CLINICAL PATHWAY

 

If you enter the clinical pathway programme at later than 20 weeks of pregnancy, then you are required to have at least one scan with a Foetal Medicine Specialist in order to assess foetal wellbeing. The results of this scan will determine whether you are able to continue with the model of antenatal care in order to birth at Origin Family-Centred Maternity Hospital.

The bulk of the antenatal and postnatal consultations carried out at Origin Family-Centred Maternity Hospital are provided by the Grové De Beer Midwife Practice (GDB), which is exclusively associated with Origin Family-Centred Maternity Hospital.

GDB offers care for low-risk women. The process involved in identifying risk includes assessing results from sonar examinations and laboratory tests, as well as consultations with the healthcare team. This process is called your clinical pathway. GDB provides antenatal care in association with support gynaecologists. The entire duration of the pregnancy is monitored carefully in accordance with evidence-based guidelines. Any new trends are discussed with fellow care providers. A postnatal home visit service is also conducted by GDB to deliver support after discharge from Origin Family-Centred Maternity Hospital.


8 weeks

 

Dating Scan
To obtain an accurate EDD (expected due date)

Foetal Medicine Specialist or Obstetrician


10-16 Weeks

 

Antenatal screening blood test (see *)
To determine risk for risk for maternal conditions

Laboratory


13 weeks

 

1st trimester  Foetal Wellbeing scan

To assess foetal wellbeing

Foetal Medicine Specialist


9-13 weeks

 

1st trimester blood test: biochemistry screening

To determine risk for foetal abnormalities. Result is combined with scan result

Laboratory


13 weeks

 

Combined result of 1st trimester biochemistry blood test and foetal wellbeing scan

Provides early information concerning baby’s risk of chromosomal abnormalities such as Down syndrome and trisomy 18

Foetal Medicine Specialist


16 weeks

 

To provide care to pregnant woman and baby

Initial consultation with Midwife


20 weeks

 

2nd trimester anomaly scan   

To assess foetal structure 

Foetal Medicine Specialist

 


20 weeks

 

Important meeting: to provide care for the pregnant woman

Consultation with Midwife


24 weeks

 

To provide care to pregnant woman and baby

Consultation with Midwife

 


27 weeks

 

Blood test: Indirect Coombs, if maternal blood group is Rh negative

To minimise risk of baby developing Rhesus disease

Laboratory

 

 


28 weeks

 

To continue team-based pregnancy care

Injection: Rhesugam, if maternal blood group is Rh negative

Used to minimise the risk of maternal antibodies forming against Rhesus factor in foetal blood

Consultation with support Obstetrician

 


30 weeks

 

To provide care to pregnant woman and baby

Consultation with Midwife


32 weeks

 

To provide care to pregnant woman and baby

Consultation with Midwife


33 weeks

 

Blood test: Indirect Coombs, if maternal blood group is Rh negative

Not done if Rhesugam was injected at 28 weeks

Laboratory


34 weeks

 

To provide care to pregnant woman and baby

Blood test: Haemoglobin

Finger-prick test at midwife consultation

Injection: Rhesugam, if maternal blood group is Rh negative

Used to minimise the risk of maternal antibodies forming against Rhesus factor in foetal blood

Consultation with Midwife


36 weeks

 

Consult

To continue team-based pregnancy care

Swab: Group B streptococcus (GBS)

To minimise risk of baby developing ‘early-onset GBS disease’

Support Obstetrician


37 weeks

 

To provide care to pregnant woman

Baby Birth Plan discussion

Swab: GBS, if not already done at 36 weeks

Consultation with Midwife


38 weeks

 

To provide care to pregnant woman and baby

Consultation with Midwife


39 weeks

 

To provide care to pregnant woman and baby

Consultation with Midwife


40 weeks

 

Scan

Assess placental health

To continue team-based pregnancy care

Consultation with support  Obstetrician


41 weeks

 

To provide care to pregnant woman and baby

Final Consultation with Midwife

 


* The following antenatal screening blood tests are standard investigations to assess whether a client’s health is considered to be low-risk or not:

Blood group and Rhesus factor

Blood group antibodies

Hepatitis B antigens

Rubella immunity

HIV status

Sexually transmitted diseases  

Full blood count to assess platelets and haemoglobin levels

 

Further blood tests:

History of anaemia, then ferritin levels are also important

History of possible thyroid abnormalities, then TSH and free T4 will be necessary