What are the recommended clinical assessment and screening tests during pregnancy?
Authors: Gyselaers Wilfried , Jonckheer Pascale , Ahmadzai Nadera , Ansari MT , Carville Serena , Dworzynski Katharina , Gaudet Laura , Glen Jessica , Jones Katie , Miller Paul , Tetzlaff Jennifer Marie , Alexander Sophie , Allegaert Karel , Beeckman Katrien , Ceysens Gilles , Christiane Yolande , De Ronne Nadine , De Thysebaert Bénédicte , Dekker Nicole , Denys Alexandra , Eeckeleers Patricia , Hernandez Ana , Mathieu Evelyne , Seuntjens Lieve , Verleye Leen , Stordeur Sabine 
Published: January 2025

1 INTRODUCTION 11 -- 1.1 BACKGROUND 11 -- 1.2 THE NEED FOR AN UPDATED GUIDELINE 11 -- 1.3 REMIT OF THE GUIDELINE 11 -- 1.3.1 Overall objectives 11 -- 1.3.2 Risk factors that may imply additional care 12 -- 1.3.3 Issues beyond the scope of the present guideline 14 -- 1.3.4 Target users of the guideline 14 -- 1.4 STATEMENT OF INTENT 14 -- 1.5 FUNDING AND DECLARATION OF INTEREST 15 -- 2 METHODOLOGY 15 -- 2.1 THE GUIDELINE DEVELOPMENT GROUP 15 -- 2.2 GENERAL APPROACH 16 -- 2.3 CLINICAL RESEARCH QUESTIONS 16 -- 2.3.1 Hierarchical approach 16 -- 2.3.2 List of clinical questions retained for the KCE 2015 guideline 17 -- 2.3.3 List of KCE 2004 topics not retained for the KCE guideline 2015 20 -- 2.4 LITERATURE SEARCH 20 -- 2.4.1 Update of KCE 2004 recommendations 20 -- 2.4.2 Full search questions 20 -- 2.5 QUALITY APPRAISAL AND STUDY SELECTION 21 -- 2.5.1 Update of KCE 2004 recommendations 21 -- 2.5.2 Full search questions 21 -- 2.6 DATA EXTRACTION 21 -- 2.6.1 Update of KCE 2004 recommendations 21 -- 2.6.2 Full search questions 22 -- 2.7 STATISTICAL ANALYSIS 22 -- 2.8 GRADING EVIDENCE 23 -- 2.8.1 Update of KCE 2004 recommendations 23 -- 2.8.2 Full search questions 23 -- 2.9 FORMULATION OF RECOMMENDATIONS 26 -- 2.9.1 Update of KCE 2004 recommendations 26 -- 2.9.2 Full search questions 27 -- 2.10 EXTERNAL REVIEW 29 -- 2.10.1 Healthcare professionals (stakeholders) 29 -- 2.10.2 Patient representatives 30 -- 2.11 FINAL VALIDATION 30 -- 3 PATIENT CENTEREDNESS 30 -- 4 CLINICAL RECOMMENDATIONS 32 -- 4.1 SCHEDULE OF ANTENATAL VISITS 32 -- 4.1.1 Number of appointments  update 32 -- 4.2 CLINICAL EXAMINATION 33 -- 4.2.1 Body mass index (BMI) - update 33 -- 4.2.2 Blood pressure - update 34 -- 4.2.3 Proteinuria - update 35 -- 4.2.4 Fundal height - update 36 -- 4.2.5 Fetal position - update 37 -- 4.2.6 Fetal movements - update 38 -- 4.3 TECHNICAL EXAMINATION 39 -- 4.3.1 Fetal heart auscultation - update 39 -- 4.3.2 Ultrasound scan during the first trimester - update 40 -- 4.3.3 Ultrasound scan during the second trimester - update 41 -- 4.3.4 Ultrasound scan during the third trimester - update 42 -- 4.4 HAEMATOLOGICAL ASSESSMENT 43 -- 4.4.1 Anaemia - update 43 -- 4.4.2 Blood group, rhesus and atypical red cell antibodies - update 44 -- 4.4.3 Haemoglobin disorders - update 44 -- 4.5 SCREENING TESTS FOR INFECTIONS 46 -- 4.5.1 CMV  full search 46 -- 4.5.2 Toxoplasmosis  full search 51 -- 4.5.3 Chlamydia  full search 57 -- 4.5.4 Group B streptococcus  full search 59 -- 4.5.5 Hepatitis B - update 64 -- 4.5.6 Hepatitis C - update 64 -- 4.5.7 HIV - update 66 -- 4.5.8 Rubella - update 67 -- 4.5.9 Syphilis - update 68 -- 4.5.10 Herpes Simplex - update 69 -- 4.5.11 Varicella - update .70 -- 4.5.12 Asymptomatic bacterial vaginosis - update 71 -- 4.5.13 Asymptomatic bacteriuria - update 72 -- 4.6 SCREENING FOR MATERNAL CLINICAL PROBLEMS 73 -- 4.6.1 Gestational diabetes - full search 73 -- 4.6.2 Hypothyroidism  full search 82 -- 4.6.3 Vitamin D deficiency  full search 88 -- 4.7 SCREENING FOR SPECIFIC PREGNANCY RELATED RISKS 93 -- 4.7.1 Risk of preterm birth  full search 93 -- 4.7.2 Risk of pre-eclampsia  full search 99 -- 4.7.3 Surveillance of pregnancies that passed their due date  full search 101 -- 5 IMPLEMENTATION AND UPDATING OF THE GUIDELINE 104 -- 5.1 IMPLEMENTATION 104 -- 5.1.1 Actors of the implementation of this guideline 104 -- 5.1.2 Barriers and facilitators for implementation of this guideline 104 -- 5.2 MONITORING THE QUALITY OF CARE 106 -- 5.3 GUIDELINE UPDATE 107