Enhanced Maternal Care in PRMH Obstetric HDU

Maternity & Gynaecology Guidelines
NHS GGC

Objectives

The purpose of this Standard Operating Procedure is to provide advice in principles of Enhanced maternal care in obstetric HDU.

Principles:

  • Early & ongoing senior MDT discussion on an individual case-by-case basis to guide decision making
  • Delivery planning may affect care location in the short-term; most appropriate care location may change and should be frequently reviewed
  • Any patient considered for Medical HDU (not including CCU) should be first discussed with ICU
  • The aim should be to keep the woman and her baby together where possible 1

Care Locations

Labour Ward HDU

Level 1 & level 2 care (Enhanced Maternal Care)

Medical HDU or CCU

 Level 2 & specialist care

ICU: East (HDU) or West (ICU)

 Level 2 & 3 care

External tertiary care centre

 Level 2 & 3 care unavailable in GRI

HDU level of care examples

Table taken from: Providing equity of critical and maternity care for the critically ill pregnant or recently pregnant woman2

More detailed outline of levels of care can be found here: Levels of Adult Critical Care Second Edition Consensus Statement3

Practical Aspects

  • Twice daily ward rounds: obstetric consultant led, with input from obstetric anaesthesia. Other specialties, and allied health professionals (pharmacy, physio, psychology, dietetics etc.) as required
  • If length of stay is > 2 days, consider need for review by specialist team
  • If diagnostic uncertainty, early involvement of consultant obstetrician and anaesthetist
  • All patients should be entered onto the WardWatcher system

Editorial Information

Last reviewed: 25/03/2025

Next review date: 31/03/2028

Version: 1

Approved By: Maternity Governance Group