Implementing A Framework for Maternity ... - Scottish Government

Appendix 2
Risk Assessment
Exit and entry examples to levels of maternity care
Section V explained the rationale for the identified entry and exclusion criteria to the different
levels of maternity care. The attached tables provide examples of morbidities and co-morbidities
which would not be suitable for delivery in the specified units, but this requires local and
regional agreement and the development of guidelines and explicit networks. This list is not
all-inclusive, and examples are given for clarity. The identification criteria may be for referral at
any level of care, for advice regarding management, or transfer to a higher level of care,
depending on local agreements. It must be stressed that any woman with significant morbidity
is not suitable for delivery in Level Ia-d. It is crucial that appropriate referral pathways are used
for any mother and baby who give cause for concern.
Level IIa exit criteria, especially for maternal reasons, will require consultant obstetrician
involvement and care will depend on the available level of service, local facilities and
emergency support. Level IIc units should be able to care for the majority of pregnancies.
Though the document has concentrated on exclusion criteria, the following table identifies the
women who are suitable to Level Ia-d of maternity care.
Exit examples for Level Ia-d care
Age
Primigravida of >16
Primigravida of