is placed to cover the chin, mouth and nose and form a seal yesno
1Yes
0No
445 [ambu_bag_is_squeezed_and_r] Ambu bag is squeezed and rising of chest is observed yesno
1Yes
0No
446 [breathing_or_crying_with_more] If breathing or crying with more than 30 breaths per minute and no severe chest in-drawing, ventilation is stopped yesno
1Yes
0No
447 [deterioration_inspite_ventilation] In case of deterioration inspite of ventilation, medical expert notified yesno
1Yes
0No
448 [condition_after_mangmnt] How is the condition of the baby after management? radio
1Stable
2Not Stable
449 [stable_baby_under_observation]
Show the field ONLY if:
[condition_after_mangmnt] = '1'
If stable, baby is kept under observation in Radiant warmer when baby is stabilized (HR > 100 bpm & breathing well) then kept in skin-skin contact with PW's chest radio
1Yes
2No
3Not Stable
450 [monitore_every_15_mins]
Show the field ONLY if:
[condition_after_mangmnt] = '1'
If stable, baby is monitored every 15 minutes for breathing and warmth radio
1Yes
2No
3Not Stable
451 [staff_refer_baby]
Show the field ONLY if:
[condition_after_mangmnt] = '2'
If not stable, did the staff refer the baby to NBSU/SNCU/higher centre? radio
1Yes
2No
3Stable
452 [mode_of_referral_adopted]
Show the field ONLY if:
[staff_refer_baby] = '1'
If referred to higher centre, what was the mode of referral adopted for referral? radio
1Hospital ambulance
2Self-vehicle
3Private vehicle
Othersmention
4Not applicable (in case of in-facility referral or no referral)
453 [no_breathing_at_all_after_20_min_ventilation]
Show the field ONLY if:
[staff_refer_baby] = '2'
If no breathing at all after 20 minutes of ventilation, ventilation is stopped, and the baby is declared dead yesno
1Yes
0No
454 [postpartum_mother_explained] Postpartum woman/mother is explained, and supportive care is given to her yesno
1Yes
0No
455 [g_observation_of_referral] G. OBSERVATION OF REFERRAL PROCESS descriptive
456 [time_of_reffral] If referred to higher centre, mention time when patient is informed about referral text (time)
457 [name_of_the_referral_facil] Name of the referral facility text
458 [referral_slip_provided] Is referral slip provided to the patient? yesno
1Yes
0No
459 [slip_complete_with_info] Is the slip complete with all information? yesno
1Yes
0No
460 [copy_of_the_partograph_provide] Is copy of the Partograph given along with referral slip at the time of required referral? radio
1Yes
2No
3Partograph not plotted
461 [referral_communicate_to_higher_facility] How was the referral communicated to the higher facility? radio
1Through calling to the higher centre
2Through WhatsApp group
3No prior communication
4Others, mention
462 [reffral_communication]
Show the field ONLY if:
[referral_communicate_to_higher_facility] = '4'
Other text
463 [mode_of_reaching_out] What was the mode of reaching out-facility referral? radio
1Hospital ambulance
2Self-vehicle
3Private vehicle
4Others
5Not applicable (in case of in-facility referral)
464 [other_mode_of_reach]
Show the field ONLY if:
[mode_of_reaching_out] = '4'
Other text
465 [available_ambulance]
Show the field ONLY if:
[mode_of_reaching_out] = '1'
If ambulance was available at time of referral? radio
1Available
2Not available
466 [exact_time_conveyance_arrived] Record the exact time the conveyance arrived text (time)
467 [referred_timely_manner] If the pregnant woman transferred to a higher facility, was she referred in a timely manner? yesno
1Yes
0No
468 [stable_at_referral_time] Was the pregnant woman stable at the time of referral? yesno
1Yes
0No
469 [against_lama] Has/have the pregnant woman or her relatives left against medical advice (LAMA)? yesno
1Yes
0No
470 [resone_for_lama]
Show the field ONLY if:
[against_lama] = '1'
what was the reason mentioned over documents for taking a discharge against medical advice? text
471 [h_outcomes_of_delivery] H. OUTCOMES OF DELIVERY descriptive
472 [outcome_of_the_delivery] Outcome of the delivery radio
1Live birth
2Stillbirth
473 [whether_macerated_or_fresh]
Show the field ONLY if:
[outcome_of_the_delivery] = '2'
whether macerated or fresh radio
1Macerated
2Fresh
474 [time_of_birth] Time of birth text (time)
475 [sex] Sex radio
1Male
2Female
476 [weight_at_birth_in_grams] Weight at birth (in grams) text (number)
477 [baby_cry_at_birth] Did the baby cry at birth? yesno
1Yes
0No
478 [time_of_declaration_death]
Show the field ONLY if:
[outcome_of_the_delivery] = '2'
time of declaration of death text (time)
479 [time] Time text (time_hh_mm_ss)
Field Annotation: @HIDDEN
480 [date] Date text (date_dmy)
Field Annotation: @HIDEBUTTON @HIDDEN
 
 481 [form_1_complete]
Section Header: Form Status
Complete? 		dropdown
0Incomplete
1Unverified
2Complete
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