Appropriate technology: antenatal care

Appropriate health technology should be effective, safe and feasible. The c urrent antenatal care model originated from western countries. The absence of direct randomized, controlled trials precludes a straight forward evalua tion of the impact of prenatal care on birth outcomes. Interventions of pro ven benefits in eliminating or alleviating adverse maternal outcomes includ e routine iron and folate supplementation in areas of high anemia prevalenc e, hemoglobin determination late in pregnancy, screening for asymptomatic b acteriuria by urine culture or dipstick, serologic screening and treatment of syphilis, obtaining a history of difficult labor in multipara or height in nullipara and external cephalic version at term. Interventions of proven benefits in eliminating or alleviating adverse newborn outcomes include ro utine measurement of fundal height, reduction of maternal physical strain, diagnosis and treatment of tuberculosis, malaria prophylaxis, adequate teta nus immunization, antenatal and perinatal Zidovudine in HIV-positive mother s and one vaginal examination during pregnancy. Only these interventions of proven benefits should be implemented. (C) 1998 International Federation o f Gynecology and Obstetrics.