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

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154 Maternal Intensive Care in Belgium KCE Reports 94 Multiple pregnancies • Strictly normal diamniotic, dichorionic twin pregnancy • Diamniotic twin pregnancy with concordant growth and normal dopplers Hypertension (Independent from gestational age) • Moderate hypertension Gestational diabetes Thromboembolism • Superficial venal thrombosis Haemorrhage Miscellaneous • Sphincter rupture < level IV • Cerclage • History of uncomplicated caesarean sections • History of uncomplicated artificial delivery • BMI under 35 (at first contact) or underweight (BMI more than 18) tttt Multiple pregnancies Hypertension (Independent from gestational age) • Moderate pre-eclampsia ssss Gestational diabetes • Without insuline therapy (diet) (cf. endocrinologic disorders) Haemorrhage Miscellaneous • Hyperemesis gravidarum • Vaginal delivery after caesarean section • Baby admission on NICU • < 16 and > 40 years uuuu • History of perinatal loss (incl. 2 nd and 3 rd trimester) • Baby for adoption Multiple pregnancies • Mono- and dichorionic twin pregnancy with discordant growth and/or abnormal doppler values • Multiple pregnancy (3 baby’s and more) Hypertension (Independent from gestational age) • Severe and/or complicated hypertension • Severe and/or complicated (pre)-eclampsia • HELLP Gestational diabetes • With insuline therapy (cf. endocrinologic disorders) Thromboembolism • DVT • Lung embolism • Arterial thrombosis Haemorrhage • Complicated antepartum haemorrhage (> 500ml) (ACOG, 2006) • Complicated delivery/expulsion/postpartum (> 1000ml) Miscellaneous • Sphincter rupture level IV • Previous or current uterus rupture • Current or previous complicated caesarean section • Current or previous complicated artificial delivery • History of recurrent perinatal loss (incl. 2 nd and 3 rd trimester) • Placenta praevia, placenta accreta and percreta ssss ACOG (2002). Clinical management guidelines for obstetrician-gynaecologists, nr 33, Diagnosis and management of preeclampia and eclampsia. Retrieved on Mai 28, 2007 from: www.agog.com. tttt 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. uuuu 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.
KCE Reports 94 Maternal Intensive Care in Belgium 155 ANNEX 4: THEORETICAL MODEL, FOETAL PATHOLOGY Prenatally assessed severe fetal malformation (acute and/or chronic) which requires subspecialist diagnostics and treatment in the first hours/days Chromosomal abnormality affecting fetus Hereditary disease in family possibly affecting fetus Suspected damage to fetus due to viral disease in the mother (Rubella) Suspected damage to fetus due to other disease in the mother (alcohol addiction, listeriosis, toxoplasmosis) Suspected damage from drugs/ radiation/ environmental toxins/ IUD Allo immunisation (e.g. rhesus, iso) Fetal cardiac arrhythmia Fetal distress (fetal metabolic acidaemia, meconium staining, fetal bradycardia, fetal tachycardia) Decreased fetal movements Threatening preterm birth: gestational age < 32 full weeks, or estimated birth weight < 1.500g Severe (P95 Multiple pregnancies (≤ 33 weeks) Fetomaternal haemorrhage (leakage of fetal blood into maternal circulation) Abnormal placenta Polyhydramnios Hydrops foetalis Oligohydramnios PPROM Infection of the amniontic cavity (amnionitis, chorioamnionitis, membranitis, placentitis) Every disorder labelled as high-risk by a neonatologist requiring a level of intermediate for the mother
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Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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