Three Doctors Masked And In The Operating Theater

Women and Newborn Health Service

Health Professionals

 

King Edward Memorial Hospital

O&G Clinical Guidelines Section B

Preface

Eligible Privately Practicing Midwives

Antepartum Care

Complications of Pregnancy

Medical Disorders Associated with Pregnancy

Pain Management in Labour

Intrapartum Care

Postnatal Care

Caesarean Section

Newborn Feeding

Complications of the Postnatal Period

Neonatal Care

Emergency Procedures

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Preface

  1. Disclaimer

  2. Guidelines development, implementation, evaluation and review processes

  3. Flowchart

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Eligible Privately Practicing Midwives

 Date Reviewed
Eligible Privately Practing Midwives: Admission to Labour and Birth Suite October 2015
Eligible Privately Practicing Midwives: Diagnostic Imaging and Pathology requests October 2015

Eligible Privately Practicing Midwives: Referral to KEMH

October 2015

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Antepartum Care

 Date Reviewed
Midwifery Care  
Exclusion Criteria for the MGP birthing in the Family Birth Centre May 2017
Midwifery Care Flow Chart April 2013
Antenatal Visits, Referrals and Screening  
Antenatal Care Schedule November 2016
Visiting Midwifery Service Antenatal Care May 2016
Folic Acid Supplementation May 2014
Genetics Service – Referral to July 2015
Family Domestic Violence- Screening for September 2014
Nicotine Dependence Assessment and Intervention March 2016
Vitamin D – Screening and Treatment in Pregnancy August 2016
Birth After Previous Caesarean Section Septermber 2017
> 41 weeks gestation: assessment of a woman July 2015
Haemaglobinopathies – Screening and Referral May 2017
Adolescent Clinic July 2014
Female Genital Mutilation November 2015
Infections in Pregnancy  
Group B Streptococcal Disease January 2016
Hepatitis B Protocol June 2015
Herpes Simplex May 2015
Syphilis in Pregnancy and the Newborn February 2015
Varicella (Chicken Pox) in Pregnancy May 2015
Rubella in Pregnancy February 2015
Chlamydia August 2015
Hepatitis C in Pregnancy March 2015
Cytomegalovirus October 2016
Measles February 2016
Substance Use in Pregnancy  
WANDAS August 2016
Antenatal Procedures  
Blood Pressure - measuring October 2015
Abdominal Examination / Palpation March 2017
Fundal height measuring with a tape measure August 2016
Assessment of Fetal growth including the Use of a Customised Fetal growth Chart January 2016
Vaginal Examination - performing August 2015
Antenatal Procedures – Diagnostic Imaging  
Amnioreduction December 2016
Intrauterine blood transfusion: Care of the woman July 2015
Antepartum Fetal Heart Rate Monitoring March 2016
Childbirth and Parenting Courses February 2015
Minor Symptoms or Disorders in Pregnancy December 2015
Complex Care – Planning for August 2014
Low papp-a or raised nuchal translucency with normal chromosomes: management of September 2015
Childbirth and Mental Illness Clinic August 2015
Antenatal Vaccination Protocol: Pertussis and Influenza April 2015
MFAU: Referral to October 2014
NIPT Screening July 2016
Vitamin B12 Deficiency during Pregnancy August 2016
Preterm Birth Prevention  
Preterm Birth Prevention Low Risk Women: Management of May 2015
Preterm Birth Prevention Moderate Risk Women: Management of May 2015
Preterm Birth Prevention High Risk Women: Management of May 2015
Progesterone use for the Prevention of Preterm Birth June 2015
Cervical Cerclage May 2016
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Complications of Pregnancy

Antenatal Admission January 2015
Hypertension in Pregnancy April 2016
Hypertension in Pregnancy – midwifery care December 2014
Antepartum Haemorrhage  
Antepartum Haemorrhage (APH) April 2016
Antepartum Haemorrhage: MFAU QRG April 2016
APH – subsequent management May 2016
Preterm Labour  
Preterm Labour September 2016
Magnesium Sulphate for Neuroprotection of the Fetus September 2016
Preterm Prelabour Rupture of Membranes (PPROM)  
PPROM Medical and Midwifery Care September 2016
Corticoid steroids: use of September 2016
Pre-labour Rupture of the Membranes at Term May 2017
Management of Pregnancy Beyond 41 Weeks September 2016
Abnormalities of Lie/Presentation  
Breech Presentation May 2017
External Cephalic Version May 2015
External cephalic Version: MFAU QRG May 2015
Breech Presentation (Uncomplicated Term) – Planned Vaginal Birth May 2017
Breech presentation planned vaginal birth: QRG May 2017
Unstable Lie at or Near Term May 2015
Rare Presentations May 2015
Multiple Pregnancy  
Multiple Pregnancy: Antenatal Management August 2015
Multiple Pregnancy: Planned Vaginal Birth June 2015
Venous Thrombosis and Embolism in Pregnancy and the Puerperium  
Venous Thrombosis Occurring in the Present Pregnancy November 2013
Antenatal Prophylaxis for Women with Proven Thrombophilia and a Previous Thrombotic Event or Obstetric Complication November 2015
Prophylaxis for Women with a Prior Thrombotic Event in whom no Thrombophilia has been Identified September 2014
Cardiac conditions November 2013
HIV Positive Women  
HIV Positive : Management of the Woman and her Neonate November 2016
Refusal of Blood transfusion and blood products: management July 2016
Decreased fetal movements: management of MFAU QRG May 2014
Non Specific Abdominal Pain: management of MFAU QRG September 2014
Abdominal trauma: management of MFAU QRG July 2014
Cholestasis in Pregnancy April 2016
Cholestasis(Suspected): management of MFAU QRG July 2014
Cholestasis (Confirmed): management of MFAU QRG July 2016
Small for Gestational Age / IUGR  
Small for Gestational Age / IUGR October 2016
Intrauterine growth restriction: MFAU QRG May 2016
BMI > 40: management of women during pregnancy and birth November 2016
Placenta Accreta (known or suspected): management of August 2014
Anaemia in Pregnancy June 2015
Fetal Death in Utero > 20 weeks: management of September 2014
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Medical Disorders Associated with Pregnancy

 
Diabetes: Screening in Pregnancy August 2015
Diabetes: Referral August 2015
Nurse Practitioner Gestational Diabetes Mellitus Clinic August 2016
Diabetes Education July 2016
Diabetes: Admission Procedure May 2015
Diabetes: Antenatal Ward Care QRG August 2015
Diabetes: Blood Glucose Monitoring May 2015
Diabetes: Hypoglycaemia Management May 2015
Diabetes: Diabetic Ketoacidosis (DKA) Management December 2015
Corticosteroids: Management in Pregnancy with Diabetes May 2017
Diabetes: Gestational Diabetes Mellitus (GDM) and Type 2 Diabetes Not Requiring Insulin or Oral Hypoglycaemic Agents (OHA's) Management August 2015
Diabetes: Requiring Insulin or Oral Hypoglycaemic Agents August 2015
Diabetes: Antenatal Care / Tests Planner QRG September 2014
Diabetes: Antenatal Medication August 2015
Diabetes: Intrapartum Management of GDM (Includes Planning for Induction of Labour (IOL) / Caesarean Section) May 2014
Diabetes: Intrapartum Management of Type 1 Diabetes Mellitus (Includes Planning for IOL / Caesarean Section) August 2015
Diabetes: Intrapartum Management of Type 2 Diabetes Mellitus (Includes Planning for IOL / Caesarean Section) January 2016
Diabetes: Postnatal Care / Follow-up April 2012
Diabetes: Blood Glucose Meter (Medisense Optium) May 2015
Diabetes: Glucagon Education (Partners): Type 1 DM May 2015
Diabetes: Insulin Pen Devices April 2016
Diabetes: GDM Management in Team Obstetric Clinics August 2015
Insulin Pump - Inpatient April 2014
Cardiac Disease in Pregnancy September 2016
PKU Maternal Management during Pregnancy July 2016
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Pain Management in Labour

 
Relaxation/Comfort Measures  
Hot/Cold Therapy January 2016
Hypnotherapy January 2016
Aromatherapy January 2016
Music and Audio Therapy January 2016
Therapeutic Touch  
Reflexology January 2016
Acupressure/Shiatsu January 2016
Massage January 2016
Transcutaneous Electrical Nerve Stimulation (TENS) January 2016
Acupuncture January 2016
Nitrous Oxide (N2O + O2): Administration of January 2016
Intramuscular / Intravenous Opioid Analgesia: Administration of  
Pethidine Administration: Intramuscular September 2014
Morphine Administration: Intramuscular August 2015
Patient-Controlled Intravenous Analgesia in Labour - see Anaesthetics Guidelines  
Neuraxial Blockade - see Clinical Guidelines: Anaesthetics  
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Intrapartum Care

 
Induction of Labour - Access through Restricted Area Guidelines (Intranet only) or contact the Clinical Guidelines Co-ordinator at KEMH  
Oxytocin Infusion for Induction of Labour: Labour & Birth Suite QRG September 2014
Artificial Rupture of the Membranes (ARM) May 2014
Oxytocin Infusion: Induction of Labour September 2014
Foley Catheter: Transcervical April 2016
Prostaglandins- Access through Restricted Area Guidelines (Intranet only) or contact the Clinical Guidelines Co-ordinator at KEMH  
Labour: Assessment on Admission to MFAU / Labour & Birth Suite  
Labour: Assessment May 2014
Labour: Admission (Booked) in Labour & Birth Suite September 2014
Labour: Moderate & High Risk Women Admitted to MFAU / Labour & Birth Suite- Medical review & Care Planning July 2016
Labour: Possible Early Labour at Term: MFAU QRG January 2016
Cervical Suture: Removal September 2014
Fetal Heart Rate Monitoring: Intrapartum April 2014
Fetal scalp electrode application September 2014
Fetal Surveillance (Intrapartum): LBS QRG May 2016
Fetal Compromise (Acute): Management if Suspected September 2015
Amnioinfusion September 2014
Fetal Scalp Blood Sampling April 2016
First Stage of Labour  
Labour (First Stage): Care of the Woman November 2013
Partogram Use August 2015
Labour (First Stage): Management of Delay July 2013
Intrauterine Pressure Catheter (IUPC) September 2014
Meconium Stained Amniotic Fluid July 2015
Second Stage of Labour  
Labour (Second Stage): Management October 2015
Episiotomy & Infiltration of the Perineum September 2014
Birth  
Birth Management September 2014
Born Before Arrival July 2015
Paediatrician Attendance for 'At Risk' Births: LBS QRG September 2015
Shoulder Dystocia May 2016
Labour (Third Stage)  
Third stage of Labour May 2017
Labour (Third Stage): Syntometrine QRG September 2015
Retained Placenta April 2016
Instrumental Vaginal Delivery January 2016
Birth After Previous Caesarean Section September 2017
Mid Trimester Termination of Pregnancy - This guideline is only available to Health Department staff via the WNHS intranet homepage (see Restricted Area Clinical Guidelines) or contact the Clinical Guidelines Co-ordinator at KEMH  
Fetal Death in Utero >20 weeks: Intrapartum Management September 2014
Specimen Collection / Examination: Post Birth  
Cord Blood Collection / Analysis July 2016
Placenta: Indications for Histopathological and Microbiological Examination July 2017
Placenta Being Taken Home: Safe Handling July 2017
Stem Cell Harvest - Cord Blood Collection March 2017
Cord Blood for Neonatal Haemoglobinopathy Screening: Collection of October 2014
Cord Blood Screening Program for Sickle Cell Disease October 2014
Cord Blood for Neonatal Haemoglobinopathies (Other Significant) October 2014
Perineal Repair  
Episiotomy / Genital Laceration: Suturing November 2016
Perineal Trauma: Third & Fourth Degree Management August 2014
Birth Notification September 2014
Birth: Photographs / Video During October 2014
Medications during Labour and Birth  
Medications (Routine) in Labour and Birth Suite: Guidelines for Prescribing March 2015
Medications (Routine) in the Family Birth Centre (FBC): Prescription & Administration August 2012
Oxytocin for the Third Stage of Labour in the FBC March 2015
Ergometrine for Primary Postpartum Haemorrhage in the FBC March 2015
Misoprostol Administration for Primary Postpartum Haemorrhage in the FBC - Access through Restricted Area Guidelines (Intranet only) or contact the Clinical Guidelines Co-ordinator at KEMH  
Syntometrine for the Third Stage of Labour in the FBC March 2015
Episiotomy in the FBC: Lignocaine Prior to March 2015
Perineal Repair in the FBC: Lignocaine for March 2015
Waterbirth May 2016
Evacuation Procedure Labour and Birth in Water September 2016
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Postnatal Care

 
Postnatal: Immediate Maternal Care in Labour & Birth Suite July 2016
Maternal Postnatal Care  
Postnatal: Care on Admission to the Ward September 2014
Postnatal: Subsequent Care May 2016
Bladder Care May 2015
Perineal Care July 2015
Measles, Mumps and Rubella (MMR) Vaccine Administration May 2014
Vaccine Administration: Contraindications and Precautions August 2012
Postnatal Care: QRG May 2016
Transfer of a Postnatal Woman by a Midwife to Home / Visiting Midwifery Service / GP Care March 2017
Postpartum Infections: treatment and management January 2017
Expressed Breast Milk (EBM): Identification & Storage on Postnatal Wards March 2014
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Caesarean Section

 
Pre-Admission Clinic for Births by Elective Caesarean January 2015
Pre-operative Management  
Caesarean Birth: Elective September 2013
Caesarean Birth: Non-Elective October 2014
Gastric Aspiration Prevention in Obstetrics February 2014
Transfer to Operating Theatre December 2015
Caesarean Birth: Midwives Attending Theatre May 2015
Uterine Tone at CS - pharmacological management of January 2017
Transfer From the Operating Theatre October 2014
Post Operative Care April 2016
Caesarean Wound Care (See Obstetrics & Gynaecology: Wound Care)  
Thromboprophylaxis after Caesarean Birth December 2014
Caesarean Birth: Maternal Assisted October 2016
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Newborn Feeding

 
WA Health Breastfeeding policy  
Breastfeeding Guidelines  
Breastfeeding: General Overview March 2015
Breastfeeding: Professional Development Requirements for Staff March 2015
Breastfeeding: Antenatal Education and Counselling August 2016
Breastfeeding: Skin to Skin Contact March 2015
Breastfeeding: The First Feed August 2017
Breastfeeding: Showing the Woman How to Breastfeed January 2015
Breastfeeding: Expressing May 2015
Breastfeeding: Storage and Thawing of Breast Milk May 2015
Breastfeeding: Medical Indications for the Use of Formula June 2015
Breastfeeding: Rooming In June 2015
Breastfeeding: Feeding According to Need June 2015
Breastfeeding: Use of Artificial Teats / Dummies April 2012
Breastfeeding: Finger Feeding Using a Fine Tube or Syringe October 2015
Breastfeeding: Cup Feeding October 2015
Breastfeeding: Discharge Home October 2015
Breastfeeding Challenges  
Breastfeeding Challenge: Nipples Flat or Inverted October 2015
Breastfeeding Challenge: Nipple Trauma August 2016
Breastfeeding Challenge: Breasts Engorged / Full / Lumpy January 2016
Breastfeeding Challenge: Blocked Ducts November 2015
Breastfeeding Challenge: Oversupply January 2016
Breastfeeding Challenge: Mastitis Management May 2017
Breastfeeding Challenge: Breast Abscess January 2016
Breastfeeding Challenge: Weight Loss Beyond 10% of Birth Weight August 2016
Breastfeeding Challenge: Increasing Breast Milk Supply August 2016
Breastfeeding Challenge: Thrush In Lactation January 2016
Breastfeeding Challenge: Preterm, Low Birth Weight, or SGA Neonate March 2016
Breastfeeding Challenge: Neonate of a Mother with Diabetes  
Breastfeeding Aids  
Breastfeeding: Supply Line to Supplement Breastfeeding February 2016
Breastfeeding: Nipple Shields February 2016
Breastfeeding: Suppression of Lactation August 2017
Formula Feed: Guidelines  
Formula Feed: Preparation May 2015
Formula Feed: Technique February 2016
Formula Feed: Fluid Requirements March 2016
Formula Feed: Fluid Requirements of a Preterm, Low Birth Weight, or SGA Baby March 2016
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Complications of the Postnatal Period

 
Postpartum Haemorrhage (PPH)  
Primary Post-Partum Haemorrhage - Access through Restricted Area Guidelines (Intranet only) or contact the Clinical Guidelines Co-ordinator at KEMH  
Uterine Inversion August 2014
Oxytocin: Prophylactic and Therapeutic Administration / Infusion Regimens May 2017
Secondary Post Partum Haemorrhage May 2016
Selective Pelvic Arterial Embolisation in the Management of Obstetric Haemorrhage March 2016
Intrauterine Haemostatic Balloon: Removal July 2016
Sepsis and Septic Shock-Maternal March 2017
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Neonatal Care

 
Neonatal Care in Labour & Birth Suite May 2017
Neonate: Immediate Care for Babies born in Labour and Birth Suite May 2017
Neonate: Immediate Care for babies NOT born in Labour and Birth Suite May 2017
Palliative Care: Immediate Care of the Palliative Neonate & Follow-up of the Postnatal Woman September 2014
Neonatal Care on the Ward  
Neonatal Observations April 2016
Neonatal Care November 2015
Sudden Unexplained Death in Infancy (SUDI): Strategies to Reduce March 2014
Neonatal Hypothermia: Management of Temperature < 36.5oC October 2014
Neonatal Screening  
Neonatal Examination September 2014
Neonatal Examination: QRG July 2016
Blood – Collection from a Neonate October 2015
Capillary Blood Collection (Heel Stab) September 2014
Newborn Bloodspot Screening February 2017
Medication Administration to the Neonate  
Intramuscular Administration to the Neonate May 2016
Vitamin K1 Administration February 2015
Hepatitis B Vaccine: Neonatal October 2014
Hepatitis B Immunoglobulin: Neonatal October 2014
Intravenous Medications on the Ward: Neonatal Administration of July 2014
Neonatal Complications  
Eye Infections: Neonatal October 2013
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Emergency Procedures

 
Resuscitation in Late Pregnancy July 2014
Cord Prolapse in the Labour and Birth Suite January 2015
Neonatal Resuscitation  
Neonatal Resuscitation: External Cardiac Massage April 2014
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