Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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150 Maternal Intensive Care in Belgium KCE Reports 94 Haematological disorders • Heterozygous haemoglobinopathy (carriers) • Anaemia not requiring a blood transfusion • Every disorder labelled as low-risk by an haematologist but not specified as a disorder requiring a level of intermediate care • Thrombophilia needing no thromboprophylaxis iiii Oncologic disorders • Every disorder labelled as low-risk by a oncologist but not specified as a disorder requiring a level of intermediate care Socio-economic problems • No (known/suspicion of) alcohol/drug abuse • No (known/suspicion of) smoking • No (known/suspicion of) signs or history of violence Trauma • Every disorder labelled as low-risk by a traumatology specialist but not specified as a disorder requiring a level of intermediate care Haematological disorders • Anaemia requiring a blood transfusion Oncologic disorders • All previous (>5 years in remission) systemic and/or invasive cancers Socio-economical problems • Pregnancy without antenatal follow-up Trauma Haematological disorders jjjj • Homozygous/double heterozygous haemoglobinopathy • Coagulation disorders: TTP, ITP, von Willebrand, haemophilia A-B, Werlhof • Any thrombophilia needing thrombophylaxis • Every disorder labelled as high-risk by a haematologist but not specified as a disorder requiring a level of standard care Oncologic disorders • All current systemic and/or invasive cancers • Every disorder labelled as high-risk by a oncologist but not specified as a disorder requiring a level of standard care Socio-economical problems • Severe alcohol (>5 units a day) abuse with obstetrical and/or fetal implications • Severe (hard) drug abuse with obstetrical and/or fetal implications • Severe smoking, 1 pack a day during pregnancy kkkk • Abuse/violence with obstetrical and/or fetal complications Trauma • Severe trauma • Every disorder labelled as high-risk by a traumatology specialist but not specified as a disorder requiring a level of standard care hhhh NHS (2003). Multiple Sclerosis, management of ms in primary and secondary care, clinical guideline 8. Retrieved on June 20, 2007, from NICE: http://www.nice.org.uk/pdf/CG008guidance.pdf iiii RCOG. (2004). Thrombophylaxis during pregnancy, labour and after vaginal delivery, guideline nr 37. Retrieved on June 20, 2007 from cebam, http://www.rcog.org.uk/resources/Public/pdf/Thromboprophylaxis_no037.pdf. jjjj National collaborating centre for women’s and children’s health. Antenatal care routine care for the healthy pregnant woman, Clinical guideline 23. Retrieved June 18, 2007 from cebam, rcog: http://www.rcog.org.uk/resources/Public/pdf/Antenatal_Care.pdf. kkkk Lodewyckx K, Peeters G, Spitz B, et al. KCE reports 6A. (2004). Nationale richtlijn prenatale zorg. Een basis voor een klinisch pad voor de opvolging van zwangerschappen. Brussel: KCE.
KCE Reports 94 Maternal Intensive Care in Belgium 151 Psychiatric disorders • Every disorder labelled as low-risk by a oncologist but not specified as a disorder requiring a level of intermediate care • No previous or current psychiatric disorders Uro-genital tract disorders • Every disorder labelled as low-risk by a uro-genital specialist but not specified as a disorder requiring a level of intermediate care Female genital mutilation type I & II Psychiatric disorders • Women taking medication, for example benzodiazepines, neuroleptica, anti-depressives (SSRI’s), … Uro-genital tract disorders • Complicated uro-genital disorders • Severe uro-genital infections (e.g. PID oooo ) • Female genital mutilation type III (infibulation) Psychiatric disorders llll • Suicidal symptoms • Severe anorexia and bulimia nervosa mmmm • Psychotic symptoms • Substance dependency nnnn • Postpartum psychosis • Mania (always hospitalisation in function of context: MIC, psychiatry, mother-child ward…) • Phobic disorders if co-morbidity (substance, depression, …) • Severe psychiatric disorders for which admission is/was required before pregnancy or during a previous pregnancy, delivery of puerperium ² • Every disorder labelled as high-risk by a psychiatrist but not specified as a disorder requiring a level of standard care pppp qqqq Uro-genital tract disorders • Every disorder labelled as high-risk by a uro-genital specialist but not specified as a disorder requiring a level of standard care llll Personal communication with dr. Heylen and dr Vanden Abeele (psychiatrists UZGent, July 28 and August 8 2007) mmmm (Tiller & Treasure, 1998 Morgan, Lacey & Sedwick, 1999; Franco e.a., 2001 Waugh & Bullik, 1999 Stein, Woolley, 1996; Russel, Treasure & Eisler, 1998; Stein, Woolley & McPherson, 1999; Timimi & Robinson, 1996; Franzen & Gerlinghoff, 1997; Franzen & Florin, 1995). nnnn Prodigy guidelines (2003). Opioid dependency. Retrieved on July, 16 2007 from cebam, http://www.cks.library.nhs.uk/opioid_dependence/view_whole_guidance oooo Elective services, HFA (2001). National referral guidelines gynaecology. Retrieved from cebam, New Zealand guidelines group on June 26, 2007. pppp Seuntjens, L. et al (2006). Zwangerschapsbegeleiding. Retrieved on June 19, 2007 from cebam, Domus Medica, www.wvvh.be qqqq Lodewyckx K, Peeters G, Spitz B, et al. KCE reports 6A. (2004). Nationale richtlijn prenatale zorg. Een basis voor een klinisch pad voor de opvolging van zwangerschappen. Brussel: KCE.
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