Welcome to Maternity Care Update for General Practitioners April 2013 Amanda Mansfield

1. Welcome to Maternity Care Update for General Practitioners April 2013 Amanda Mansfield Consultant Midwife

2. Seeing Women – 1st Point of Call • Aims • Initial Consultation • Booked by 12 completed weeks – Midwife • Full Booking Bloods– 9 weeks • Bookings >12 wks – 01753 634561 • Late booking >20 wks • Migrant women without previous full medical assessment – GP • Recognise and intervene with an obstetric emergency • Promoting Health and lifestyle • Discussion options in relation to pregnancy options

5. E-Learning http://n3.learning.bmj.com/learning/module-intro/.html?moduleId=10031119

6. Booking Assessment Booking History:- Low Risk Intermediate Risk High Risk Shared Care – Midwife/GP Consultant Led – Obstetrician (+other specialties) Choice of Place of Birth – Which hospital Choice of Mode of Birth – Which hospital does what?

7. Antenatal Care

8. Referrals • Antenatal Clinic • Fetal Assessment Unit ->20 weeks gestation 7-5pm Monday – Friday • Raised blood pressure – APEC guidelines ( 3 readings above 140/90 • +or – proteinuria) • • Diagnosed cholestasis. - Pregnancy itching should only be referred if there are • abnormal Liver function tests. The GP’s will complete a full assessment of these • women and refer if appropriate. • • Diagnosed IUGR • • Postnatal checks for women with babies in SCBU • • Pre- term premature rupture of membranes • • Small pv bleeds ie. Spotting after 20 weeks gestation • • Hyperemesis/dehydration after 20 weeks gestation • • Anti D administration (see antenatal guideline No 24) • • Glucose Tolerance Test – for suspected diabetes (see LW policy chapter 8) • • Pre LSCS clerking (pre op assessment) • • VBAC assessment at 41 weeks • • Betamethasone injections