Table 3.8Other factors indicating increased risk suggesting planned birth at an obstetric unit

FactorAdditional information
Previous complicationsUnexplained stillbirth/neonatal death or previous death related to intrapartum difficulty
Previous baby with neonatal encephalopathy
Pre-eclampsia requiring preterm birth
Placental abruption with adverse outcome
Uterine rupture
Primary postpartum haemorrhage requiring additional treatment or blood transfusion
Retained placenta requiring manual removal in theatre
Caesarean section
Shoulder dystocia
Current pregnancyMultiple birth
Placenta praevia
Pre-eclampsia or pregnancy-induced hypertension
Preterm labour or preterm prelabour rupture of membranes
Placental abruption
Anaemia – haemoglobin less than 8.5 g/dl at onset of labour
Confirmed intrauterine death
Induction of labour
Substance misuse
Alcohol dependency requiring assessment or treatment
Onset of gestational diabetes
Malpresentation – breech or transverse lie
Body mass index at booking of greater than 35 kg/m2
Recurrent antepartum haemorrhage
Fetal indicationsSmall for gestational age in this pregnancy (less than fifth centile or reduced growth velocity on ultrasound)
Abnormal fetal heart rate (FHR)/Doppler studies
Ultrasound diagnosis of oligo-/polyhydramnios
Previous gynaecological historyMyomectomy

From: 2, Summary of recommendations and care pathway

Cover of Intrapartum Care
Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth.
NICE Clinical Guidelines, No. 55.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2007 Sep.
Copyright © 2007, National Collaborating Centre for Women’s and Children’s Health.

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