Green-top Guidelines 2022: What You Need to Know
If you are an obstetrician or a gynaecologist, or a medical student or trainee interested in this field, you may have heard of the Green-top Guidelines. These are evidence-based clinical guidelines that provide recommendations for the diagnosis and management of various conditions related to women's health. In this article, we will explain what the Green-top Guidelines are, why they are important, how they are developed and updated, and what are the latest ones published in 2022. We will also show you how you can access and download the Green-top Guidelines for free or at a discounted rate.
Introduction
What are Green-top Guidelines?
Green-top Guidelines are clinical guidelines produced by the Royal College of Obstetricians and Gynaecologists (RCOG) in the UK. They provide systematically developed recommendations that assist clinicians and patients in making decisions about appropriate treatment for specific conditions. They cover a wide range of topics related to obstetrics and gynaecology, such as pregnancy complications, menstrual disorders, infertility, endometriosis, menopause, pelvic pain, sexual health, contraception, abortion, cancer screening, and more. They are called Green-top Guidelines because they have a green cover page.
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Why are they important for obstetricians and gynaecologists?
Green-top Guidelines are important for obstetricians and gynaecologists because they help them to provide high-quality care to their patients based on the best available evidence. They also help them to keep up to date with the latest developments and innovations in their field. By following the Green-top Guidelines, clinicians can ensure that they are following the standards of good practice set by the RCOG and other professional bodies. They can also reduce the risk of errors, complications, litigation, and complaints.
How are they developed and updated?
The Green-top Guidelines are developed and updated following a rigorous process outlined in the handbook . The process involves the following steps:
A topic is identified and prioritised by the RCOG Guidelines Committee based on clinical need, relevance, feasibility, and availability of evidence.
A guideline development group is formed consisting of experts in the topic area, representatives of relevant stakeholders, patient representatives, methodologists, and RCOG staff.
A systematic review of the literature is conducted to identify and appraise the evidence relevant to the topic.
The guideline development group drafts the guideline using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach to assess the quality of evidence and formulate recommendations.
The draft guideline is peer-reviewed by external reviewers and stakeholders, including other professional organisations, patient groups, NHS bodies, and RCOG Fellows and Members.
The draft guideline is revised based on the feedback received from the peer-review process.
The final guideline is approved by the RCOG Guidelines Committee and published on the RCOG website.
The guideline is disseminated through various channels, such as journals, newsletters, social media, courses, events, podcasts, webinars, etc.
The guideline is monitored for its impact and implementation using various methods, such as audits, surveys, feedback forms, etc.
The guideline is reviewed every three years or sooner if new evidence emerges that requires a change in recommendations.
Main body
What What are the latest Green-top Guidelines published in 2022?
So far, in 2022, the RCOG has published two new Green-top Guidelines and updated one existing guideline. Here is a brief overview of each of them:
Intrahepatic cholestasis of pregnancy
This is a new guideline that replaces the previous one published in 2011. It provides recommendations for the diagnosis and management of intrahepatic cholestasis of pregnancy (ICP), a condition that causes itching and abnormal liver function tests in pregnant women. It can also increase the risk of adverse outcomes for the mother and the baby, such as preterm birth, stillbirth, neonatal unit admission, and maternal haemorrhage. The guideline covers the following aspects:
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Green-top guidelines for obstetricians and gynaecologists 2022 pdf
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Green-top guideline on induction of labour 2022 pdf free
Green-top guideline on preterm birth 2022 pdf download
Green-top guideline on fetal growth restriction 2022 pdf free
Green-top guideline on gestational diabetes 2022 pdf download
Green-top guideline on ectopic pregnancy and miscarriage 2022 pdf free
Green-top guideline on antenatal corticosteroids 2022 pdf download
Green-top guideline on placenta praevia and accreta 2022 pdf free
Green-top guideline on postpartum haemorrhage 2022 pdf download
Green-top guideline on thromboembolic disease in pregnancy 2022 pdf free
Green-top guideline on hypertension in pregnancy 2022 pdf download
Green-top guideline on multiple pregnancy 2022 pdf free
Green-top guideline on pre-eclampsia 2022 pdf download
Green-top guideline on fetal monitoring in labour 2022 pdf free
Green-top guideline on shoulder dystocia 2022 pdf download
Green-top guideline on vaginal birth after caesarean section 2022 pdf free
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Green-top guideline on perineal tears 2022 pdf free
Green-top guideline on pelvic organ prolapse 2022 pdf download
Green-top guideline on urinary incontinence in women 2022 pdf free
Green-top guideline on endometriosis 2022 pdf download
Green-top guideline on ovarian cysts in postmenopausal women 2022 pdf free
Green-top guideline on heavy menstrual bleeding 2022 pdf download
Green-top guideline on menopause and hormone replacement therapy 2022 pdf free
Green-top guideline on contraception for women aged over 40 years 2022 pdf download
Green-top guideline on long acting reversible contraception 2022 pdf free
Green-top guideline on emergency contraception 2022 pdf download
Green-top guideline on sexual and reproductive health for individuals with inherited bleeding disorders 2022 pdf free
Green-top guideline on female genital mutilation and its management 2022 pdf download
Green-top guideline on diagnosis and management of endometrial hyperplasia 2022 pdf free
Green-top guideline on prevention and management of group B streptococcal infection in pregnancy and newborn babies 2022 pdf download
Green-top guideline on chickenpox in pregnancy and the newborn baby 2022 pdf free
Green-top guideline on rubella in pregnancy and the newborn baby 2022 pdf download
Green-top guideline on cytomegalovirus in pregnancy and the newborn baby 2022 pdf free
Green-top guideline on toxoplasmosis in pregnancy and the newborn baby 2022 pdf free
Green-top guideline on listeriosis in pregnancy and the newborn baby 2022 pdf free
Green-top guideline on herpes simplex virus in pregnancy and the newborn baby 2022 pdf download
Green-top guideline on hepatitis B virus in pregnancy and the newborn baby 2022 pdf free
Green-top guideline on hepatitis C virus in pregnancy and the newborn baby 2022 pdf download
Green-top guideline on human immunodeficiency virus (HIV) in pregnancy and the newborn baby 2022 pdf free
The definition and classification of ICP based on serum bile acid levels.
The risk factors and pathophysiology of ICP.
The clinical features and diagnosis of ICP, including the use of symptom scoring, liver function tests, bile acid tests, and ultrasound.
The management of ICP, including the use of ursodeoxycholic acid, antihistamines, vitamin K, delivery timing, mode of delivery, fetal monitoring, and postnatal care.
The information and support that should be provided to women with ICP and their partners.
The future implications and follow-up of ICP for the mother and the baby.
You can access the full guideline .
Diagnosis and management of ectopic pregnancy
This is a new guideline that replaces the previous one published in 2016. It provides recommendations for the diagnosis and management of ectopic pregnancy, a condition that occurs when a fertilised egg implants outside the uterus, usually in the fallopian tube. It can cause severe pain, bleeding, infection, and rupture of the tube. It can also be life-threatening for the woman and result in loss of fertility. The guideline covers the following aspects:
The epidemiology and risk factors of ectopic pregnancy.
The clinical features and diagnosis of ectopic pregnancy, including the use of serum human chorionic gonadotrophin (hCG) levels, transvaginal ultrasound scan, laparoscopy, and histopathology.
The management options for ectopic pregnancy, including expectant management, medical management with methotrexate, surgical management with salpingectomy or salpingotomy, and combination therapy.
The criteria for choosing the appropriate management option based on clinical factors, patient preferences, availability of resources, and safety.
The follow-up and monitoring of women after ectopic pregnancy management, including serum hCG measurements, ultrasound scan, pain relief, contraception advice, psychological support, and future pregnancy counselling.
You can access the full guideline .
Other Green-top Guidelines in development or under review
Besides the two new guidelines mentioned above, there are several other Green-top Guidelines that are either in development or under review by the RCOG. Some of them are:
Management of endometrial hyperplasia (in development)
Management of ovarian cysts in postmenopausal women (in development)
Management of genital herpes in pregnancy (under review)
Management of early pregnancy loss (under review)
Management of preterm prelabour rupture of membranes (under review)
You can find out more about the status and progress of these guidelines . How can you access and download the Green-top Guidelines?
If you are interested in reading or downloading the Green-top Guidelines, there are several ways you can do so. Here are some of them:
Online access via RCOG website or app
The easiest and most convenient way to access the Green-top Guidelines is to visit the RCOG website . There you can find all the published guidelines in alphabetical order, as well as the ones in development or under review. You can also search for a specific guideline by using the search box or the filters. You can read the guidelines online or download them as PDF files for free.
Alternatively, you can also access the Green-top Guidelines via the RCOG app, which is available for both iOS and Android devices. The app allows you to browse, search, and download the guidelines on your smartphone or tablet. You can also bookmark your favourite guidelines, share them with others, and receive notifications when new or updated guidelines are available. You can download the app for free from the App Store or Google Play.
PDF download and print options
If you prefer to have a hard copy of the Green-top Guidelines, you can also order them from the RCOG online shop . There you can find all the available guidelines in PDF format, which you can download and print yourself. Alternatively, you can also order printed copies of the guidelines, which will be delivered to your address. The prices vary depending on the number of pages and the delivery location. You can also get discounts if you order multiple copies of the same guideline.
Subscription and membership benefits
If you are a regular user of the Green-top Guidelines, you may want to consider subscribing to the RCOG online library . The online library gives you unlimited access to all the Green-top Guidelines, as well as other RCOG publications, such as books, journals, reports, podcasts, webinars, etc. You can also access other resources from external sources, such as Cochrane Library, BMJ Best Practice, ClinicalKey, etc. The subscription fee is 120 per year for UK residents and 150 per year for overseas residents.
Another option is to become a member of the RCOG . The RCOG offers various types of membership for different categories of professionals involved in women's health care, such as Fellows, Members, Associates, Trainees, Affiliates, etc. By becoming a member of the RCOG, you can enjoy many benefits, such as free or discounted access to the Green-top Guidelines and other RCOG publications and resources, as well as opportunities for professional development, networking, recognition, and involvement in RCOG activities. The membership fees vary depending on the type and location of membership.
Conclusion
Summary of key points and recommendations
In conclusion, the Green-top Guidelines are evidence-based clinical guidelines that provide recommendations for the diagnosis and management of various conditions related to women's health. They are produced by the RCOG following a rigorous process that involves systematic review of literature, expert input, peer-review, and stakeholder consultation. They are important for obstetricians and gynaecologists because they help them to provide high-quality care to their patients based on the best available evidence. They also help them to keep up to date with the latest developments and innovations in their field.
The latest Green-top Guidelines published in 2022 are intrahepatic cholestasis of pregnancy and diagnosis and management of ectopic pregnancy. There are also several other Green-top Guidelines that are either in development or under review by the RCOG. You can access and download the Green-top Guidelines for free or at a discounted rate via various methods, such as online access via RCOG website or app, PDF download and print options, subscription and membership benefits.
Call to action and further resources
We hope that this article has given you a clear overview of what the Green-top Guidelines are and how they can help you in your practice. We encourage you to visit the RCOG website to receive regular updates on the Green-top Guidelines and other RCOG activities.
If you have any questions or feedback about the Green-top Guidelines, you can contact the RCOG Guidelines Team at to get involved in the development and review of the Green-top Guidelines and share your expertise and experience with other clinicians and researchers.
Thank you for reading this article and we hope that you have found it useful and informative. We look forward to hearing from you and working with you to improve the quality of care for women's health.
FAQs
Here are some frequently asked questions about the Green-top Guidelines:
What is the difference between Green-top Guidelines and other types of guidelines?
Green-top Guidelines are clinical guidelines produced by the RCOG that provide recommendations for the diagnosis and management of specific conditions related to women's health. They are based on a systematic review of literature and expert input, and they follow the GRADE approach to assess the quality of evidence and formulate recommendations. They are different from other types of guidelines, such as NICE guidelines, SIGN guidelines, WHO guidelines, etc., which may have different scopes, methods, formats, and audiences.
How can I trust the quality and validity of the Green-top Guidelines?
The Green-top Guidelines are developed and updated following a rigorous process that ensures their quality and validity. The process involves a guideline development group consisting of experts in the topic area, representatives of relevant stakeholders, patient representatives, methodologists, and RCOG staff. The process also involves a systematic review of literature, peer-review by external reviewers and stakeholders, approval by the RCOG Guidelines Committee, dissemination through various channels, monitoring for impact and implementation, and review every three years or sooner if new evidence emerges.
How can I use the Green-top Guidelines in my practice?
The Green-top Guidelines are intended to assist clinicians and patients in making decisions about appropriate treatment for specific conditions. They are not prescriptive or mandatory, but rather provide guidance based on the best available evidence. They should be used in conjunction with clinical judgement, patient preferences, local policies, resources, and circumstances. They should also be adapted to the local context and culture where necessary.
How can I provide feedback or suggest a topic for a Green-top Guideline?
The RCOG welcomes feedback and suggestions from users of the Green-top Guidelines. You can contact the RCOG Guidelines Team at to suggest a topic for a new or updated Green-top Guideline. The topic proposal form will ask you to provide information about the clinical need, relevance, feasibility, and availability of evidence for the topic.
Where can I find more information about the Green-top Guidelines?
You can find more information about the Green-top Guidelines on the RCOG website . There you can find all the published guidelines, as well as the ones in development or under review. You can also find information about the development process, the handbook for developers, the GRADE approach, the impact and implementation of guidelines, the guidelines network, and other related resources.
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