Part D: Clinical Assessments
This section discusses assessments that are offered to all women during pregnancy. Recommendations are based on evidence about the accuracy of assessments in predicting complications in pregnancy and the effectiveness of interventions in reducing symptoms.
A range of clinical assessments is offered to promote and enhance the physical and emotional wellbeing of a woman and her baby during pregnancy. This section discusses assessments that are offered to all women during pregnancy. Recommendations are based on evidence about the accuracy of assessments in predicting complications in pregnancy and the effectiveness of interventions in reducing symptoms.
The summary of advice on assessments during pregnancy considered a priority for inclusion in these Guidelines. Advice on other assessments, such as routine breast and pelvic examination (which are not recommended) is included in the NICE Guidelines (NICE 2008).
Summary of advice for women about assessments during pregnancy
Calculation of body mass index at the first antenatal visit allows appropriate advice about nutrition and physical activity to be given during pregnancy
Ultrasound scanning is most accurate in determining gestational age between 8 and 14 weeks of pregnancy; after 24 weeks of pregnancy, the date of the last menstrual period is used
Ultrasound scanning at 18–20 weeks of pregnancy detects structural anomalies
Fetal growth is assessed at each antenatal visit
Promoting awareness of the normal pattern of fetal movement assists women in knowing when to seek advice if they perceive decreased or absent movements
Hearing the fetal heart is not predictive of pregnancy outcomes.
Discussing risk and protective factors for preterm birth may assist some women to reduce their risk.
Measuring blood pressure at the first antenatal visit allows identification of women who have chronic hypertension and may require additional monitoring during pregnancy.
Testing women for proteinuria at the first antenatal visit identifies existing kidney disease or urinary tract infection.
Routine measuring of blood pressure during pregnancy allows monitoring for new onset hypertension.
After the first antenatal visit, proteinuria is tested in women with risk factors for, or clinical indications of, pre-eclampsia.
- NICE (2008) Antenatal Care. Routine Care for the Healthy Pregnant Woman. National Collaborating Centre for Women’s and Children’s Health. Commissioned by the National Institute for Health and Clinical Excellence. London: RCOG Press.