2.  severe anemia  Heart failure, which developed as a result of heart disease  pneumonia  asthma

3.  difficulty in breathing  Pallor of the conjunctiva, tongue, nail phalanxes and / or hands  Drowsiness and fatigue  Flat or concave nails  Hemoglobin 7 g / dl or less  Hematocrit 20% or less

4.  Measure the pulse, blood pressure, respiratory rate, temperature  Determine hemoglobin, hematocrit  Screening for helminthic infestation, malaria

5.  Do a quick assessment of the overall condition of the woman Place the woman on her left side Start intravenous infusion and pour liquid  Give oxygen at 4-6 L / min through a mask or nasal cannula If necessary, use of blood components  - Slowly pour the red blood cells (packed red blood cells, washed red blood cells)  - Enter furosemide 40 mg intravenously after the transfusion of each unit of blood  Assign ferruginous preparations  - Ferrous sulfate or iron fumerat 120 mg orally  - Maltofer, Ferrum Lek, ginotardiferon, ferlatum etc.  PLUS folic acid 400 mg orally once daily for 6 months during pregnancy. Continue treatment for 3 months after delivery.

6. difficulty in breathing Diastolic murmurs and / or rough systolic murmur with a palpable tremor of the heart on the front of the chest wall Heart rhythm disturbance enlarged heart Rattling Cyanosis (blueness) cough Swelling of the lower extremities enlarged liver Swelling of the neck veins

7.  Measure the pulse, blood pressure, respiratory rate, temperature  ECG  Echocardiography (after removing the signs of NC)  In case of difficulty of diagnosis conduct chest X-ray

8. Treat congestive heart failure. Used medications may include: - Morphine 10 mg intramuscularly once; - Furosemide 40 mg intravenously - Digoxin 0.5 mg intramuscularly once; - OR 0.3 mg nitroglycerin sublingual again after 15 minutes if necessary. Assistance in case of heart failure that developed during childbirth Place the woman on her left side. Limit transferring liquids to reduce the risk of circulatory overload and strictly enroll fluid balance in the map. Ensure adequate analgesia

9.  If required oxytocin use solution of higher concentration and pour it to a lower speed in order to maintain fluid balance Eliminate the bearing-down period in the phase of exile. If necessary, reduce the burden on women during childbirth, perform an episiotomy and forceps delivery complete. Ensure active management of the third stage of labor.  The presence of heart failure is not an indication for caesarean section. Note: Do not give ergometrine.

10.  difficulty breathing  The high temperature  Cough with phlegm  Chest pain  Sealing lung tissue hoarseness  Rapid breathing  Wheezing / whistling

11.  Measure the pulse, blood pressure, respiratory rate, temperature  ECG  auscultation of the lungs  R-graphy lung

12.  To confirm the diagnosis of pneumonia may require chest X-ray.  Assign erythromycin 500 mg oral 4 times a day for 7 days.  Assign a steam inhalation.  Eliminate TB

13. Pregnancy -> 1/3 deteriorate 1/3 improve 1/3 no change Differentiate from other conditions

14.  similar to non-pregnant  do not avoid necessary drugs!  Rx GERD if problematic  severe attack worse for fetus than drugs  systemic steroids when necessary