Tag Archives: RCOG

Reducing baby deaths and injuries

Each baby counts

The Royal College of Obstetricians and Gynaecologists has published Each Baby Counts: 2015 Summary Report.  This report provides a detailed analysis of all stillbirths, neonatal deaths and brain injuries that occurred during childbirth in 2015 and identifies the key clinical actions needed to improve the quality of care and prevent future cases. These clinical actions include: improving fetal monitoring; enhancing neonatal care; and reducing human factors by understanding ‘situational awareness’ to ensure the safe management of complex clinical decisions.

Click to read the report here
Read the RCOG press release here
RCM press release here

 

Management of Inherited Bleeding Disorders in Pregnancy (RCOG Green-top Guideline No. 71)

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Image Source: NHS Photo Library

Women who have inherited bleeding disorders may be at significant risk of bleeding following miscarriage, abortion, antenatal procedures and delivery. They require multidisciplinary specialised care tailored to the individual, with cross-specialty communication, including anaesthetists and neonatologists as necessary.

The conditions covered in this guideline are haemophilia A and B, von Willebrand disease (VWD), factor XI deficiency, rare factor deficiencies, fibrinogen disorders, Bernard Soulier Syndrome (BSS), Glanzmann’s thrombasthenia (GT) and other platelet function disorders.

This guideline is intended for both specialist haematologists and obstetricians who have experience in managing pregnant patients with bleeding disorders. In addition, it may be a useful reference text for obstetric anaesthetists and neonatologists.  This is the first edition of a combined United Kingdom Haemophilia Centre Doctors’ Organisation (UKHCDO) and Royal College of Obstetricians and Gynaecologists (RCOG) guideline although a previous guideline was written by the UKHCDO in 2006.

Read the full guideline here

Management of Breech Presentation (RCOG Green-top Guideline No. 20b)

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Image Source: NHS Photobank

This guideline provides up-to-date information on methods of delivery for women with breech presentation, this is the fourth edition of this guideline, first published in 1999 and revised in 2001 and 2006 under the same title.

The aim of this guideline is to aid decision making regarding the route of delivery and choice of various techniques used during delivery. It does not include antenatal or postnatal care. Information regarding external cephalic version is the topic of the separate Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 20a External Cephalic Version and Reducing the Incidence of Term Breech Presentation.

To access the full guideline click here

External Cephalic Version and Reducing the Incidence of Term Breech Presentation (RCOG Green-top Guideline No. 20a)

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Image source: NHS Photobank

This guideline summarises the evidence regarding the routine use of external cephalic version (ECV) for breech presentation, and is the second edition of this guideline, first published in 2006 under the title External Cephalic Version (ECV) and Reducing the Incidence of Breech Presentation.

It presents the best evidence concerning methods to prevent noncephalic presentation at delivery and therefore caesarean section and its sequalae. The mode and technique of delivering a breech presentation is summarised in the Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 20b Management of Breech Presentation.

For the full guidance click here

Providing Quality Care for Women: Obstetrics and Gynaecology Workforce

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Image Source: NHS Photo Library 

RGOG: Providing Quality Care for Women: Obstetrics and Gynaecology Workforce

The recommendations take account of the significant variation in service provision around the country in terms of workload complexity, geography and current middle-grade staffing. Therefore, the report recognises that there is no single solution to delivering safe maternity and gynaecological services.

The report specifically looks at the need for some degree of resident consultant working as a solution to workforce issues and recommends the use of hybrid rotas, which include both resident and non-resident out-of-hours shifts.

The report also includes case studies demonstrating how this model is working in practice across the country, and proposes RCOG standards for consultant job descriptions and job plans to support the recommendations.

Maternity Standards

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Image Source: NHS Photo Library

RCOG Standards for Maternity Care – This document sets out a framework for commissioners and service providers of high-level service standards that aim to improve outcomes and reduce variation in maternity care.  The framework is endorsed by the Royal College of Midwives and the British Maternal and Fetal Medicine Society. It builds on the Standards for Maternity Care published by the RCOG in 2008.

The new framework provides an up-to-date structure for the delivery of quality improvement and safe maternity care. It covers:

  • Pre-pregnancy services
  • Antenatal care
  • Vulnerable women
  • Medical complexity
  • Inpatient care
  • Elective birth
  • Intrapartum care
  • Postnatal care
  • Fetal medicine
  • Perinatal loss

Multi-disciplinary teams should use the framework and standards to ensure their contributions meet the needs of women, their babies and their families, whether or not they have medical or obstetric complications.

The framework and standards should also support maternity staff to work in well-structured teams, with supportive line management and infrastructure to deliver safe, personal, kind, professional and high-quality maternity care

Management of Monochorionic Twin Pregnancy, Green-top Guideline No. 51

The Royal College of Obstetrics and Gynaecologists has updated its guideline Monochorionic Twin Pregnancy, Management Green-top Guideline No. 51.  The purpose of this guideline is to describe and, if possible, quantify the problems associated with monochorionic placentation and to identify the best evidence to guide clinical care, including routine fetal surveillance and treatment of complications at secondary and tertiary levels.