Health Authority Abu Dhabi Standard

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1 Health Authority Abu Dhabi Standard Document Title: HAAD Standard for Routine Antenatal Screening and Care Document Ref. Number: HAAD/ANSC/SD Version 0.9 Approval Date: Octoberber 2011 Effective Date: 15 January 2012 Last Reviewed: N/A Next Review: December 2012 Document Owner: Applies to: Classification: Public Health/Family and SchoolHealth HAAD Licensed Health Care Providers Public 1. Purpose This standard is intended to ensure that all pregnant women receive the requisite screening and counseling during the pre-conception and antenatal periods. To do this, it mandates: 1.1 The screening schedule for pre-conception and antenatal screening; 1.2 Recommended education and counseling during the pre-conception and antenatal periods; and 1.3 The data recording and reporting requirements for antenatal care. 2. Scope 2.1 This standard applies to all Healthcare Providers (Facilities and Professionals) licensed by HAAD in the Emirate of Abu Dhabi delivering antenatal health services. 2.2 Interim advisory status applies for a period of six months from the date of publication by HAAD, after which the Standard becomes mandatory. At this point all HAAD licensed healthcare facilities providing Antenatal Screening and care must comply with this standard. 3 Duties for Healthcare Providers All licensed healthcare providers engaged in providing antenatal care must: 3.1 Provide clinical services and patient care in accordance with this standard and consistent with internationally recognised evidence based clinical care pathways; 3.2 Obtain consent for screening and care from the patient, in accordance with the HAAD Consent Policy; 3.3 Where a patient refuses any mandatory screening and care, inform the patient of the potential consequences. Refusal must be documented on the patient s medical record including patient signature; 3.4 Report and submit data to HAAD via e-claims and in accordance with the HAAD Reporting of Health Statistics Policy and as set out in the HAAD Data Standards and Procedures (found online at and 3.5 Comply with HAAD policies and standards on managing patient medical records, including developing effective recording systems, maintain patient records, 1

2 maintain confidentiality, privacy and security of patient information; and educating patients on services provided and satisfying the requirements of patients rights and responsibilities charter. 4. Enforcement and Sanctions 4.1 Where a healthcare provider is in breach of a duty under this Policy, HAAD may take any or all of the following actions:issue a warning to the healthcare provider, Suspend the license of the healthcare provider for a period of time that HAAD determines to be appropriate in the circumstances of the case, Require re-evaluation of the competence of the professional to practice as HAAD determines to be appropriate in the circumstances of the case, Revoke the license of the professional or healthcare provider. 4.2 HAAD may impose sanctions in relation to any breach of this Policy in accordance with the [HAAD Policy on Enforcement and Sanctions]. Decisions on suspending and/or revoking of licences will be determined by considering the circumstances of the case and consistent with the terms and procedures of the HAAD Licensing Committee and in accordance with measures under the law. 5. Standard 1 - Clinical Definitions 5.1 Antenatal Care is defined as occurring during the prenatal period; which is the time in pregnancy between conception and birth. 5.2 Pre-conception care is a set of interventions that identify and address biomedical, behavioral, and social risks to a woman of reproductive age to reduce risk factors that might affect future pregnancies, through prevention and management of health issues that require action before conception. The goal of preconception care is to provide: 1) screening for risks, 2) health promotion and education, and 3) interventions to address identified risks. Pre-conception screening should be limited to a maximum of one per year; any subsequent care shall follow the clinical pathway appropriate for the screening findings. 6. Standard 2 - Service Specifications 6.1 Screening Service - the provider must: Provide and support Pre-conception and Antenatal services as detailed in Appendix 1 periodically or as determined necessary by the licensed medical practitioner responsible for the patient s care.; Comply with the HAAD Patient Rights and Responsibilities Policy and Charter and deliver culturally and socially relevant patient information and education; Comply with the HAAD Consent policy and ensure that individuals receive appropriate and adequate information relevant to the service 2

3 and grant consent prior to screening. Where consent is granted, providers must document and retain signed consent forms on medical records. Records of women refusing screening tests must also be documented. 7. Standard 3 Licensed Healthcare Professionals: 7.1 All licensed health professionals involved in antenatal care must: Be licensed and, where required, authorised by HAAD; Maintain their competencies and satisfy HAAD requirements for continuing medical education and continuing professional development; Comply with the HAAD Standard for Clinical Privileging, Scopes of Practice (where they exist) and limit their practice to the skills, competencies and the privileges granted within the particular facility with which they are associated; and Ensure that the multi-disciplinary teams must comprise the necessary personnel and staff with requisite qualifications and skills. 8. Standard 4 - Payment for Pre-conception and Antenatal Care 8.1 Eligibility for reimbursement under the Health Insurance scheme is as follows: For UAE Nationals Antenatal Care shall be covered under Maternity benefits of Thiqa scheme Pre-conception care shall covered under Thiqa scheme Preventative Care, and be in compliance with the Standard for Thiqa Preventative (available at For Non-Nationals (Basic and Enhanced products holders), Coverage should be consistent with their insurance policy and policy schedule of Benefits approved by HAAD. 8.2 Reimbursement for Pre-conception and Antenatal services shall be in accordance with Standard Provider Contract, HAAD Mandatory Tariff and associated Claims and Adjudication Rules, and the Claims and Adjudication Standard; all documents are available at the HAAD website in Data Dictionary. 3

4 Appendix 1: Routine Antenatal Screening and Care Screening Medical and family history including risk profiles Height and weight/bmi Blood pressure Physical examination Cholesterol & HDL ** Rubella, Varicella Vit D screening HBA1C ** Cervical cancer screening** 1 Event Preconception Visit (1 per 12 months) First Antenatal visit ( ideally before 10 weeks) 16 weeks Medical and family history including risk profiles Confirming pregnancy; Pregnancy test. Physical examination including: Height, weight, BMI, blood pressure Rubella suseptibility, HIV, Varicella, Syphilis (RPR, VDRL), Hep B virus, CBC, Vit D, Haemoglobinopathy screening***, ABO/Rh/Ab screen Urine dipstick & CNS Cervical cancer screening *** Book first trimester combined Down Syndrome Screening (as per note 1) If Chorionic Villus Sampling (CVS) * is medically indicated, this should be done between weeks Accurate recording of menstrual dates Urine dipstick Preterm labour screening* Review labs from visit 1 Schedule Anomaly scan to be done weeks (as per note 2) If Amniocentesis*, is medically indicated, this should be done after 16 weeks * Counseling & Education (15 min) Immunization & Chemoprophylaxis Nutrition and weight Smoking cessation List of medications, vitamins Accurate recording of menstrual dates Importance of early registration of pregnancy and continuity of care Physiology of pregnancy Genetic couselling Tetanus booster * Rubella* Varicella * Hepatitis B vaccine* Folic acid supplement Physical activity Nutrition & diet including Vit D supplements Nausea and vomiting Importance of continuity of care Physiology of pregnancy Discuss antenatal screening including fetal aneuploidy screening Genetic Couselling Hepatitis B* Tetanus booster* Nutritional supplements including folic acid Progesterone* Influenza (inactivated)* -recommended Nutrition and weight List of medications, herbal supplements, vitamins Fetal growth Breastfeeding Nausea and vomiting Physiology of pregnancy Continuity of care Unsensitized Rh-negative women require RhoGAM 1 For further details on these items please refer to Routine Prenatal Care, Institute for Clinical Systems Improvement (http://www.icsi.org/prenatal_care_4/prenatal_care routine full_version 2.html ); Antenatal Care, National Institute of Clinical Excellence, ; and CDC Guidelines for Vaccinating Pregnant Women (http://www.cdc.gov/vaccines/pubs/preg-guide.htm) * If clinically indicated or high risk; ** As per protocol; *** If not done previously 4

5 Appendix 1: Routine Antenatal Screening and Care 25 weeks (nulliparous women) 28 Weeks 31 weeks (nulliparous women) Screening Counseling & Education (15 min) Classes Family issues Length of stay Gestational diabetes mellitus (GDM) Continuity of care Gestational Diabetes Mellitus screening Repeat Rh antibody screen* CBC Urine dipstick- proteinuria Hepatitis B Ag* Follow-up modifiable risk factors Discussing plans for work Physiology of pregnancy Fetal growth Awareness of fetal movement Continuity of care Continuity of care Immunization & Chemoprophylaxis Rh o (D) Immune Globulin (RhoGAM)* Rh o (D) Immune Globulin (RhoGAM)* 5

6 Appendix 1: Routine Antenatal Screening and Care Event 34 Weeks 36 Weeks 38 Weeks Screening Counseling & Education (15 min) Immunization & Chemoprophylaxis Ultrasound* Travel Breastfeeding Episiotomy Labor & delivery issues Warning s igns/pregnancyinduced hypertension Vaginal birth after cesarean (VBAC)* External cephalic version (ECV)* Rh o (D) Immune Globulin (RhoGAM)* Confirm fetal position (if breech, offer cephalic version) Culture for group B streptococcus CBC Postpartum care Breastfeeding Pediatric care (care of new baby, vit K) Contraception When to call provider Discussion of postpartum depression Vaginal birth after cesarean (VBAC)* Cesarean Section (C-S) consents and discussion if indicated* Pain management Consider weekly visits Cervix exam* Postpartum vaccinations Infant CPR Options for post-term pregnancy Labor & delivery update C-S consents and discussion if indicated* Pain management 6

7 Appendix 1: Routine Antenatal Screening and Care Event 40 Weeks (nulliparous women) 41 Weeks Screening Urine- proteinuria Urine- proteinuria Offer a membrane sweep Offer induction of labour Ultrasound Fetal assessment (ultrasound+ CTG) Counseling & Education (15 min) Immunization & Chemoprophylaxis Postpartum vaccinations Infant CPR Options for post-term pregnancy Labor & delivery update Postpartum vaccinations Infant CPR Options for post-term pregnancy Labor & delivery update Note 1: Down Syndrome screening: Note 2: Combined test between 11 weeks 0 days and 13 weeks and 6 days (nuchal translucency, beta-human chorionic gonadotropin, pregnancy associated plasma protein-a) Serum screening test (triple or quadruple test) between 15 weeks and 0 days and 20 weeks and 0 days Anomaly scan (18-20 weeks) If the woman choses, an ultrasound scan should be performed between 18 weeks 0 days and 20 weeks 6 days to detect structural anomalies. For a woman whose placenta extends across the internal cervical os, offer another scan at 32 weeks. 7

8 Appendix 2: High Risk Pregnancies Note 3: The guideline makes recommendations on baseline clinical care for all pregnant women. Pregnant women with the following conditions usually require additional care to be determined by treating Physician: Cardiac disease, including hypertension Renal disease Endocrine disorders or diabetes requiring insulin Psychiatric disorders (being treated with medication) Hematological disorders Autoimmune disorders Epilepsy requiring anticonvulsant drugs Malignant disease Severe asthma HIV or HBV infection Obesity (body mass index 30 kg/m2 or above) or underweight (body mass index below 18 kg/m2) Higher risk of developing complications, for example, women aged 40 and older, women who smoke Women who are particularly vulnerable (such as teenagers) or who lack social support. Note 4: In addition, women who have experienced any of the following in previous pregnancies usually require additional care to be determined by treating physician: recurrent miscarriage (three or more) preterm birth severe pre-eclampsia, HELLP syndrome or eclampsia rhesus isoimmunisation or other significant blood group antibodies uterine surgery including caesarean section, myomectomy or cone biopsy antenatal or postpartum haemorrhage on two occasions puerperal psychosis Grand multiparity (more than six pregnancies) A stillbirth or neonatal death A small-for-gestational-age infant (below 5th centile) A large-for-gestational-age infant (above 95th centile) A baby weighing below 2.5 kg or above 4.5 kg A baby with a congenital abnormality (structural or chromosomal).

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