NICE issued guidelines on routine care for the healthy pregnant woman in March 2008. They recommend:
| Gestation | Purpose of visit |
|---|---|
| 8 - 12 weeks (ideally < 10 weeks) | Booking visit |
| • general information e.g. diet, alcohol, smoking, folic acid, vitamin D, antenatal classes | |
| • BP, urine dipstick, check BMI | |
| Booking bloods/urine | |
| • FBC, blood group, rhesus status, red cell alloantibodies, haemoglobinopathies | |
| • hepatitis B, syphilis | |
| • HIV test is offered to all women | |
| • urine culture to detect asymptomatic bacteriuria | |
| 10 - 13+6 weeks | Early scan to confirm dates, exclude multiple pregnancy |
| 11 - 13+6 weeks | Down's syndrome screening including nuchal scan |
| 16 weeks | Information on the anomaly and the blood results. If Hb < 11 g/dl consider iron |
| Routine care: BP and urine dipstick | |
| 18 - 20+6 weeks | Anomaly scan |
| 25 weeks (only if primip) | Routine care: BP, urine dipstick, symphysis-fundal height (SFH) |
| 28 weeks | Routine care: BP, urine dipstick, SFH |
| Second screen for anaemia and atypical red cell alloantibodies. If Hb < 10.5 g/dl consider iron | |
| First dose of anti-D prophylaxis to rhesus negative women | |
| 31 weeks (only if primip) | Routine care as above |
| 34 weeks | Routine care as above |
| Second dose of anti-D prophylaxis to rhesus negative women* Information on labour and birth plan | |
| 36 weeks | Routine care as above |
| Check presentation - offer external cephalic version if indicated | |
| Information on breast feeding, vitamin K, 'baby-blues' | |
| 38 weeks | Routine care as above |
| 40 weeks (only if primip) | Routine care as above |
| Discussion about options for prolonged pregnancy | |
| 41 weeks | Routine care as above |
| Discuss labour plans and possibility of induction |