2024 exceptional surveillance of antenatal care (NICE guideline NG201)
Methods
The exceptional surveillance process consisted of:
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Considering the new evidence and intelligence that triggered the exceptional review.
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Examining related NICE guidance and quality standards.
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Examining the NICE event tracker for relevant ongoing and published events.
For further details about the process and the possible update decisions that are available, see the section on ensuring that published guidelines are current and accurate in developing NICE guidelines: the manual.
Relevant NICE guidance
The NICE guideline on antenatal care (updated 2023) covers organising and delivering antenatal care, routine clinical care, and support for pregnant women and partners but does not include recommendations for end of life care.
NICE guideline NG142 provides general guidelines on end of life care. The guideline covers organising and delivering end of life care services, which provide care and support in the final weeks and months of life (or for some conditions, years), and the planning and preparation for this. It aims to ensure that people have access to the care that they want and need in all care settings. It also includes advice on services for carers. The guideline is intended to be used alongside the NICE guideline on care of dying adults in the last days of life, which covers clinical care for people who are considered to be in the last days of life.
Relevant guidance/guidelines produced by external organisations
The American College of Obstetricians and Gynaecologists (ACOG) guideline on End-of-Life Decision Making (updated 2018) addresses the ethical difficulties of providing end of life care to pregnant women. It highlights the importance of respecting patient autonomy and involving multidisciplinary teams in the decision making process. The guideline also emphasises the need for advance care planning, clear communication, and adherence to both ethical and legal standards when making end of life decisions in pregnant women. Royal College of Obstetricians and Gynaecologists (RCOG) does not have a specific guideline on end of life care. However, RCOG published relevant guidance on Managing Events Surrounding a Maternal Death and Supporting the Family and Staff (February 2024), which offers guidance for healthcare professionals on supporting families and staff following a maternal death.
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