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This guideline covers the care of pregnant women and pregnant trans and non-binary people and their babies during labour and immediately after birth. It focuses on women and pregnant people who give birth between 37 and 42 weeks of pregnancy (‘term’). The guideline helps women and pregnant people to make informed choices about where to have their baby and about their care in labour. It also aims to reduce variation in aspects of care.
View recommendations for NG235Show all sections
Sections for NG235
- Overview
- Recommendations
- Recommendations for research
- Rationale and impact
- Context
- Appendix A: Adverse outcomes for different places of birth
- Appendix B: Outcomes for different places of birth – by BMI at booking
- Appendix C: Outcomes for intravenous remifentanil patient-controlled analgesia (PCA) compared with intramuscular pethidine
This guideline covers methods for monitoring the wellbeing of the baby during labour. It includes risk assessment to determine the appropriate level of fetal monitoring, using clinical assessment in addition to fetal monitoring, and interpreting and acting on monitoring findings.
Asthma: diagnosis, monitoring and chronic asthma management (BTS, NICE, SIGN) (NG245)
This guideline covers diagnosing, monitoring and managing asthma in adults, young people and children. It aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks. It does not cover managing severe asthma or acute asthma attacks.
Fever in under 5s: assessment and initial management (NG143)
This guideline covers the assessment and early management of fever with no obvious cause in children aged under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care.
This guideline covers the circumstances for inducing labour, methods of induction, assessment, monitoring, pain relief and managing complications. It aims to improve advice and care for pregnant women who are thinking about or having induction of labour.
Heart valve disease presenting in adults: investigation and management (NG208)
This guideline covers investigation and management of heart valve disease presenting in adults. It aims to improve quality of life and survival for people with heart valve disease through timely diagnosis and appropriate intervention.
This guideline covers the routine postnatal care that women and their babies should receive in the first 8 weeks after the birth. It includes the organisation and delivery of postnatal care, identifying and managing common and serious health problems in women and their babies, how to help parents form strong relationships with their babies, and baby feeding. The recommendations on emotional attachment and baby feeding also cover the antenatal period.
This guideline covers how to create the right conditions for mental wellbeing at work. It aims to promote a supportive and inclusive work environment, including training and support for managers and helping people who have or are at risk of poor mental health.
This guideline covers diagnosing and managing atrial fibrillation in adults. It includes guidance on providing the best care and treatment for people with atrial fibrillation, including assessing and managing risks of stroke and bleeding.
This guideline covers recognising, assessing and treating post-traumatic stress disorder (PTSD) in children, young people and adults. It aims to improve quality of life by reducing symptoms of PTSD such as anxiety, sleep problems and difficulties with concentration. Recommendations also aim to raise awareness of the condition and improve coordination of care.
This guideline covers encouraging people to increase the amount they walk or cycle for travel or recreation purposes.
Physical activity: brief advice for adults in primary care (PH44)
This guideline covers providing brief advice on physical activity to adults in primary care. It aims to improve health and wellbeing by raising awareness of the importance of physical activity and encouraging people to increase or maintain their activity level.
Ectopic pregnancy and miscarriage: diagnosis and initial management (NG126)
This guideline covers diagnosing and managing ectopic pregnancy and miscarriage in women with complications, such as pain and bleeding, in early pregnancy (that is, up to 13 completed weeks of pregnancy). It aims to improve how early pregnancy loss is diagnosed, and the support women are given, to limit the psychological impact of their loss.
Vitamin B12 deficiency in over 16s: diagnosis and management (NG239)
This guideline covers recognising, diagnosing and managing vitamin B12 deficiency in people aged 16 and over, including deficiency caused by autoimmune gastritis. It also covers monitoring for gastric cancer in people with autoimmune gastritis.
This guideline covers rehabilitation after stroke for over 16s. It aims to ensure people are assessed for common problems and conditions linked to stroke, and get the care and therapy they need. It includes recommendations on the organisation and delivery of rehabilitation in hospital and the community.
Cardiovascular disease: risk assessment and reduction, including lipid modification (NG238)
This guideline covers identifying and assessing risk of cardiovascular disease (CVD) in adults without established CVD. It covers lifestyle changes and lipid-lowering treatment (including statins) for primary and secondary prevention of CVD, and includes guidance for people who also have diabetes or chronic kidney disease.
This guideline covers diagnosis and management of thyroid cancer in people aged 16 and over. It aims to reduce variation in practice and increase the quality of care and survival for people with thyroid cancer.
Barrett's oesophagus and stage 1 oesophageal adenocarcinoma: monitoring and management (NG231)
This guideline covers monitoring, treatment and follow-up for people aged 18 and over with Barrett’s oesophagus and stage 1 oesophageal adenocarcinoma. It includes advice on endoscopic and non-endoscopic techniques. It aims to improve outcomes by ensuring the most effective investigations and treatments are used.
Spinal metastases and metastatic spinal cord compression (NG234)
This guideline covers recognition, referral, investigation and management of spinal metastases and metastatic spinal cord compression (MSCC). It is also relevant for direct malignant infiltration of the spine and associated cord compression. It aims to improve early diagnosis and treatment to prevent neurological injury and improve prognosis.
Meningitis (bacterial) and meningococcal disease: recognition, diagnosis and management (NG240)
This guideline covers recognising, diagnosing and managing bacterial meningitis and meningococcal disease in babies, children, young people and adults. It aims to reduce death and disability by helping healthcare professionals recognise meningitis and treat it quickly and effectively.
This guideline covers diagnosing and managing epilepsy in children, young people and adults in primary and secondary care, and referral to tertiary services. It aims to improve diagnosis and treatment for different seizure types and epilepsy syndromes, and reduce the risks for people with epilepsy.
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Sections for NG217
- Overview
- 1 Diagnosis and assessment of epilepsy
- 2 Information and support
- 3 Referral to tertiary specialist services
- 4 Principles of treatment, safety, monitoring and withdrawal
- 5 Treating epileptic seizures in children, young people and adults
- 6 Treating childhood-onset epilepsies
- 7 Treating status epilepticus, repeated or cluster seizures, and prolonged seizures
This guideline covers exercise referral schemes for people aged 19 and older, in particular, those who are inactive or sedentary. The aim is to encourage people to be physically active.
Social, emotional and mental wellbeing in primary and secondary education (NG223)
This guideline covers ways to support social, emotional and mental wellbeing in children and young people in primary and secondary education (key stages 1 to 5), and people 25 years and under with special educational needs or disability in further education colleges. It aims to promote good social, emotional and psychological health to protect children and young people against behavioural and health problems.
Self-harm: assessment, management and preventing recurrence (NG225)
This guideline covers assessment, management and preventing recurrence for children, young people and adults who have self-harmed. It includes those with a mental health problem, neurodevelopmental disorder or learning disability and applies to all sectors that work with people who have self-harmed.
This guideline covers identifying and treating primary hypertension (high blood pressure) in people aged 18 and over, including people with type 2 diabetes. It aims to reduce the risk of cardiovascular problems such as heart attacks and strokes by helping healthcare professionals to diagnose hypertension accurately and treat it effectively.
This guideline covers care for pregnant women and pregnant people with a twin or triplet pregnancy in addition to routine care during pregnancy and labour. It aims to reduce the risk of complications and improve outcomes.
This guideline covers how to improve the physical environment to encourage and support physical activity. The aim is to increase the general population’s physical activity levels.
This guideline covers care and management for adults (aged 18 and over) with type 2 diabetes. It focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels, and identifying and managing long-term complications.
This guideline covers nutrition and weight management in pregnancy for anyone who may become pregnant, is planning to become pregnant or is already pregnant, and nutrition in children up to 5 years. Care of babies and children born preterm or with low birth weight is not covered. The guideline does not give detailed advice on what constitutes a healthy diet.
This guideline covers assessing and managing heavy menstrual bleeding (menorrhagia). It aims to help healthcare professionals investigate the cause of heavy periods that are affecting a woman’s quality of life and to offer the right treatments, taking into account the woman’s priorities and preferences.
This guideline covers diagnosing and managing abdominal aortic aneurysms. It aims to improve care by helping people who are at risk to get tested, specifying how often to monitor asymptomatic aneurysms, and identifying when aneurysm repair is needed and which procedure will work best.
Venous thromboembolic diseases: diagnosis, management and thrombophilia testing (NG158)
This guideline covers diagnosing and managing venous thromboembolic diseases in adults. It aims to support rapid diagnosis and effective treatment for people who develop deep vein thrombosis (DVT) or pulmonary embolism (PE). It also covers testing for conditions that can make a DVT or PE more likely, such as thrombophilia (a blood clotting disorder) and cancer. It does not cover pregnant women.
This guideline covers diagnosing and managing hypertension (high blood pressure), including pre-eclampsia, during pregnancy, labour and birth. It also includes advice for women with hypertension who wish to conceive and women who have had a pregnancy complicated by hypertension. It aims to improve care during pregnancy, labour and birth for women and their babies.
Depression in children and young people: identification and management (NG134)
This guideline covers identifying and managing depression in children and young people aged 5 to 18 years. Based on the stepped-care model, it aims to improve recognition and assessment and promote effective treatments for mild and moderate to severe depression.
This guideline covers the early and longer-term (rehabilitation) management of acute coronary syndromes. These include ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina. The guideline aims to improve survival and quality of life for people who have a heart attack or unstable angina.
Stroke and transient ischaemic attack in over 16s: diagnosis and initial management (NG128)
This guideline covers interventions in the acute stage of a stroke or transient ischaemic attack (TIA). It offers the best clinical advice on the diagnosis and acute management of stroke and TIA in the 48 hours after onset of symptoms.
This guideline covers the short-term management of violence and aggression in adults (aged 18 and over), young people (aged 13 to 17) and children (aged 12 and under). It is relevant for mental health, health and community settings. The guideline aims to safeguard both staff and people who use services by helping to prevent violent situations and providing guidance to manage them safely when they occur.
Early and locally advanced breast cancer: diagnosis and management (NG101)
This guideline covers diagnosing and managing early and locally advanced breast cancer. It aims to help healthcare professionals offer the right treatments to people, taking into account the person's individual preferences.
This guideline covers preventing and managing foot problems in children, young people and adults with diabetes. It aims to reduce variation in practice, including antibiotic prescribing for diabetic foot infections.
Improving outcomes in children and young people with cancer (CSG7)
This guideline covers how healthcare services for children and young people with cancer should be organised. It aims to improve care by recommending which healthcare professionals should be involved and the types of hospital or cancer centre best suited to provide the care.
Rehabilitation for chronic neurological disorders including acquired brain injury (NG252)
This guideline covers rehabilitation in all settings for children, young people and adults with a chronic neurological disorder, neurological impairment or disabling neurological symptoms due to acquired brain injury, acquired spinal cord injury, acquired peripheral nerve disorder, functional neurological disorder or progressive neurological disease.
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Sections for NG252
- Overview
- Designing and commissioning rehabilitation services
- Assessing rehabilitation needs and goal setting
- Rehabilitation planning and delivery
- Information, advice and learning as part of rehabilitation
- Rehabilitation to maintain, improve or support function
- Rehabilitation to support education, work, social and leisure activities, relationships and sex
- Terms used in this guideline
Adrenal insufficiency: identification and management (NG243)
This guideline covers identifying and managing adrenal insufficiency (hypoadrenalism) in babies, children, young people and adults. It aims to improve the treatment of primary, secondary and tertiary adrenal insufficiency, and the prevention and management of adrenal crisis.
This guideline covers investigating all suspected thyroid disease and managing primary thyroid disease (related to the thyroid rather than the pituitary gland). It does not cover managing thyroid cancer or thyroid disease in pregnancy. It aims to improve quality of life by making recommendations on diagnosis, treatment, long-term care and support.
Intravenous fluid therapy in children and young people in hospital (NG29)
This guideline covers general principles for managing intravenous (IV) fluids for children and young people under 16 years, including assessing fluid and electrolyte status and prescribing IV fluid therapy. It applies to a range of conditions and different settings. It does not include recommendations relating to specific conditions. This guideline represents a major opportunity to improve patient safety for children and young people having IV fluid therapy in hospital.
Integrated health and social care for people experiencing homelessness (NG214)
This guideline covers providing integrated health and social care services for people experiencing homelessness. It aims to improve access to and engagement with health and social care, and ensure care is coordinated across different services.
This guideline covers planning and delivering multi-agency services for domestic violence and abuse. It aims to help identify, prevent and reduce domestic violence and abuse among women and men in heterosexual or same-sex relationships, and among young people.
Dementia: assessment, management and support for people living with dementia and their carers (NG97)
This guideline covers diagnosing and managing dementia (including Alzheimer’s disease). It aims to improve care by making recommendations on training staff and helping carers to support people living with dementia.
This guideline covers assessment, treatment, monitoring and inpatient care for children, young people and adults with eating disorders. It aims to improve the care people receive by detailing the most effective treatments for anorexia nervosa, binge eating disorder and bulimia nervosa.
This guideline covers diagnosing and managing bladder cancer in people 18 and above referred from primary care with suspected bladder cancer, and those with newly diagnosed or recurrent bladder (urothelial carcinoma, adenocarcinoma, squamous-cell carcinoma or small-cell carcinoma) or urethral cancer.
Pancreatic cancer in adults: diagnosis and management (NG85)
This guideline covers diagnosing and managing pancreatic cancer in adults aged 18 and over. It aims to improve care by ensuring quicker and more accurate diagnosis, and by specifying the most effective treatments for people depending on how advanced their cancer is.