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e468434f4794d3c5 | ## **1.6 Choice of procedure for abortion**
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng140/evidence/b-information-needs-of-women-undergoing-an-abortion-pdf-6905052974) B: [information needs of women undergoing an abortion](https://www.nice.or... |
6cffc4f68152846b | ## **1.6 Choice of procedure for abortion**
-between-130-and-240-weeks-gestation-pdf-248581907029) K: medical [versus surgical abortion between 13](https://www.nice.org.uk/guidance/ng140/evidence/k-medical-versus-surgical-abortion-between-130-and-240-weeks-gestation-pdf-248581907029)[+0](https://www.nice.org.uk/guidan... |
922ad4a8958f69d9 | ## **1.7 Abortion before definitive ultrasound evidence of an intrauterine pregnancy**
- 1.7.1 Consider abortion before there is definitive ultrasound evidence of an intrauterine pregnancy (a yolk sac) for women who do not have signs or symptoms of an ectopic pregnancy.
- 1.7.2 For women who are having an abortion bef... |
743c3b59af3ef646 | ## **1.7 Abortion before definitive ultrasound evidence of an intrauterine pregnancy**
- provide 24-hour emergency contact details, and advise them to get in contact immediately if they develop symptoms that could indicate an ectopic pregnancy (see [symptoms and signs of ectopic pregnancy and initial](http://www.nice.... |
2379f6c9be10c7f9 | ## **1.7 Abortion before definitive ultrasound evidence of an intrauterine pregnancy**
To find out why the committee made the recommendations and how they might affect practice, see the rationale and impact section on abortion before definitive ultrasound evidence of an intrauterine pregnancy.
Full details of the evi... |
76e54b6957bdc554 | ### **Up to and including 9+6 weeks' gestation**
1.8.1 For women who are having a medical abortion and will be taking the mifepristone up to and including 9+6 weeks' gestation, offer the option of expulsion at home. Mifepristone and misoprostol can be taken at home or in the clinic or hospital.
> This recommendation ... |
0d232ac06ade4226 | ## **At 10+0 weeks' gestation**
1.8.2 For women who are having a medical abortion and will be taking the mifepristone at 10+0 weeks' gestation, offer the option of expulsion at home after they have taken the misoprostol. Misoprostol can be taken in the clinic or hospital.
To find out why the committee made the recomm... |
6a555542f93a7ea3 | ## **At 10+0 weeks' gestation**
- 600 mg orally for medical abortion of developing intrauterine pregnancy, followed 36 to 48 hours later by 400 micrograms misoprostol orally or 1 mg gemeprost vaginally, up to and including 49 days of amenorrhoea
- 600 mg orally for medical abortion of developing intrauterine pregnancy... |
071c005d2260d982 | ## **At 10+0 weeks' gestation**
- 600 mg orally for medical abortion for medical reasons, followed 36 to 48 hours later by prostaglandin administration, beyond the first trimester
- 200 mg orally for cervical priming, 36 to 48 hours before first trimester surgical abortion.
All other uses of mifepristone are off labe... |
683ddca1720404f5 | ## **At 10+0 weeks' gestation**
- 400 micrograms orally as an initial dose for medical abortion of developing intrauterine pregnancy, 36 to 48 hours after 600 mg mifepristone orally, up to and including 49 days of amenorrhoea
- 800 micrograms vaginally as an initial dose for medical abortion of developing intrauterine... |
b3a5d9182b3360a0 | ## **At 10+0 weeks' gestation**
- 1.9.1 Offer interval treatment (usually 24 to 48 hours) with mifepristone and misoprostol to women who are having a medical abortion up to and including 10+0 weeks' gestation.
- 1.9.2 For women who are having a medical abortion up to and including 9+0 weeks' gestation, give them the c... |
395754da2e23a69b | ## **At 10+0 weeks' gestation**
To find out why the committee made the recommendations and how they might affect practice, see the rationale and impact section on the interval between mifepristone and misoprostol for medical abortion up to and including 10+0 weeks. |
6123052e49bcf69a | ## **At 10+0 weeks' gestation**
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng140/evidence/h-simultaneous-versus-delayed-mifepristone-misoprostol-administration-for-medical-abortion-up-to-100-weeks-gestation-pdf-6905052980) H: [medical abortion ... |
49fb2723b4f2cf04 | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
In September 2019, mifepristone for abortion only has a UK marketing authorisation for: |
afcbe3d0553caae5 | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
- 600 mg orally for medical abortion of developing intrauterine pregnancy, followed 36 to 48 hours later by 400 micrograms misoprostol orally or 1 mg gemeprost vaginally, up to and including 49 days of amenorrhoea
- 600 mg orally for medical abortion of devel... |
8e832cf4733b2c0f | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
- 600 mg orally for medical abortion for medical reasons, followed 36 to 48 hours later by prostaglandin administration, beyond the first trimester
- 200 mg orally for cervical priming, 36 to 48 hours before first trimester surgical abortion.
All other uses ... |
cfdcb7962c86aacd | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
- 400 micrograms orally as an initial dose for medical abortion of developing intrauterine pregnancy, 36 to 48 hours after 600 mg mifepristone orally, up to and including 49 days of amenorrhoea
- 800 micrograms vaginally as an initial dose for medical abortio... |
9e0e459577af33e7 | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
- 1.10.1 For women who are having a medical abortion between 10+1 and 23+6 weeks' gestation and who have taken 200 mg mifepristone, offer an initial dose (36 to 48 hours after the mifepristone) of:
- 800 micrograms misoprostol, given vaginally, **or**
- 600... |
311780b320a18c79 | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
To find out why the committee made the recommendations and how they might affect practice, see the rationale and impact section on medical abortion between 10+1 and 23+6 weeks. |
72c2b99232b57b8b | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng140/evidence/j-misoprostol-after-mifepristone-for-inducing-medical-abortion-between-101-and-240-weeks-gestation-pdf-248581907028) J: [medic... |
766c3c6cb97c6d41 | #### **1.10 Medical abortion between 10+1 and 23 +6 weeks**
er-mifepristone-for-inducing-medical-abortion-between-101-and-240-weeks-gestation-pdf-248581907028) weeks' gestation. |
e30264a5e8a1b319 | #### **1.11 Medical abortion after 23 +6 weeks**
In September 2019, mifepristone for abortion only has a UK marketing authorisation for: |
83e41350f9f7efec | #### **1.11 Medical abortion after 23 +6 weeks**
- 600 mg orally for medical abortion of developing intrauterine pregnancy, followed 36 to 48 hours later by 400 micrograms misoprostol orally or 1 mg gemeprost vaginally, up to and including 49 days of amenorrhoea
- 600 mg orally for medical abortion of developing intra... |
545a5d19e5ebd409 | #### **1.11 Medical abortion after 23 +6 weeks**
- 600 mg orally for medical abortion for medical reasons, followed 36 to 48 hours later by prostaglandin administration, beyond the first trimester
- 200 mg orally for cervical priming, 36 to 48 hours before first trimester surgical abortion.
All other uses of mifepris... |
cc734d7c19cac264 | #### **1.11 Medical abortion after 23 +6 weeks**
- 400 micrograms orally as an initial dose for medical abortion of developing intrauterine pregnancy, 36 to 48 hours after 600 mg mifepristone orally, up to and including 49 days of amenorrhoea
- 800 micrograms vaginally as an initial dose for medical abortion of develo... |
38166345c5d85194 | #### **1.11 Medical abortion after 23 +6 weeks**
- 1.11.1 For women who are having a medical abortion between 24 +0 and 25+0 weeks' gestation, consider 200 mg oral mifepristone, followed by 400 micrograms misoprostol (vaginal, buccal or sublingual) every 3 hours until delivery.
- 1.11.2 For women who are having a medi... |
b1246d4d2494d5ed | ## **1.12 Cervical priming before surgical abortion**
- 600 mg orally for medical abortion of developing intrauterine pregnancy, followed 36 to 48 hours later by 400 micrograms misoprostol orally or 1 mg gemeprost vaginally, up to and including 49 days of amenorrhoea
- 600 mg orally for medical abortion of developing ... |
2cdb8bb3f38b5e5e | ## **1.12 Cervical priming before surgical abortion**
- 600 mg orally for medical abortion for medical reasons, followed 36 to 48 hours later by prostaglandin administration, beyond the first trimester
- 200 mg orally for cervical priming, 36 to 48 hours before first trimester surgical abortion.
All other uses of mif... |
bdb64e591c289fe8 | ## **1.12 Cervical priming before surgical abortion**
- 400 micrograms orally as an initial dose for medical abortion of developing intrauterine pregnancy, 36 to 48 hours after 600 mg mifepristone orally, up to and including 49 days of amenorrhoea
- 800 micrograms vaginally as an initial dose for medical abortion of d... |
57987e4364ea14a5 | ### **Up to and including 13+6 weeks**
- 1.12.1 For women who are having a surgical abortion up to and including 13+6 weeks' gestation, offer cervical priming with:
- 400 micrograms sublingual misoprostol, given 1 hour before the abortion **or**
- 400 micrograms vaginal misoprostol, given 3 hours before the abortion... |
288c58f1d974d385 | #### **Between 14+0 and 23 +6 weeks**
- 1.12.3 For women who are having a surgical abortion between 14+0 and 23+6 weeks' gestation, offer cervical priming.
- 1.12.4 For women who are having a surgical abortion between 14+0 and 16+0 weeks' gestation, consider:
- osmotic dilators **or**
- buccal, vaginal or sublingual... |
16c1c4a39a6b9120 | #### **Between 14+0 and 23 +6 weeks**
- 1.12.5 For women who are having a surgical abortion between 16+1 and 19+0 weeks' gestation, consider:
- osmotic dilators **or**
- buccal, vaginal or sublingual misoprostol.
- 1.12.6 For women who are having a surgical abortion between 19+1 and 23+6 weeks' gestation, offer osmo... |
81b7d7c560d3ecb0 | #### **Between 14+0 and 23 +6 weeks**
- 1.12.8 Do not offer misoprostol for cervical priming if the woman has had an osmotic dilator inserted the day before the abortion.
To find out why the committee made the recommendations and how they might affect practice, see the rationale and impact section on cervical priming... |
d646e36d6ae5c6e6 | ## **1.13 Anaesthesia and sedation for surgical abortion**
- 1.13.1 For women who are having surgical abortion, consider local anaesthesia alone, conscious sedation with local anaesthesia, deep sedation or general anaesthesia. To help women make an informed choice, discuss the options with them and explain that:
- ha... |
bc69b7506a9a0507 | ## **Follow-up after medical abortion up to and including 10+0 weeks**
- 1.14.1 For women who have had a medical abortion up to and including 10+0 weeks' gestation with expulsion at home, offer the choice of self-assessment, including remote assessment (for example telephone or text messaging), as an alternative to cl... |
71e919cc9f393f05 | #### 1.14.3 Explain to women:
- what aftercare and follow-up to expect
- what to do if they have any problems after the abortion, including how to get help out of hours
- that it is common to feel a range of emotions after the abortion.
- 1.14.4 Advise women to seek support if they need it, and how to access it (if re... |
e3af812404a2f221 | #### 1.14.3 Explain to women:
To find out why the committee made the recommendations and how they might affect practice, see the rationale and impact section on follow-up and support after an abortion. |
bb177896ed1246de | #### 1.14.3 Explain to women:
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng140/evidence/i-followup-after-medical-abortion-up-to-100-weeks-pdf-6905052981) I: [follow-up after medical abortion up to 10](https://www.nice.org.uk/guidance/ng140/evid... |
e73b4b61db57b748 | ## **1.15 Improving access to contraception**
1.15.1 Commissioners and providers should ensure that the full range of reversible contraceptive options (depot medroxyprogesterone acetate [DMPA], contraceptive implant, intrauterine methods, oral contraceptives, contraceptive
patches, vaginal rings or barrier contracept... |
b5e74bf6d5f9d363 | ## **1.15 Improving access to contraception**
- 1.15.2 Providers should ensure that healthcare professionals have the knowledge and skills to provide all contraceptive options.
- 1.15.3 Providers should ensure they can provide the contraceptive implant, and that women who choose this method are offered it on:
- the d... |
4ba2c39ea9b7ee3b | ## **1.15 Improving access to contraception**
- consider providing it at the same appointment when they take the mifepristone
- explain that having the injection at this stage may increase the risk of ongoing pregnancy, although overall the risk is low.
To find out why the committee made the recommendations and how ... |
15b49451b697281c | # **Antenatal care**
NICE guideline
Published: 19 August 2021
[www.nice.org.uk/guidance/ng201](https://www.nice.org.uk/guidance/ng201) |
9a05aaa83810c55c | # **Overview**
This guideline covers the routine antenatal care that women and their babies should receive. It aims to ensure that pregnant women are offered regular check-ups, information and support. We have also published a guideline on postnatal care, which covers the topics of emotional attachment and baby feedin... |
f42bd4f3b37779af | ### **Who is it for?**
- Healthcare professionals
- Commissioners of antenatal care services
- Women using antenatal services, their partners, their families, and the public |
a5127cf4e517cac5 | # **Recommendations**
People have the right to be involved in discussions and make informed decisions about their care, as described in [NICE's information on making decisions about your](https://www.nice.org.uk/about/nice-communities/nice-and-the-public/making-decisions-about-your-care) [care.](https://www.nice.org.u... |
a0977ec3099bf6cb | # **Recommendations**
[Making decisions using NICE guidelines](http://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/using-NICE-guidelines-to-make-decisions) explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medici... |
d9383c1f384fcd59 | # **Recommendations**
Supporting women to make decisions about their care is important during pregnancy. Healthcare professionals should ensure that women have the information they need to make decisions and to give consent in line with [General Medical Council \(GMC\)](https://www.gmc-uk.org/ethical-guidance/ethical-... |
46c1ef62197ec355 | #### **Starting antenatal care**
- 1.1.1 Ensure that antenatal care can be started in a variety of straightforward ways, depending on women's needs and circumstances, for example, by self-referral, referral by a GP, midwife or another healthcare professional, or through a school nurse, community centre or refugee host... |
e204fad66745685f | #### **Starting antenatal care**
appointment. This should include information about modifiable factors that may affect the pregnancy, including stopping smoking, avoiding alcohol, taking supplements, and eating healthily. See also recommendation 1.3.9 and the [NICE guidelines on maternal and child nutrition,](https://... |
31dbcc1d9fe7f496 | #### **Starting antenatal care**
- Ensure that the materials are available in different languages or formats such as digital, printed, braille or Easy Read.
- 1.1.3 The referral form for women to start antenatal care should:
- enable healthcare professionals to identify women with:
- specific health and social care ... |
c7f05ee7516fa0e9 | #### **Starting antenatal care**
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng201/evidence/f-accessing-antenatal-care-pdf-9202942627) F: [accessing antenatal care.](https://www.nice.org.uk/guidance/ng201/evidence/f-accessing-antenatal-care-pdf-... |
d2dea918a347a410 | #### **Antenatal appointments**
- 1.1.4 Offer a first antenatal (booking) appointment with a midwife to take place by 10+0 weeks of pregnancy.
- 1.1.5 If women contact or are referred to maternity services later than 9+0 weeks of pregnancy, offer a first antenatal (booking) appointment to take place within 2 weeks if ... |
338fd7b7bfae6f1c | #### **Antenatal appointments**
- 1.1.7 Plan 10 routine antenatal appointments with a midwife or doctor for nulliparous women. (See [schedule of appointments.](https://www.nice.org.uk/guidance/ng201/resources/schedule-of-antenatal-appointments-pdf-9204300829))
- 1.1.8 Plan 7 routine antenatal appointments with a midwi... |
192992f69a4e2356 | #### **Antenatal appointments**
- 1.1.10 Offer additional or longer antenatal appointments if needed, depending on the woman's medical, social and emotional needs. Also see the [NICE guidelines on](https://www.nice.org.uk/guidance/cg110) [pregnancy and complex social factors](https://www.nice.org.uk/guidance/cg110), [... |
dbef8afcbe23fc64 | #### **Antenatal appointments**
- 1.1.11 Ensure that reliable interpreting services are available when needed, including British Sign Language. Interpreters should be independent of the woman rather than using a family member or friend.
- 1.1.12 Those responsible for planning and delivering antenatal services should a... |
69f6cf4e60679777 | #### **Antenatal appointments**
- evidence review [H: timing of first antenatal appointment](https://www.nice.org.uk/guidance/ng201/evidence/h-timing-of-first-antenatal-appointment-pdf-9202942629)
- evidence review [I: number of antenatal appointments](https://www.nice.org.uk/guidance/ng201/evidence/i-number-of-antena... |
aadcf02c4ca57204 | #### **Involving partners**
- 1.1.14 A woman can be supported by a partner during her pregnancy so healthcare professionals should:
- involve partners according to the woman's wishes **and**
- inform the woman that she is welcome to bring a partner to antenatal appointments and classes.
- 1.1.15 Consider arranging t... |
c8326e1663f7fc83 | #### **Involving partners**
- displaying positive images of partner involvement (for example, on notice boards and in waiting areas)
- providing seating in consultation rooms for both the woman and her partner
• considering providing opportunities for partners to attend appointments remotely as appropriate.
For a s... |
5886e6e0caeaad87 | #### **Involving partners**
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng201/evidence/c-involving-partners-pdf-9202942624) C: [involving partners](https://www.nice.org.uk/guidance/ng201/evidence/c-involving-partners-pdf-9202942624) and evidence... |
0bd714fc02b313f9 | #### **Taking and recording the woman's history**
- 1.2.1 At the first antenatal (booking) appointment, ask the woman about:
- her medical history, obstetric history and family history (of both biological parents) |
fb6d5b07558434c7 | #### **Taking and recording the woman's history**
- previous or current mental health concerns such as depression, anxiety, severe mental illness, psychological trauma or psychiatric treatment, to identify possible mental health problems in line with the [section on](https://www.nice.org.uk/guidance/cg192/chapter/1-Re... |
fdf80126308bd215 | #### **Taking and recording the woman's history**
- current and recent medicines, including over-the-counter medicines, health supplements and herbal remedies
- allergies
- her occupation, discussing any risks and concerns
- her family and home situation, available support network and any health or other issues aff... |
087e1f97fe5591ce | #### **Taking and recording the woman's history**
- contact details for her partner and her next of kin
- factors such as nutrition and diet, physical activity, smoking and tobacco use, alcohol consumption and recreational drug use (see also recommendations 1.3.8 and 1.3.9\).
- 1.2.2 Consider reviewing the woman's pre... |
de3a6178ae337fcc | #### **Taking and recording the woman's history**
- compared with white women (8/100,000), the risk of maternal death during pregnancy and up to 6 weeks after birth is:
- 4 times higher in black women (34/100,000)
- 3 times higher in women with mixed ethnic background (25/100,000)
- 2 times higher in Asian women (1... |
4f4f3b77ba365344 | #### **Taking and recording the woman's history**
- 1.2.5 Ask the woman about domestic abuse in a kind, sensitive manner at the first antenatal (booking) appointment, or at the earliest opportunity when she is alone. Ensure that there is an opportunity to have a private, one-to-one discussion. Also see the [NICE guide... |
8f676e4dd6c13716 | #### **Taking and recording the woman's history**
- 1.2.6 Assess the woman's risk of and, if appropriate, discuss female genital mutilation (FGM) in a kind, sensitive manner. Take appropriate action in line with [UK](https://www.gov.uk/government/publications/safeguarding-women-and-girls-at-risk-of-fgm) [government gu... |
5aa021083c0424a6 | #### **Taking and recording the woman's history**
- 1.2.7 Refer the woman for a clinical assessment by a doctor to detect cardiac conditions if there is a concern based on the pregnant woman's personal or family history. See also the [section on heart disease in the NICE guideline on](https://www.nice.org.uk/guidance/... |
8e26648d059ae0eb | #### **Taking and recording the woman's history**
- 1.2.9 After discussion with and agreement from the woman, contact the woman's GP to share information about the pregnancy and potential concerns or complications during pregnancy.
- 1.2.10 At every antenatal appointment, carry out a risk assessment as follows:
- ask... |
5b7ae1a3f75fdbb0 | #### concerns
- review and reassess the plan of care for the pregnancy
- identify women who need additional care.
For guidance on organising, planning and providing care and support for pregnant women who are approaching end of life and their carers, see the [NICE guideline on end of life care for adults: service del... |
a532053cd1a225e0 | ### **1.2.11 At every antenatal contact, update the woman's antenatal records to include details of history, test results, examination findings, medicines and discussions.**
For a short explanation of why the committee made the recommendations and how they might affect practice, see the rationale and impact section on... |
d70df1fa1b18fc02 | #### **Examinations and investigations**
- 1.2.12 At the first face-to-face antenatal appointment:
- offer to measure the woman's height and weight and calculate body mass index
- offer a blood test to check full blood count, blood group and rhesus D status.
- 1.2.13 At the first antenatal (booking) appointment, dis... |
7f8962e682e365a8 | #### **Examinations and investigations**
- [NHS sickle cell and thalassaemia screening programme](https://www.gov.uk/topic/population-screening-programmes/sickle-cell-thalassaemia)
- [NHS fetal anomaly screening programme](https://www.gov.uk/topic/population-screening-programmes/fetal-anomaly).
Inform the woman that ... |
c5b7a818f82164b5 | #### **Examinations and investigations**
- 1.2.14 Offer pregnant women an ultrasound scan to take place between 11+2 weeks and 14+1 weeks to:
- determine gestational age
- detect multiple pregnancy
- and if opted for, screen for Down's syndrome, Edwards' syndrome and Patau's syndrome (see the [NHS fetal anomaly scr... |
f69188ecfdadc295 | #### **Examinations and investigations**
- anti-D prophylaxis to rhesus-negative women in line with [NICE's technology](https://www.nice.org.uk/guidance/ta156) [appraisal guidance on routine antenatal anti-D prophylaxis for women who](https://www.nice.org.uk/guidance/ta156) are rhesus [D negative](https://www.nice.org... |
afcbfa18356085d6 | #### **Examinations and investigations**
For a short explanation of why the committee made the recommendations and how they might affect practice, see the rationale and impact section on examinations and investigations.
Full details of the evidence and the committee's discussion are in [evidence review](https://www.n... |
20404e94e5ddbe86 | #### **Venous thromboembolism**
- 1.2.18 Assess the woman's risk factors for venous thromboembolism at the first antenatal (booking) appointment, and after any hospital admission or significant health event during pregnancy. Consider using guidance by an appropriate professional body, for example, the [Royal College o... |
2728467bf2423bd3 | #### **Venous thromboembolism**
- 1.2.20 For women at risk of venous thromboembolism, offer referral to an obstetrician for further management.
For a short explanation of why the committee made the recommendations and how they might affect practice, see the rationale and impact section on venous thromboembolism.
Ful... |
d64fa604276fda77 | #### **Gestational diabetes**
1.2.21 At the first antenatal (booking) appointment, assess the woman's risk factors for
gestational diabetes in line with the [recommendations on gestational diabetes](https://www.nice.org.uk/guidance/ng3/chapter/Recommendations#gestational-diabetes) [risk assessment in the NICE guideli... |
ab45027185d1db80 | #### **Pre-eclampsia and hypertension in pregnancy**
- 1.2.23 At the first antenatal (booking) appointment and again in the second trimester, assess the woman's risk factors for pre-eclampsia, and advise those at risk to take aspirin in line with the [section on antiplatelet agents in the NICE guideline on](https://ww... |
b1f12e93efb5dce4 | #### **Pre-eclampsia and hypertension in pregnancy**
- 1.2.24 Measure and record the woman's blood pressure at every routine face-to-face antenatal appointment using a device validated for use in pregnancy, and following the [recommendations on measuring blood pressure in the NICE](https://www.nice.org.uk/guidance/ng1... |
c63be04a041d3d35 | #### **Pre-eclampsia and hypertension in pregnancy**
- 1.2.25 For women under 20+0 weeks with hypertension, follow the [recommendations on](https://www.nice.org.uk/guidance/ng133/chapter/Recommendations#management-of-chronic-hypertension-in-pregnancy) [the management of chronic hypertension in pregnancy in the NICE gu... |
6a08df7ec41eee6b | #### **Pre-eclampsia and hypertension in pregnancy**
- 1.2.26 Refer women over 20+0 weeks with a first episode of hypertension (blood pressure of 140/90 mmHg or higher) to secondary care to be seen within 24 hours. See the [recommendations on diagnosing hypertension in the NICE](https://www.nice.org.uk/guidance/ng136/... |
722c11be3cbd1fc6 | #### **Pre-eclampsia and hypertension in pregnancy**
- 1.2.27 Urgently refer women with severe hypertension (blood pressure of 160/ 110 mmHg or higher) to secondary care to be seen on the same day. The urgency of the referral should be determined by an overall clinical assessment.
- 1.2.28 Offer a urine dipstick test ... |
bed030562f749744 | #### **Pre-eclampsia and hypertension in pregnancy**
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng201/evidence/k-identification-of-hypertension-in-pregnancy-pdf-331305934358) K: [identification of hypertension in pregnancy](https://www.nice.org... |
6fc95446435c126e | #### **Monitoring fetal growth and wellbeing**
- 1.2.29 Offer a risk assessment for fetal growth restriction at the first antenatal (booking) appointment, and again in the second trimester. Consider using guidance by an appropriate professional or national body, for example, the [Royal College of](https://www.rcog.org... |
ec64214a294680c7 | #### **Monitoring fetal growth and wellbeing**
- 1.2.30 Offer symphysis fundal height measurement at each antenatal appointment after 24+0 weeks (but no more frequently than every 2 weeks) for women with a singleton pregnancy unless the woman is having regular growth scans. Plot the measurement onto a growth chart in ... |
de20e06ef50376b4 | #### **Monitoring fetal growth and wellbeing**
- 1.2.32 If there are concerns that the symphysis fundal height is small for gestational age, offer an ultrasound scan for fetal growth and wellbeing, the urgency of which may depend on additional clinical findings, for example, reduced fetal
movements or raised maternal... |
2ab026aef57f1e7f | #### **Monitoring fetal growth and wellbeing**
- 1.2.33 Do not routinely offer ultrasound scans after 28 weeks for uncomplicated singleton pregnancies.
- 1.2.34 Discuss the topic of babies' movements with the woman after 24+0 weeks, and:
- ask if she has any concerns about her baby's movements at each antenatal conta... |
60e38f4be27a56fd | #### **Monitoring fetal growth and wellbeing**
For a short explanation of why the committee made the recommendations and how they might affect practice, see the rationale and impact section on monitoring fetal growth and wellbeing.
Full details of the evidence and the committee's discussion are in: |
8d046dbe3f95c2a1 | #### **Monitoring fetal growth and wellbeing**
- evidence review [O: monitoring fetal growth](https://www.nice.org.uk/guidance/ng201/evidence/o-monitoring-fetal-growth-pdf-331305934362)
- evidence review [P: fetal movement monitoring](https://www.nice.org.uk/guidance/ng201/evidence/p-fetal-movement-monitoring-pdf-3313... |
2f880e7bd335fbe6 | #### **Breech presentation**
1.2.36 Offer abdominal palpation at all appointments after 36+0 weeks to identify possible breech presentation for women with a singleton pregnancy.
- 1.2.37 If breech presentation is suspected on abdominal palpation, offer an ultrasound scan to determine the presentation.
- 1.2.38 For wo... |
b46da95416b1688c | #### **Breech presentation**
Also see the [recommendations on breech presentation in the NICE guideline](https://www.nice.org.uk/guidance/ng192/chapter/Recommendations#planned-caesarean-birth) [on caesarean birth](https://www.nice.org.uk/guidance/ng192/chapter/Recommendations#planned-caesarean-birth), and the [recomme... |
5740c1da8834a450 | #### **Breech presentation**
For a short explanation of why the committee made the recommendations and how they might affect practice, see the rationale and impact section on breech presentation. |
2bba343bf78534df | #### **Breech presentation**
Full details of the evidence and the committee's discussion are in [evidence review](https://www.nice.org.uk/guidance/ng201/evidence/l-identification-of-breech-presentation-pdf-331305934359) L: [identification of breech presentation](https://www.nice.org.uk/guidance/ng201/evidence/l-identi... |
28279cc004b25ffa | #### **Communication – key principles**
- 1.3.1 When caring for a pregnant woman, listen to her and be responsive to her needs and preferences. Also see the [NICE guideline on patient experience in adult NHS](https://www.nice.org.uk/guidance/cg138) [services,](https://www.nice.org.uk/guidance/cg138) in particular the ... |
97c211d23272828e | #### **Communication – key principles**
- 1.3.3 Women's decisions should be respected, even when this is contrary to the views of the healthcare professional.
- 1.3.4 When giving women (and their partners\) information about antenatal care, use clear language, and tailor the timing, content and delivery of information... |
6bbad12394d71e31 | #### **Communication – key principles**
- supportive and respectful
- evidence-based and consistent
- translated into other languages if needed.
For more guidance on communication, providing information (including different formats and languages), and shared decision making, see the [NICE](https://www.nice.org.uk/g... |
91b6d92f9178e4bf | #### **Communication – key principles**
- 1.3.5 Explore the knowledge and understanding that the woman (and her partner) has about each topic to individualise the discussion.
- 1.3.6 Check that the woman (and her partner) understands the information that has been given, and how it relates to them. Provide regular oppo... |
ed2e474821973a6c | #### **Communication – key principles**
- evidence review [B: approaches to information provision](https://www.nice.org.uk/guidance/ng201/evidence/b-approaches-to-information-provision-pdf-9202942623)
- [evidence review A: information provision](https://www.nice.org.uk/guidance/ng201/evidence/a-information-provision-p... |
5f497d54bd232e22 | #### **Information about antenatal care**
- 1.3.7 At the first antenatal (booking) appointment, discuss antenatal care with the woman (and her partner) and provide her [schedule of antenatal appointments](https://www.nice.org.uk/guidance/ng201/resources/schedule-of-antenatal-appointments-pdf-9204300829).
- 1.3.8 At th... |
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