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C If the transabdominal scan is unclear,
a transvaginal scan should be offered.
transvaginal Fetal growth and Fetal growth and wellbeing Abdominal palpation for Abdominal palpation for fetal presentation
Fetal presentation should be
assessed by abdominal
palpation at 36 weeks or later,
when presentation is likely to
influence the plans for the
birth. Abdominal palpation for fetal presentation Routine assessment of presentation by
should not be offered before 36 weeks
because it is not always
accurate and may be uncomfortable.
C Suspected fetal malpresentation
should be confirmed by ultrasound.
ultrasound Measurement of Measurement of symphysis–fundal distance Pregnant women should be offered
Pregnant estimation of fetal size at each antenatal
appointment to detect small- or large-for
gestational- age infants.
gestational Symphysis–fundal height should be
measured and plotted at each antenatal
appointment. Routine monitoring of Routine monitoring of fetal movements
should not be offered.
A Auscultation of fetal Auscultation of fetal heart Auscultation of the fetal heart
may confirm that the fetus is
alive but is unlikely to have
any predictive value
and routine listening is
therefore not recommended.
therefore Auscultation of fetal heart When requested by the
of the fetal heart may
reassurance D Cardiotocography
Cardiotocography The evidence does not support the
routine use of antenatal electronic
fetal heart rate monitoring
(cardiotocography) for fetal
assessment in women with an
uncomplicated pregnancy and
therefore it should not be offered.
A Ultrasound assessment Ultrasound assessment in the third trimester
The evidence does not support
the routine use of ultrasound
scanning after 24 weeks’
gestation and therefore it
should not be offered. A
should Umbilical artery Umbilical artery Doppler ultrasound
The use of umbilical artery
Doppler ultrasound for the
prediction of fetal growth
restriction should not be
offered Uterine artery Doppler ultrasound
The use of uterine artery
Doppler ultrasound for the
prediction of pre eclampsia
should not be offered
routinely. Pregnancy after 41 weeks
Pregnancy after 41 weeks Prior to formal induction of
Prior labour, women should be offered a
vaginal examination for membrane
sweeping. Women with uncomplicated
pregnancies should be offered
induction of labour beyond 41 A
weeks. Breech presentation at term
Breech presentation at term 1.
5. All women who have an uncomplicated
singleton breech pregnancy at 36 weeks’
gestation should be offered external cephalic
Exceptions include :
women in labour, and
a uterine scar or abnormality;
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- Fall '11