Implementing A Framework for Maternity ... - Scottish Government
Implementing A Framework for Maternity ... - Scottish Government
Implementing A Framework for Maternity ... - Scottish Government
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Exit examples Level IIa: past history<br />
Significant Respiratory Disease<br />
Significant asthma i.e. requiring<br />
previous hospitalisation or parenteral<br />
steroid therapy<br />
Cystic fibrosis<br />
Congenital abnormality<br />
Emphysema (COPD)<br />
Certain congenital abnormalities<br />
Haematological Disorders<br />
Haematological disease – e.g.<br />
thrombocytopenia, aplastic anaemia<br />
Coagulation abnormality –<br />
thrombophilia, disseminated<br />
intravascular coagulation<br />
(DIC) DVT or pulmonary embolus (any<br />
history)<br />
Reproductive/Genital Tract<br />
Cancer<br />
Infection<br />
Significant infection e.g. Group B<br />
haemolytic streptococci<br />
Any blood borne virus (HIV, Hep B, Hep C)<br />
Sepsis<br />
Drug or Alcohol Intake<br />
History of drug or alcohol abuse<br />
There should be a review if the woman<br />
uses therapeutic medication<br />
Special Needs in Pregnancy<br />
Will need to be independently<br />
considered e.g.<br />
Learning disability<br />
Social exclusion<br />
Refugee mother<br />
Significant Neurological Disease<br />
Neurological disorders, including ME,<br />
MS<br />
Epilepsy<br />
Spina bifida /hydrocephaly<br />
Paraplegia<br />
Endocrine Disorders<br />
Significant endocrine disease<br />
Significant medical disease especially<br />
if unstable (thyroid, adrenal disease<br />
e.g. Addisons)<br />
Diabetes (Type I)<br />
Musculo-Skeletal Disorders<br />
Significant connective tissue disorder<br />
Transplant Surgery<br />
Heart<br />
Lung<br />
Liver<br />
Kidney<br />
Surgery & Anaesthesia<br />
Any history of significant surgery or<br />
anaesthetic complication must be<br />
considered<br />
Neonatal History<br />
Any history of intrapartum asphyxia<br />
should be reviewed<br />
Previous neonatal birth injury<br />
Previous baby with haemorrhagic<br />
disease of the newborn<br />
Risk of, or known, inherited disease<br />
Previous iso-immunisation or ABO<br />
incompatibility<br />
Cardiac Disorders<br />
Congenital heart disease – corrected<br />
or uncorrected<br />
Acquired heart disease – ischaemic<br />
heart disease, cardiomyopathy<br />
Significant Gastro-intestinal<br />
Disorders<br />
Fatty liver of pregnancy<br />
Hepatobilary disease<br />
Crohn’s disease<br />
Ulcerative colitis<br />
Renal Disease<br />
Renal disease<br />
Renal failure, impairment dialysis<br />
Significant Mental Illness<br />
Diagnosed schizophrenia<br />
Manic depressive psychosis<br />
Genetic Disorders<br />
Marfan’s syndrome<br />
Ehlers Danlos syndrome<br />
It is not advisable <strong>for</strong> any ‘at risk’<br />
fetus to be delivered in a level IIa<br />
unit<br />
page 37
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