Clinical Practice Guidelines Antenatal Care — Module II


Acronyms and abbreviations



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Acronyms and abbreviations


25-OHD 25-hydroxyvitamin D

AACR Australasian Association of Cancer Registries

AAFP American Academy of Family Physicians

AAOS American Academy of Orthopaedic Surgeons

AAP American Academy of Pediatrics

ABS Australian Bureau of Statistics

ACOG American College of Obstetricians and Gynecologists

ADA American Diabetes Association

ADIPS Australasian Diabetes in Pregnancy Society

AGREE Appraisal of Guidelines Research and Evaluation

AHMAC Australian Health Ministers’ Advisory Council

AHMC Australian Health Ministers’ Conference

AIFS Australian Institute of Family Studies

AIHW Australian Institute of Health and Welfare

ANZSA Australian and New Zealand Stillbirth Association

APA American Psychiatric Association

ATAPS Access to Allied Psychological Services

-hCG beta-human chorionic gonadotrophin

BMI body mass index

CARPA Central Australian Rural Practitioners Association

CBR consensus-based recommendation

CCPHPC Community Care and Population Health Principal Committee

CDC Centers for Disease Control and Prevention (United States)

CDSMC Community and Disability Services Ministers’ Conference

CEH Centre for Culture Ethnicity and Health

CER Centre for Epidemiology and Research

CGE Centre for Genetics Education (NSW Health)

CI confidence interval

CIE Centre for International Economics

COAG Council of Australian Governments

CRL crown–rump length

CTFPHE Canadian Task Force on the Periodic Health Examination

DFAT Department of Foreign Affairs and Tourism

DAME Diabetes and Antenatal Milk Expression (Study)

DNA deoxyribonucleic acid

DoH Department of Health

dTpa diphtheria-tetanus-acellular pertussis

EAC Expert Advisory Committee

ECCI European Congenital Cytomegalovirus Initiative

ECV external cephalic version

EIA enzyme immunoassay

EPDS Edinburgh Postnatal Depression Scale

FGM/C female genital mutilation/cutting

FSANZ Food Standards Australia and New Zealand

GORD gastro-oesophageal reflux disorder

GP general practitioner

HAPO Hyperglycemia and Adverse Pregnancy Outcome Study

HbA1c glycated haemoglobin

HbsAg hepatitis B surface antigen

HIV human immunodeficiency virus

HoRSCHA House of Representatives Standing Committee on Health and Ageing

HPV human papilloma virus

IADPSG International Association of Diabetes and Pregnancy Study Groups

IARC International Agency for Research on Cancer

ICER incremental cost-effectiveness ratio

IOM Institute of Medicine (United States)

LIFE Living Is For Everyone

LLETZ large loop excision of the transformation zone

MCH mean corpuscular haemoglobin

MCV mean corpuscular volume

mmHg millimetres of mercury

MSIJC Maternity Services Inter-Jurisdictional Committee

NAAT nucleic acid amplification test

NAATI National Association of Accreditation for Translators and Interpreters

NACCHO National Aboriginal Community Controlled Health Organisation

NCHECR National Centre for HIV Epidemiology and Clinical Research

NCSP National Cervical Screening Program

NHMRC National Health and Medical Research Council

NICE National Institute for Health and Clinical Excellence

NPS National Prescribing Service (UK)

NRHA National Rural Health Association

NT DHCS Northern Territory Department of Health and Community Services

NZCM New Zealand College of Midwives

OR odds ratio

PAPP-A pregnancy-associated placental protein-A

PCR polymerase chain reaction

PHAC Public Health Agency of Canada

PP practice point

RACGP Royal Australian College of General Practitioners

RADIUS Routine Antenatal Diagnostic Imaging with Ultrasound

RANZCOG Royal Australian and New Zealand College of Obstetricians and Gynaecologists

RCOG Royal College of Obstetricians and Gynaecologists (United Kingdom)

RCT randomised controlled trial

RNA ribonucleic acid

RR relative risk

SIDS sudden infant death syndrome

SIGN Scottish Intercollegiate Guidelines Network

SOGC Society of Obstetricians and Gynaecologists of Canada

square Suicide, Questions, Answers and Resources

SUDI sudden and unexpected death in infancy

TGA Therapeutic Goods Administration

TSH thyroid-stimulating hormone

USPSTF United States Preventive Services Task Force

WHA Women’s Hospitals Australasia

WHO World Health Organization

Glossary


Aboriginal and Torres Strait Islander peoples: It is recognised that there is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinships, and tribes, as well as ways of living. Furthermore, Aboriginal and Torres Strait Islander peoples may currently live in urban, rural or remote settings, in urbanised, traditional or other lifestyles, and frequently move between these ways of living.

Amniocentesis: A diagnostic test for chromosomal anomalies, such as trisomy 21 (Down Syndrome), where an ultrasound guided needle is used to extract a sample of the amniotic fluid.

Antiretroviral treatment: the use of medicines to reduce growth of retroviruses, primarily HIV.

Auscultation: The detection of the fetal heart using Doppler or a Pinard stethoscope.

Cardiotocography: A technical means of recording the fetal heart rate and uterine contractions.

Chorionic villus sampling (CVS): diagnostic test for chromosomal anomalies such as Trisomy 21 (Down syndrome) where an ultrasound guided needle is used to extract a sample of the placenta.

Cognitive-behavioural therapy: Psychological therapy based on the assumption that faulty thinking patterns, maladaptive behaviours and "negative" emotions are all inter-related. Treatment focuses on changing an individual's thoughts (cognitive patterns) or maladaptive behaviours in order to change emotional states. Cognitive-behavioural therapy integrates the cognitive restructuring approach of cognitive therapy with the behavioural modification techniques of behavioural therapy.

Ectopic pregnancy: a pregnancy in which implantation of the fertilised egg takes place outside the uterus, usually in a fallopian tube. Ectopic pregnancies usually result in miscarriage but can cause rupture of the fallopian tube and severe internal bleeding.

Edinburgh Postnatal Depression Scale (EPDS): The EPDS was developed and validated as a screening tool for depression in the postnatal period. It has subsequently been validated for use in pregnant women and is therefore appropriate for use throughout the perinatal period.

External cephalic version: A procedure in which a health professional uses his or her hands on a woman’s abdomen to turn a breech baby.

First antenatal visit – The first visit specifically for antenatal care following confirmation of the pregnancy.

Herbal medicines: Preparations such as tablets, tinctures and infusions that are made from plant parts. These preparations are usually formulated based on traditional uses of Western or Chinese herbs.

Induction of labour: A procedure to artificially start the process of labour by way of medical, surgical or medical and surgical means.

Low birth weight: Birth weight of less than 2500 g.

Migrant and refugee women: The term ‘migrant and refugee’ is used in these Guidelines to refer both to women who are voluntary migrants and women who come to Australia as refugees, humanitarian entrants or asylum seekers.

Miscarriage: the spontaneous end of a pregnancy at a stage where the embryo or fetus is incapable of surviving independently, generally defined in humans as before 20 weeks.

Nuchal translucency thickness assessment: An ultrasound scan performed between 11 and 13 weeks of pregnancy that measures the thickness of the nuchal fold behind the baby’s neck – a marker of chromosomal anomaly, such as Trisomy 21 (Down syndrome).

Oligohydramnios: A deficiency of amniotic fluid.

Passive smoking: The inhalation of smoke, called second-hand smoke or environmental tobacco smoke, from tobacco products used by others.

Perinatal period: For the purposes of these guidelines, ‘perinatal’ is defined as the period covering pregnancy and the first year following pregnancy or birth. It is acknowledged that other definitions of this term are used for data collection and analysis. The definition used here broadens the scope of the term perinatal in line with understanding of mental health in pregnancy and following birth.

Pernicious anaemia: An autoimmune condition that results in an inability to absorb vitamin B12.

Placenta praevia: An obstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix.

Placental abruption: A potentially life-threatening obstetric complication in which the placental lining separates from the uterus of the mother.

Preterm birth: Birth at less that 37 weeks gestation.

Proteinuria: The presence of an excess of serum proteins in the urine.

Psychological preparation: In the context of these Guidelines, this is defined as using psychological approaches (eg focusing on coping skills, cognitive restructuring, problem-solving and decision-making) to assist women and their partners to be prepared for parenthood.

Psychosocial: In the context of these Guidelines, this refers to social factors that have the potential to affect a woman’s emotional well-being.

Pyelonephritis: An ascending urinary tract infection that has reached the pyelum (pelvis) of the kidney.

Singleton breech: A single baby whose buttocks (rather than head) is overlying the maternal pelvis.

Stillbirth: The birth of a baby that has died in the uterus after 20 weeks of pregnancy or reaching a weight of more than 400 g if gestational age is unknown.

Sudden and unexpected death in infancy: The sudden death of an infant that is unexpected by history and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation.

10.13Methodological terms


ADAPTE framework: A systematic approach to aid in the adaptation of guidelines produced in one setting to be used in a different cultural and/or organisational context.

AGREE: A framework for assessing the quality of clinical practice guidelines, including that the potential biases of guideline development have been addressed adequately and that the recommendations are both internally and externally valid, and are feasible for practice. This process involves taking into account the benefits, harms and costs of the recommendations, as well as the practical issues attached to them. Therefore, the assessment includes judgements about the methods used for developing the guidelines, the content of the final recommendations, and the factors linked to their uptake.

Citation bias: The citation or non-citation of research. Citing of trials in publications is not objective so retrieving studies using this method alone may result in biased results. Unsupported studies tend to be cited often which may also bias results.

Consensus-based recommendation: Recommendations based on systematic review of the literature where evidence is found to be limited or lacking.

Language bias: The publication of research findings in a particular language. Significant results are more likely to be published in English so a search limited to English-language journals may result in an overestimation of effect.

Multiple publication bias: The multiple or singular publication of research findings. Studies with significant results tend to be published multiple times which increases the chance of duplication of the same data and may bias the results of a review.

Odds ratio: the ratio of the likelihood of an event occurring in one group to that of it occurring in another group. An odds ratio of 1 indicates that the condition or event under study is equally likely to occur in both groups. An odds ratio greater than 1 indicates that the condition or event is more likely to occur in the first group and an odds ratio less than 1 indicates that the condition or event is less likely to occur in the first group.

Outcome reporting bias: The selective reporting of some outcomes but not others. Outcomes with favourable findings may be reported more. For example, adverse events have been found to be reported more often in unpublished studies. This may result in more favourable results for published studies.

Practice point: For the purposes of these Guidelines, these cover areas of antenatal care that were beyond the scope of the literature reviews but where the EAC or Working Group for Aboriginal and Torres Strait Islander Women’s Antenatal Care determined there was a need for advice. These points are based on best practice clinical judgement.

Publication bias: The publication or non-publication of research findings. Small, negative trials tend not to be published and this may lead to an overestimate of results of a review if only published studies are included.

Randomised controlled trial: A study in which participants are allocated at random to receive one of several clinical interventions. One of these interventions is the standard of comparison or control. The control may be a standard practice, a placebo or no intervention at all.

Recommendation: Evidence-based action statement developed through systematic review of the literature and graded based on consideration of the evidence base, consistency of the evidence, clinical impact of the proposed recommendation and generalisability and applicability of the evidence.

Relative risk: The ratio of the risk (rate) of an outcome in an exposed group (eg to a specific medicine) to the risk (rate) of the outcome in an unexposed group in a specified time period.

Sensitivity: The proportion of people with the condition who have a positive test result.

Specificity: The proportion of people without the condition who have a negative test result.

Systematic literature review: A systematic review of evidence focused on a research question(s) that aims to identify, appraise, select and synthesise all high quality research evidence relevant to that question.



Time-lag bias: The rapid or delayed publication of research findings. Studies with positive results tend to be published sooner than studies with negative findings and hence results may be overestimated until the negative studies ‘catch up’.

1 Recommendations are numbered using Arabic numerals (eg 1, 2, 3), consensus-based recommendations using Roman numerals (eg i, ii, iii) and practice points using letters (eg a, b, c).

2 Also referred to as child and family health nurses in some jurisdictions.

3 This section is a revised version of material included in Module I of the Guidelines.

4 This section is a revised version of material included in Module I of the Guidelines.

5 While the Edinburgh Postnatal Depression Scale was developed for use postnatally, antenatal evaluation is generally associated with an adequate sensitivity and specificity to detect depressive symptoms. There is also evidence to support its use in detecting symptoms of anxiety.

6 This section is a revised version of material included in Section 6.3 of Module I of the Guidelines.

7 See the latest version of the Australian Immunisation Handbook (www.immunise.health.gov.au) for discussion of specific vaccinations during pregnancy.


8 Other than the recommendation on caffeine and the practice points, this section is a summary of information provided in the Australian Dietary Guidelines (NHMRC 2013).

9 Tests are offered in the context of engagement and consultation with women. Health professionals must use standard precautions for infection prevention and control. Tests evolve with advances in technology.



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