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High risk pregnancy

What is the programme and its aims?
This programme focuses on women who have higher risk pregnancies for a variety of reasons. Our overall aim is to improve the identification and care of women in the East Midlands who are at higher risk, and to ensure a consistent, optimised approach to the care of these women to improve their experience and outcomes. Focusing on selected risk factors we are endeavouring to agree an East Midlands approach, building on national recommendations and evidence, then supporting implementation and audit. This approach has been demonstrated in our work on agreeing standards of care for women with a raised body mass index.

Why is the programme required?
Maternal obesity is recognised as an important risk factor for adverse outcomes in maternity care, including stillbirth. The likelihood of stillbirth is doubled if the mother has a high body mass index. For the woman, there is also an increased risk of hypertension, gestational diabetes, difficulties in delivery and many other complications. A recent snapshot audit across the East Midlands providers suggest that where data was collected, between 6.67 percent and 13.34 percent of pregnant women had a body mass index of more than 35 at booking. This audit estimates the number of women with a body mass index over 35 to be in excess of 4,000 women across the East Midlands, which is a significant number.

Who are the partners?
  • clinicians
  • clinical commissioning group commissioners
  • primary care
  • GPs
How are we making a difference?
The Maternity Clinical Steering Group with support from the East Midlands Clinical Network developed and agreed a local set of quality and clinical standards for the care of women with a raised body mass index. This approach supports local services to use agreed best practice and in so doing helps to reduce variations in care across the area. As part of this work all provider services agreed to use a standardised patient information leaflet across the East Midlands to facilitate consistent user information. The network facilitated the delivery of this leaflet to our provider organisations.

What’s next?
Providers in the region have undertaken audits against some of the standards produced for management of pregnant women with a raised body mass index. The results of these audits may identify any gaps in provision and inform future work in this area.

The focus for further work to support improving outcomes for women with high risk pregnancy will be finalised over the coming months.

What are the key resources?
pdfEast Midlands best practice standards of care for pregnant women with a raised body mass index.

Who to contact for further information?
This email address is being protected from spambots. You need JavaScript enabled to view it., Maternity and Children’s Quality Improvement Coordinator