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Queensland Clinical Guidelines
Translating evidence into best clinical practice

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28/04/2023

Clinical form: Neonatal seizure and neurological observations

SW1209-V1

  • First publication of clinical form for neonatal seizure and neurological observation

28/04/2023

Clinical form: Encephalopathy servity assessment and therapeutic cooling critiera

SW1208-V1

  • First publication of clinical form for encephalopathy severity assessment and therapeutic hypothermia criteria

21/04/2023

Education presentation: Neonatal resuscitation

E22.5-1-V6-R27

  • Amendment to education presentation to clarify chest compression techniques to be used if one or two person performing

21/04/2023

Working party list: Fetal movements

WP23.46-1-V2-R28

  • List of working party members for review of fetal movements

21/04/2023

Education presentation: Rh D woman and pregnancy

E23.74-1-V1-R28

  • New publication education presentation

21/04/2023

Consumer information: Rh D woman and pregnancy

C23.74-1-V1-R28

  • New publication consumer information sheet

31/03/2023

Neonatal medicine benzylpenicillin

NMedQ20.013-V4-R25

  • Amendment to align with ASID recommendations for term infants: Dosage for sepsis (IV and IM) for baby at 37+0 weeks or more current gestational age at 8 or more days of age FROM 60 mg/kg every 8 hours TO 60mg/kg every 6 hours.

31/03/2023

Neonatal medicine clonidine

NMedQ22.085-V2-R27

  • Amendment: Preparation instructions for tablet use added

30/03/2023

Term small for gestational age baby

MN22-16-V6-R27

  • Amendment: Correction Table 9. Estimate of growth restriction using Fenton growth charts - Female weight at 41+0 weeks gestation on 10th percentile FROM 3980 g TO 2980 g

30/03/2023

Retinopathy of prematurity consensus statement

O21.55-1-V2-R26

  • Amendment: Added for further information refer to RANZCO guideline

30/03/2023

List of working party members for Stillbirth care review

WP23.24-1-V1-R28

  • Working party members for Stillbirth care review

30/03/2023

Guideline: Rh D negative women and pregnancy

MN23.74-V1-R28

  • New publication clinical guideline and supplement

10/03/2023

Consumer information: Breastfeeding and medicines

C23.19-2-V1-R28

  • New publication to accompany breastfeeding clinical guideline

10/03/2023

Consumer information: Induction of labour (IOL)

C23.22-1-V4-R27

  • Accompany IOL clinical guideline

10/03/2023

Consumer information: Induction of labour (IOL): Part 1 cervical ripening

C23.22-2-V1-R27

  • New publication to accompany IOL clinical guideline

10/03/2023

Consumer information: Induction of labour (IOL): Part 2 rupturing your membranes and oxytocin

C23.22-3-V1-R27

  • New publication to accompany IOL clinical guideline

28/02/2023

Guideline: Intrapartum pain management

MN23.75-V1-R28

  • First publication of clinical guideline on intrapartum pain management and associated resources
  • Incorporated existing 4 shortGuides on pharmacological analgesia (now rescinded)

28/02/2023

Neonatal medicine poloxamer 10%

NMedQ23.099-V1-R28

  • First publication of neonatal medicine poloxamer 10%

28/02/2023

Neonatal medicine palivizumab

NMedQ23.098-V1-R28

  • First publication of neonatal medicine palivizumab

28/02/2023

Neonatal medicine rasburicase

NMedQ23.097-V1-R28

  • First publication of neonatal medicine rasburicase

28/02/2023

Neonatal medicine levothyroxine

NMedQ23.096-V1-R28

  • First publication of neonatal medicine levothyroxine

15/02/2023

Guideline Stillbirth care

MN18.24-V8-R23

  • Review date extended while review in progress. Nil other amendments

15/02/2023

Guideline Neonatal stabilisation for retrieval

MN18.18-V4-R23

  • Review date extended while review in progress. Nil other amendments

06/02/2023

Eduction presentation Gestational diabetes mellitus

E21.33-1-V3-R26

  • Amendment slide 23 Metformin: Maximum dose metformin: FROM 2500 mg standard release (SR) TO: Metformin 2500 mg intermediate release (IR)

06/02/2023

Neonatal medicine Adrenaline

NMedQ22.079-V4-R27

  • Amendment: Added to ETT dose: volume equivalent in mL/kg

06/02/2023

Neonatal medicine Caffeine Citrate

NMedQ19.006-V2-R24

  • Added to preparation instructions: prescribed dose greater than 0.5 mL (10 mg) may be given undiluted
  • Added to special considerations: small dose volumes can be difficult to administer accurately to VLBW infants therefore diluted preparation is the preferred option in this cohort
  • Added to signs of toxicity: tremors and tachypnoea
  • Added QR code
  • Deleted UAC icon: wording amended about administration via UAC
  • Minor referencing updates

16/01/2023

Neonatal medicine Vancomycin

NMedQ23.094-V1-R28

  • First publication of neonatal medicine vancomycin

16/01/2023

Neonatal medicine Valganciclovir

NMedQ23.093-V1-R28

  • First publication of neonatal medicine valganciclovir

16/01/2023

Neonatal medicine Ganciclovir

NMedQ23.092-V1-R28

  • First publication of neonatal medicine ganciclovir

16/01/2023

Neonatal medicine Fluconazole

NMedQ23.095-V1-R28

  • First publication of neonatal medicine fluconazole

03/01/2023

Neonatal medicine Adrenaline

NMedQ22.079-V3-R27

  • Amendment: Correction to IV infusion preparation instructions. FROM: Draw up 0.3 mg/kg (0.3 mL/kg of 1:10,000) TO: Draw up 0.3 mg/kg (3 mL/kg of 1:10,000)s

21/12/2022

Termination of pregnancy

MN19.21-V8-R24

  • Amendment: For MS-2 Step: FROM undertake routine antenatal serum screening. TO: If MToP with MS-2 Step, routine antenatal serum screening not required, consider based on history/opportunistically with other serum tests

21/12/2022

Neonatal jaundice

MN22.7-V9-R27

  • Full Review
  • Removed: Elements of care relevant to QCG 'Standard care' clinical guideline
  • Removed: Nomograms referenced to QCG 'Nomograms for jaundice phototherapy and exchange transfusion'

21/12/2022

Neonatal seizures

MN22.23-V4-R27

  • Full Review
  • Removed: Elements of care relevant to QCG 'Standard care' clinical guideline
  • Removed: Drug regimens referenced to QCG 'NeoMedQ neonatal medicine monographs'
  • Updated: Classification of seizures as per International League of Epilepsy

21/12/2022

Induction of labour

MN22.22-V8-R27

  • Full Review
  • Expanded: Guidance on communication and decision making, timing of birth, risks and benefits of IOL compared with expectant management, setting for cervical ripening
  • Updated: prolonged pregnancy, suspected fetal macrosomia, intrahepatic cholestasis, advanced maternal age, transcervical balloon catheter

21/12/2022

Normal birth

MN22.25-V4-R27

  • Full Review
  • Removed: Elements of care relevant to 'Standard care' clinical guideline
  • Transferred to 'Intrapartum pain management' clinical guideline: Pharmacological and non pharmacological support including water immersion, and nitrous oxide and oxygen

05/12/2022

Preterm labour and birth

MN20.06-V10-R25

  • Flowchart MgSO4: Amendment - loading dose aligned with text FROM over 15 minutes | TO over 20 minutes
  • Table 2. Risk factors associated with preterm birth: Addition - risk of PTB based on ethnicity
  • Table 3 Risk reduction measures: Addition - recommendation for universal routine cervical length measurement during mid-trimester ultrasound
  • Section 3.1 Progesterone therapy: Amendment - recommendation strengthened FROM Consider prophylactic progesterone | TO Recommend vaginal progesterone from 16-36 weeks if incidentally diagnosed shortened cervix or prior spontaneous preterm birth between 20–34 weeks
  • Section 3.2 Cervical cerclage: Addition - consider cervical cerclage for women with cervical length less than 10 mm
  • Section 5.4 Antenatal corticosteroids: Amendment - recommendations aligned with QCG guideline: Antenatal corticosteroids

25/11/2022

Standard care

MN22.50-V2-R27

  • Guideline and supplement (Full Review)

22/11/2022

Pain and bleeding in early pregnancy

C22.29-2-V4-R27

  • New publication: Consumer information to accompany the Early pregnancy loss clinical guideline

22/11/2022

Having a miscarriage

C22.29-4-V1-R27

  • New publication: Consumer information to accompany the Early pregnancy loss clinical guideline

22/11/2022

Ectopic pregnancy

C22.29-1-V2-R27

  • New publication: Consumer information to accompany the Early pregnancy loss clinical guideline

22/11/2022

Methotrexate for ectopic pregnancy

C22.29-5-V1-R27

  • New publication: Consumer information to accompany the Early pregnancy loss clinical guideline

11/11/2022

Neonatal resuscitation checklist

F22.5-3-V3-R27

  • Amendment: Added additional equipment when humidification required (adaptor 15m/10f-10m neonatal; humidification T-piece circuit;humidifer chamber; sterile water for injection 1L bag)

09/11/2022

Hypoxic ischaemic encephalopathy

MN21.11-V11-R26

  • Amendment: Table 6 HIE staging, to align with Flowchart Assessing baby for therapeutic hypothermia FROM: If three or more signs of moderate or severe HIE or seizures at any time in first six hours consult with neonatologist regarding commencing TH. TO: If two or more signs of moderate or severe HIE or seizures at any time in first six hours consult with neonatologist regarding commencing TH

09/11/2022

Termination of pregnancy

MN19.21-V7-R24

  • Amendment: Rh D immunoglobulin no longer recommended for MToP before 10+0 weeks gestation
  • Amendment: Recommendation for prophylactic antibiotics for MToP changed FROM: Insufficient evidence to recommend the use of antibiotics prior to MToP TO: Prophylactic antibiotics not recommended for MToP
  • Added: Information when counselling women about the potential for live birth

28/10/2022

Syphilis in pregnancy

MN18.44-V5-R23

  • Amendment: Universal screening at 28 weeks gestation recommended

14/10/2022

Early pregnancy loss

MN22.29-V6-R27

  • Guideline and associated resources: Peer review

14/10/2022

Neonatal resuscitation

MN22.5-V6-R27

  • Guideline and associated resources: Peer review

26/09/2022

Neonatal medicine pyridoxine

NMedQ22.089-V1-R27

  • First publication neonatal medicine pyridoxine

26/09/2022

Neonatal medicine phenytoin

NMedQ22.090-V1-R27

  • First publication neonatal medicine phenytoin

26/09/2022

Neonatal medicine lidocaine

NMedQ22.091-V1-R27

  • First publication neonatal medicine lidocaine

26/09/2022

Neonatal medicine clonazepam

NMedQ22.088-V1-R27

  • First publication neonatal medicine clonazepam

21/09/2022

Adult inpatient management of steroid induced hyperglycaemia

ACG22.73-1-V1-R27

  • First publication (in collaboration with Queensland Diabetes Clinical Network)

09/08/2022

Early onset Group B Streptococcal disease

MN22.20-V6-R27

  • Flowchart: Neonatal management of early onset Group B Streptococcal disease (EOGBSD) updated to reflect text
  • Section 2 Risk factors: FROM another baby of multiple | TO other baby of multiple
  • Section 5.2 Criteria for investigation of sepsis: increased observation – removal of preterm labour at less than 37+0 weeks
  • Section 5.2 Criteria for investigation of sepsis: increased observation – addition of guidance for monitoring newborn with sibling currently treated for GBS infection
  • Section 5.4 Antibiotic therapy: FROM treatment of GBS meningitis for diagnosed infection | TO guidance for treatment of both confirmed and suspected GBS meningitis

02/08/2022

Aciclovir

NMedQ19.10-V3.R24

  • Amendment to preparation instructions: powdered vial no longer available

29/07/2022

Safer infant sleep

MN22.71-V1-R27

  • First publication (in collaboration with QLD Paediatric Quality Council)

29/07/2022

Early onset Group B Streptococcal disease

MN22.20-V5-R27

  • Peer Review: Risk factor approach re-endorsed

26/07/2022

Neonatal medicine adrenaline (epinephrine)

NMedQ22.079-V2-R27

  • Amendment: to align with ANZCOR recommendation for rapid IV bolus during resuscitation. FROM: Adrenalin every 2–3 minutes TO: Adrenaline every 3–5 minutes

26/07/2022

Neonatal medicine phosphate

NMedQ22.087-V1-R27

  • First publication neonatal medicine phosphate

26/07/2022

Neonatal medicine magnesium sulfate

NMedQ22.086-V1-R27

  • First publication neonatal medicine magnesium sulfate

26/07/2022

Neonatal medicine clonidine

NMedQ22.085-V1-R27

  • First publication neonatal medicine clonidine

26/07/2022

Neonatal medicine azithromycin

NMedQ22.084-V1-R27

  • First publication neonatal medicine azithromycin

26/07/2022

Neonatal medicine argipressin (vasopressin)

NMedQ22.083-V1-R27

  • First publication neonatal medicine argipressin

14/06/2022

Hypoglycaemia - newborn

MN19.8-V12-R24

  • Amendments Flowchart 3: Management of neonatal hypoglycaemia (baby symptomatic or BGL 1.5 mmol/L
    • Renamed TO Management of BGL less than 1.5 mmol/L or baby symptomatic,
    • Amended criteria for commencement of weaning IV therapy to align with document text
      • FROM BGL 2.6 mmol/L for more than 12 hours
      • TO BGL 3.0 mmol/L for more than 12 hours.
    • Duplicate label on outflow amended FROM yes TO no
    • Urgent treatment:
      • FROM If asymptomatic or mild symptoms: Administer IV 10% glucose bolus, Consider glucose gel 40% and breastfeed in addition, Commence 10% glucose infusion at 60 mL/kg, Give glucagon IM or subcut if IV access delayed by more than 15 minutes -If symptomatic or BGL not improving: Give glucagon IV (IM or subcut if IV access delayed by more than 15 minutes), Commence 10% glucose infusion at 80 mL/kg
      • TO Commence 10% glucose infusion at 60 mL/kg/day, If symptomatic or BGL not improving commence at 80 mL/kg/day; Give 10% glucose 1–2 mL/kg IV bolus Consider glucose gel 40% and breastfeed, Recheck BGL after 30 minutes, If BGL improving, continue 10% glucose IV adjust as needed, If symptomatic or BGL not improving give glucagon IV, Repeat BGL after 30 minutes and if required, repeat glucose bolus and glucagon, If IV access delayed > 15 minutes give glucagon IM or subcut.
  • Added to Definitions: enteral feeding
  • Table 5 Screening:
    • Last row split into two rows (new row: Validate BGL less than 2.6 mmol/L) no content change
  • Table 8: Initial management (first 48 hours of life)
    • References to NeoMedQ monographs rationalised to top of page
    • Third row (BGL less than 1.5 mmol/L or unrecordable) spilt into two rows (new row Difficult IV access) no content change
    • Last row: (Ceasing BGL monitoring) moved to new table: Ceasing BGL monitoring
  • Table 11: BGL monitoring First row (BGL)
    • Split into 5 rows (no content change)
    • Last row (Ceasing BGL monitoring) moved to new table: Ceasing BGL monitoring
  • Table 12: Ceasing BGL monitoring
    • New table from content in Table 8 and Table 11
    • Correction to criteria for ceasing after 48 hours
      • FROM 3 mmol/L TO 3.3 mmol/L
  • Subsequent table numbering increased by 1
  • Table 15: Medications
    • References updated to relevant NeoMedQ medicine monographs only
  • Minor formatting corrections throughout

19/05/2022

Gestational diabetes mellitus

MN21.33-V7-R26

  • Flowchart: Screening and diagnosis of GDM - amended: information from guideline (Table 16 Self-monitoring) about fasting BGL and commencement of pre- and postprandial self-monitoring (when OGTT not suitable)

19/05/2022

Neonatal medicine topiramate

NMedQ21.067-V2-R26

  • Deleted from special considerations “if therapeutic hypothermia refer to QCG Neonatal seizures guideline”

16/05/2022

Neonatal Seizures

MN17.23-V3-R22

  • Review date extended FROM May 2022 TO May 2023

16/05/2022

Early pregnancy loss

MN17.29-V5-R22

  • Review date extended FROM May 2022 TO May 2023

16/05/2022

Induction of labour

MN17.22-V7-R22

  • Review date extended FROM March 2022 TO March 2023

16/05/2022

Gestational diabetes mellitus

MN21.33-V6-R26

  • Flowchart: Screening and diagnosis of GDM - added: information from guideline (Table 16 Self-monitoring) for suggested target BGLs when self-monitoring
  • Flowchart Screening and diagnosis of GDM and Tables 8 and 14: - FROM: ‘evidence of fetal hyperinsulinaemia on growth USS’. TO: ‘evidence of excess fetal growth/adiposity on growth USS’
  • Table 20 Metformin FROM: Maximum dose: 2500mg (SR) TO: Maximum dose: 2500mg (immediate release) (no dose change)

29/04/2022

Statewide nomograms forms (all)

SW1106 to SW1111 (V2)

  • Update (all): additional fields to capture start and end time of phototherapy

29/04/2022

Maternity care for mothers and babies during the COVID-19 pandemic

MN21.063-V12-R26

  • Guideline, supplement and flowchart: Updated information about close contact management. Update to COVID-19 vaccination intervals after positive COVID-19 result.

21/04/2022

Neonatal medicine vitamin D

NMedQ22.075-V2-R27

  • Added: information if receiving low birth weight formula or human milk fortifier and commencement if no previous pentavite.

21/04/2022

Preterm prelabour rupture of membranes (PPROM)

MN18.48-V2-R23

  • Guideline and education: Recommended antibiotics for PPROM updated and aligned with Therapeutic Guidelines.

25/03/2022

Hypoglycaemia - newborn

MN19.8-V11-R24

  • Guideline and flowchart: Treatment recommendations for symptomatic baby or BSL less than 1.5 mmol/L with glucagon and glucose amended at Section 4.2, Section 4.5.1, and flowchart management of neonatal hypoglycaemia (baby symptomatic or BGL less than 1.5 mmol/L).

25/03/2022

Term small for gestational age newborn baby

MN22.16-V6-R27

  • Guideline and associated resources: Full review

09/03/2022

Termination of pregnancy

MN19.21-V6-R24

  • Guideline: Alignment with legislative amendments related to student health practitioner assisting with a termination
  • Guideline: Alignment with legislative amendments related to child abuse (Criminal Code Act 1899)

09/03/2022

Maternity care for mothers and babies during COVID-19 pandemic

MN21.63-V11-R26

  • Guideline: Neonatal flowchart updated to include close contact testing and isolation/quarantine requirements
  • Guideline: Visitor restrictions to a neonatal unit specified

01/03/2022

Neonatal medicine metronidazole

NMedQ22.080-V1-R27

  • First publication neonatal medicine metronidazole

01/03/2022

Neonatal medicine micafungin

NMedQ22.081-V1-R27

  • First publication neonatal medicine micafungin

01/03/2022

Neonatal medicine omnipaque

NMedQ22.082-V1-R27

  • First publication neonatal medicine omnipaque

01/03/2022

Neonatal medicine adrenaline

NMedQ22.079-V1-R27

  • First publication neonatal medicine adrenaline

01/03/2022

Rheumatic heart disease and pregnancy

MN22.40-1-V1-R27

  • First publication

16/02/2022

Neonatal medicine ceftriaxone

NeoMedQ21.068-V5-R26

  • Added: Preparation instructions for IM 350 mg/mL final concentration

10/02/2022

Maternity care for mothers and babies during COVID-19 pandemic

MN21.63-V10-R26

  • Guideline: Definition of a neonatal (baby) close contact amended
  • Guideline: Visitor information updated

11/01/2022

Consumer role

O22.34-4-V3-R27

  • Published Consumer representative role updated

11/01/2022

Neonatal medicine vitamin E

NMedQ22.076-V1-R27

  • First publication neonatal medicine monograph vitamin E

11/01/2022

Neonatal medicine vitamin D

NMedQ22.075-V1-R27

  • First publication neonatal medicine monograph vitamin D

11/01/2022

Neonatal medicine vitalipid N (infant)

NMedQ22.078-V1-R27

  • First publication neonatal medicine monograph vitalipid N (infant)

11/01/2022

Neonatal medicine prednisolone

NMedQ22.074-V1-R27

  • First publication neonatal medicine monograph prednisolone

11/01/2022

Neonatal medicine pentavite

NMedQ22.077-V1-R27

  • First publication neonatal medicine monograph pentavite

07/01/2022

Maternity care for mothers and babies during COVID-19 pandemic

MN21.63-V9-R26

  • Guideline: removed reference to patient transfer to designated hospital

05/01/2022

Maternity care for mothers and babies during COVID-19 pandemic

MN21.63-V8-R26

  • Guideline, education presentation and consumer information: Added booster vaccination information, added omicron variant of concern

20/12/2021

Hypoxic ischaemic encephalopathy (HIE)

MN21.11-V10-R26

  • Peer review and update of literature and references

20/12/2021

Maternity shared care operational framework

MN21.27-V3-R26

  • Full review and update of literature and references
  • Elements of Standard care removed

26/11/2021

Newborn assessment (routine)

MN21.4-V6-R26

  • Peer review and update of literature and references
  • Added: additional detail about newborn bloodspot screening
  • Added: flowchart for critical congenital heart disease screening

26/11/2021

Establishing breastfeeding

MN21.19-V4-R26

  • Peer review and update of literature and references

22/11/2021

Maternity care for mothers and babies during COVID-19 pandemic

MN21.63-V7-R26

  • Full review and update of literature and references
  • New: Flowchart Location and precautions if SCOVID or COVID-19, including rapid PCR testing
  • New: Section Peripartum risk management with abbreviated and reordered infection prevention and control information
  • New: Section Clinical course in pregnancy and postpartum
  • New: Recommendations for ACE inhibitors, carboprost, tranexamic acid, low dose aspirin, delayed cord clamping, neonatal testing for COVID-19, neonatal administration of vitamin K, hepatitis B vaccine and immunoglobulin
  • New: Information for neonatal supportive care
  • Updated information: vaccination, organisation of neonatal unit
  • Deleted: Flowchart Assessment of inpatient woman
  • Deleted: Operational Framework

15/11/2021

Neonatal resuscitation

MN16.5-V5-R21

  • Review date extended FROM Nov 2021 TO Dec 2022. Nil content changes

15/11/2021

Early onset Group B streptococcal disease

MN16.20-V4-R21

  • Review date extended FROM Nov 2021 TO Dec 2022. Nil content changes

02/11/2021

Neonatal medicine adenosine

NMedQ21.072-V1-R26

  • First publication neonatal medicine monograph adenosine

02/11/2021

Neonatal medicine noradrenaline (norepinephrine)

NMedQ21.073-V1-R26

  • First publication neonatal medicine monograph noradrenaline (norepinephrine)

25/10/2021

Respiratory distress and CPAP

MN20.3-V9-R25

  • Flowchart: Signs of deterioration/CPAP failure aligned with Table 21. CPAP Clinical course.
  • Amended FROM: O2 50 % To: O2 40%

08/10/2021

Ceftriaxone

NMedQ21.068-V4-R26

  • Removed 500 mg vial (as not available)
  • Amended 1g IM preparation. Final concentration changed FROM 350 mg/mL TO 250 mg/mL
  • Amended 1g IV preparation. Final concentration 40 mg/mL unchanged

24/09/2021

COVID-19 vaccination and pregnancy: PowerPoint presentation

ed21.63-1-V1-R26

  • New to accompany update of: Maternity care for mothers and babies during COVID-19 pandemic guideline

24/09/2021

Perinatal substance use: neonatal

MN21.38-V2-R26

  • Full review

24/09/2021

Perinatal substance use: maternal

MN21.37-V2-R26

  • Full review

21/09/2021

Maternity care for mothers and babies during COVID-19 pandemic

MN20.63-V6-R25

  • Partial update to include vaccination information. Refer to supplement for full history of update.

10/09/2021

Dexamethasone

NMQ.061-V2-R26

  • Amended protocol title FROM 14 day course TO 12 day course. No change to dosages.

09/09/2021

Non-urgent referral for antenatal care

MN16.28-V3-R21

  • Rescinded

09/09/2021

Hypoglycaemia-newborn

MN19.8-V10-R24

  • Correction to Flowchart: Preventative care of the well at risk (for hypoglycaemia) newborn baby. Meconium stained liquor changed to Meconium aspiration syndrome (F19.8-1-V9-R24)

06/09/2021

Ceftriaxone

NMQ21.068-V3-R26

  • Added preparation for 1 g vial via IM route

01/09/2021

Antenatal corticosteroids

MN21.64-V1-R26

  • New publication

01/09/2021

Obesity and pregnancy (including post bariatric surgery)

MN21.14-V6-R26

  • Updated following full review

16/08/2021

Neonatal medicine: phenobarbital

NMedQ21.062-V1-R26

  • First publication of neonatal medicine phenobarbital

13/08/2021

Neonatal medicine: aciclovir

NMQ20.010-V2-R24

  • Amended FROM gestational age TO current gestational age
  • Deleted UAC icon and instructions updated
  • Added QR code

13/08/2021

Neonatal medicine: cefazolin

NMQ20.053-V2-R25

  • Added higher dosage regimen for severe infection
  • Amended FROM gestational age TO current gestational age
  • Deleted UAC icon and instructions updated

13/08/2021

Neonatal medicine: sodium chloride 23.4%

NMQ21.070-V2-R26

  • Clarified oral administration from glass ampoule

13/08/2021

Neonatal medicines: ampicillin

  • Added statement clarifying administration if 10% glucose infusing.

13/08/2021

Neonatal medicines: amoxicillin, ampicillin, benzylpenicillin, cefazolin, cefepime, cefotaxime, ceftriaxone, flucloxacillin, gentamicin

  • Added statement about interaction if co-prescribed with aminoglycosides, cephalosporins, penicillins or teicoplanin.
  • Added statement about order of administration if co-prescribed

06/08/2021

All consumer information (excluding those under review)

  • Updated with QR code

30/07/2021

Gestational diabetes mellitus

MN21.33-V5-R26

  • Table 20 Metformin: Amended From: Maximum dose: 2500mg (SR) or 2000 g (XR) oral daily
  • To: Maximum dose: 2500mg (SR) or 2000 mg (XR) oral daily

20/07/2021

Neonatal medicine: ceftriaxone

NMedQ21.068-V1-R26-R24

  • First publication of neonatal medicine ceftriaxone

20/07/2021

Neonatal medicine: amlodipine

NMedQ21.069-V1-R26

  • First publication of neonatal medicine amlodipine

20/07/2021

Neonatal medicine: dexamethasone

NMedQ21.061-V1-R26

  • First publication of neonatal medicine dexamethasone

20/07/2021

Neonatal medicine: levetiracetam

NMedQ21.071-V1-R26

  • First publication of neonatal medicine levetiracetam

20/07/2021

Neonatal medicine: sodium chloride 23.4%

NMedQ21.070-V1-R26

  • First publication of neonatal medicine sodium chloride 23.4%

20/07/2021

Neonatal medicine: topiramate

NMedQ21.067-V1-R26

  • First publication of neonatal medicine topiramate

20/07/2021

Primary postpartum haemorrhage

MN18.1-V10-R23

  • Amended: Flowchart Massive haemorrhage protocol (MHP): acronym CBP (critical bleeding protocol) replaced with MHP (massive haemorrhage protocol)
  • Minor formatting updates)

08/07/2021

Syphilis in pregnancy

MN18.44-V4-R23

  • Clarified guidance for administration of benzathine penicillin for late latent syphilis in pregnancy

10/06/2021

Newborn hypoglycaemia

MN19.8-V9-R24

  • Amendment: Flowcharts aligned with guideline re threshold for neonatologist consultation

14/05/2021

Hypertension and pregnancy

MN21.13-V9-R26

  • Amendment to Flowchart: Management of hypertension in pregnancy. FROM Clonidine 50–150 micrograms BD,  TO Clonidine 50–100 micrograms BD (to align with section 5.2)

06/05/2021

Nomograms for neonatal jaundice, phototherapy and exchange transfusion

Statewide forms (SW1106-SW111)

  • New statewide forms for use by gestation and birthweight

06/05/2021

Neonatal medicine: Sucrose

NMedQ21.066-V1-R26-R24

  • First publication of neonatal medicine sucrose

06/05/2021

Neonatal medicine: Hepatitis B vaccine

NMedQ21.064-V1-R26

  • First publication of neonatal medicine Hepatitis B vaccine

06/05/2021

Neonatal medicine: Hepatitis B immunoglobulin

NMedQ20.065-V1-R26

  • First publication of neonatal medicine Hepatitis B immunoglobulin

06/05/2021

Neonatal medicine: phytomenadione

NMedQ21.063-V1-R26

  • First publication of neonatal medicine phytomendatione

24/03/2021

Hypoglycaemia- newborn

MN19.8-V8-R24

  • Amendment: 3.1 Screening and assessment of at risk baby (asymptomatic) Table 5 Screening
  • FROM: If glucometer BGL is less than or equal to 2 mmol/L, confirmation by a validated diagnostic testing method is recommended
  • TO: If glucometer BGL is less than or equal to 2 mmol/L, confirmation by a validated diagnostic testing method is essential and urgent

12/03/2021

Gestational diabetes mellitus (GDM)

MN21.33-V3-R26

  • Amendment Table 8 Testing for GDM Post-bariatric surgery: In first trimester consider:
  • FROM: If HbA1c greater than or equal to 41 mmol/mol (5.9%), or fasting BGL is greater than or equal to 7.0 mmol/L treating woman as if has type 2 diabetes
  • TO: If HbA1c greater than or equal to 48 mmol/mol (6.5%), or fasting BGL is greater than or equal to 7.0 mmol/L treating woman as if has type 2 diabetes

05/03/2021

Maternity care for mothers and babies during COVID-19 pandemic

MN20.63-V5-R25

  • New Section inserted (with incremental increase in subsequent numbers within section) 1.2 Vaccination

03/03/2021

Neonatal medicine: Ampicillin

NMedQ19.012-V4-R24

  • Amended preparation instructions for dosage greater than 50 mg/kg (meningitis dose)
  • Removed UAC icon and amended instructions for administration via UAC
  • Added PMA equivalent to current gestational age

03/03/2021

Neonatal medicine: Ferrous sulfate

NMedQ20.036-V2-R25

  • Amended product expiry information to include local unit policy
  • Added QR code

03/03/2021

Neonatal medicine: Gentamicin

NMedQ20.038-V2-R25

  • Added to special considerations: re volume of administration via IM route
  • Removed UAC icon and amended instructions for administration via UAC
  • Amended corrected gest age to current gest age and added current gest age is equivalent to PMA
  • Added QR code

03/03/2021

Neonatal medicine: Hydrocortisone

NMedQ19.023-V2-R24

  • Amended preparation instructions
  • Deleted stability information for infusion and reconstituted solution
  • Added QR code

26/02/2021

Gestational diabetes mellitus (GDM)

MN21.33-V2-R26

  • Peer review
  • Updated as outlined in supplement
  • Minor formating and reorganisation of flow
  • References updated

23/02/2021

Syphilis in pregnancy, guideline, supplement and antenatal flowchart

MN18.44-V3-R23

  • Added: additional guidance for administration of benzathine penicillin for late latent syphilis in pregnancy
  • One dose every 7 days for a total of 3 doses. If dose is missed or interval between doses is 9 or more days, recommend the full course is restarted
  • Update: flowchart to reflect above

22/02/2021

Neonatal medicine: Fentanyl

NMedQ21.052-V1-R26

  • First publication of neonatal medicine fentanyl

22/02/2021

Neonatal medicine: Dantrolene

NMedQ21.057-V1-R26

  • First publication of neonatal medicine dantrolene

22/02/2021

Neonatal medicine: Alprostadil

NMedQ21.058-V1-R26

  • First publication of neonatal medicine alprostadil

22/02/2021

Neonatal medicine: Insulin

NMedQ21.055-V1-R26

  • First publication of neonatal medicine insulin

22/02/2021

Neonatal medicine: Glucose and Insulin

NMedQ21.052-V1-R26

  • First publication of neonatal medicine glucose and insulin infusion

22/02/2021

Neonatal medicine: Enoxaparin

NMedQ21.060-V1-R26

  • First publication of neonatal medicine enoxaparin

22/02/2021

Neonatal medicine: ERYthromycin

NMedQ21.052-V1-R26

  • First publication of neonatal medicine ERYthromycin

16/02/2021

Retinopathy of prematurity (ROP): consensus statement

O21.55-1-V1-R26

  • First publication of ROP consensus statement

01/02/2021

Hypertension and pregnancy: guideline, supplement, flowcharts, consumer information, education presentation and knowledge assessment

MN21.13-V8-R26

  • Full review
  • Title change FROM: Hypertensive disorders of pregnancy TO: Hypertension and pregnancy
  • Definitions: Removed of definitions included in Standard care guideline: woman centred care, informed choice, informed consent
  • Flowcharts: Updated to reflect clinical information in guideline
  • Introduction: Added Australian statistics of maternal and neonatal outcomes
  • Definitions updated FROM: hypertension; moderate hypertension; severe hypertension; white coat hypertension TO: mild to moderate hypertension; severe hypertension
  • Classification: Additional clarity on classification of hypertension occurring prior to 20 weeks gestation; after 20 weeks gestation
  • Table 5 Initial investigations: Added calcium recommendation for supplementation
  • Section 4.2 screening for pre-eclampsia risk: Added use of PlGF:sLFT-1 ratio and PAPP-A biochemical markers in maternal serum as part of pre-eclampsia investigations
  • Table 8 Risk reduction: Updated FROM: Aspirin 100 mg per day TO: Aspirin recommendation 100–150 mg per day, preferably at night
  • Table 9 Adverse perinatal outcomes: Added information about longer term sequelae for adverse perinatal outcomes
  • Section 8.1 Model of care: Added PlGF:slFT-1 ratio for monitoring outpatient eligible women
  • Section 9.2 Intrapartum: Added carbetocin for management of third stage
  • Section 10 Postpartum: Added consideration of risk with non-compliance when prescribing postpartum antihypertensive drug therapy. NSAIDS recommendations updated to indicate only avoiding their use in women with severe preeclampsia and/or renal impairment
  • Section 10.1 Discharge and follow up: Added information about contraception and weaning of antihypertensive medications
  • References: Updated

17/12/2020

Vaginal birth after caesarean (VBAC):consumer information, education presentation and knowledge assessment

  • New publication to accompany VBAC clinical guideline MN20.12-V5-R25

09/12/2020

Neonatal medicine: Glucagon

NMedQ19.021-V2-R24

  • Amended administration instructions for IV infusion
  • QR code added

03/12/2020

Neonatal medicine: Benzylpenicillin

NMedQ20.013-V2-R25

  • Amended dose for congenital syphilis FROM 50 mg/kg TO 30 mg/kg according to day of life
  • PMA changed to "current gestational age"
  • QR code added

03/12/2020

Syphilis in pregnancy

MN18.44-V2-R23

  • Neonatal dosage of benzylpenicillin changed from 50 mg/kg to 30 mg/kg
  • Precautionary single dose of neonatal benzathine penicillin changed from 50 mg/kg IM once to 37.5 mg/kg IM once
  • Neonatal flowchart: Added diagnosis of congenital syphilis from parellel testing results
  • Added empirical treatment is indicated if maternal treatment for syphilis in pregnancy is inadequate

30/10/2020

Neonatal medicine: Vecuronium

NMedQ20.51-V1-R25

  • First publication of neonatal medicine monograph vecuronium

30/10/2020

Neonatal medicine: Neostigmine

NMedQ20.54-V1-R25

  • First publication of neonatal medicine monograph neostigmine

30/10/2020

Neonatal medicine: Cefazolin

NMedQ20.53-V1-R25

  • First publication of neonatal medicine monograph cefazolin

12/10/2020

Neonatal resuscitation equipment checklist

F20.5-3-V1-R21

  • First publication of neonatal resuscitation equipment checklist

28/09/2020

Gestational diabetes mellitus

MN15.33-V1-R20

  • Screening and diagnosis during COVID-19 moved to guideline Maternity care for mothers and babies during COVID-19 pandemic

28/09/2020

Maternity care for mothers and babies during COVID-19 pandemic

MN20.63-V4-R25

  • Added sections: Flow chart: Responding to the evolving COVID-19 situation
  • Updated: Specific recommendations for maternity care (all women) to include if local risk is low, PPE, Neonatal filters, Water immersion and water birth
  • Detail replaced with link to external source: Testing criteria, Infection prevention and control, Visitor restrictions, Self-isolation requirements, Specimen collection, PPE use
  • Updated: References, Minor formatting

25/09/2020

Vaginal birth after caesarean (VBAC)

MN20.12-V5-R25

  • Added: Flow chart: Decision making framework for women with previous caesarean section (CS),
  • Added sections: Additional risk benefit considerations for planned VBAC versus elective repeat caesarean section (ERCS), Antenatal counselling, New appendices
  • Updated: Formatting and style, Risks and benefits of planned VBAC and ERCS, Induction and augmentation of labour, Pain relief for VBAC
  • Updated Intrapartum care recommendations: Consideration of intravenous cannulation and collection of bloods, Vaginal examination recommendations
  • Removed: Sections covered by Queensland Clinical Guideline: Standard care

25/09/2020

Perinatal care of the extremely preterm baby

MN20.32-V2-R25

  • Title changed FROM Perinatal care at the threshold of viability TO Perinatal care of the extremely preterm baby
  • Term threshold of viability discontinued throughout guideline
  • Section 1 Introduction: Added information about international trends; Updated Queensland data
  • Section 2.6 Counselling:Added emotional wellbeing
  • Section 4.1 Updated outcome data from ANZNN
  • Section 4.2 Updated definition of severe impairment and intellectual disability
  • Section 5.2 Antenatal corticosteroids: Added evidence of benefit at lower gestations
  • Section 5.6 Care at birth: Added evidence for delayed cord clamping
  • Section 5.7 Resuscitation at birth: Amended less than 23+0 weeks FROM: not recommended TO: not usually recommended, Added Palliative care is usually recommended, Deleted for 23+0–23+6 weeks ‘Life sustaining interventions not usually recommended’, Added for 23+0–23+6 weeks ‘Recommend counselling by practitioners experienced in the care of extremely premature babies’,
  • Section 6.1 Symptom management: Updated assessment of pain and discomfort, Replaced medicine details with reference to relevant NeoMedQ monographs
  • Appendices: Updated with current informationTables

15/09/2020

Fetal movements

MN18.46-V2-R23

  • Tables: Fetal maternal transfusion and Ongoing management and Flowchart Altered fetal movements:  Re flow cytometry or Kleihauer-Betke - Added: Consult with haematology service at testing pathology laboratory for preferred test

09/09/2020

Primary postpartum haemorrhage

MN18.1-V9-R23

  • Section 2.1 Risk factors: Added precipitate labour
  • Section 3.4.2 Second line pharmacological therapy for uterine atonia: Amended prescribing considerations–observations required for carboprost administration
  • Section 3.6 Tissue: Added unexpected placenta accrete
  • Section 3.4.3 Intractable bleeding: Added new content medical procedures - care after intrauterine balloon tamponade insertion
  • Section 3.4.3 Intractable bleeding: Separated medical and surgical treatments into separate tables
  • Appendix A: Updated to align with Section 3.4 changes
  • Minor formatting updates

09/09/2020

Perineal care

MN18.30-V4-R23

  • Section 1.1 Australian Context. Updated IHPA financial penalties and WHA collaborative information
  • Section 8.2 Antibiotics. Updated to align with Therapeutic Guidelines
  • Section 5.7 Instrumental birth. Added reference to QCG Instrumental vaginal birth for prophylactic antibiotics

09/09/2020

Instrumental vaginal birth

MN18.49-V2-R23

  • Post-intervention care: Antibiotics. Added Consider antibiotic prophylaxis against postpartum infectious morbidity
  • Post-intervention care: Baby care. Added Use Neonatal Early Warning Tool (NEWT) or similar to record observations

09/09/2020

Neonatal medicine: Furosemide (Frusemide)

NMedQ20.50-V1-R25

  • First publication of neonatal medicine monograph furosemide (frusemide)

21/08/2020

VTE prophylaxis in pregnancy and the puerperium

MN20.9-V7-R25

  • Flowchart Antenatal and postnatal thromboprophylaxis according to risk. Added option of high prophylactic dosage with LMWH if previous VTE and high risk thrombophilia (rather than therapeutic anticoagulation only)
  • Section 5.3.1 LMWH. Added seek expert advice as required
  • Table 18 Other anticoagulants. Deleted Fraxiparine (as LMWH)

21/08/2020

Neonatal medicine: Hyoscine butylbromide

NMedQ20.47-V1-R25

  • First publication of neonatal medicine monograph hyoscine butylbromide

21/08/2020

Neonatal medicine: Flucytosine

NMedQ20.46-V1-R25

  • First publication of neonatal medicine monograph flucytosine

21/08/2020

Neonatal medicine: Captopril

NMedQ20.44-V1-R25

  • First publication of neonatal medicine monograph captopril

21/08/2020

Neonatal medicine: Amoxicillin

NMedQ20.45-V1-R25

  • First publication of neonatal medicine monograph amoxicillin

18/08/2020

Termination of pregnancy

MN19.21-V5-R24

  • Added at Section 4.4 Special circumstances: Female genital mutilation
  • Amended Section 7.2.2: Recommendation for one hour observation after mifepristone removed

24/07/2020

Neonatal medicine: Albumin

NMedQ20.048-V1-R25

  • First publication of neonatal medicine monograph albumin

24/07/2020

Neonatal medicine: Ibuprofen

NMedQ20.043-V1-R25

  • First publication of neonatal medicine monograph ibuprofen

24/07/2020

Neonatal medicine: Paracetamol

NMedQ20.042-V1-R25

  • First publication of neonatal medicine monograph paracetamol

24/07/2020

Neonatal medicine: cefEPIME

NMedQ20.049-V1-R25

  • First publication of neonatal medicine monograph cefEPIME

24/07/2020

Neonatal medicine: Ampicillin

NMedQ19.012-V3-R24

  • Dosage: gestational age amended to current gestational age
  • IV preparation: amended to produce enough volume to prime the line
  • QR code added

24/07/2020

CPAP Clinical learning resources

O20.3-1-V1-R25

  • Full review of resources to align with CPAP and respiratory distress clinical guidelines

08/07/2020

Neonatal medicine: Octreotide

NMQ19.024-V2-R24

  • Hypoglycaemia dosage for IV infusion amended FROM: 1–5 microgram/kg/hour, maximum 25 microgram/kg/day TO: 5–25 microgram/kg/day, maximum dose for term baby 40 microgram/kg/day
  • Chylothorax dosage for subcutaneous dosage added

01/07/2020

Gestational diabetes mellitus

MN15.33-V1-R20

  • Updated to align with ADIPS testing for gestational diabetes mellitus during COVID-19 pandemic: antenatal and postnatal testing advice (updated 07 May 2020)

01/07/2020

Respiratory distress and CPAP

MN20.3-V8-R25

  • Amendments: Table 2 Clinical standards
  • Bullet points reordered
  • FROM: Consult with neonatologist via Retrieval Services Queensland (RSQ) for advice or retrieval of baby to a higher level of service as required If level 5 neonatal service, oxygen requirement is greater than 50% to maintain SpO2 within target range
  • TO: Consult with neonatologist via Retrieval Services Queensland (RSQ) for advice or retrieval of baby to a higher level of service as required If level 5 neonatal service, oxygen requirement is greater than 40% to maintain SpO2 within target range
  • Table 22 Weaning CPAP
  • FROM: Bradycardic episodes are lower than 100 beats per minute
  • TO: Bradycardic episodes are not lower than 100 beats per minute
  • Appendix B Pulmonary air leaks–Pneumomediastinum
  • FROM: Air in the pericardial space
  • TO: Air in the mediastinal space

25/06/2020

Preterm labour and birth

MN20.6-V9-R25

  • Peer Review
  • Formatting updated
  • References updated to align with current evidence
  • Flowchart updated to reflect changes
  • Definition of terms: Amendment and update to ‘Health care providers’, addition of cervical incompetence, removal of Informed choice, informed consent, definition of obstetrician, woman centred care (refer to the Queensland Clinical Guideline: Standard care guideline)
  • Addition of Section 1.1 Background: Gestational age from definition of terms to background, Moderately preterm (32+0 to 33+6 weeks) Very preterm (28+0 to 31+6 weeks),  Extremely preterm (less than 27+6 weeks)
  • Section 1.2 Perinatal mental health (table 1): Minimal content change: information from previous guideline consolidated into table formatting and areas that can be referenced to the standard care guideline removed and referenced, addition of information on perinatal mental health
  • Section 3.2 Cervical cerclage (table 6): Addition of indications of cervical cerclage to include a history of cervical trauma and PPROM in a previous pregnancy, emergency cerclage indication added
  • Section 4 Clinical assessment of labour (table 7): Added importance of treatment based on appropriate clinical diagnosis
  • Section 4 Clinical assessment of labour (table 7): Emphasis on fFN and TVCL measurement in conjunction to assist with diagnosis of PTL added
  • Section 4.2 Fetal fibronectin testing (table 10): Added testing women for fFN if asymptomatic but have a history of cervical surgery, addition of fFN tests greater than 200 ng/mL and less than 10 ng/mL
  • Section 5 Management of PTL: Added information about upcoming technologies to assist clinicians in diagnosing PTL
  • Section 5.2 in-utero transfer: Removal of gestational ages for transfer, recommendations to align with Queensland Clinical Guideline: Perinatal care at the threshold of viability
  • Section 5.6 MgSO4 for neuroprotection (table 19): Added consider MgSO4 for gestations up to 34+0 weeks gestation
  • Appendix B: Consumer advice after threatened PTL, removed and consolidated into consumer information handout,  Consumer information updated

29/05/2020

NeoMedQ Infloran

NMQ20.041-V1-R25

  • First publication of neonatal medicine monograph infloran

29/05/2020

NeoMedQ Curosurf

NMQ20.040-V1-R25

  • First publication of neonatal medicine monograph curosurf

29/05/2020

NeoMedQ Survanta

NMQ20.039-V1-R25

  • First publication of neonatal medicine monograph survanta

29/05/2020

Respiratory distress and CPAP

MN20.3-V7-R25

  • Full review of guideline, supplement and clinician education

22/05/2020

NeoMedQ: Flucloxacillin

NMQ19.14.V2-R24

  • IM route preparation: amended FROM add 2 mL water for injection (to 500 mg vial) TO add 1.6 mL water for injection (to 500 mg vial)
  • IV dosage: meningitis dosage moved to separate line (no change to dose)
  • Stability: deleted storage information for IV solution

29/04/2020

Maternity care of women and babies during COVID-19 pandemic

MN20.63.V3-R25

  • New sections added: Flowchart for inpatient assessment, Flowchart for modified schedule for low-risk women during COVID-19, Risk of venous thromboembolism
  • Updated information about: antenatal corticosteroids, tocolysis, Appendix C viral/bacterial filter requirements
  • Updated acknowledgements

20/04/2020

Early onset Group B streptococcal disease guideline, supplement and neonatal flowchart

MN16.20.V4-R21

  • Updated to align with NeoMedQ monographs penicillin, ampicillin and gentamicin
  • Updated to align with QCG shortGuides: PPROM and PROM

14/04/2020

COVID-19: Consumer information COVID-19 and pregnancy

C20.63-1-V3-R25

  • Updated information about neonatal testing not routinely recommended

14/04/2020

Gestational diabetes: FAQ and flowchart screening and diagnosis during COVID-19 pandemic

O20.33-1-V2-R20 and f20.33-1-V4-R20

  • Updated FAQ and flowchart: correction of postpartum testing time from 4-6 weeks to 4-6 months postpartum

03/04/2020

Gestational diabetes mellitus

O20.33-1-V1-R20

  • First publication of FAQ about GDM screening and diagnosis during COVID-19 pandemic

03/04/2020

COVID-19 short videos added

  • COVID-19 - Reduce the risk
  • COVID-19 and pregnancy

14/04/2020

Maternity care for mothers and babies during COVID-19 pandemic

MN20.63-V2-R25

  • Publication of Version 2 (previously titled: Perinatal care of suspected or confirmed COVID-19 pregnant woman)

New sections added

  • Data collection
  • Home visiting
  • Recommendations for maternity care (all women)
  • Clinical emergencies
  • Maternal discharge
  • Newborn risk management
  • Newborn discharge
  • Neonatal ventilation set-up

Updated recommendations for:

  • Inpatient hospital visiting
  • Intrapartum PPE
  • Nitrous oxide use
  • Waterbirth
  • Newborn testing

Updated

  • Title of guideline
  • Flowcharts to align with text
  • References
  • Minor formatting and document flow

08/04/2020

Gestational diabetes

MN15.33-V1-R20

  • Updated FAQ and flowchart to include postpartum recommendations during COVID-19

31/03/2020

Gestational diabetes mellitus

f-20.33-1-V2-R20

  • First publication of flowchart: Screening and diagnosis during COVID-19 pandemic
  • Update added to GDM guideline (MN15.33-V1-R20) advising of new flowchart

26/03/2020

Maternity care for mother's and babies during COVID-19 pandemic, guideline, supplement and operational framework

MN20.63-V1-R25 (guideline), MN20.63-2-V1-R25 (operational framework)

  • First publication of guideline and operational framework

13/03/2020

COVID-19 guidance for maternity services

Version 1

  • First publication of guidance

02/03/2020

NeoMedQ: Morphine sulfate

NMedQ20.032-V1-R25

  • First publication of monograph

02/03/2020

NeoMedQ: Morphine hydrochloride

NMedQ20.037-V1-R25

  • First publication of monograph

02/03/2020

NeoMedQ: Midazolam

NMedQ20.033-V1-R25

  • First publication of monograph

02/03/2020

NeoMedQ: Gentamicin

NMedQ20.038-V1-R25

  • First publication of monograph

02/03/2020

NeoMedQ: Ferrous sulfate

NMedQ20.036-V1-R25

  • First publication of monograph

02/03/2020

NeoMedQ: Benzylpenicillin

NMedQ20.013-V1-R25

  • First publication of monograph

02/03/2020

NeoMedQ: Epoetin alfa

NMedQ20.035-V1-R25

  • First publication of monograph

29/11/2019

NeoMedQ: Suxamethonium

NMedQ19.031-V1-R24

  • First publication of monograph

01/03/2020

Venous thromboembolism (VTE) prophylaxsis in pregnancy and the puerperium

MN20.9-V6-R25

  • Second full review.
  • Amended: VTE risk assessment scoring system

01/04/2019

Primary postpartum haemorrhage

MN18.1-V8-R23

  • Initiated following evidence updates to carbetocin use for PPH.
  • 2.3 Intrapartum risk management
    • Emergency caesarean section: Use of carbetocin added
    • Elective caesarean section: Evidence for carbetocin use deleted (use of carbetocin retained)
  • 2.3.1 Third stage management: Added new evidence for oxytocin IV versus IM
  • 2.3.2 Syntometrine
    • Moved from third stage management
    • Added carbetocin preferred to syntometrine
  • 2.3.3 Carbetocin: Added. New content
  • 2.3.4 Secondary prevention with misoprostol: Moved from postnatal risk management (no change to content)
  • Minor formatting updates

26/08/2019

Neonatal medicines

NM19.54-V1-R24

  • First publication of guideline

29/11/2019

NeoMedQ: Amphotericin B Liposomal

NMedQ19.025-V1-R24

  • First publication of monograph

20/02/2020

NeoMedQ: Suxamethonium

NMedQ19.031-V2-R24

  • Intext reference moved to clarify dosage is 2 mg/kg (not 2 mg/kg2)

29/11/2019

NeoMedQ: Ampicillin

NMedQ19.012-V2-R24

  • Co-prescription with aminoglycosides changed from ‘separate by 1 hour’ to ‘give aminoglycoside first and flush between'
  • Meningitis dose (more than 50 mg/kg):
    • Preparation clarified
    • Administration duration changed from ‘30 minutes’ to ‘15–30 minutes’
  • Endorsed by Queensland Neonatal Services Advisory Group (QNSAG)

29/11/2019

NeoMedQ: Calcium folinate

NMedQ19.034-V1-R24

  • First publication of monograph

29/11/2019

NeoMedQ: Hydroxocobalamin

NMedQ19.030-V1-R24

  • First publication of monograph

16/10/2019

NeoMedQ: Dopamine

NMedQ19.027-V1-R244

  • First publication of monograph

16/10/2019

NeoMedQ: Dobutamine

NMedQ19.026-V1-R24

  • First publication of monograph

16/10/2019

NeoMedQ: Tetracaine (amethocaine) (eye)

NMedQ19.029-V1-R24

  • First publication of monograph

16/10/2019

NeoMedQ: Ipratropium

NMedQ19.028-V1-R24

  • First publication of monograph

03/06/2019

NeoMedQ: Caffeine Citrate

NMedQ19.006-V1-R24

  • First publication of monograph

26/08/2019

NeoMedQ: Diazoxide

NMedQ19.029-V1-R24

  • First publication of monograph

26/08/2019

NeoMedQ: Glucagon

NMedQ19.021-V1-R24

  • First publication of monograph

26/08/2019

NeoMedQ: Glucose gel

NMedQ19.020-V1-R24

  • First publication of monograph

26/08/2019

NeoMedQ: HydroCHLOROTHIAZIDe

NMedQ19.022-V1-R24

  • First publication of monograph

26/08/2019

NeoMedQ: Hydrocortisone

NMedQ19.023-V1-R24

  • First publication of monograph

26/08/2019

NeoMedQ: Octreotide

NMedQ19.024-V1-R24

  • First publication of monograph

29/07/2019

NeoMedQ: lamIVUDine

NMedQ19.016-V1-R24

  • First publication of monograph

29/07/2019

NeoMedQ: Flucloxacillin

NMedQ19.014-V1-R24

  • First publication of monograph

29/07/2019

NeoMedQ: Heparinised saline

NMedQ19.015-V1-R24

  • First publication of monograph

29/07/2019

NeoMedQ: Nevirapine

NMedQ19.017-V1-R24

  • First publication of monograph

28/06/2019

NeoMedQ: Aciclovir

NMedQ19.010-V1-R24

  • First publication of monograph

28/06/2019

NeoMedQ: Ampicillin

NMedQ19.012-V1-R24

  • First publication of monograph

28/06/2019

NeoMedQ: cefOTAXIME

NMedQ19.011-V1-R24

  • First publication of monograph

29/07/2019

NeoMedQ: Zidovudine

NMedQ19.018-V1-R24

  • First publication of monograph

28/06/2019

NeoMedQ: Meropenem

NMedQ19.009-V1-R24

  • First publication of monograph

03/06/2019

NeoMedQ: Atropine

NMedQ19.7-V1-R24

  • First publication of monograph

03/06/2019

NeoMedQ: Calcium gluconate 10%

NMedQ19.8-V1-R24

  • First publication of monograph

06/03/2019

NeoMedQ: Atenolol

NMedQ19.1-V1-R24

  • First publication of monograph

06/03/2019

NeoMedQ: Choral hydrate

NMedQ19.2-V1-R24

  • First publication of monograph

06/03/2019

NeoMedQ: Chloramphenicol

NMedQ19.3-V1-R24

  • First publication of monograph

06/03/2019

NeoMedQ: Hypromellose

NMedQ19.4-V1-R24

  • First publication of monograph

06/03/2019

NeoMedQ: Mupirocin

NMedQ19.5-V1-R24

  • First publication of monograph

04/11/2019

Stillbirth care

MN19.24-V8-R24

  • Change initiated to align induction of labour regimens between Termination of pregnancy and Stillbirth care guidelines
  • Section 4.2.2 Induction of labour:
    • Renamed to section 4.3 Induction of labour
    • Deleted misoprostol and mifepristone regimens from Table 13 IOL medications
  • Added Sections:
    • 4.3.1 Care during induction of labour
    • 4.3.2 Induction regimen for women at risk of uterine rupture
    • 4.3.3 Induction regimen for women not known to be at risk of uterine rupture
  • Minor formatting. References updated

06/03/2019

Stillbirth care

MN19.24-V7-R23

  • Updated reporting tool from National Perinatal Death Clinical Audit Tool (NPDCAT) to Australian Perinatal Mortality Clinical Audit Tool (APMCAT).
    • Removed NPDCAT and added APMCAT to list of definitions (page 6)
    • Table 7 Reporting and Documentation: amended
  • Reference list updated

29/11/2019

Intrapartum fetal surveillance

MN19.15-V6-R24

  • Reviewed and re-endorsed with limited changes
  • Flowchart: Abnormal fetal heart (Fetal Blood Sampling Guide): Deleted: Abnormal urgent birth and pH and lactate values
  • Table 2 Facility responsibilities: Added to Systems row
    Refer to Appendix A Interpretation of CTG - Using a traffic light system can assist effective interpretation of a CTG
  • Table 5 Principles of intermittent auscultation: Added to Transition to continuous monitoring:
    • Hypertension:
      -Systolic greater than or equal to 160 mmHg or diastolic greater than or equal to 110mmHg between contractions or
      -Systolic greater than or equal to 140 mmHg or diastolic greater than or equal to 90mmHg on two consecutives readings taken 30 minutes apart between contractions
    • Hypertonus or tachysystole
    • Confirmed delay in first or second stage of labour
  • Table 14 Intrapartum fetal blood sampling: Acute meningoencephalitis deleted from risks
  • Section 7 Other methods of fetal monitoring:
    From: Intrauterine pressure catheters (IUPC)
    To: Intrauterine pressure catheters (IUPC) may be considered for use on obese women where palpation of contractions is difficult
  • Minor formatting
  • Reference to Standard care guideline added
  • Relevant references updated

11/12/2019

Intrapartum fetal surveillance

MN19.15-V7-R24

  • Terminology corrected: ‘Hypersystole’ replaced with ‘tachysystole’ in flowchart Mode of fetal monitoring and Appendix B

19/12/2018

Intrapartum fetal surveillance

MN15.15-V5-R20

  • Align definitions of labour with QCG Normal birth guideline
  • Definition of terms:
    • From Early labour: Regular painful contractions (i.e. every five minutes and persisting for longer than 30 minutes) which may be associated with a show, intact membranes or some cervical changes (not full effacement), and or less than 4 cm dilatation.
      To Early labour (latent first stage): Irregular painful contractions which may be associated with a show, intact membranes or some cervical changes (not full effacement), and or less than 4–6 cm dilatation.
    • From Established labour: Regular painful contractions (which may be associated with a show, ruptured membranes or cervical changes (full effacement, 4 cm or more dilatation).
      To: Established labour (active first stage): Regular painful contractions (which may be associated with a show, ruptured membranes or cervical changes (full effacement, 4–6 cm or more dilatation).
  • Table 3 Risk factors Intrapartum:
  • From:
    • Prolonged first stage of labour:
      • Less than 0.5 cm per hour in active phase (cervix greater than or equal to 4 cm and effaced
    • Prolonged second stage where birth is not imminent:
      • Greater than 1 hour in a multiparous woman
      • Greater than 2.5 hours in a primiparous woman
  • To: Prolonged first or second stage of labour: Refer to Queensland Clinical Guideline:Normal birth
  • Minor formatting updates

14/12/2018

Syphilis in pregnancy

MN18.44-V1-R23

  • First publication.

14/12/2018

Preterm prelabour rupture of membranes (PPROM)

MN18.48-V1-R23

  • First publication.

14/12/2018

Term prelabour rupture of membranes (PROM)

MN18.47-V1-R23

  • First publication.

14/12/2018

Instrumental vaginal birth

MN18.49-V1-R23

  • First publication.

14/11/2018

Standard care

MN18.50-V1-R23

  • First publication.
    Describes generic healthcare concepts (standard care), standards or practices assumed to be common knowledge or in common use in Queensland maternity and neonatal service delivery.

08/10/2018

Fetal movements

MN18.46-V1-R23

  • First publication of short guide

07/03/2018

Hypoxic-ischaemic encephalopathy (HIE)

MN16.11-V9-R21

  • Change initiated by clinician to improve clarity around current evidence for therapeutic cooling criteria
  • Checklist for therapeutic hypothermia amended:
    • Removed statement about criteria with limited evidence
    • Added standard criteria for cooling to checklist.
  • Base deficit changed to base excess throughout document.
  • Description of base excess units of measure changed throughout document
    From '≥ minus 12 mmol/L ‘
    To ‘equal to or worse than minus 12 mmol/L’

10/01/2018

Hypoxic-ischaemic encephalopathy (HIE)

MN17.11-V8-R21

  • Checklist for therapeutic hypothermia (page 3) : re-ordered criteria.
  • Assessment of encephalopathy severity (page 4): Added assessment codes for normal and not applicable. Added space to record time of assessment.
  • Change requested by clinician. Supports clarity of therapeutic hypothermia criteria and documentation of Modified Sarnat assessment.

09/11/2017

Epidural in labour

MN17.41-V1-R22

  • First publication. Includes care considerations, and risks and benefits compared to opioids.

09/11/2017

Nitrous oxide and oxygen in labour

MN17.45-V1-R22

  • First publication.

09/11/2017

Opioids in labour

MN17.43-V1-R22

  • First publication. Includes comparison of morphine and pethidine.

09/11/2017

Remifentanil via PCA in labour

MN17.42-V1-R22

  • First publication. Includes comparison of remifentanil (via PCA) to epidural and other opioids.

18/08/2017

Hypoxic-iscahemic encephalopathy

MN17.11-V7-R21

  • Amendment to Passive Cooling (Table 11). Temperature monitoring using axillary temperature and frequency clarified/reworded. Appendix D amended to align.
  • Amendments to reference list (typos)
  • Format of medications updated (not capitalised)

10/07/2018

Induction of labour

MN17.22-V7-R22

  • Change to TGA approvals for cervidil (dinoprostone)
  • Table 19: Indications for removal of dinoprostone pessary amended
    From: "Insufficient cervical ripening after 12 hours"
    To: "Insufficient cervical ripening after 24 hours"
  • Table 16: Balloon (transcervical) catheter insertion amended at ‘Equipment’
    From: "26 French gauge Foley catheter"
    To: "Foley catheter with balloon capacity of at least 30 mL"
  • Section 2.2 Concern for fetal wellbeing amended to align with intrapartum fetal surveillance terminology
    From: "…decreased fetal movements, oligohydramnios, non-reassuring fetal surveillance test, fetal abnormality…"
    To: "…decreased fetal movements, oligohydramnios, abnormal fetal surveillance, fetal abnormality"
  • Minor updates to reference list
  • Guideline Supplement: Section 4.6 National Safety and Quality Health Service Standards (NSQHS) updated to align with 2017 publication of NSQHS standards

20/06/2017

Induction of labour

MN17.22-V6-R22

  • Amendment to Table 17 Post balloon catheter insertion. Added to first row of table-monitoring: “engagement of the fetal head” and “medical review required if malpresentation or fetal head 5/5 palpable after insertion”
  • Amendment to Flowchart Balloon catheter as above

10/03/2017

Induction of labour

MN17.22-V5-R22

  • First complete guideline review. Endorsed by:
    • QCG Sterring committee
    • Statewide Maternity and Neonatal Clinical Network

08/04/2015

Induction of labour

MN11.22-V4-R16

  • Flowchart: Oxytocin row: shaded blue; frequency of observations amended
  • Table 4 Term prelabour rupture of membranes, Recommendations Deleted Recommend expedited IOL as contradicts Early onset Group B streptococcal disease guideline
  • Table 5 Previous caesarean section, Risk/Benefit deleted content and added ‘Refer to guideline: Vaginal birth after caesarean section (VBAC)’
  • Table 17: Maximum dose and Indications for removal rows: the timing for Dinoprostone gel administration amended to be based on the woman’s individual circumstances and the obstetrician’s discretion
  • Table 18: Cautions Amended wording from ‘Oxytocin should be used with caution..’ to ‘Oxytocin is contraindicated in women with a previous uterine scar or high parity ..’

13/12/2013

Induction of labour

MN11.22-V3-R16

  • Added: Section 1.5 Care if induction postponed
  • Added to Table 17 Indications for removal: re use of dinoprostone gel following insufficient cervical ripening
  • Added to Table 19 Administration: re use of secondary IV access
  • Added to Table 21. Monitoring: Additional assessments before ARM
  • Added to Table 23 Uterine hypercontractility: Use of off-licence sublingual GTN

25/10/2011

Induction of labour

MN11.22-V2-R16

  • Minor formatting corrections
  • Table 18: Oxytocin considerations – Frequency of temperature monitoring amended from 4 hourly to 2 hourly

17/09/2011

Induction of labour

MN11.22-V2-R16

  • First publication
  • Endorsed by:
    • QCG Steering Committee
    • Statewide Maternity and Neonatal Clinical Network
    • Patient Safety and Quality Executive Committee

06/05/2010

Hypoxic-ischaemic encephalopathy

NN1005.11-V1-R13

  • First publication

13/05/2010

Hypoxic-ischaemic encephalopathy

NN1005.11-V2-R13

  • IV Dextrose reworded to IV Glucose

22/08/2011

Hypoxic-ischaemic encephalopathy

MN10.11-V3-R15

  • New website. Name and format updates

26/10/2011

Hypoxic-ischaemic encephalopathy

MN10.11-V4-R15

  • Appendix D: Anticonvulsant therapy deleted.
  • Reference to Queensland Maternity and Neonatal Clinical Guideline Neonatal Seizures added.

2/03/2016

Hypoxic-ischaemic encephalopathy

MN16.11-V5-R21

  • First full review of original publication
  • Removed sections on general medical neonatal intensive care management
  • Flow charts added
  • Inclusion criteria for therapeutic hypothermia amended
  • First Guideline Supplement published
  • Endorsed by: Statewide Maternity and Neonatal Clinical Network (Queensland)

16/03/2016

Hypoxic-ischaemic encephalopathy

MN16.11-V6-R21

  • Flow chart: Criteria for therapeutic hypothermia (cooling): “pH less than or equal to 7.00” amended to “pH less than 7.00”

16/03/2016

Hypoxic-ischaemic encephalopathy

MN16.11-V6-R21

  • Flow chart: Criteria for therapeutic hypothermia (cooling): “pH less than or equal to 7.00” amended to “pH less than 7.00”

30/09/2010

Breastfeeding initiation

NN1010.19-V1-R13

  • First publication

22/08/2011

Breastfeeding initiation

MN10.19-V2-R15

  • Review date extended.
  • Identifier updated.
  • Program name updated.
  • Correction page 7. Removed duplicate words.

28/07/2016

Establishing breastfeeding

MN16.19-V3-R21

  • Full review and update
  • Title amended to Establishing breastfeeding from Breastfeeding initiation
  • Scope broadened to include:
    • Clinical standards, communication, antenatal care and common breastfeeding concerns
  • Sections deleted include:
    • Appendix A: Factors influencing breastfeeding
    • Appendix E: LATCH Breastfeeding assessment tool
    • Appendix G: Storage of expressed breast milk for home use

17/09/2011

Early pregnancy loss

MN11.29-V1-R16

  • First publication

29/05/2018

Early pregnancy loss

MN17.29-V5-R22

  • Change initiated by clinical lead at Table 11: Row 5 (Ongoing management)
    • From: USS not routinely recommended
    • To: Repeat USS in one week and thereafter as clinically indicated. If fetal heart present on USS, refer urgently to MFM for follow-up—direct injection of potassium chloride may be indicated
  • Minor corrections to reference list
  • NSQH standards updated in supplement

19/03/2015

Early pregnancy loss

MN11.29-V2-R16

  • Updated Section 9: Details of Queensland Trophoblast Centre (QTC)
  • Updated contact details of Appendix C: Support Contacts
  • Formatting updates including name change and branding

16/07/2015

Early pregnancy loss

MN11.29-V3-R16

  • Revised recommendation at Table 10, Row 1 (Prior to commencement):
    From "Advise loading with Sodium Citrotartrate (as sachets) or IV 8.4%Sodium Bicarbonate in 100mls over 1 hour"
    To "Advise loading with Sodium Citrotartrate (as sachets)"
  • Minor formatting updates

8/05/2017

Early pregnancy loss

MN17.29-V4-R22

  • First full review

10/11/2010

Group B Streptococcus

MN1011.20-V1-R13

  • First publication

22/08/2011

Group B Streptococcus

MN10.20-V2-R15

  • Review date extended.
  • Identifier updated.
  • Program name updated.

25/11/2016

Group B Streptococcus

MN16.20-V3-R21

  • Full review.
  • Risk factor approach re-endorsed.
  • Additional information added re: penicillin allergy, prelabour rupture of membranes

15/08/2015

Gestational diabetes mellitus

MN15.33-V1-R20

  • First publication

6/08/2010

Hypertensive disorders of pregnancy

MN1008.13-V1-R13

  • First publication

22/08/2011

Hypertensive disorders of pregnancy

MN10.13-V2-R15

  • Review date extended.
  • Identifier updated.
  • Program name updated.

16/05/2012

Hypertensive disorders of pregnancy

MN10.13-V3-R15

  • Section 1.1 Definition: Added requirement for clinical and laboratory assessment if rise in BP
  • Section 10 Postpartum: Specified observations. Added reduction in frequency of monitoring requires approval from obstetric/medical team
  • Appendix A: Reference to mercury sphygmomanometer deleted

20/06/2013

Hypertensive disorders of pregnancy

MN10.13-V4-R15

  • Section 6.1 Mild-moderate hypertension: BP levels for considering treatment with antihypertensive agents lowered from 140-169/90-109 mm Hg to 140-160/90-100 mmHg
  • Section 6.2 Severe hypertension: BP levels requiring treatment with antihypertensive agents lowered from ≥170/110 mmHg to >160/100 mmHg
  • Flowcharts updated to reflect above

10/08/2015

Hypertensive disorders of pregnancy

MN15.13-V5-R20

  • First full review.

12/08/2015

Hypertensive disorders of pregnancy

MN15.13-V6-R20

  • Tables 3 and 7 and Appendix B: description of proteinuria changed
    from "protein to creatinine ratio greater than or equal to 30 g/mmol"
    to "protein to creatinine ratio greater than or equal to 30 mg/mmol"

16/08/2016

Hypertensive disorders of pregnancy

MN15.13-V7-R20

  • Missing words at 2.2 Diagnosis of preeclampsia reinserted.
  • Appendix B: random protein to creatinine ratio units changed from "mg/mol" to "mg/mmol"
  • Minor typographical corrections

6/08/2010

Intrapartum fetal surveillance

MN1008.15-V1-R13

  • First publication

22/08/2011

Intrapartum fetal surveillance

MN10.15-V2-R15

  • Review date extended. Identifier updated. Program name updated.
  • Amendment to Appendix A: Reduced and Absent baseline variability – added “For longer than 40 minutes” to end of each definition

21/11/2012

Intrapartum fetal surveillance

MN10.15-V3-R15

  • Section 2.1 Antenatal risk factors: Amended to include diabetes/gestational diabetes on oral hypoglycaemics

10/06/2015

Intrapartum fetal surveillance

MN.15.15-V4-R20

  • Changes to risk factors requiring continuous CTG monitoring in labour
  • Amendments to interpretation of CTG with regard to baseline, baseline variability and decelerations
  • Inclusion of additional information regarding:
    • Intrapartum fetal blood sampling and paired umbilical blood gas or lactate analysis
    • Recommendations for documentation and clinical handover
    • Multiple pregnancies and preterm labour

1/11/2009

Neonatal resuscitation

NN0911.5-V1-R11

  • First publication.

25/10/2011

Neonatal resuscitation

MN11.5-V2-R16

  • Full review
  • Scope revised to focus on care considerations rather than didactic instruction
  • Flow chart revised to align with the Australian Resuscitation Council
  • Section 3.1 Supplemental oxygen administration – target oxygen saturations amended
  • Laryngeal mask information provided
  • Formatting alterations
  • Supplement developed

10/07/2018

Neonatal resuscitation

MN16.5-V5-R21

  • Alignment with ANZCOR. Appendix A: Equipment and medications for neonatal resuscitation updated:
    From: "Intraosseous needles 50 mm length 18/G"
    To: "Intraosseous needles"
  • Oxygen saturation target ranges updated to align with QNSAG recommendations (Section 4.3 Oxygen saturation monitoring)
    From: "After 10 minutes of age the target differs for example: For term babies the target is 94%–99% SpO2. For preterm babies requiring ongoing respiratory support the target is 91%–95% SpO2."
    To: "In the absence of good quality evidence, Queensland Neonatal Services Advisory Group (QNSAG) endorse the following consensus recommendation for oxygen saturation targets for preterm and term babies after 10 minutes of age:
    - For term babies the target SpO2 range is 92–98%
    - For preterm babies the target SpO2 range is 90–95%"
  • Minor typo corrections
  • Supplement: Section 4: Safety and Quality Standards updated

28/07/2016

Neonatal resuscitation

MN16.5-V3-R21

  • Full review
  • Amended for consistency with Australian and New Zealand Council on Resuscitation (ANZCOR)
  • Temperature management and monitoring expanded
  • Equipment list amended
  • Timing of cord clamping clarified
  • Attendance at training or refresher courses by clinicians recommended
  • Initial assessment including use of oximetry clarified
  • Indications for suctioning clarified
  • Management of meconium exposed baby amended
  • Initial pressure settings for PPV amended
  • Endorsement of two thumb technique for cardiac compressions when two clinicians available
  • UVC as preferred route for adrenaline (epinephrine) administration
  • Naloxone doses and method of administration removed
  • Reference to critical blood loss protocol added

25/10/2011

Neonatal seizures

MN11.23-V1-R16

  • First publication

8/05/2017

Neonatal seizures

MN17.23.V2.R22

  • Full review
  • Initial and subsequent investigations differentiated
  • Additional antiepileptic drug information:
    • Levetiracetam
    • Topiramate
    • Pyridoxine
  • Additional information regarding management of suspected meningitis as a cause of seizures

02/10/2019

Neonatal seizures

MN17.23.V3.R22

  • Amendment to Table 16 Midazolam
    From:
    Maintenance IV infusion: 60–400 micrograms/kg/hour (1–7 micrograms/minute)
    To:
    Maintenance IV infusion: 60–400 micrograms/kg/hour (1–7 micrograms/kg/minute)
  • Updated to current guideline template
  • Supplement updated

12/09/2016

Neonatal resuscitation

MN16.5-V4-R21

  • ETT dose and administration, second dot point corrected (page 25, Table 21):
    from "Do not delay attempts at vascular access as effectiveness of IV adrenaline (epinephrine) has not been established"
    to "Do not delay attempts at vascular access as effectiveness of ETT adrenaline (epinephrine) has not been established."

17/09/2011

Non-urgent referral for antenatal care

MN11.28-V1-R16

  • First publication

17/08/2012

Non-urgent referral for antenatal care

MN11.28-V2-R16

  • Deleted: Appendix A: Obstetric risk score tool.
  • Deleted: Appendix B: Antenatal referral and checklist form
  • Updated: Section 3.2 with additional screening tools
  • Updated: References

15/07/2016

Non-urgent referral for antenatal care

MN11.28-V3-R16

  • Content endorsed as current with minor amendments
  • Added Section 3.1 Use of telehealth services

25/03/2010

Obesity

MN1003.14-V1-R13

  • First publication

22/08/2011

Obesity

MN10.14-V2-R13

  • Review date extended. Identifier updated. Program name updated.

15/09/2011

Obesity

MN10.14-V2-R13

  • Appendix B: Modifications to wording of “Suggested responsibilities for referral” to indicate optional nature of transfer and referral based on BMI and the need for individual assessment

13/03/2013

Obesity

MN10.14-V4-R15

  • Section 1. General principles of care added
  • Appendix B: Suggested responsibilities for referral removed. Local strategies to optimise care added

17/12/2015

Obesity in pregnancy

MN15.14-V5-R20

  • Full review
  • Flowchart added
  • Additional detail on weight management strategies
  • Supplement created

29/04/2012

Perineal care

MN12.30-V1-R17

  • First publication

19/03/2015

Perineal care

MN12.30-V2-R17

  • Minor formatting, brand and name updates
  • Added to Section 7.1 Table 15 (page 20): Avoid Codeine Phosphate or Codeine containing preparations in breastfeeding women (Codeine Phosphate is a category L4 in lactation i.e. possibly hazardous. Removed example of Codeine as pain relief.
  • Amendment Section 3.3 Perineal stretching device (page 10): Technique amended to more closely reflect written device instructions as provided by manufacturer

11/06/2018

Perineal care

MN18.30-V3-R23

  • Full review at scheduled review date. All evidence reviewed.

26/03/2018

Primary postpartum haemorrhage

MN18.1-V7-R23

  • Amendment to flowchart Initial response to PPH.
    Added: Dose of carboprost if administered intramyometrial (500 micrograms).

2/07/2009

Primary postpartum haemorrhage

MN0907.1-V1-R11

  • First publication

22/08/2011

Primary postpartum haemorrhage

MN09.1-V2-R11

  • New website: updated name and format changes

7/12/2012

Primary postpartum haemorrhage

MN12.1-V3-R17

  • First full review
  • Flow charts amended/added:
    • Initial response
    • Massive transfusion protocol
    • Emergency donor panel activation
  • Supplement added

17/10/2013

Primary postpartum haemorrhage

MN12.1-V4-R17

  • Rebranded with Queensland Government logo
  • Definition of terms: Added PRIME
  • Flow chart: Emergency donor panel activation: Target results: ‘Base excess < minus 6’, amended to ‘Base excess > minus 6’
  • Section 3.2 Monitoring in the fourth stage of labour; Table 5 Recommended observations post birth:
    • Removed Normal birth column
    • Added oxygen saturation and level of consciousness to observations (as per National consensus statement: essential elements for recognising and responding to clinical deterioration1)
  • Section 4.1 Tone: Carboprost information moved to Section 4.1.2
  • Section 4.1.2 Uterine atonia and second line drugs: New section, Dinoprost added as Carboprost not readily obtainable within Australia
  • Section 4.4 Thrombin; Table 15 Coagulopathy; Row Coagulopathy correction; 3rd bullet point: deleted ‘refer to Table 4’

28/03/2017

Primary postpartum haemorrhage

MN12.1-V5-R17

  • Section 4.1.2 and Flowchart–initial response: Clarified administration instructions for Carboprost
  • Oxytocin infusion regimen updated from 40 IU in 1 L IV solution to 30 IU in 500 mL IV solution to align with Induction of labour clinical guideline
  • Minor formatting/branding updates

07/03/2018

Primary postpartum haemorrhage

MN18.1-V6-R23

  • Second full review
  • Removed:
    • Emergency donor panel
    • Blood transfusion administration
    • PPH proforma
  • Added:
    • Point of care blood clot analyser use
    • Fibrinogen concentrate
    • Tranexamic acid administration
    • Prophylactic misoprostol
    • Requirements and actions for low resource settings

29/04/2012

Normal birth

MN12.25-V1-R17

  • First publication

09/11/2017

Normal birth

MN17.25-V2-R22

  • Full review at five year scheduled review point.

11/06/2018

Normal birth

MN17.25-V3-R22

  • Water immersion: risks and benefits amended
    From: “May increase genital tract trauma”
    To: “Conflicting evidence about effect on perineal trauma”
  • Added: Refer to Queensland Clinical Guideline: Perineal care guideline
  • References updated
  • Supplement updated: Safety and Quality (Section 5.6) updated with 2017 National Safety and Quality Health Service Standards

14/04/2016

Perinatal substance use: maternal

MN16.37-V1-R21

  • First publication
  • Replaces Queensland Clinical Guideline: Neonatal Abstinence Syndrome (MN10.10-V4-R15)

12/10/2009

Assessment and management of threatened preterm labour

MN0909.6-V1-R11

  • First publication

1/12/2009

Assessment and management of threatened preterm labour

MN0909.6-V2-R11

  • Correction to acknowledgements

22/08/2011

Assessment and management of threatened preterm labour

MN09.6-V3-R11

  • Minor format and name change updates

15/09/2011

Assessment and management of threatened preterm labour

MN09.6-V4-R14

  • Review date extended until 2014

23/12/2014

Preterm labour and birth

MN14.6-V5-R19

  • First full review
  • Updated title to Preterm labour and birth
  • Added risk reduction measures
  • Added consumer advice after threatened preterm labour
  • Guideline supplement created

28/09/2015

Preterm labour and birth

MN14.6-V6-R19

  • Amendment to Section 3.2 Cervical cerclage: Clarified recommendation that multiple dilation and evacuations, cervical surgery or other abnormalities are not themselves indications for cerclage.
  • Amendment to Section 4 Clinical assessment of PTL: Clarified purpose of sterile speculum examination to visualise cervix and membranes

20/06/2016

Preterm labour and birth

MN14.6-V7-R19

  • Amendment to Section 5.5 Antibiotics and Flowchart:
    • Ampicillin dose if signs of chorioamnionitis changed from 1 g every 4 hours to 1 g every 6 hours
    • Regimen if chorioamnionitis and penicillin allergy clarified to include Clindamicin or Lincomycin 600mg IV every 8 hours and Gentamicin 5 mg IV daily and Metronidazole 500 mg IV every 12 hours

25/11/2016

Preterm labour and birth

MN14.6-V8-R19

  • Amendment to Section 5.5 Antibiotics and Flowchart: Antibiotic regimen for PPROM deleted and replaced with reference to regimen to prolong latency in Queensland Clinical Guideline: Early onset Group B Streptococcal Disease

26/03/2018

Stillbirth care

MN18.24-V6-R23

  • Full review at 5 year scheduled review date
  • Additional information and guidance about communication with parents
  • Information about RCA and clinical incident review added
  • Induction of labour section updated
  • Core and selective investigations based on maternal history and circumstances of baby’s death
  • Reporting requirements updated

13/05/2011

Stillbirth care

MN1105.24-V1-R14

  • First publication

17/05/2011

Stillbirth care

MN1105.24-V2-R14

  • Correction to flowchart Perinatal Reporting

22/08/2011

Stillbirth care

MN11.24-V3-R16

  • Review date extended
  • Identifier updated
  • Program name updated

6/11/2012

Stillbirth care

MN11.24-V4-R16

  • Flowchart Perinatal Reporting - Left hand blue box:
    From: In-utero death AND birth occurs at less than 20 weeks and/or birth weight less than 400 g
    To: In-utero death and birth occurs at less than 20 weeks AND birth weight less than 400 g
  • Flowchart Perinatal Reporting - Stillbirth box:
    From: In-utero death and birth occurs at greater than 20 weeks OR birth weight greater than 400 g
    To: In-utero death and birth occurs at greater than or equal to 20 weeks OR birth weight greater than or equal to 400 g
  • Flowchart Perinatal Reporting (Middle yellow box) Addition: Footnote “Although registration with RBDM is not required, parents may choose to register the birth. Refer to Section 3.1”
  • Definition of stillbirth: “where gestation is not known” deleted from definition
  • Breaking the news: Addition regarding options for registration

15/07/2016

Stillbirth care

MN11.24-V4-R16

  • Review date extended until December 2017
  • Corporate identity updated
  • Program name updated

04/11/2019

Termination of pregnancy

MN19.21-V4-R24

  • Full review of clinical content
  • Medical practitioner responsibilities and gestational age requirements for ToP services added
  • Amended:
    • Clinical standards updated
    • Appendices incorporated into text
  • Added:
    • Performance of a termination definition
    • Assault and domestic violence
    • Memory creation and palliative care following live birth
    • Considerations for late termination
    • Prophylactic antibiotics for surgical termination
    • Discharge instructions and follow up
    • Contraception

04/12/2018

Termination of pregnancy

MN13.21-V3-R19

  • Amendments initiated following enactment of the Queensland Termination of Pregnancy Act 2018
  • Titled amended from Therapeutic termination of pregnancy to Termination of pregnancy
  • Termination healthcare added to Definition of terms
  • All sections referencing Queensland law relevant to termination amended to align with Termination of Pregnancy Act 2018 and Crown Law advice
  • Section on Facility level approvals deleted
  • Local service delivery added at Section 3 Clinical standards
  • Section on Indemnity deleted
  • Section on Legal test for each case deleted
  • Flowchart Summary of termination of pregnancy amended to align with updated content
  • Flowchart Medical termination with MS-2 Step added
  • Section 7.5 MS-2 Step (up to and including 63 days gestation) added
  • Appendix B: Mifepristone and misoprostol protocol amended so applicable only after 63 days gestation
  • TGA approvals updated
  • Minor formatting and branding updates

03/04/2013

Therapeutic termination of pregnancy

MN13.21-V1-R18

  • First publication

27/02/2018

Therapeutic termination of pregnancy

MN13.21-V2-R19

  • Review date extended to December 2019 to align with the work of the Queensland Law Reform Commission on termination of pregnancy
  • Minor updates to branding and formatting

20/02/2014

Trauma in pregnancy

MN14.31-V1-R19

  • First publication

10/09/2019

Trauma in pregnancy

MN19.31-V2-R19

  • Full review.
  • Added sections:
    • Uterine and placental considerations
    • Haemorrhage
    • Penetrating trauma
    • Burns
    • Domestic and family violence
    • Appendix for Injury Severity Score
  • Updated:
    • Management of haemorrhage
    • Maternal position for CPR
    • Terminology for perimortem caesarean section updated to resuscitative hysterotomy

1/12/2009

Vaginal birth after caesarean section (VBAC)

MN0911.12-V1-R11

  • First publication

22/08/2011

Vaginal birth after caesarean section (VBAC)

MN09.12-V2-R11

  • New website. Name and format changes.

15/09/2011

Vaginal birth after caesarean section (VBAC)

MN09.12-V3-R14

  • Review date extended

10/06/2015

Vaginal birth after caesarean section (VBAC)

MN15.12-V4-R19

  • First full review
  • Guideline supplement published
  • Considerations of planned VBAC following 2 previous caesarean sections included
  • Increased focus on shared decision making
  • Expanded Sections:
    • Flow chart
    • Antenatal care
    • Discussion and planning
    • Induction of labour
    • Uterine rupture
  • Section Intrapartum care: aligned to QCG Normal birth guideline where appropriate

27/10/2009

Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

MN0910.9-V1-R11

  • First publication

22/08/2011

Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

MN09.9-V2-R11

  • New website. Name and format changes.

15/09/2011

Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

MN09.9-V3-R12

  • Review date extended

20/02/2014

Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

MN14.9-V4-R19

  • First full review of original publication
  • Added: Risks associated with VTE prophylaxis, signs and symptoms of VTE, AOR of risk factors, Discharge information
  • Removed: Warfarin and Heparin decision support aids

17/10/2014

Venous thromboembolism (VTE) prophylaxis in pregnancy and the puerperium

MN14.9-V5-R19

  • Amendments to flowchart, guideline text (Sections 2.3, 4, 4.2, 4.4) and Appendix A
  • Low risk antenatal women: removed recommendation to consider Graduated compression stockings (GCS), amended number of risk factors for low risk category from 1–2 to 0–2
  • Moderate and high risk antenatal women: Added qualifier Discuss GCS to recommendation
  • Low and moderate risk postnatal women: Added qualifier Discuss GCS to recommendation
  • Added references to new Department of Health LMWH and factor Xa inhibitor guidelines
  • Added to flowcharts, Section 4 and Appendix A. ‘Determine dose (standard, intermediate or therapeutic) based on individual assessment. Refer to full guideline - Section 5: Specific patient groups and Appendix A: Drug information’

2/07/2009

Newborn examination

NN0907.4-V1-R11

  • First publicaiton

22/08/2011

Newborn examination

MN09.4-V2-R11

  • Name and format updates

25/10/2011

Newborn examination

MN09.4-V3-R14

  • Review date extended until 2014

22/07/2014

Routine newborn assessment

MN14.4-V4-R19

  • First full review
  • Updated title to Routine newborn assessment
  • Inclusion of Indications for further review
  • Additional information related to: discharge planning, consultation and review
  • Guideline supplement developed

24/06/2019

Routine newborn assessment

MN14.4-V5-R21

  • Re-endorsed as current. Review date extended until 2021.
  • Minor amendments to Table 4
    • Moved: bilious vomiting from growth and feeding to abdomen
    • Added to: skin–petechiae newly appearing or associated with purpura
    • Added to: eyes–yellow sclera
    • Amended: nose–from non-patent nares to nasal obstruction
    • Added to neurological–absent/exaggerated reflexes
  • Supplement: National Safety and Quality Health Service Standards updated
  • Minor formatting updates

18/02/2010

Hypoglycaemia and blood sugar level monitoring

NN1002.8-V1-R12

  • First publication

22/08/2011

Hypoglycaemia and blood sugar level monitoring

MN10.8-V2-R12

  • New website. Name and format updates.

27/07/2012

Hypoglycaemia and blood sugar level monitoring

MN10.8-V3-R12

  • Hydrochlorothiazide dosage corrected
  • Reference to Neofax added

20/08/2013

Newborn hypoglycaemia

MN13.8-V4-R18

  • First full review
  • Name of guideline changed from Neonatal hypoglycaemia and blood glucose monitoring to Newborn hypoglycaemia
  • BGL monitoring recommendations
  • Definition of severe hypoglycaemia
  • Addition of flow charts
  • Supplement published

18/06/2015

Newborn hypoglycaemia

MN13.8-V5-R18

  • Amendment: indications for the option of using Glucose Gel 40% included
  • Author changed to Queensland Clinical Guidelines
  • Front cover updated

27/09/2019

Newborn hypoglycaemia

MN19.8-V6-R24

  • Full review
  • Additional information added about:
    • Use of glucose gel 40% and presentation of medication
    • Calculation and preparation of glucose concentrations for IV administration
    • Use of glucagon early in treatment
    • Reference to NeoMedQ monographs for medication doses and other information
    • BGL levels for baby greater than 24 hours and when to cease monitoring
  • Addition of nurse practitioner to review baby
  • Investigations prioritised
  • Information added about six hour fast test
  • Flowcharts separated into 3 levels of care-screening, BGL1.5 mmol/L–2.5 mmol/L and BGL less than 1.5 mmol/L

16/10/2019

Newborn hypoglycaemia

MN19.8-V7-R24

  • Amendment to wording
  • Flowchart: Risk factors in Preventative care of the well at risk (for hypoglycaemia) newborn baby:
    From "Meconium stained liquor" to "meconium aspiration syndrome"
  • Table 2 Maternal risk factors
    • Maternal medications—Terbutaline: Words added as tocolysis within previous 48 hours
    • Maternal conditions—Maternal pre-eclampsia/eclampsia or hypertension or other conditions causing placental insufficiency: Words added from any cause, and Reference amended

24/06/2019

Neonatal jaundice

MN17.7-V8-R22

  • Amendment following change request
  • Section 4 Additional information added regarding the importance of assessment of babies with risk factors
  • Measurement of bilirubin (Table 8): Additional information added regarding Context for assessing jaundice and TcB meter correlation with TBR
  • Table 13 Additional information added regarding indications for phototherapy in facilities when access to TSB result is delayed, and seizure risk from phototherapy.
  • Minor formatting

1/10/2009

Neonatal jaundice: prevention, assessment and management

NN0911.7-V1-R11

  • First publication

26/03/2018

Neonatal jaundice

MN17.7-V6-R22

  • Amendment
  • Urine output clarified in Table 7 Clinical assessment
  • INR and BGL added to investigations in flowchart and LFT, INR and BGL to Section 4 Clinical assessment for suspected conjugated hyperbilirubinaemia

22/08/2011

Neonatal jaundice: prevention, assessment and management

MN09.7-V2-R11

  • New website. Name and format updates.

25/10/2011

Neonatal jaundice: prevention, assessment and management

MN09.7-V3-R14

  • Review date extended until 2014

07/12/2012

Neonatal jaundice

MN12.7-V4-R17

  • First full review
  • Title updated to 'Neonatal jaundice'
  • Supplement created
  • Content reviewed and updated: Inclusion of applicable guidelines from the National Institute of Health and Clinical Excellence Clinical guideline: Neonatal jaundice
  • Flow chart added: Assessment and investigation of jaundice
  • Neonatal jaundice treatment graphs updated

21/12/2017

Neonatal jaundice

MN17.7-V5-R22

  • Full review at 5 year scheduled review time point
  • Flowchart reviewed and simplified
  • Reference to Kramer’s rule removed from body of guideline and Appendix
  • Information added about bilirubin induced neuropathy (BIND)
  • Reference to Queensland centre for Mothers and Babies (QCMB) removed
  • Transcutaneous bilirubinometer (TcB) information updated
  • Operational details for organising retrieval of baby to higher level service removed
  • Additional information about phototherapy added
  • Detailed information about exchange
  • The administration IV Ig transfusion moved to Treatments of no benefit and not recommended
  • Additional information about emerging research added
  • Information included about conjugated hyperbilirubinaemia (also included in parent information sheet regarding normal stools)

17/04/2018

Neonatal jaundice

MN17.7-V7-R22

  • Amendment to less common causes of hyperbilirubinaemia (Table 6):
    Gilbert’s syndrome deleted from less common causes of conjugated hyperbilirubinaemia and added to less common causes of unconjugated hyperbilirubinaemia
  • Reference styles updated
  • Minor formatting

04/09/2014

Perinatal care at the threshold of viability

MN14.32-V1-R19

  • First publication

28/04/2016

Perinatal substance use: neonatal

MN16.38-V1-R21

  • First publication
  • Replaces Queensland Clinical Guideline: Neonatal Abstinence Syndrome (MN10.10-V4-R15)

15/02/2017

Perinatal substance use: neonatal

MN16.38-V2-R21

  • Corrected Finnegan Neonatal Abstinence Severity Score tool (Appendix A):
    Sneezing > 3–4 in half hour score 1
    Nasal flaring score 2

6/08/2010

Neonatal abstinence syndrome

NN1008.10-V1-R13

  • First publication

22/08/2011

Neonatal abstinence syndrome

MN10.10-V2-R15

  • Review date extended. Identifier updated. Program name updated.

01/12/2011

Neonatal abstinence syndrome

MN10.10-V3-R15

  • Route of morphine administration added to flow chart
  • Minor formatting to flowchart

01/08/2013

Neonatal abstinence syndrome

MN10.10-V4-R15

  • Added permission to use and full citation for Appendix A: Finnegan Neonatal Abstinence Severity Score
  • Updated front cover image

02/07/2009

Management of neonatal respiratory distress incorporating the administration of continuous positive airway pressure (CPAP)

NN0906.3-V1-R11

  • First publication

24/09/2009

Management of neonatal respiratory distress incorporating the administration of continuous positive airway pressure (CPAP)

NN0906.3-V2-R11

  • Minor formatting correction

22/08/2011

Management of neonatal respiratory distress incorporating the administration of continuous positive airway pressure (CPAP)

MN09.3-V3-R11

  • New website . Name and format updates.

24/10/2011

Management of neonatal respiratory distress incorporating the administration of continuous positive airway pressure (CPAP)

MN09.3-V4-R14

  • Review date extended until 2014

24/10/2014

Neonatal respiratory distress including CPAP

MN14.3-V5-R19

  • First full review
  • Flowchart added
  • Expanded sections: Complications of CPAP, neonatal care and monitoring requirements
  • New images added
  • Supplement created

10/07/2018

Neonatal respiratory distress including CPAP

MN14.3-V6-R19

  • Oxygen saturation target ranges updated to align with QNSAG recommendations throughout.
    From: 92–96% for babies greater than 32 weeks
    To: Term babies 92–98%. Preterm babies 90– 95%
  • Added to Definition of terms: Oxygen saturation target range
    "In the absence of good quality evidence, Queensland Neonatal Services Advisory Group (QNSAG) endorse the following consensus recommendation for oxygen saturation targets for babies after 10 minutes of age:
    - For term babies the target SpO2 range is 92–98%
    - For preterm babies the target SpO2 range is 90–95%"
  • Minor typo corrections
  • Supplement: Section 4: Safety and Quality Standards updated

10/07/2018

Neonatal stabilisation for retrieval

MN18.18-V4-R23

  • Oxygen saturation target ranges updated to align with QNSAG recommendations
    From: "Target oxygen saturation Term baby is 94%–99%; Preterm baby 91%–95%"
    To: "In the absence of good quality evidence, Queensland Neonatal Services Advisory Group (QNSAG) endorse the following consensus recommendation for oxygen saturation targets after 10 minutes of age:
    - Term baby 92–98%
    - Preterm baby 90–95%"
  • Supplement: Section 4: Safety and Quality Standards updated

07/03/2018

Neonatal stabilisation for retrieval

MN18.18-V3-R23

  • Full review at 5 year scheduled review date
  • Flowchart: Respiratory distress added
  • Appendix removed—Peripheral intravenous insertion sites
  • Appendix removed—UAC and UVC insertion distances
  • Appendix removed—ETT length and size by corrected gestation
  • Amendments to Checklist: Preparation for retrieval
  • Specific conditions information expanded

31/10/2011

Neonatal stabilisation for retrieval

MN11.18-V1-R16

  • First publication

9/05/2017

Neonatal stabilisation for retrieval

MN11.18-V2-R17

  • Review date extended
  • Identifier updated. Branding updated.
  • Queensland Emergency Medical Coorindation Centre (QCC) renamed to Retrieval Services Queensland (RSQ)

14/12/2010

Term small for gestational age (SGA) baby

MN1012.16-V1-R13

  • First publication

22/08/2011

Term small for gestational age (SGA) baby

MN10.16-V2-R15

  • Review date extended. Identifier updated. Program name updated.

15/07/2016

Term small for gestational age baby

MN16.16-V3-R21

  • First full review
  • Removed content covered in subsequently published Queensland Clinical Guidelines and referenced these guidelines
  • Removed antenatal specific care
  • Amended small for gestational age (SGA) risk factors to risk factors specific for the term SGA baby
  • Expanded parental considerations
  • Removed content on routine care for all babies
  • Replaced Beeby growth charts with Fenton preterm growth charts which merge with the WHO growth charts

28/11/2016

Term small for gestational age baby

MN16.16-V4-R21

  • Amended Investigations (Section 3.3 Table 7):
    from "Chormosomes BoBs and SNP array in all cases"
    to "SNP array (single nucleotide polymorphism) plus consider FISH (fluorescence in situ hybridization) if clinical suspicion of specific conditions (e.g. trisomy 21,13 or 18)"

22/08/2011

Maternity shared care

MN11.27-V1-R16

  • First publicaiton

25/05/2016

Maternity shared care

MN16.27-V2-R21

  • Content endorsed as current with minor amendments and updates
  • Updates to format and presentation
Last updated: 27 April 2023