Antenatal Service

1.

Antenatal screening should include Blood Group, Haemoglobin, Mean Corpuscular Volume, Syphilis Serology, Rubella Antibody, Hepatitis B surface Antigen.

2.

Facilities for cervical smear should be provided.*

3.

Antepartum cardiotocography should be available on a daily basis.

4.

Ultrasound scanner is available for immediate scanning if required.

5.

Provision and availability of prenatal diagnosis, either in-house or via referral / networking.

6.

Regular antenatal educational programme or classes are made available to clients.

7.

There should be at least one midwife or nurse-midwife in the team of nurses serving a sizable obstetric outpatient clinic.

8.

There should be at least one specialist obstetrician in the team of doctors attending an obstetric outpatient clinic.

Intrapartum Service

1.

Fetal heart monitors should be available for intrapartum continuous fetal heart rate monitoring if required. There should be at least two intrapartum monitors (with fetal scalp electrode for fetal heart signal pick up and with capacity to monitor twins depending on case mix) for every 1,000 deliveries per year in the hospital.

2.

Facilities for foetal scalp blood pH analysis should be available.

3.

Epidural analgesia should be available.

4.

There should be acceptable privacy agreeable to each patient at delivery.

5.

During labour, the ratio of midwives to patients should not be less than 1:3. During the second stage of labour, there should be a minimum of two attendants present during each delivery, of which one must be registered doctor or midwife. For high risk patients, a doctor must be present. When complications arise, a qualified obstetrician should be available within a short period.

6.

Qualified anaesthesiologists should be available when required.

7.

24-hour emergency Caesarean section should be available, and can be arranged and performed within a short period.

8.

Neonatal resuscitation station with adequate equipment should be available closeby the delivery bed.

9.

Paediatrician should be available to standby for delivery of high risk foetuses.

10.

Adult resuscitation equipment and facilities should be available to cope with obstetrical emergency.

Postnatal and Neonatal Service

1.

There should be at least one Neonatal Intensive Care Unit bed for every 1,000 livebirths or effective neonatal transport system established with other hospital.

2.

Early neonatal vaccination programme should be provided for Poliomyelitis, Tuberculosis and Hepatitis B.

3.

Routine neonatal screening should be provided for cogenital G6PD deficiency and congenital hypothyroidism. The neonate should be examined by a doctor before discharge.

4.

Postnatal physiotherapy and exercise should be provided when required.

5.

Expertise and facilities for supporting breast feeding should be available.

6.

Telephone hotline service should be available.

Supporting Services

1.

Blood components therapy and transfusion service should be available 24 hours a day.

2.

Haemoglobin, WBC, platelets, electrolytes, blood gas (including cord blood), coagulation studies, urea, blood sugar should be available 24 hours a day.

3.

Postmortem examinations of stillbirths and neonatal deaths should be available.

4.

Radiological facilities should be available in the hospital.

5.

An ultrasound scanner should be available in the hospital 24 hours a day.