Other factors suggesting planned birth at obstetric unit

Other factors indicating increased risk suggesting planned birth at an obstetric unit

• previous complications
  • unexplained stillbirth/neonatal death or previous death related to intrapartum difficulty
  • previous baby with neonatal encephalopathy
  • pre-eclampsia requiring preterm birth
  • placental abruption with adverse outcome
  • eclampsia
  • uterine rupture
  • primary postpartum haemorrhage requiring additional treatment or blood transfusion
  • retained placenta requiring manual removal in theatre
  • caesarean section
  • shoulder dystocia
• current pregnancy
  • multiple birth
  • placenta praevia
  • pre-eclampsia or pregnancy-induced hypertension
  • preterm labour or preterm prelabour rupture of membranes
  • placental abruption
  • anaemia - haemoglobin less than 8.5 g/dl at onset of labour
  • confirmed intrauterine death
  • induction of labour
  • substance misuse
  • alcohol dependency requiring assessment or treatment
  • onset of gestational diabetes
  • malpresentation - breech or transverse lie
  • body mass index at booking of greater than 35 kg/m2
  • recurrent antepartum haemorrhage
• fetal indications
  • small for gestational age in this pregnancy (less than fifth centile or reduced growth velocity on ultrasound)
  • abnormal fetal heart rate (FHR)/Doppler studies
  • ultrasound diagnosis of oligo-/polyhydramnios
• previous gynaecological history
  • myomectomy
  • hysterotomy

Reference:

1. NICE (September 2007).Intrapartum care.