Green-top Guidelines
How Green-top Guidelines are developed
The Green-top Guidelines are produced following the process outlined in the handbook Developing a Green-top Guideline: Guidance for developers (PDF 2.4mb), under the direction of the RCOG Guidelines Committee.
The recommendations are not intended to dictate an exclusive course of management or treatment.
They must be evaluated with reference to individual patient needs, resources and limitations unique to the institution and variations in local populations. It is hoped that this process of local ownership will help to incorporate these guidelines into routine practice.
Below, you can browse Green-top Guidelines by title or year published.
Green-top Guidelines by year published
2024
Care of late intrauterine fetal death and stillbirth (Green-top Guideline No. 55)
The purpose of this guideline is to identify evidence-based options for parents and their families who have a late intrauterine fetal death (IUFD) after 24+0 completed weeks of pregnancy of a singleton fetus and to incorporate information on general care before, during and after birth, and care in future pregnancies.
Published: 28 October 2024
Outpatient Hysteroscopy (Green-top Guideline No. 59)
The aim of this guideline is to provide clinicians with up to date, evidence-based information regarding outpatient hysteroscopy, with particular reference to minimising pain and optimising the experience of the woman or person.
Published: 19 August 2024
Small-for-Gestational-Age Fetus and a Growth Restricted Fetus, Investigation and Care (Green-top Guideline No. 31)
This guideline provides advice regarding the investigation and care of the small-for-gestational age fetus and fetal growth restricted fetus. It reviews the risk factors for these conditions and provides recommendations regarding surveillance, diagnosis and management, including recommendations for fetal monitoring and birth.
Published 14 May 2024
The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum (Green-top Guideline No.69)
The guideline provides updated evidence-based or best clinical practice information regarding the diagnosis and subsequent management of nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) across community, ambulatory day care and inpatient settings.
Published 5 February 2024
2023
Recurrent Miscarriage (Green-top Guideline No. 17)
The guideline provides comprehensive information on risk factors, recommended investigations and treatments for recurrent first trimester and one or more second trimester miscarriages.
Published 19 June 2023
2022
Intrahepatic cholestasis of pregnancy (Green-top Guideline No. 43)
This guideline summarises the evidence regarding the diagnosis, and the maternal and fetal risks of intrahepatic cholestasis of pregnancy (ICP), previously called obstetric cholestasis.
Published 09/08/2022
Cervical cerclage (Green-top Guideline No. 75)
The purpose of this guideline is to review the literature and provide evidence-based guidance on the use of cerclage in women at risk of preterm birth and second trimester loss.
Published 24/02/2022
Antenatal corticosteroids to reduce neonatal morbidity and mortality (Green-top Guideline No. 74)
The aim of this guideline is to provide evidence-based recommendations on the use of antenatal corticosteroids in women at risk of preterm birth or undergoing caesarean birth at term.
Published 17/02/2022
2021
Amniocentesis and Chorionic Villus Sampling (Green-top Guideline No. 8)
This guideline sets a series of evidence-based standards to ensure a high level and consistency of practice in the provision and performance of amniocentesis and chorionic villus sampling (CVS).
Published 25/10/2021
2020
Gestational Trophoblastic Disease (Green-top Guideline No. 38)
This guideline describes the presentation, management, treatment and follow-up of gestational trophoblastic disease (GTD) and gestational trophoblastic neoplasia (GTN).
Published 30/09/2020
Assisted Vaginal Birth (Green-top Guideline No. 26)
This guideline provides evidence-based information on the use of forceps and vacuum extractor for both rotational and non-rotational operative vaginal deliveries.
Published 29/04/2020
2019
Maternal Collapse in Pregnancy and the Puerperium (Green-top Guideline No. 56)
This guideline covers the different causes of maternal collapse, the identification of women at increased risk and the management of maternal collapse.
Published 17/12/2019
Care after non-invasive pre-natal testing (NIPT)
This is the proposed scope for the new RCOG Green-top Guideline on Non-Invasive Prenatal Testing.
Published 31/10/2019
Care of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes from 24+0 Weeks of Gestation (Green-top Guideline No. 73)
This guideline covers recommendations for the diagnosis, assessment, care and timing of birth of women presenting with suspected PPROM from 24+0 to 36+6 weeks of gestation. It also addresses care in a subsequent pregnancy.
Published 18/06/2019
2018
Care of Women with Obesity in Pregnancy (Green-top Guideline No. 72)
This guideline covers interventions prior to conception, and during and after pregnancy when caring for women with obesity.
Published 22/11/2018
Vasa Praevia: Diagnosis and Management (Green-top Guideline 27b)
This guideline describes the diagnostic modalities and reviews the evidence-based approach to the clinical management of pregnancies complicated by vasa praevia.
Published 27/09/2018
Placenta Praevia and Placenta Accreta: Diagnosis and Management (Green-top Guideline No. 27a)
This guideline describes the diagnostic modalities and reviews the evidence-based approach to the clinical management of pregnancies complicated by placenta praevia and placenta accreta.
Published 27/09/2018
2017
Group B Streptococcal Disease, Early-onset (Green-top Guideline No. 36)
This guideline provides guidance for obstetricians, midwives and neonatologists on the prevention of early-onset neonatal group B streptococcal (EOGBS) disease.
Published 13/09/2017
Management of Inherited Bleeding Disorders in Pregnancy (Green-top Guideline No. 71)
This guideline is intended for both specialist haematologists and obstetricians who have experience in managing pregnant patients with bleeding disorders. In addition, it may be a useful reference text for obstetric anaesthetists and neonatologists.
Published 27/04/2017
External Cephalic Version and Reducing the Incidence of Term Breech Presentation (Green-top Guideline No. 20a)
This guideline summarises the evidence regarding the routine use of external cephalic version (ECV) for breech presentation.
Published 16/03/2017
Management of Breech Presentation (Green-top Guideline No. 20b)
This guideline provides up-to-date information on methods of delivery for women with breech presentation.
Published 16/03/2017
2016
Postpartum Haemorrhage, Prevention and Management (Green-top Guideline No. 52)
This guideline provides information about the prevention and management of postpartum haemorrhage (PPH), primarily for clinicians working in obstetric-led units in the UK; recommendations may be less appropriate for other settings where facilities, resources and routine practices differ.
Published 16/12/2016
Management of Bladder Pain Syndrome (Green-top Guideline No. 70)
This guideline provides evidence-based information for primary and secondary care clinicians on the symptoms and treatment options for bladder pain syndrome (BPS) in women.
Published 09/12/2016
Premenstrual Syndrome, Management (Green-top Guideline No. 48)
This guideline reviews the diagnosis, classification and management of premenstrual syndrome. In addition, the evidence for pharmacological and nonpharmacological treatments is examined.
Published 01/12/2016
Monochorionic Twin Pregnancy, Management (Green-top Guideline No. 51)
This guideline provides clinicians with up-to-date evidence-based information regarding the management of monochorionic twin pregnancy.
Published 16/11/2016
Diagnosis and Management of Ectopic Pregnancy (Green-top Guideline No. 21)
This guideline provides evidence-based guidance on the diagnosis and management of ectopic pregnancies.
Published 04/11/2016
Ovarian Cysts in Postmenopausal Women (Green-top Guideline No. 34)
This guideline provides information on the investigation and management of postmenopausal women with known ovarian cysts.
Published 19/07/2016
This guideline summarises the evidence and how to manage women with hyperemesis gravidarum.
Published 22/06/2016
Epilepsy in Pregnancy (Green-top Guideline No. 68)
This guideline summarises the evidence on maternal and fetal outcomes in women with epilepsy.
Published 20/06/2016
This guideline provides clinicians with up-to-date evidence-based information regarding the management of endometrial hyperplasia.
Published 26/02/2016
This guideline provides information about the diagnosis and treatment of ovarian hyperstimulation syndrome (OHSS).
Published 26/02/2016
2015
Birth after Previous Caesarean Birth (Green-top Guideline No. 45)
This guideline provides evidence-based information to inform the care of women undergoing either planned vaginal birth after previous caesarean section (VBAC) or elective repeat caesarean section (ERCS).
Published 01/10/2015
Post-Hysterectomy Vaginal Vault Prolapse (Green-top Guideline No. 46)
This guideline aims to assist generalist and subspecialist gynaecologists in the management of posthysterectomy vaginal vault prolapse (PHVP). The management of urinary incontinence is not covered in this guideline; however, the role of concomitant continence procedures at the time of surgery for vault prolapse is addressed.
Published 24/07/2015
Female Genital Mutilation and its Management (Green-top Guideline No. 53)
This guideline reviews the evidence on female genital mutilation (FGM) and provides guidance for clinicians involved in the care of women who have undergone FGM.
Published 10/07/2015
Third- and Fourth-degree Perineal Tears, Management (Green-top Guideline No. 29)
This guideline provides evidence-based guidance on the diagnosis, management and treatment of third- and fourth-degree perineal tears (obstetric anal sphincter injuries, referred to as OASIS).
Published 12/06/2015
Blood Transfusions in Obstetrics (Green-top Guideline No. 47)
This guideline offers guidance about the appropriate use of blood products that neither compromises the affected woman nor exposes her to unnecessary risk. Strategies to maximise the haemoglobin (Hb) level at delivery as well as to minimise blood loss are also discussed.
Published 29/05/2015
Thrombosis and Embolism during Pregnancy and the Puerperium: Acute Management (Green-top Guideline No. 37b)
This guideline provides advice on the immediate investigation and management of women in whom venous thromboembolism (VTE) is suspected during pregnancy and the puerperium.
Published 13/04/2015
Thrombosis and Embolism during Pregnancy and the Puerperium, Reducing the Risk (Green-top Guideline No. 37a)
This guideline provides advice on the prevention of venous thromboembolism (VTE) during pregnancy and birth and following delivery.
Published 13/04/2015
Chickenpox in Pregnancy (Green-top Guideline No. 13)
This guideline assesses the evidence regarding the maternal and fetal risks of varicella zoster virus (VZV) infection in pregnancy and whether these complications can be prevented or modified by the administration of varicella zoster immune globulin (VZIG) or by treatment with aciclovir.
Published 21/01/2015
2014
Polycystic Ovary Syndrome, Long-term Consequences (Green-top Guideline No. 33)
This guideline provides information based on clinical evidence about the long-term health consequences of PCOS.
Published 05/11/2014
Umbilical Cord Prolapse (Green-top Guideline No. 50)
This guideline provides evidence-based advice on the prevention, diagnosis and management of umbilical cord prolapse.
Published 05/11/2014
Red Cell Antibodies during Pregnancy, The Management of Women with (Green-top Guideline No. 65)
This guideline aims to assist clinicians with the initial assessment and appropriate management of pregnant women with red blood cell antibodies.
Published 28/05/2014
Thalassaemia in Pregnancy, Management of Beta (Green-top 66)
This guideline provides evidence-based guidance on the management of women with beta (β) thalassaemia major and intermedia in pregnancy.
Published 27/03/2014
2013
Small-for-Gestational-Age Fetus, Investigation and Management (Green-top Guideline No. 31)
This guideline reviews the risk factors for a small-for-gestational-age (SGA) fetus and provides recommendations regarding screening, diagnosis and management, including fetal monitoring and delivery.
Published 22/03/2013
2012
Chronic Pelvic Pain, Initial Management (Green-top Guideline No. 41)
This guideline provides an evidence-based summary for the generalist to facilitate appropriate investigation and management of women presenting for the first time with chronic pelvic pain.
Published 23/05/2012
Sepsis in Pregnancy, Bacterial (Green-top Guideline No. 64a)
This guideline covers the recognition and management of serious bacterial illness in the antenatal and intrapartum periods and its management in secondary care.
Published 23/05/2012
Sepsis following Pregnancy, Bacterial (Green-top Guideline No. 64b)
This guideline provides guidance in the management of sepsis in the puerperium (sepsis developing after birth until 6 weeks postnatally).
Published 25/04/2012
Shoulder Dystocia (Green-top Guideline No. 42)
This guideline reviews the evidence regarding the possible prediction, prevention and management of shoulder dystocia.
Published 28/03/2012
2011
Antepartum Haemorrhage (Green-top Guideline No. 63)
This guideline provides advice for clinicians working in obstetric units on how to deal with antepartum haemorrhage.
Published 05/12/2011
Ovarian Masses in Premenopausal Women, Management of Suspected (Green-top Guideline No. 62)
This guideline aims to assist clinicians with the initial assessment and appropriate management of suspected ovarian masses in premenopausal women.
Published 02/12/2011
Sickle Cell Disease in Pregnancy, Management of (Green-top Guideline No. 61)
This guideline describes the management of pregnant women with sickle cell disease, including preconceptual screening and antenatal, intrapartum and postnatal management.
Published 26/08/2011
Venous Thromboembolism and Hormone Replacement Therapy (Green-top Guideline No. 19)
This guideline has been archived. Please see the guideline produced by the Faculty of Sexual and Reproductive Healthcare (FSRH).
Published 31/05/2011
Cervical Cerclage (Green-top Guideline No. 60)
This guideline has been archived. Please see Green-top Guideline No. 75 Cervical cerclage and the NICE guideline [NG25] Preterm labour and birth.
Published 19/05/2011
Recurrent Miscarriage, Investigation and Treatment of Couples (Green-top Guideline No. 17)
This guideline provides guidance on the investigation and treatment of couples with three or more first-trimester miscarriages, or one or more second-trimester miscarriages.
Published 19/05/2011
Obstetric Cholestasis (Green-top Guideline No. 43)
This guideline summarises the evidence for the fetal risks associated with obstetric cholestasis and provides guidance on the different management choices and the options available for its treatment.
Published 19/05/2011
Rhesus D Prophylaxis, The Use of Anti-D Immunoglobulin for (Green-top Guideline No. 22)
This guideline has been archived. Please see the British Committee for Standards in Haematology (BCSH) guideline on anti-D administration in pregnancy.
Published 27/04/2011
Hysteroscopy, Best Practice in Outpatient (Green-top Guideline No. 59)
This guideline provides clinicians with evidence-based information regarding outpatient hysteroscopy, with a focus on minimising pain and optimising the woman’s experience.
Published 27/04/2011
Reduced Fetal Movements (Green-top Guideline No. 57)
This guideline reviews the risk factors for reduced fetal movements in pregnancy and makes management recommendations
Published 25/02/2011
Vulval Skin Disorders, Management (Green-top Guideline No. 58)
This guideline has been archived. Please see the British Association for Sexual Health and HIV (BASHH) guideline on the management of vulval conditions.
Published 22/02/2011
Preterm Labour, Tocolytic Drugs (Green-top Guideline No. 1B)
This guideline has been archived. Please see the NICE guideline [NG25] Preterm labour and birth.
Published 22/02/2011
2010
Late Intrauterine Fetal Death and Stillbirth (Green-top Guideline No. 55)
This guideline identifies evidence-based options for women who have a late intrauterine fetal death of a singleton fetus.
Published 10/11/2010
Antenatal Corticosteroids to Reduce Neonatal Morbidity (Green-top Guideline No. 7)
This guideline has been archived. Please see the NICE guideline [NG25] Preterm labour and birth.
Published 31/10/2010
Preterm Prelabour Rupture of Membranes (Green-top Guideline No. 44)
This guideline has been archived. Please see GTG No. 73 Care of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes, and the NICE guideline [NG25] Preterm labour and birth.
Published 01/10/2010
Venous Thromboembolism and Hormonal Contraception (Green-top Guideline No. 40)
This guideline has been archived. Please see the Faculty of Sexual and Reproductive Healthcare (FSRH) statement on venous thromboembolism and hormonal contraception.
Published 27/09/2010
Malaria in Pregnancy, Diagnosis and Treatment (Green-top Guideline No. 54B)
This guideline provides clinicians with evidence-based information on the diagnosis and treatment of malaria in pregnancy in situations likely to be encountered in UK medical practice.
Published 28/04/2010
Malaria in Pregnancy, Prevention (Green-top Guideline No. 54A)
This guideline provides clinicians with evidence-based information about the prevention of malaria in pregnancy in situations likely to be encountered in UK clinical practice (i.e. in UK residents visting malaria endemic areas).
Published 28/04/2010