Clinical Guidelines
National Clinical Guidelines in Obsterics and Gynaecology
The National Clinical Guidelines are a programme of work agreed between the National Women and Infants Health Programme (NWIHP) and the Institute of Obstetricians and Gynaecologists of the Royal College Physicians of Ireland. In March 2021, Professor Keelin O’Donoghue was appointed as the Clinical Lead for Guideline Development (Maternity and Gynaecology) at the National Women and Infants Health Programme.
Within the Guideline Programme Team, Professor O’Donoghue is responsible for the review, update, and production of National Clinical Guidelines in relation to Maternity and Gynaecology services. Ms Nicolai Murphy was appointed as Programme Manager. Together they have set out an ambitious programme of work. A new guideline process has been developed; part of this process includes a multidisciplinary Expert Advisory Group, appointed at the offset to review guidelines prior to publication.
The following documents have been developed by the Guideline Programme Team and are approved for use by National Women and Infants Health Programme and the Institute of Obstetricians and Gynaecologists:
- Guideline Template (docx, size 1.1 MB)
- Guideline Programme Team Objectives (PDF, size 138.9 KB, 1 page)
- Guideline Developer information sheet (PDF, size 200.9 KB, 7 pages)
- Guideline Process flowchart (PDF, size 81.5 KB, 1 page)
- Expert Advisory Group Terms of Reference (PDF, size 193.1 KB, 6 pages)
- Conflict of Interest form (docx, size 32.7 KB)
- Guideline Review feedback form (PDF, size 163.2 KB, 2 pages)
National Clinical Guidelines (NWIHP and Institute of Obs and Gynaecologists, 2021-Present)
National Clinical Guidelines (year published)
Assessment and Management of Stress Urinary Incontinence (2023) (PDF, size 2.2 MB, 81 pages)
Diagnosis and Management of Mesh Complications (2023) (PDF, size 2.9 MB, 65 pages)
Diagnosis and Management of Pelvic Organ Prolapse (2023) (PDF, size 2.1 MB, 65 pages)
Diagnosis and Management of Placenta Accreta Spectrum (2023) (PDF, size 2.3 MB, 113 pages)
- Template for documentation of MDT outcome (PDF, size 576.5 KB, 2 pages)
- Proforma of ultrasound and MRI signs in PAS (PDF, size 619.1 KB, 2 pages)
- Quick Summary Document (PDF, size 613KB, 6 pages)
- Plain Language Summary (PDF, size 566KB, 4 pages)
Prevention and Management of Primary Postpartum Haemorrhage (2023) (PDF, size 3.2 MB, 125 pages)
- Quick Summary Document (PDF, size 1.06MB, 12 pages)
- Plain Language Summary (PDF, size 570KB, 4 pages)
Assessment and Management of Postmenopausal Bleeding (2023) (PDF, size 2.1 MB, 65 pages)
Assessment and Management of Recurrent Miscarriage (2023) (PDF, size 2.5 MB, 117 pages)
The Fetal Anatomy Ultrasound (2023) (PDF, size 3.9 MB, 133 pages)
Stillbirth - Prevention, Investigation, Management and Care (2023) (PDF, size 2.7 MB, 185)
- Quick Summary Document (PDF, size 675KB, 12 pages)
- Plain Language Summary Stillbirth (PDF, size 599.9 KB, 6 pages)
Vaginal Birth After Caeserean Section (2023) (PDF, size 2.1 MB, 69 pages)
- Quick Summary Document (PDF, size 627.9 KB, 6 pages)
- Plain Language Summary (PDF, size 583.8 KB, 4 pages)
Clinical Updates (year published)
- Monkeypox in Pregnancy – Guidance for Maternity Services (2022)
- Stillbirth, Surveillance on Fetal Wellbeing and SARS-COV-2 Infection (Jan 2022)
- Guidance on Thromboprophylaxis with SARS-COV-2 Infection in Pregnancy and Post-Partum (Jan 2022)
- Rapid Risk Assessment Tool for VTE Thromboprophylaxis in Pregnancy Post-Partum (Jan 2022)
National Clinical Guidelines (year commissioned)
The following Clinical Guidelines have been commissioned by the National Women and Infants Health Programme and the Royal College of Physicians in Ireland. They are currently in the process of production and review.
- Antenatal Corticosteroids to reduce Neonatal Morbidity and Mortality (2021)
- Induction of Labour (2021)
- Hyperemesis and Nausea/Vomiting in Pregnancy (2021)
- Varicella in Pregnancy (2022)
- Amniocentesis and Chorionic Villus Sampling (2022)
- Investigations and Management of Infertility (2022)
- Preterm Labour (2022)
- Prevention and Management of Venous Thromboembolism in Pregnancy (2022)
- Management of Monochorionic Twin Pregnancy (2022)
- Fetal Growth Restriction (2022)
- Diagnosis and Management of Ectopic Pregnancy (2022)
- Rheumatic/Rheumatological Disease in Pregnancy (2022)
- Hypertension in Pregnancy (2022)
- Management of Domestic Violence and Abuse in Pregnancy (2022)
- Diagnosis and Management of Endometriosis (2022)
- Diagnosis and Management of Menopause in Secondary Care/Menopause Speciality Services (2022)
- Management of Dichorionic Twin Pregnancy (2023)
- Reduced Fetal Movements in Pregnancy (2023)
- Management of Miscarriage (2023)
- Assisted Vaginal Birth (2023)
- Management of Lichen Sclerosus (2023)
National Clinical Guidelines: National Women and Infants Health Programme 2017-2021
The National Women and Infants Health Programme was established in January 2017, to lead the management, organisation and delivery of Maternity, Gynaecology and Neonatal services. In this time, various Clinical Guidelines have been developed and approved for use in the maternity and women’s health care system.
Guideline, Year Published (*due for update)
- Bereavement Care following a Maternal Death within a Hospital Setting (2017)
- Interim Clinical Guidance Termination of Pregnancy Under 12 Weeks (2018)*
- Risk to Life or Health of a Pregnant Woman in relation to Termination of Pregnancy (2019)*
- Nutrition during Pregnancy (2019)
- Management of Female Genital Mutilation (2019)
- Pathway for Management of Fatal Fetal Anomalies and/or Life Limiting Conditions Diagnosed during Pregnancy: Termination of Pregnancy (2020)*
- COVID-19 Infection Guidance for Maternity Services (2021)
- Perinatal Management of Extreme Preterm Birth at the Threshold of Viability (2021)
- Intrapartum Fetal Heart Rate Monitoring in Ireland (2022)*
- Intrapartum Fetal Heart Rate Monitoring Patient Information Leaflet (PDF, 554 KB, 2 pages)
National clinical programme for obstetrics and gynaecology 2010-2016
Previously, National Clinical Guidelines were developed through the National Clinical Programme for Obstetrics and Gynaecology, a joint initiative between HSE Clinical Strategy and Programmes Division. This programme was led by Professor Michael Turner of the UCD Centre for Human Reproduction at the Coombe Women and Infants University Hospital from 2010-2016
Guideline title, year published (*update planned, 2023)
The below guidelines are archived. You can contact the National Women and Infant’s Health Programme on NWIHP.Corporate@hse.ie to request a copy of the guideline you require
- Management of Multiple Pregnancy (2012)*
To be updated as:
Management of Monochorionic Twin Pregnancy
Management of Dichorionic Twin Pregnancy - Antenatal Routine Enquiry Regarding Violence in the Home (2012)*
To be updated as:
Domestic Violence in Pregnancy - Venous Thromboprophylaxis in Pregnancy (2013)*
To be updated as:
Prevention and Management of Venous Thromboembolism in Pregnancy - Fetal Growth Restriction - Recognition, Diagnosis & Management (2014)*
- Management of Early Pregnancy Miscarriage (2012)*
- The Diagnosis and Management of Ectopic Pregnancy (2014)*
- The Manangement of Hypertension in Pregnancy (2016)*
- Chickenpox in Pregnancy (2015)*
To be updated as:
Varicella in Pregnancy
Guideline Title, Year Published (**update required)
The below guidelines are archived. You can contact the National Women and Infant’s Health Programme on NWIHP.Corporate@hse.ie to request a copy of the guideline you require
- Urinary Retention-Pregnancy, Postpartum, Post Gynae Surgery (2018)*
- Medication Guidelines for Obstetrics and Gynaecology, First Edition, Volume 1: Antimicrobial Prescribing Guidelines (2017)*
- Managment of Breech Presentation (2017)*
- Investigation and Management of Ovarian Cysts in Postmenopausal Women (2017)*
- Oxytocin to Accelerate or Induce Labour (2016)*
- Cord Prolapse (2015)*
- Listeriosis in Pregnancy (2015)*
- The Investigation and Management of Menorrhagia (2015)*
- Bacterial Infections Specific to Pregnancy (2015)*
- Management of Urinary Tract Infections in Pregnancy (2015)*
- The Irish Maternity Early Warning System (IMEWS) (2014)*
- The Management of Second Trimester Miscarriage (2014)*
- Parvovirus B19 Exposure/Infection During Pregnancy (2014)*
- Resuscitation of the Pregnant Woman (2014)*
- Methadone Prescribing and Administration in Pregnancy (2013)*
- Tocolytic Treatment in Pregnancy (2013)*
- Antenatal Magnesium Sulphate for Fetal Neuroprotection (2013)*
- Preterm Prelabour Rupture of the Membranes (2013)*
- The use of Anti-D Immunoglobin for the Prevention of RHD Haemolytic Disease of the Newborn (2012)*
- Management of Pelvic Girdle Pain in Pregnancy and Post-Partum (2012)*
- Management of Obstetric Anal Sphincter Injury (2012)*
- Ovarian Hyperstimulation Syndrome (2012)*
- Obesity and Pregnancy (2011)*
- Ultrasound Diagnosis of Early Pregnancy Miscarriage (2010)*
Guidelines relevant to maternity & gynaecology developed within other hse clinical programmes
- Guidelines for Health Professionals working in Maternity Settings on the Care of Women with Concealed Pregnancy
- National Guidelines on Referral and Forensic Clinical Examination following Rape and Sexual Assault (Ireland) (2023) (GOV.ie)
- Guidelines for the Management of Pre-Gestational and Gestational Diabetes Mellitus from Pre-Conception to the Postnatal Period (2010)
- Health Service Executive Standards and Recommended Practices for Postmortem Examination Services (2012)(lenus.ie)
To be replaced by:
HSE National Clinical Guidelines for Postmortem Examination Services (2023) - Guidelines for the Critically Ill Woman in Pregnancy
- Preventing Perinatal Transmission: A Practical Guide to the Antenatal and Perinatal Management of HIV, HEP B and C, Herpes Simplex and Syphilis (2015) (hpsc.ie)
- Guidance on Management of Outbreaks of Sexually Transmitted Infections (2016) (hpsc.ie)
- Practice Guide for Management of Women with Epilepsy
- https://www.hse.ie/eng/services/list/5/cancer/
- https://www.gov.ie/en/publication/90221b-clinical-,moieffectiveness/#
National Clinical Guideline: National Clinical Effectiveness Committee (NCEC): Irish Maternity Early Warning System (IMEWS) 2019
- IMEWS Version 2 (full report)
- IMEWS Version 2 (summary report)
- Systematic Review Update
- Budget Impact Analysis
- GRADE EtD Framework
Supporting Documents
- IMEWS V2 Completion Audit
- IMEWS V2 Completion Audit (Excel Version)
- Instruction for Excel Audit Tool
- IMEWS V2 Escalation Response Audit
- IMEWS V2 Escalation Response Audit (Excel Version)
- IMEWS Physiological Changes in Pregnancy
- IMEWS V2 Chart A Generic
- IMEWS V2 Chart B Generic
- IMEWS V2 Frequently Asked Questions
- IMEWS Patient Information Leaflet
- IMEWS Guidelines