The Royal Women's Hospital utilises a routine antenatal care schedule of 10 visits summarised in the table below.
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This schedule is a basic map to guide episodes of care for well women, and should be used flexibly in accordance with the needs of each woman. A reduced number of content-specific, longer consultations as compared with the traditional 14 visits for well women is considered best practice, in terms of perinatal outcomes, client satisfaction and cost effectiveness.¹
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However, with reference to flexibility and consumer-centred care, it may be that a well woman desires an increased number of visits and should be given this opportunity.
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Routine low risk antenatal care schedule
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| WHAT
| Assessments, Investigations, Discussions
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| Midwife Assessment & Obstetric Consultation
| Offer dating* U/S, discuss/give MSST form (for 15+/40), Social issues screening, Smoking assessment, Maternity service assessment, discuss options of care
| Routine: Bld group & antibodies, FBE, Ferritin, Hep B, TPHA, Rubella, HIV with pre-test counselling, MSU & Dipslide, Request 18-20/40 ultrasound
| As Indicated: Haemaglobinopathy/Thalassaemia screen, Hep C, Vit D, Pap smear
| Available: Genetic Counsellor, Social worker
| All results are reviewed in the following weeks’ PBC
| *Dating U/S not available on the day at Community Clinics
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| Consultant/ Registrar & Midwife
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| | Standard Antenatal Check, MSST if requested, review & discuss results
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| | | Standard Antenatal Check, review & discuss 18-20/40 ultrasound
| Organise GCT, FBE, red cell antibodies for 26/40
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| | 26
| (plus 28 if having Anti-D)
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| Standard Antenatal Check & Midwife Pre-Admission Clinic (PAC)
| Routine: GCT, FBE, red cell antibodies for all women
| If indicated: GTT, offer extra visit if Rh(D) neg for 28/40 Anti-D at Royal Women's Hospital or hospital Community Clinic
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| | | | | 33
| (change to 34 if having Anti-D)
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| Standard Antenatal Check
| If Rh(D) negative and having Anti-D, change to 34/40 at Royal Women's Hospital or hospital Community Clinic
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| | | Consultant Review
| Routine: GBS
| If indicated: FBE
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| | | | | | Standard Antenatal Check
| Give request form (red) for CTG / AFI prior to the 41/40 appointment
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| | | Consultant Review
| CTG / AFI prior to appointment
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1. Three Centres Consensus Guidelines on Antenatal Care Project, Mercy Hospital for Women, Southern Health and Women's & Children's Health 2001, pp5-7.1. Three Centres Consensus Guidelines on Antenatal Care Project, Mercy Hospital for Women, Southern Health and Women's & Children's Health 2001, pp5-7.
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Royal Women's Hospital Clinical Practice Guidelines (CPGs) are intended to provide guidance to health care professionals, based on a thorough evaluation of research evidence, on the practical assessment and management of specific clinical issues or situations. The guidelines allow some flexibility on the part of the health care professional based on the needs of the specific patient for whom they are caring.
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