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 va
rious antenatal visits, and also for transmitting the information to t
he delivery staff. If properly designed, it could also serve as an imp
ortant means to assess epidemiological characteristics of the pregnant
population, necessary for deciding priorities in a public health pers
pective. A cross-sectional study of nomen giving birth in Leon, Nicara
gua, showed that the majority of the women could be classified as high
-risk pregnancies. The present paper discusses the design of the Nicar
aguan antenatal card, as well as its risk factors. A revision of the a
ntenatal card and the accompanying manual is suggested, particularly w
ith regard to the definitions of the high-risk criteria and the propos
ed action.