NICE clinical guidelines are recommendations about the treatment and care of Baseline prothrombin measurements should be taken before starting treatment with warfarin. Specific factors that might contribute to a high-risk pregnancy include: They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. 3 0 obj Often a pregnancy is classified as high risk because of issues that arise from the pregnancy itself and that have little to do with the mother's health. In the absence of any explicit guidance from NICE, the recommendation to refer those at high risk of pre-eclampsia early in pregnancy is based on the Pre-eclampsia Community Guideline (PRECOG). 25 April 2019. The recommendations on management of women at high risk of, or exhibiting clincical featues of pre-eclampsia are largely based on expert opinion in the National Institute of Health and Care Excellence (NICE) guideline Hypertension in pregnancy: diagnosis and management [NICE, 2019b]. NICE guideline 133 on the management of hypertension in pregnancy aims to reduce the risks of preterm birth for the baby, and describes treatments to prevent or delay early labour and birth. The risk of carcinogenesis as a result of in-utero exposure to ionizing radiation is unclear but is probably very small. In addition, it is necessary the obstetrician plans the woman's labour. ATSM: High Risk Pregnancy (2018) The advanced high risk pregnancy ATSM will prepare you to deal with complex problems in late pregnancy, in particular cases that need multidisciplinary management. Advise and support people at high risk of or with CVD to achieve a healthy diet in line with Behaviour change: the principles for effective interventions (NICE public health guidance 6) Physical activity. ATSM: High Risk Pregnancy (2018) The advanced high risk pregnancy ATSM will prepare you to deal with complex problems in late pregnancy, in particular cases that need multidisciplinary management. Intrapartum care for women with existing medical conditions, Intrapartum care for women with obstetric complications, guideline on care during labour and birth for healthy women and their babies, recommendations on continuous cardiotocography, acute kidney injury and chronic kidney disease, assess and reduce the environmental impact of implementing NICE recommendations, Pregnant women, their families and carers, Obstetricians, midwives, anaesthetists and other healthcare professionals caring for women in labour, Providers and commissioners of maternity services. This guideline includes recommendations on: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. Nutritional supplements — folic acid (400 micrograms per day for uncomplicated pregnancies for the first 12 weeks) and vitamin D (10 micrograms per day throughout pregnancy). NICE is developing a new guideline on Intrapartum care for high risk women.. %���� Finally, we have looked at the uptake publications@nice.org.uk and quote: • N1625 (quick reference guide) • N1626 (‘Understanding NICE guidance’). Typically, special monitoring or care throughout pregnancy is needed. These could be very minor problems, but in some cases, a high-risk condition can be life threatening for a woman or her baby. In April 2019 we replaced recommendations on continuous cardiotocography for women with a previous caesarean section with links to our guideline on caesarean section. But pregnant women are in the moderate risk (clinically vulnerable) group as a precaution. Antenatal and postnatal mental health Antenatal care for uncomplicated pregnancies Diabetes in pregnancy Ectopic pregnancy and miscarriage Hypertension in pregnancy Maternal and child nutrition Pregnancy and complex social factors: service provision NICE has also produced a guideline on care during labour and birth for healthy women and their babies. This guideline includes recommendations on: Antenatal and postnatal mental health Antenatal care for uncomplicated pregnancies Diabetes in pregnancy Ectopic pregnancy and miscarriage Hypertension in pregnancy Maternal and child nutrition Pregnancy and complex social factors: service provision Vaginal delivery is recommended as first choice in most patients, with a few exceptions. <> It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. Pregnancy. 4 0 obj Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. The NICE guidelines suggest that the first antenatal visit occur before 10 weeks pregnancy due to the high information needs in early pregnancy. The guidance also acknowledges that the presence of multiple (3 or more) minor risk factors (such as first pregnancy, low body mass index, long or short intervals between pregnancies) constitutes a risk for a SGA baby and there is a rationale for further screening and refinement of risk in this instance.
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