At the first contact with a healthcare professional: food hygiene, including how to reduce the risk of a food‑acquired infection, lifestyle advice, including smoking cessation, and the implications of recreational drug use and alcohol consumption in pregnancy. 1.3.14.1 Pregnant women should be informed that, if they are planning to travel abroad, they should discuss considerations such as flying, vaccinations and travel insurance with their midwife or doctor. [2008]. See NICE's guideline on smoking: stopping in pregnancy and after childbirth. [2008], 1.10.2 Ultrasound estimation of fetal size for suspected large‑for‑gestational‑age unborn babies should not be undertaken in a low‑risk population. 1.4.2.2 Antacids may be offered to women whose heartburn remains troublesome despite lifestyle and diet modification. Antenatal care (NICE clinical guideline 62) The advice in the NICE guideline covers the routine care that all healthy women can expect to receive during their pregnancy. At the first contact with a healthcare professional: food hygiene, including how to reduce the risk of a food‑acquired infection, lifestyle advice, including smoking cessation, and the implications of recreational drug use and alcohol consumption in pregnancy, all antenatal screening, including screening for haemoglobinopathies, the anomaly scan and screening for Down's syndrome, as well as risks and benefits of the screening tests, nutrition and diet, including vitamin D supplementation for women at risk of vitamin D deficiency, and details of the, exercise, including pelvic floor exercises, place of birth (refer to intrapartum care, further discussion of all antenatal screening, discussion of mental health issues (refer to, breastfeeding information, including technique and good management practices that would help a woman succeed, such as detailed in the, preparation for labour and birth, including information about coping with pain in labour and the birth plan, awareness of 'baby blues' and postnatal depression, options for management of prolonged pregnancy, Information should be given in a form that is easy to understand and accessible to pregnant women with additional needs, such as physical, sensory or learning disabilities, and to pregnant women who do not speak or read English, Information can also be given in other forms such as audiovisual or touch‑screen technology; this should be supported by written information, Pregnant women should be offered information based on the current available evidence together with support to enable them to make informed decisions about their care. Your antenatal services should be readily and easily accessible and sensitive to your needs. Antenatal examination will then allow planning of intrapartum care, Healthcare professionals need to be alert to the symptoms or signs of domestic violence and women should be given the opportunity to disclose domestic violence in an environment in which they feel secure, Pregnant women should be offered screening for anaemia. These include: women with darker skin (such as those of African, African–Caribbean or South Asian family origin, women who have limited exposure to sunlight, such as women who are housebound or confined indoors for long periods, or who cover their skin for cultural reasons. Prescription medicines should be used as little as possible during pregnancy and should be limited to circumstances in which the benefit outweighs the risk. 1.5.1.1 Maternal weight and height should be measured at the booking appointment, and the woman's body mass index should be calculated (weight [kg]/height[m]2). 1.8.9.1 Pregnant women should not be offered routine antenatal screening for group B streptococcus because evidence of its clinical and cost effectiveness remains uncertain. [2008]. Review, discuss and document results of tests taken at 28 weeks and action as required. 1.9.2.4 Blood pressure should be measured as outlined below: remove tight clothing, ensure arm is relaxed and supported at heart level, inflate cuff to 20–30 mmHg above palpated systolic blood pressure, lower column slowly, by 2 mmHg per second or per beat, read blood pressure to the nearest 2 mmHg, measure diastolic blood pressure as disappearance of sounds (phase V). Antenatal care for uncomplicated pregnancies. 1.1.1 . 04 February 2019. [2008], 1.9.3.1 Routine screening for preterm labour should not be offered. Pregnant women should be offered vaccination against: Influenza during the flu season (October to January). 26 March 2008 [2008], 1.1.1.2 Information should be given in a form that is easy to understand and accessible to pregnant women with additional needs, such as physical, sensory or learning disabilities, and to pregnant women who do not speak or read English. 1.7.2.5 Information about screening for Down's syndrome should be given to pregnant women at the first contact with a healthcare professional. People have the right to be involved in discussions and make informed decisions about their care, as described in your care. Appendix D: Antenatal appointments (schedule and content) [2008] The schedule below, which has been determined by the purpose of each appointment, presents the recommended number of antenatal care appointments for women who are healthy and whose pregnancies remain uncomplicated in the antenatal period: 10 appointments for nulliparous women and 7 for parous women. UK [2008], 1.7.2.4 When it is not possible to measure nuchal translucency, owing to fetal position or raised body mass index, women should be offered serum screening (triple or quadruple test) between 15 weeks 0 days and 20 weeks 0 days. Comprehensive information on the antenatal care of the healthy woman with an uncomplicated singleton pregnancy. In February 2019, we withdrew a recommendation on screening for German measles (rubella), as this is no longer offered by the NHS. For more details about haemoglobinopathy variants refer to the NHS Antenatal and Newborn Screening Programme. Screening should take place early in pregnancy (at the booking appointment) and at 28 weeks when other blood screening tests are being performed. If clinical symptoms remain troublesome, standard haemorrhoid creams should be considered, Women should be informed that varicose veins are a common symptom of pregnancy that will not cause harm and that compression stockings can improve the symptoms but will not prevent varicose veins from emerging, Women should be informed that an increase in vaginal discharge is a common physiological change that occurs during pregnancy. 1.3.10.3 Offer personalised information, advice and support on how to stop smoking. [2008], 1.1.1.4 Pregnant women should be offered information based on the current available evidence together with support to enable them to make informed decisions about their care. Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. Welcome to Guidelines. 10 –18 Union Street Recommendations on comprehensive care, glycaemic monitoring and targets, lifestyle and antihyperglycaemic interventions, and approaches to self-management and optimal models of care, This promotional resource has been funded and provided by GSK. 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. Specific information should include: the screening pathway for both screen‑positive and screen‑negative results, the decisions that need to be made at each point along the pathway and their consequences, the fact that screening does not provide a definitive diagnosis and a full explanation of the risk score obtained following testing, information about chorionic villus sampling and amniocentesis, balanced and accurate information about Down's syndrome. The Royal College of Obstetricians and Gynaecologists has produced guidance on COVID-19 and pregnancy for all midwifery and obstetric services. all antenatal screening, including screening for haemoglobinopathies, the anomaly scan and screening for Down's syndrome, as well as risks and benefits of the screening tests. [2008], 1.7.1.8 Participation in regional congenital anomaly registers and/or UK National Screening Committee‑approved audit systems is strongly recommended to facilitate the audit of detection rates. This will ensure consistency of gestational age assessment and reduce the incidence of induction of labour for prolonged pregnancy.

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