Antenatal care: routine care for the healthy pregnant woman
National Institute for Clinical Excellence
Record ID 32003001247
English
Authors' objectives:
This report provides guidelines for the routine antenatal care for the healthy pregnant woman.
Authors' recommendations:
Key recommendations
1. Pregnant women should be offered evidence-based information and support to enable them to make informed decisions regarding their care. Information should include details of where they will be seen and who will undertake their care. Addressing womens choices should be recognised as being integral to the decision-making process.
2. A schedule of antenatal appointments should be determined by the function of the appointments. For a woman who is nulliparous with an uncomplicated pregnancy, a schedule of ten appointments should be adequate. For a woman who is parous with an uncomplicated pregnancy, a schedule of seven appointments should be adequate.
3. Pregnant women should be offered an early ultrasound scan to determine gestational age (in lieu of last menstrual period [LMP] for all cases) and to detect multiple pregnancies. This will ensure consistency of gestational age assessments, improve the performance of mid-trimester serum screening for Down's syndrome and reduce the need for induction of labour after 41 weeks.
4. Pregnant women should be offered screening for Down's syndrome with a test which provides the current standard of a detection rate above 60% and a false-positive rate of less than 5%. The following tests meet this standard:
From 11 to 14 weeks: - nuchal translucency (NT) - the combined test (NT, hCG and PAPP-A)
From 14 to 20 weeks: - the triple test (hCG, AFP and uE3) - the quadruple test (hCG, AFP, uE3, inhibin A)
From 11 to 14 weeks and 14 to 20 weeks: - the integrated test (NT, PAPP-A + hCG, AFP, uE3, inhibin A) - the serum integrated test (PAPP-A + hCG, AFP, uE3, inhibin A).
5. The evidence does not support routine screening for gestational diabetes mellitus and therefore it should not be offered.
Authors' methods:
Clinical guideline
Details
Project Status:
Completed
URL for project:
http://www.nice.org.uk/cat.asp?c=89310
Year Published:
2003
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Female
- Practice Guidelines as Topic
- Pregnancy
- Prenatal Care
- Prenatal Diagnosis
- Down Syndrome
Contact
Organisation Name:
National Institute for Clinical Excellence
Contact Address:
MidCity Place, 71 High Holborn, London WC1V 6NA, UK. Tel: +44 020 7067 5800; Fax: +44 020 7067 5801
Contact Name:
nice@nice.nhs.uk
Contact Email:
nice@nice.nhs.uk
Copyright:
National Institute for Clinical Excellence (NICE)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.