* Extra appointment if this is your first baby. endocrine disorders or diabetes requiring insulin, psychiatric disorders (being treated with medication), use of recreational drugs such as heroin, cocaine (including crack cocaine) and ecstasy, higher risk of developing complications, for example, women aged 40 and older, women who smoke. Numerator – the number of women in the denominator followed up within locally defined timescales. 18-20 Week Morphology Ultrasound Scan followed by an appointment with the GP as soon as possible Rationale for visit - Care to include: Review morphology USS results and refer if necessary to Maternal Fetal Medicine or Specialist Obstetrician Women with pre-eclampsia who have severe hypertension or are at a high risk of adverse events, or if there are any clinical concerns, are admitted to hospital and monitored. NICE guidance and other sources used to create this interactive flowchart. Concern would arise if, after delivery, the baby has a heartbeat below 60 beats/minute that is not getting faster. awareness of 'baby blues' and postnatal depression. for women whose babies are in the breech presentation, offer external cephalic version (ECV). Some women may need to stay in hospital until after the birth of their baby. breastfeeding, including hints and tips for success, vitamin K and screening tests for your newborn baby. Pregnant women are offered testing for gestational diabetes if they are identified as at risk of gestational diabetes at the booking appointment. Outcomes for women for each planned place of birth include rates of spontaneous vaginal birth, transfer to obstetric unit, obstetric intervention and delivering a baby with or without serious medical problems. <>>> Numerator – the number of women in the denominator who decide not to attend an evidence-based stop smoking service who receive follow-up. A minimum of eight contacts for antenatal care can reduce perinatal deaths by up to 8 per 1000 births when compared to a minimum of four visits, according to the WHO. Topics covered should include: food hygiene, including how to reduce the risk of a food‑acquired infection, lifestyle advice, including smoking cessation, recreational drug use and alcohol consumption. Pregnant women with an uncomplicated singleton breech presentation at, a) Evidence of local arrangements to ensure that pregnant women with a suspected breech presentation at, b) Evidence of local arrangements to ensure that pregnant women with a confirmed uncomplicated singleton breech presentation at, a) Proportion of pregnant women with a suspected breech presentation at. 4 0 obj ‘Childbearing potential’ should be determined for women on an individual basis. All rights reserved. Use this guideline for making your appointments and understanding common procedures for each visit: Weeks Possible Tests 6–8 Blood type, rubella titer, blood counts, hepatitis screen, ultrasound. d) Proportion of pregnant women who smoke and decide not to attend an evidence-based stop smoking service who receive follow-up. baseline fetal heart rate of 100 to 160 beats per minute, baseline variability of 5 to 25 beats per minute. You’ll have more appointments if you’re diagnosed with a pregnancy-related condition like high blood pressure or gestational diabetes or if you are pregnant with twins or multiple babies. 14 March 2016 Information on risk assessment and testing for gestational diabetes updated. Antihypertensive treatment should aim to lower blood pressure from the moderate or severe range, while avoiding excessive reductions that may affect fetal growth. Any risk assessment for gestational diabetes should be corrected for family origin. Proportion of women at low risk of complications whose labour is progressing normally who do not have amniotomy or oxytocin. Women have skin-to-skin contact with their babies after the birth. measure your blood pressure and test your urine for protein. Denominator – the number of pregnant women at intermediate risk of VTE at the booking appointment. Women with any 1 of these risk factors should be offered testing for gestational diabetes.