The Royal College of Obstetricians and Gynaecologists has updated Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36). This guideline guidance for obstetricians, midwives and neonatologists on the prevention of early-onset (less than 7 days of age) neonatal group B streptococcal (EOGBS) disease.
GBS is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. There is variation in practice across the UK regarding the best strategies to prevent EOGBS disease.
The Royal College of Obstetricians and Gynaecologists (RCOG) has highlighted the publication of a survey, to understand women’s perceptions of how much they should eat during pregnancy. The survey, commissioned by the National Charity Partnership,, found 69 per cent of women are unaware of how many extra calories they need to consume during pregnancy. The RCOG is working with the National Charity Partnership to bust the ’eating for two’ myth and make it easier for people to understand how to make healthy choices during pregnancy to avoid unhealthy weight gain.
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
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.
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.
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.
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.