{"id":722,"date":"2020-07-25T14:03:51","date_gmt":"2020-07-25T14:03:51","guid":{"rendered":"http:\/\/www.socn.scot.nhs.uk\/?page_id=722"},"modified":"2026-02-26T11:16:19","modified_gmt":"2026-02-26T11:16:19","slug":"guidelines","status":"publish","type":"page","link":"https:\/\/www.nn.nhs.scot\/socn\/professionals\/guidelines\/","title":{"rendered":"Guidelines and Pathways"},"content":{"rendered":"\n<p>Below are guidelines for the management of women of childbearing age with cardiovascular disease.<\/p>\n\n\n\n<p>These guidelines provide information on contraception, management of women with known cardiac disease in pregnancy and recognising acute presentations of cardiac disease in pregnancy.<\/p>\n\n\n\n<p>The Network are developing guidelines and pathways of care relevant to NHS Scotland and these will be available later in the year.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Guidelines<\/h2>\n\n\n\n<p><strong>Preventing maternal mortality: It&#8217;s ok to ask:<\/strong> This animation provides guidance to doctors in assessing unwell pregnant or post-partum women with the aim of reducing indirect maternal mortality rates. Produced by Dr Rebecca Northridge in collaboration with the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Obstetricians and Gynaecologists.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Preventing maternal mortality: It&#039;s ok to ask\" width=\"640\" height=\"360\" src=\"https:\/\/www.youtube.com\/embed\/qb7lntscULc?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\"><\/h3>\n\n\n\n<h3 class=\"wp-block-heading\">Acute cardiovascular presentations in pregnancy<\/h3>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright\"><img loading=\"lazy\" decoding=\"async\" width=\"101\" height=\"300\" src=\"http:\/\/www.socn.scot.nhs.uk\/wp-content\/uploads\/sites\/29\/2020\/04\/unwell-101x300.png\" alt=\"\" class=\"wp-image-434\" srcset=\"https:\/\/www.nn.nhs.scot\/socn\/wp-content\/uploads\/sites\/29\/2020\/04\/unwell-101x300.png 101w, https:\/\/www.nn.nhs.scot\/socn\/wp-content\/uploads\/sites\/29\/2020\/04\/unwell.png 198w\" sizes=\"auto, (max-width: 101px) 100vw, 101px\" \/><\/figure>\n<\/div>\n\n\n<p>Cardiac disease accounts for a quarter of maternal deaths in the UK. &nbsp;77% of the women who died did not know they had a cardiac condition. The following are guides to assist in recognising signs and symptoms that are not normal in pregnancy and investigating appropriately.<\/p>\n\n\n\n<p>The Royal College of Physicians Acute care toolkit: &nbsp;Managing acute medical problems in pregnancy&nbsp;<a href=\"https:\/\/www.rcp.ac.uk\/improving-care\/resources\/acute-care-toolkit-15-managing-acute-medical-problems-in-pregnancy\/\">Toolkit<\/a>&nbsp; including red flags when women present with chest pain, palpitation and breathlessness. They also include flowcharts for assessing and managing these presentations<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Management of heart disease in pregnancy<\/h3>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignleft\"><img loading=\"lazy\" decoding=\"async\" width=\"268\" height=\"480\" src=\"http:\/\/www.socn.scot.nhs.uk\/wp-content\/uploads\/sites\/29\/2020\/04\/woman.png\" alt=\"\" class=\"wp-image-407\" srcset=\"https:\/\/www.nn.nhs.scot\/socn\/wp-content\/uploads\/sites\/29\/2020\/04\/woman.png 268w, https:\/\/www.nn.nhs.scot\/socn\/wp-content\/uploads\/sites\/29\/2020\/04\/woman-168x300.png 168w\" sizes=\"auto, (max-width: 268px) 100vw, 268px\" \/><\/figure>\n<\/div>\n\n\n<p><a href=\"https:\/\/academic.oup.com\/eurheartj\/article\/46\/43\/4462\/8234487\">European Society of Cardiology Guidelines on the management of cardiovascular diseases during pregnancy&nbsp;<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/rcpsg.ac.uk\/documents\/media-releases\/maternal-health\/335-addressing-the-heart-of-the-issue\/file\">Addressing the Heart of the Issue<\/a>&nbsp;<\/p>\n\n\n\n<p>Standards for healthcare professionals in Scotland in pre-pregnancy, antenatal and postnatal care of women with cardiac disease<\/p>\n\n\n\n<p><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0735109716333526?via%3Dihub\">High Risk Cardiac Disease in Pregnancy \u2013 Part I<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S073510971633354X?via%3Dihub\">High Risk Cardiac Disease in Pregnancy Part II<\/a>&nbsp;<\/p>\n\n\n\n<p>Published in 2016 \u2018High Risk Cardiac Disease in Pregnancy\u2019&nbsp;reviews the available published reports and provide recommendations on the&nbsp;management of women with high-risk cardiovascular conditions during pregnancy.<\/p>\n\n\n\n<p><a href=\"https:\/\/www.nice.org.uk\/guidance\/ng121\">NICE Intrapartum care for women with existing medical conditions or obstetric complications and their babies 2019<\/a>&nbsp;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Contraceptive guidance for women with cardiovascular disease<\/h3>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright\"><img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"200\" src=\"http:\/\/www.socn.scot.nhs.uk\/wp-content\/uploads\/sites\/29\/2020\/04\/contraception-300x200.png\" alt=\"\" class=\"wp-image-517\" srcset=\"https:\/\/www.nn.nhs.scot\/socn\/wp-content\/uploads\/sites\/29\/2020\/04\/contraception-300x200.png 300w, https:\/\/www.nn.nhs.scot\/socn\/wp-content\/uploads\/sites\/29\/2020\/04\/contraception-272x182.png 272w, https:\/\/www.nn.nhs.scot\/socn\/wp-content\/uploads\/sites\/29\/2020\/04\/contraception.png 530w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/figure>\n<\/div>\n\n\n<p>Please click on the links below: Faculty for Sexual &amp; Reproductive Health<\/p>\n\n\n\n<p><a href=\"https:\/\/www.cosrh.org\/Public\/Public\/Standards-and-Guidance\/uk-medical-eligibility-criteria-for-contraceptive-use-ukmec.aspx\">UK Medical Eligibility Criteria for Contraceptive Use (UKMEC)<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.cosrh.org\/Public\/Documents\/fsrh-guidance-fsrh-guidance-management-of-women-taking-anticoagulants.aspx?WebsiteKey=f858b086-d221-4a83-9688-824162920b1b\">Management of women taking anticoagulants or antiplatelet medications who request intrauterine contraception or subdermal implants<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/doi.org\/10.1093\/eurheartj\/ehv141\">Contraception and cardiovascular disease<\/a><\/p>\n\n\n\n<p>Contraceptive counselling should begin early in females with heart disease. &nbsp;This article discusses the various methods of contraception, their safety and efficacy relative to their cardiac condition.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Guideline disclaimer<\/h2>\n\n\n\n<p>These guidelines do not intended to be construed or to serve as a standard of care. Standards of care are determined on the basis of all clinical data available for an individual case and are subject to change as scientific knowledge and technology advance and patterns of care evolve. Adherence to guideline recommendations will not ensure a successful outcome in every case, nor should they be construed as including all proper methods of care or excluding other acceptable methods of care aimed at the same results. The ultimate judgement must be made by the appropriate healthcare professional(s) responsible for clinical decisions regarding a particular clinical procedure or treatment plan. This judgement should only be arrived at following discussion of the options with the patient, covering the diagnostic and treatment choices available. It is advised, however, that&nbsp; significant departures from the national guideline or any local guidelines derived from it should be fully documented in the patient\u2019s case notes at the time the relevant decision is taken.<\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"nhsuk-card__description\">Below are guidelines for the management of women of childbearing age with cardiovascular disease. These guidelines provide information on contraception, [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":0,"parent":16,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-722","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/pages\/722","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/comments?post=722"}],"version-history":[{"count":78,"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/pages\/722\/revisions"}],"predecessor-version":[{"id":1811,"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/pages\/722\/revisions\/1811"}],"up":[{"embeddable":true,"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/pages\/16"}],"wp:attachment":[{"href":"https:\/\/www.nn.nhs.scot\/socn\/wp-json\/wp\/v2\/media?parent=722"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}