NICE clinical guidelines
Issued: March 2008 (last modified: June 2010)
CG62

Antenatal care

This is an extract from the guidance. The complete guidance is available at guidance.nice.org.uk/cg62

Introduction

This guidance partially updates and replaces NICE clinical guideline 6, 'Antenatal care: routine care for healthy pregnant women' (published October 2003).

Changes in this update

In this update, the recommendations on antenatal information, gestational age assessment, vitamin D supplementation, alcohol consumption, screening for haemoglobinopathies, screening for structural anomalies, screening for Down's syndrome, screening for chlamydia, gestational diabetes, pre-eclampsia, asymptomatic bacteriuria, placenta praevia, preterm birth, and fetal growth and well-being, as well as the schedule of antenatal appointments, have changed. In addition, some recommendations on smoking cessation and mental health have changed because NICE has produced public health guidance on smoking cessation (NICE public health guidance 10) and a clinical guideline on antenatal and postnatal mental health (NICE clinical guideline 45). Following NICE protocol, we have incorporated the relevant recommendations verbatim into this guideline and have marked them clearly. No other recommendations are affected.

The new and updated recommendations are marked 'New'.

The original antenatal care guideline was published by NICE in 2003. Since then several important pieces of evidence have become available, particularly concerning gestational diabetes, haemoglobinopathy and ultrasound, so that the update has been initiated earlier than planned. This early update has also provided an opportunity to look at a number of aspects of antenatal care, including:

  • the development of a method of assessing pregnant women to identify those for whom additional care is necessary (the 'Antenatal assessment tool')

  • giving information to pregnant women

  • lifestyle considerations:

    • vitamin D supplementation

    • alcohol consumption

  • screening for the baby:

    • use of ultrasound to assess gestational age and screen for fetal abnormalities

    • methods of assessing normal fetal growth

    • haemoglobinopathy screening

  • screening for the pregnant woman:

    • gestational diabetes

    • pre-eclampsia and preterm labour

    • placenta praevia

    • asymptomatic bacteriuria

  • chlamydia.