Implementing A Framework for Maternity ... - Scottish Government

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Exit examples Level IIa: intrapartum Maternal Maternal/Combined Fetus/Baby Postpartum haemorrhage (>500 mls) Intrapartum haemorrhage Birth weight 4000g Mother gives cause for concern Maternal pyrexia >38˚C on two occasions (30 mins apart) Retained placenta Newly diagnosed medical disease or morbidity Exit examples Level IIa: postnatal Postpartum haemorrhage Sepsis Mother gives cause for concern Neonatal seizures Persisting hypothermia Feeding difficulties persisting at 36 hours of age Failure to pass urine in first 24 hours Baby gives cause for concern Apgar score 6 or less at 5 minutes of age Respiratory difficulties after resuscitation (respiratory rate >60/min or requiring supplementary oxygen to maintain saturation >92%) Placenta acreta Infant gives cause for concern Maternal Neonatal Persisting hypoglycaemia Failure to pass meconium in first 36 hours Jaundice in first 24 hours/ positive Coombes test page 39
Exit examples Level IIb: past history Significant Respiratory Disease Emphysema (COPD) Cystic fibrosis Congenital abnormality Haematological Disorders Haematological disease – e.g. thrombocytopenia, aplastic anaemia Coagulation abnormality – thrombophilia, disseminated intravascular coagulation (DIC) Reproductive/Genital Tract Cancer Infection Significant infection e.g. Group B haemolytic streptococci page 40 Significant Neurological Disease Spina bifida /hydrocephaly Paraplegia Endocrine Disorders Significant medical disease especially if unstable (thyroid , adrenal disease e.g. Addisons) Diabetes (Type I) Musculo-Skeletal Disorder Significant connective tissue disorder Genetic Disorders Marfan’s syndrome Ehlers Danlos syndrome Cardiac Disorders Congenital heart disease – corrected or uncorrected Acquired heart disease – ischaemic heart disease, cardiomyopathy Transplant Surgery Heart Lung Liver Kidney Renal disease Renal failure, impairment or dialysis Significant Mental Illness Manic depressive psychosis Fetus/Neonate Any history of low birthweight babies should be reviewed
Page 1 and 2: Implementing A Framework for Matern
Page 3 and 4: Foreword Our National Health Servic
Page 6 and 7: Contents Key Messages from the Expe
Page 8 and 9: 8. There is no such thing as ‘zer
Page 10 and 11: Introduction 1. Scotland’s mix of
Page 12 and 13: 10. The report shows that in 2002,
Page 14 and 15: Principles 1.1 Acute maternity serv
Page 16 and 17: Assessing and Managing Risk 1. Risk
Page 18 and 19: Risk assessment and management 6. T
Page 20 and 21: Table 1 Levels of intrapartum care
Page 22 and 23: Education, Training and Workforce I
Page 24 and 25: Principles 3.7 A national, post-reg
Page 26 and 27: Developing the maternity workforce
Page 28 and 29: Stakeholder Engagement 1. The Scott
Page 30 and 31: Information Management and Technolo
Page 32 and 33: Transport in Acute Maternity Servic
Page 34 and 35: Appendix 1 Membership of Short Life
Page 36 and 37: Miss Eleanor Stenhouse Senior Midwi
Page 38 and 39: Exit examples for Level Ia-d: mater
Page 40 and 41: Exit examples Level Ia-d: present p
Page 42 and 43: Exit examples Level IIa: past histo
Page 46 and 47: Exit examples for Level IIb: presen
Page 48 and 49: Entry examples for Level III Matern
Page 50 and 51: Clinical judgement and decision-mak
Page 52 and 53: Additional competency which will be
Page 54 and 55: Glossary Accredited Certified as be
Page 56 and 57: Named Midwife A named, qualified mi
Page 58: Further copies are available from T

Implementing A Framework for Maternity ... - Scottish Government

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