National Clinical Guidelines in Obstetrics and Gynaecology

The national clinical guidelines are a programme of work agreed between the National Women and Infants Health Programme and the Institute of Obstetricians and Gynaecologists of the Royal College Physicians Ireland. In March 2021, Professor Keelin O’Donoghue was appointed as the new Clinical Lead for Guideline Development (Maternity & Gynaecology).

Within the Guideline Programme Team (GPT), Professor O’Donoghue is responsible for the review, update and production of national clinical guidelines in relation to Maternity and Gynaecology services. Ms Nicolai Murphy was appointed as Programme Manager. Together they have set out an ambitious programme of work. A new guideline process has been developed; part of this process includes a multidisciplinary Expert Advisory Group (EAG), appointed at the offset to review guidelines prior to publication.

The following documents have been developed by the GPT and are approved for use by National Women and Infants Health Programme (NWIHP) and the Institute of Obstetricians and Gynaecologists (IOG):

• Guideline Template

• Guideline Programme Team Objectives

• Guideline Developer information sheet

• Guideline Process flowchart

• Expert Advisory Group Terms of Reference

• Conflict of Interest form

• Guideline review feedback form

National Clinical Guidelines (NWIHP and IOG, 2021-Present)

Commissioned Guideline (year commissioned)

• Group B Strep in Pregnancy (2021)

• Recurrent Miscarriage (2021)

• Antenatal Corticosteroids in Pregnancy (2021)

• Placenta Accreta Spectrum (2021)

• Ultrasound - Anatomy Scan in Pregnancy (2021)

• Diagnosis and Management  of Mesh Complications (2020)

• Pelvic Organ Prolapse (2020)

• Assessment and Management of Stress Urinary Incontinence (2020)

• Induction of Labour (2021)

• Investigation and Management of Late Fetal Intrauterine Death and Stillbirth (2021)

• Investigation and Management of Postmenopausal Bleeding (2021)

• Hyperemesis and Nausea/Vomiting in Pregnancy (2021)

• Prevention and Management of Primary Postpartum Haemorrhage (2021)

• Fetal Growth Restriction (2022)

• Complications of Early Termination of Pregnancy (2022)

• Ectopic Pregnancy (2022)

• Vaginal Birth after C-Section (2022)

• Rheumatic/Rheumatological Disease in Pregnancy (2022)

• Hypertension in Pregnancy (2022)

• Domestic Violence in Pregnancy (2022)

• Endometriosis (2022)

• Menopause (2022)

National Women and Infants Health Programme 2017-2020

The National Women and Infants Health Programme (NWIHP) was established in January 2017, to lead the management, organisation and delivery of maternity, gynaecology and neonatal services with the support of the Institute of Obstetricians and Gynaecologists, RCPI. 

• Intrapartum Fetal Heart Rate Monitoring In Ireland (2022) 

• Pathway for management of FFA and/or life limiting conditions diagnosed during pregnancy (2020)

• Interim Clinical Guidance Termination of Pregnancy Under 12 Weeks (2018*)*due for update

• Risk to Life or Health of a Pregnant Woman in Relation to Termination of Pregnancy (2019)

• Pathway for Management of Fatal Fetal Anomalies and/or Life-Limiting Conditions Diagnosed During Pregnancy: Perinatal Palliative Care (2019)

• Perinatal Management of Extreme Preterm Birth at the Threshold of Viability (2021)

• COVID-19 Infection Guidance for Maternity Services (2021)

  • Stillbirth, Surveillance of Fetal Wellbeing and SARS-CoV-2 Infection (January 2022 Update)

  • Guidance on thromboprophylaxis with SARS-CoV-2 infection in pregnancy and post-partum (January 2022 Update)

  • Rapid Risk Assessment Tool for VTE Thromboprophylaxis in Pregnancy / Post-partum (January 2022 Update)

National Clinical Programme for Obstetrics and Gynaecology 2010-2016

Previously, national clinical guidelines were developed through the National Clinical Programme for Obstetrics and Gynaecology, a joint initiative between HSE Clinical Strategy and Programmes Division. This programme was led by Professor Michael Turner of the UCD Centre for Human Reproduction at the Coombe Women and Infants University Hospital from 2010-2016.

Guideline (year published)

• Antenatal Magnesium Sulphate for Fetal Neuroprotection (2013*)

• Antenatal Routine Enquiry Regarding Violence in The Home (2012*)

• Bacterial Infections Specific to Pregnancy (2015* | Update planned for 2022)

• Bereavement Care following Maternal Death within a Hospital Setting (2017*)

• Chickenpox in Pregnancy (2015*)

• Clinical Practice Guideline Alcohol Consumption in Pregnancy (2018*)

• Clinical Practice Guideline the Irish Maternity Early Warning System (IMEWS) (2014*)

• Cord Prolapse (2015*)

• Delivery after Previous Caesarean Section (2011* | Update planned for 2022)

• Fetal Growth Restriction - Recognition, Diagnosis & Management (2014* | Update planned for 2022)

• Investigation and Management of Ovarian Cysts in Postmenopausal Women (2017*)

• Investigation in Postmenopausal Bleeding (2013* | Update planned for 2022)

• Listeriosis in Pregnancy (2015*)

• Management of Breech Presentation (2017*)

• Management of Early Pregnancy Miscarriage (2012*)

• Management of Female Genital Mutilation (FGM) (2019)

• Management of Multiple Pregnancy (2012* | Update planned for 2022)

• Management of Obstetric Anal Sphincter Injury (2012*)

• Management of Pelvic Girdle Pain in Pregnancy and Post-Partum (2012*)

• Management of Urinary Tract Infections in Pregnancy (2015* | Update planned for 2022)

• Medication Guidelines for Obstetrics and Gynaecology First Edition Volume 1: Antimicrobial Prescribing Guidelines (2016)

• Medication Guidelines for Obstetrics and Gynaecology First Edition Volume 2: Antimicrobial safety In Pregnancy and Lactation (2016)

• Methadone Prescribing and Administration in Pregnancy (2013*)

• Nutrition in Pregnancy (2019)

• Obesity and Pregnancy (2011*)

• Ovarian Hyperstimulation Syndrome (2012*)

• Oxytocin to Accelerate or Induce Labour (2016*)

• Parvovirus B19 Exposure/Infection During Pregnancy (2014*)

• Preterm Pre-labour Rupture of The Membranes (2013*)

• Resuscitation of The Pregnant Woman (2014*)

• The Diagnosis and Management of Ectopic Pregnancy (2014* | Update Planned For 2022)

• The Diagnosis and Management of Severe Pre-Eclampsia and Eclampsia (2011* | Update planned for 2022)

• The Investigation and Management of Menorrhagia (2015*)

• The use of Anti-D Immunoglobin for the Prevention of Rhd Haemolytic Disease of the Newborn (2012*)

• The Management of Hypertension in Pregnancy (2016* | Update planned for 2022)

• The Management of Second Trimester Miscarriage (2014*)

• Tocolytic Treatment in Pregnancy (2013*)

• Ultrasound Diagnosis of Early Pregnancy Miscarriage (2010*)

• Urinary Retention-Pregnancy, Postpartum, Post Gynae Surgery (2018*)

• Venous Thromboprophylaxis in Pregnancy (2013* | Update planned for 2022)
  
  *due for update

Useful Links

National Clinical Effectiveness Committee; National Clinical Guidelines

The National Clinical Effectiveness Committee (NCEC) was established by the Minister for Health in September 2010. National Clinical Guidelines are systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and service users’ decisions about appropriate healthcare for specific clinical circumstances across the entire clinical system. The aim of National Clinical Guidelines is to provide guidance and standards for improving the quality, safety and cost effectiveness of healthcare in Ireland. Find out more >

National Cancer Control Programme

Cancer prevention, diagnosis and treatment, is a major healthcare challenge. The National Cancer Control Programme (NCCP) works with health service providers to prevent cancer, treat cancer, and increase survival and quality of life for those who develop cancer, by converting the knowledge gained through research, surveillance and outcome evaluation into strategies and actions. The National Cancer Control Programme (NCCP) is developing national evidence-based clinical guidelines for the diagnosis, staging and treatment of common cancers, through its Guideline Development Groups. Find out more >

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