Skip to main content
  1. Right Decisions
  2. DGRefHelp - NHS Dumfries & Galloway
  3. Sexual health
  4. Pregnancy related
  5. Preconception health
  6. Back
  7. What are the more common risks factors associated with a poorer pregnancy outcome?
  8. Long term health conditions
Important: please update your RDS app to version 4.7.3 Details with newsletter below.

Please update your RDS app to v4.7.3

We asked you in January to update to v4.7.2.  After the deployment planned for 27th February, this new update will be needed to ensure that you are able to download RDS toolkits even when the RDS website is not available. We will wait until as many users as possible have downloaded the new version before switching off the old system for app downloads and moving entirely to the new approach.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. 

To update to the latest release:

 On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Right Decision Service newsletter: February 2025

Welcome to the February 2025 update from the RDS team

1.     Next release of RDS

 

A new release of RDS is planned (subject to outcomes of current testing) for week beginning 24th February. This will deliver:

 

  • Fixes to mitigate the recurring glitches with the RDS admin area and the occasional brief user interface outages which have arisen following implementation of the new distributed technology infrastructure in December 2024.

 

  • Capability to embed content from Google calendar, Google Maps, Daily Motion, Twitter feeds, Microsoft Stream into RDS pages.

 

  • Capability to include simple multiplication in RDS calculators.

 

The release will also incorporate a number of small fixes, including:

  • Exporting of form within Medicines Sick Day Guidance in polypharmacy toolkit
  • Links to redundant content appearing in search in some RDS toolkits
  • Inclusion of accordion headers alongside accordion text in search result snippets.
  • Feedback form on mobile app.
  • Internal links on mobile app version of benzo tapering tool

 

We will let you know when the date and time for the new release are confirmed.

 

2.     New RDS developments

There is now the capability to publish toolkits on the web with left hand side navigation rather than tiles on the homepage. To use this feature, turn on the “Toggle navigation panel” option at the top of the Page settings menu at toolkit homepage level – see below. Please note that publication to downloadable mobile app for this type of navigation is still under development.

The Benzodiazepine tapering tool is now available as part of the RDS toolkit for the national benzodiazepine prescribing guidance developed by the Scottish Government Effective Prescribing team. The tool uses this national guidance developed with a wide-ranging multidisciplinary group. This should be used in combination with professional judgement and an understanding of the needs of the individual patient.

3.     Archiving and version control and new RDS Search and Browse interface

Due to the intensive work Tactuum has had to undertake on the new technology infrastructure has pushed back the delivery dates again and some new requirements have come out of the recent user acceptance testing. It now looks likely to be an April release for the search and browse interface. The archiving and version control functionality may be released earlier. We’ll keep you posted.

4.     Statistics

At the end of January, Olivia completed the generation of the latest set of usage statistics for all RDS toolkits. If you would like a copy of the stats for your toolkit, please contact Olivia.graham@nhs.scot .

 

5.     Review of content past its review date

We have now generated reports of all RDS toolkit content that has exceeded its review date by 6 months or more. We will be in touch later this month with toolkit owners and editors to agree the plan for updating or withdrawing out of date content.

 

6.     Toolkits in development

Some important toolkits in development by the RDS team include:

  • National CVD prevention pathways – due for release end of March 2025.
  • National respiratory pathways, optimal cancer diagnostic pathways and cancer prehabilitation pathways from the Centre for Sustainable Delivery. We will shortly start work on the national cancer referral pathways, first version due for release via RDS around end of June 2025.
  • HIS Quality of Care Review toolkit – currently in final stages of quality assurance.

 

The RDS team and other information scientists in HIS have also been producing evidence summaries for the Scottish Government Realistic Medicine team, to inform development of national guidance around Procedures of Limited Clinical Value. This guidance will in due course be translated into an RDS toolkit.

 

7. Training sessions for new editors (also serve as refresher sessions for existing editors) will take place on the following dates:

  • Friday 28th February 12-1 pm
  • Tuesday 11th March 4-5 pm

 

To book a place, please contact Olivia.graham@nhs.scot, providing your name, organisation, job role, and level of experience with RDS editing (none, a little, moderate, extensive.)

 

To invite colleagues to sign up to receive this newsletter, please signpost them to the registration form  - also available in End-user and Provider sections of the RDS Learning and Support area.   If you have any questions about the content of this newsletter, please contact his.decisionsupport@nhs.scot  If you would prefer not to receive future newsletters, please email Olivia.graham@nhs.scot and ask to be removed from the circulation list.

With kind regards

 

Right Decision Service team

Healthcare Improvement Scotland

 

 

Long term health conditions

It is important to refer women with long term health conditions to their GP and/or specialists services since good preconception care may help women with long term health conditions have healthier pregnancies and healthier babies.

All women should be advised regarding effective contraception whilst waiting for GP and/or specialist input.

 

 

Diabetes

  • The National Institute for Clinical Excellence (NICE) recommends that women with pre-exisiting diabetes should access specialist services prior to conception.
  • Tight control of blood sugars reduces the chance of miscarriage, stillbirth, neonatal death, macrosomic babies and congenital malformation.
  • The use of a higher dose of folate (5mg daily) should be clarified with her GP/diabetes specialist. See 'Folic acid supplements'.

 

Hepatitis B/C

  • Women with hepatitis B or C may pass the infection on to their baby and so should discuss preconception care with their specialist.
  • Current Hepatitis C treatment options are unsuitable for use in pregnancy due to concerns over teratogenicity.
  • Pregnancy also needs to be avoided for four months following maternal use of ribavarin and seven months after paternal use.

 

HIV 

  • HIV positive women and HIV negative women with an HIV positive male partner should discuss their plans for pregnancy well in advance with their HIV specialist in order to reduce risk of HIV transmission and to optimise healthy outcomes.
  • A woman with HIV can be safely treated with antiretroviral therapy (ART) which can reduce the HIV transmission rate to 0.27%.
  • The international birth register of women on ART has not seen an increase in birth defects in women treated with ART.
  • A HIV negative woman with a HIV positive male partner who does not have a consistent undetectable viral load may be considered for HIV pre exposure prophylaxis (PrEP) to reduce risk of HIV transmission.

 

Mental health problems

  • Women with previous or existing mental health problems are more likely to experience problems during and after pregnancy.
  • Dealing with the underlying causes of poor mental health and treating mental health problems before pregnancy can help prevent negative pregnancy outcomes for both mother and baby.

 

Rheumatoid arthritis (RA)

  • Women with RA are normally under specialist care and a multi disciplinary approach to pregnancy planning is vital.

 

Seizure disorders

  • The aim is to keep the woman seizure free during the pregnancy, whilst trying to reduce the possible teratogenic risk to the fetus from anti-epileptic drugs (AED). See 'Medication not uncommonly used in women of reproductive age'.
  • It is important to refer women with seizure disorders to their GP and/or specialists for pre conception advice.
  • The use of a higher dose of folate (5mg daily) should be clarified with her GP/epilepsy specialist. See 'Folic acid supplements'.

 

Systemic Lupus Erythematosis (SLE)

  • Maternal and fetal outcomes are improved when the patient is on stable therapy and the disease has been quiescent for at least six months prior to the pregnancy.
  • SLE can involve the heart and vascular system, lungs and kidneys.
  • Women with SLE are normally under specialist care and a multi disciplinary approach to pregnancy planning is vital.

 

Other long health conditions

Including:

  • asthma
  • cardiovascular disease
  • eating disorders
  • hypertension
  • blood clots
  • phenylketonuria
  • renal disease
  • thrombophilia
  • thyroid disease

 

Editorial Information

Last reviewed: 30/09/2021

Next review date: 30/09/2025

Author(s): West of Scotland Managed Clinical Network for Sexual Health Clinical Guidelines Group .

Version: 3.1

Approved By: West of Scotland Managed Clinical Network in Sexual Health