NICE NG201: Antenatal Care
Appointment Schedule
- Nulliparous women: plan 10 routine antenatal appointments with a midwife or doctor (recommendation 1.1.7).
- Parous (multiparous) women: plan 7 routine antenatal appointments with a midwife or doctor (recommendation 1.1.8).
- This mirrors the appointment counts used under CG62 — the headline "10 vs 7" figures are unchanged — but NG201 reframes each appointment around structured information-giving and shared decision-making rather than a fixed checklist.
Booking Appointment (ideally by 10+0 weeks)
- Full history, height, weight, and BMI calculation (recommendation 1.2.12).
- Booking bloods: full blood count, blood group and rhesus D status (1.2.12).
- Infectious disease screening: HIV, syphilis, hepatitis B (1.2.13).
- Sickle cell and thalassaemia screening (1.2.13).
- Mental health enquiry: ask about depression, anxiety, severe mental illness, and psychological trauma (1.2.1).
- Domestic abuse enquiry: ask in a kind, sensitive manner, when the woman is alone (1.2.5).
- Female genital mutilation (FGM) risk assessment (1.2.6).
Screening Timeline
| Gestation | Test/Intervention | |-----------|-------------------| | By 10+0 weeks | Booking appointment, booking bloods, infection and haemoglobinopathy screening | | 11+2 to 14+1 weeks | Dating ultrasound (gestational age, multiple pregnancy detection) with optional combined screening for Down's, Edwards', and Patau's syndromes (1.2.14) | | 18+0 to 20+6 weeks | Anomaly ultrasound (fetal anomalies, placental location) (1.2.15) | | 24+0 to 28+0 weeks | Oral glucose tolerance test (OGTT) for women with gestational diabetes risk factors (1.2.22) | | 28 weeks | Repeat bloods (full blood count, group and antibodies); anti-D prophylaxis offered to RhD-negative women (1.2.16) |
Key Points Carried Over / Updated from CG62
- The core booking-blood panel, dating-scan window, anomaly-scan window, and 28-week antibody/anti-D step are broadly consistent with the CG62-era pathway, with the "10 appointments (nulliparous) / 7 appointments (parous)" schedule unchanged.
- NG201 makes explicit several areas that were thinner or absent in CG62's 2008 text:
- Named acknowledgement that Black, Asian, and mixed-ethnicity women face higher maternal and perinatal mortality risk, prompting closer monitoring and information provision (1.2.3).
- Structured FGM risk assessment as a distinct booking-visit item (1.2.6).
- Explicit vaccination discussion in pregnancy — influenza, pertussis, and RSV immunisation (1.3.8).
- Sleep-position safety advice: avoid going to sleep on the back from 28 weeks onward (1.3.25).
- Clear alcohol messaging: no known safe level of alcohol in pregnancy (1.3.10).
- Earlier and more structured birth-preference discussion, beginning before 28 weeks, covering place and mode of birth (1.3.14).
- Greater emphasis on partner involvement and information throughout appointments (1.1.14–1.1.16).
High-Yield Exam Points
- NG201 (2021, last reviewed 2024) is the current guideline — CG62 (2008) is superseded; if a question references "the current NICE antenatal care guideline," it means NG201.
- Appointment schedule: 10 for nulliparous, 7 for parous women — this number is unchanged from CG62.
- Combined screening window: 11+2 to 14+1 weeks; anomaly scan: 18+0 to 20+6 weeks; OGTT for GDM risk: 24+0 to 28+0 weeks; anti-D and repeat bloods at 28 weeks.
- NG201 adds explicit, examinable content not prominent in CG62: FGM risk assessment, ethnic-disparity-driven risk counselling, flu/pertussis/RSV vaccination discussion, "no safe level" alcohol advice, and sleep-position advice (avoid supine sleep after 28 weeks) as a modifiable stillbirth-risk factor.
- Booking appointment target remains by 10+0 weeks of gestation.
Source: National Institute for Health and Care Excellence (NICE) — supersedes the older NICE CG62 (published March 2008); NG201 was published 19 August 2021 and updates and replaces CG62 in full. See the earlier guideline at `content/guidelines/nice/nice-cg62-antenatal-care.md` for the pre-2021 version. (Last reviewed 27 December 2024 (NICE reviews this guideline only if new evidence emerges that is likely to change the recommendations — it is not on a fixed review cycle).)
Read the original on nice.org.uk
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