1.3.4.1 Few medicines have been established as safe to use in pregnancy. 1.2.3.1 Antenatal care should be readily and easily accessible to all pregnant women and should be sensitive to the needs of individual women and the local community. [2008], 1.7.2.1 All pregnant women should be offered screening for Down's syndrome. This guideline includes recommendations on: We checked this guideline in January 2017 and we are updating it. 1.3.3.2 Pregnant women should be offered information on how to reduce the risk of salmonella infection by: avoiding raw or partially cooked eggs or food that may contain them (such as mayonnaise). Welcome to Guidelines. [2008], 1.9.2.3 The presence of significant hypertension and/or proteinuria should alert the healthcare professional to the need for increased surveillance. London 1.8.6.1 Pregnant women should not be offered routine screening for hepatitis C virus because there is insufficient evidence to support its clinical and cost effectiveness. 1.3.9.1 The recommendation has been withdrawn. 1.3.10.2 Pregnant women should be informed about the specific risks of smoking during pregnancy (such as the risk of having a baby with low birthweight and preterm birth). Antenatal care is the care that you receive from healthcare professionals during your pregnancy. 1.1.1.1 . See the UK Chief Medical Officers' low-risk drinking guidelines for advice on drinking in pregnancy. Last updated: The principles outlined in this section apply to all aspects of the Antenatal care guideline. This allows enough time for treatment if anaemia is detected, Haemoglobin levels outside the normal UK range for pregnancy (that is, 11g/100 ml at first contact and 10.5g/100 ml at 28 weeks) should be investigated and iron supplementation considered if indicated, Women should be offered testing for blood group and rhesus D status in early pregnancy, It is recommended that routine antenatal anti‑D prophylaxis is offered to all non‑sensitised pregnant women who are rhesus D‑negative, Women should be screened for atypical red‑cell alloantibodies in early pregnancy and again at 28 weeks, regardless of their rhesus D status, Pregnant women with clinically significant atypical red‑cell alloantibodies should be offered referral to a specialist centre for further investigation and advice on subsequent antenatal management, If a pregnant woman is rhesus D‑negative, consideration should be given to offering partner testing to determine whether the administration of anti‑D prophylaxis is necessary, Pre‑conception counselling (supportive listening, advice‑giving and information) and carrier testing should be available to all women who are identified as being at higher risk of haemoglobinopathies, using the Family Origin Questionnaire from the, Information about screening for sickle cell diseases and thalassaemias, including carrier status and the implications of these, should be given to pregnant women at the first contact with a healthcare professional, Screening for sickle cell diseases and thalassaemias should be offered to all women as early as possible in pregnancy (ideally by 10 weeks). Information intended for UK healthcare professionals only.PM-GB-UCV-WCNT-200015 V2.0, Recommendations on the diagnostic tests, treatment regimens, and health promotion principles for the effective management of vulvovaginal candidiasis, This guidance provides evidence-based recommendations and good practice points for health professionals on the use of progestogen-only injectables available in the UK, This international evidence-based guideline summary on the assessment and management of polycystic ovary syndrome covers screening, diagnostic assessment, pharmacological treatment, and lifestyle, This site is intended for UK healthcare professionals, Guidelines Live 2020—now available on demand, antenatal and postnatal mental health NICE guideline CG192, Midwives Information and Resource Service, vitamin D: supplement use in speciOc population groups, the UK Chief Medical Officers' low-risk drinking guidelines, NHS Antenatal and Newborn Screening Programme, high-throughput non-invasive prenatal testing for fetal RHD genotype, KDIGO guideline on diabetes management in CKD, COPD: LAMA/LABA as initial maintenance therapy for appropriate symptomatic patients, COPD: LAMA/LABA therapy—Real life case studies, FSRH Progestogen-only injectable contraception guideline. [2008], 1.7.1.4 If an anomaly is detected during the anomaly scan pregnant women should be informed of the findings to enable them to make an informed choice as to whether they wish to continue with the pregnancy or have a termination of pregnancy. Discuss neonatal Vitamin K and Hep B vaccination. 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. Further information about possible occupational hazards during pregnancy is available from the, A woman's occupation during pregnancy should be ascertained to identify those who are at increased risk through occupational exposure, Pregnant women (and those intending to become pregnant) should be informed that dietary supplementation with folic acid, before conception and throughout the first 12 weeks, reduces the risk of having a baby with a neural tube defect (for example, anencephaly or spina bifida). Status: In progress Developed As: CG Provisional Schedule. NICE guidance is prepared for the National Health Service in England. Pregnant women should be offered information on how to reduce the risk of listeriosis by: not eating ripened soft cheese such as Camembert, Brie and blue‑veined cheese (there is no risk with hard cheeses, such as Cheddar, or cottage cheese and processed cheese), not eating pâté (of any sort, including vegetable), not eating uncooked or undercooked ready‑prepared meals. 1.4.6.3 The effectiveness and safety of oral treatments for vaginal candidiasis in pregnancy are uncertain and these treatments should not be offered. 1.5.5.1 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. Following NICE protocol, the recommendations have been incorporated verbatim into this guideline. 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. The right of a woman to accept or decline a test should be made clear. The healthcare professional should ensure the woman has understood this information and has sufficient time to make an informed decision. Particular care should be taken to enquire as to whether women at greatest risk are following advice to take this daily supplement. The principles outlined in this section apply to all aspects of the Antenatal care guideline. 1.3.3.1 Pregnant women should be offered information on how to reduce the risk of listeriosis by: not eating ripened soft cheese such as Camembert, Brie and blue‑veined cheese (there is no risk with hard cheeses, such as Cheddar, or cottage cheese and processed cheese), not eating pâté (of any sort, including vegetable). Longer appointments are needed early in pregnancy to allow comprehensive assessment and discussion. Pregnant women should be informed that liver and liver products may also contain high levels of vitamin A, and therefore consumption of these products should also be avoided. Consider visiting pregnant women at home if it is difficult for them to attend specialist services, Monitor smoking status and offer smoking cessation advice, encouragement and support throughout the pregnancy and beyond, Discuss the risks and benefits of nicotine replacement therapy (NRT) with pregnant women who smoke, particularly those who do not wish to accept the offer of help from the NHS Stop Smoking Service. Routine involvement of obstetricians in the care of women with an uncomplicated pregnancy at scheduled times does not appear to improve perinatal outcomes compared with involving obstetricians when complications arise, Antenatal care should be provided by a small group of healthcare professionals with whom the woman feels comfortable.