Clinical Guidelines

National Clinical Guidelines in Obsterics and Gynaecology

The National Clinical Guidelines are a programme of work agreed between the National Women and Infants Health Programme (NWIHP) and the Institute of Obstetricians and Gynaecologists of the Royal College Physicians of Ireland. In March 2021, Professor Keelin O’Donoghue was appointed as the Clinical Lead for Guideline Development (Maternity and Gynaecology) at the National Women and Infants Health Programme.  

Within the Guideline Programme Team, Professor O’Donoghue is responsible for the review, update, and production of National Clinical Guidelines in relation to Maternity and Gynaecology services. Ms Nicolai Murphy was appointed as Programme Manager. Together they have set out an ambitious programme of work. A new guideline process has been developed; part of this process includes a multidisciplinary Expert Advisory Group, appointed at the offset to review guidelines prior to publication.

The following documents have been developed by the Guideline Programme Team and are approved for use by National Women and Infants Health Programme and the Institute of Obstetricians and Gynaecologists:

National Clinical Guidelines (NWIHP and Institute of Obs and Gynaecologists, 2021-Present)

National Clinical Guidelines (year published)

Reduced Fetal Movements (2024) (PDF, 1,750Kb, 84 pages)

Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality (2024) (PDF, 2,274Kb, 104 pages)

The Diagnosis and Management of Ectopic Pregnancy (2024) (PDF, 1,891Kb, 88 pages)

Screening and Management of Domestic Violence in Pregnancy and the Early Postnatal Period (2024) (PDF, 1,766Kb, 72 pages)

Varicella in pregnancy (2023) (PDF, 2,008Kb, 62 pages)

Management of rheumatic diseases in the preconception, antenatal and postnatal periods (2023) (PDF, 2,054Kb, 52 pages)

Induction of Labour (2023) (PDF, 2,399Kb, 98 pages)

Fertility – Investigation and Management in Secondary Care (2023) (PDF, 2,087Kb, 76 pages)

Assessment and Management of Stress Urinary Incontinence (2023) (PDF, 2.2 MB, 81 pages)

Diagnosis and Management of Mesh Complications (2023) (PDF, 2.9 MB, 65 pages)

Diagnosis and Management of Pelvic Organ Prolapse (2023) (PDF, 2.1 MB, 65 pages)

Diagnosis and Management of Placenta Accreta Spectrum (2023) (PDF, 2.3 MB, 113 pages)

Prevention and Management of Primary Postpartum Haemorrhage (2023) (PDF, 3.2 MB, 125 pages)

Assessment and Management of Postmenopausal Bleeding (2023) (PDF, 2.1 MB, 65 pages)

Investigation and Management of Complications of Early Termination of Pregnancy (2023) (PDF, 2.2 MB, 69 pages)

Assessment and Management of Recurrent Miscarriage (PDF, 2.38 MB, 116 pages)

The Fetal Anatomy Ultrasound (2023) (PDF, 3.9 MB, 133 pages)

Stillbirth - Prevention, Investigation, Management and Care (2023) (PDF, 2.7 MB, 185 pages)

Vaginal Birth After Caeserean Section (2023) (PDF, 2.1 MB, 69 pages)

Prevention of Early-Onset Group B Streptococcal Disease in Term Infants (2023) (PDF, 2.2 MB, 81 pages)

Clinical Updates (year published)

National Clinical Guidelines (year commissioned)

The following Clinical Guidelines have been commissioned by the National Women and Infants Health Programme and the Royal College of Physicians in Ireland. They are currently in the process of production and review.

  • Antenatal Corticosteroids to reduce Neonatal Morbidity and Mortality (2021)
  • Hyperemesis and Nausea/Vomiting in Pregnancy (2021)
  • Amniocentesis and Chorionic Villus Sampling (2022)
  • Preterm Labour (2022)
  • Prevention and Management of Venous Thromboembolism in Pregnancy (2022)
  • Management of Monochorionic Twin Pregnancy (2022)
  • Fetal Growth Restriction (2022)
  • Diagnosis and Management of Ectopic Pregnancy (2022)
  • Hypertension in Pregnancy (2022)
  • Management of Domestic Violence and Abuse in Pregnancy (2022)
  • Diagnosis and Management of Endometriosis (2022)
  • Diagnosis and Management of Menopause in Secondary Care/Menopause Speciality Services (2022)
  • Management of Dichorionic Twin Pregnancy (2023)
  • Reduced Fetal Movements in Pregnancy (2023)
  • Management of Miscarriage (2023)
  • Assisted Vaginal Birth (2023)
  • Management of Lichen Sclerosus (2023) 

National Clinical Guidelines: National Women and Infants Health Programme 2017-2021

The National Women and Infants Health Programme was established in January 2017, to lead the management, organisation and delivery of Maternity, Gynaecology and Neonatal services. In this time, various Clinical Guidelines have been developed and approved for use in the maternity and women’s health care system.

Guideline, Year Published (*due for update)

National clinical programme for obstetrics and gynaecology 2010-2016

Previously, National Clinical Guidelines were developed through the National Clinical Programme for Obstetrics and Gynaecology, a joint initiative between HSE Clinical Strategy and Programmes Division. This programme was led by Professor Michael Turner of the UCD Centre for Human Reproduction at the Coombe Women and Infants University Hospital from 2010-2016

Guideline title, year published (*update planned, 2023)

The below guidelines are archived. You can contact the National Women and Infant’s Health Programme on NWIHP.Corporate@hse.ie to request a copy of the guideline you require

  • Management of Multiple Pregnancy (2012)*
    To be updated as:
    Management of Monochorionic Twin Pregnancy
    Management of Dichorionic Twin Pregnancy
  • Antenatal Routine Enquiry Regarding Violence in the Home (2012)*
    To be updated as:
    Domestic Violence in Pregnancy
  • Venous Thromboprophylaxis in Pregnancy (2013)*
    To be updated as:
    Prevention and Management of Venous Thromboembolism in Pregnancy
  • Fetal Growth Restriction - Recognition, Diagnosis & Management (2014)*
  • Management of Early Pregnancy Miscarriage (2012)*
  • The Diagnosis and Management of Ectopic Pregnancy (2014)*
  • The Manangement of Hypertension in Pregnancy (2016)*
  • Chickenpox in Pregnancy (2015)*
    To be updated as:
    Varicella in Pregnancy

Guideline Title, Year Published (**update required)

The below guidelines are archived. You can contact the National Women and Infant’s Health Programme on NWIHP.Corporate@hse.ie to request a copy of the guideline you require

  • Urinary Retention-Pregnancy, Postpartum, Post Gynae Surgery (2018)*
  • Medication Guidelines for Obstetrics and Gynaecology, First Edition, Volume 1: Antimicrobial Prescribing Guidelines (2017)*
  • Managment of Breech Presentation (2017)*
  • Investigation and Management of Ovarian Cysts in Postmenopausal Women (2017)*           
  • Oxytocin to Accelerate or Induce Labour (2016)*
  • Cord Prolapse (2015)*
  • Listeriosis in Pregnancy (2015)*
  • The Investigation and Management of Menorrhagia (2015)*
  • Bacterial Infections Specific to Pregnancy (2015)*
  • Management of Urinary Tract Infections in Pregnancy (2015)*
  • The Irish Maternity Early Warning System (IMEWS) (2014)*
  • The Management of Second Trimester Miscarriage (2014)*
  • Parvovirus B19 Exposure/Infection During Pregnancy (2014)*
  • Resuscitation of the Pregnant Woman (2014)*
  • Methadone Prescribing and Administration in Pregnancy (2013)*
  • Tocolytic Treatment in Pregnancy (2013)*
  • Antenatal Magnesium Sulphate for Fetal Neuroprotection (2013)*
  • Preterm Prelabour Rupture of the Membranes (2013)*
  • The use of Anti-D Immunoglobin for the Prevention of RHD Haemolytic Disease of the Newborn (2012)*
  • Management of Pelvic Girdle Pain in Pregnancy and Post-Partum (2012)*
  • Management of Obstetric Anal Sphincter Injury (2012)*
  • Ovarian Hyperstimulation Syndrome (2012)*
  • Obesity and Pregnancy (2011)*
  • Ultrasound Diagnosis of Early Pregnancy Miscarriage (2010)*

Guidelines relevant to maternity and gynaecology developed within other HSE clinical programmes

National Clinical Guideline: National Clinical Effectiveness Committee (NCEC): Irish Maternity Early Warning System (IMEWS) 2019

Supporting Documents

National Guidelines in Neonatology and Paediatrics

The Use of Parenteral Nutrition in Neonatal and Paediatric Units (PDF, size 1.2 MB, 84 pages)