Each Baby Counts Themed Report – Anaesthetic Care
Each baby counts has published a report following analysis of the anaesthetic care given to mothers of babies reported to each baby counts between 2015 – 17. The report is supported by the Royal College of Anaesthetists and Obstetric Anaesthetists Association.
Key findings highlight:
The report highlights a number of key recommendations including:
The full report is available here.
NHS hospitals not following NICE guidelines on twin & triplet pregnancies leading to deaths of up to 55 babies
A report by TAMBA (twins & multiple births association) has concluded that if all hospital were to follow nice guidelines for twin, triplet & more pregnancies then 55 baby deaths could be prevented each year.
If mums of multiples are able to have a discussion by 24 weeks with a multidisciplinary team about risks of preterm labour and possible outcomes of preterm birth it correlates to a lower stillbirth rate.
If all recommendation from the report are adopted it is thought lives could be saved and fewer babies would need neonatal care.
Find out more on the TAMBA website.
NHS Resolution publish annual figures – Greatest value of claims for Obstetrics
NHS Resolution has published its annual report for the period of 2017/2018. In total the value of payments was £2.2 billion.
Focusing specifically on maternity claims it is reported that only 10% of clinical claims relate to obstetrics however they accounted for 48% of the total value of new claims reported, a value of £2.1 billion. The value for claims relating to cerebral palsy and brain damage continues to rise despite the number of claims falling by 20.
It is estimated that the projected costs of obstetric payments to be made in 2018/19 could be £735.7 million.
NHS resolution is working on a number of initiatives to help improve care in maternity including informing the development of Rapid Resolution and Redress, a thematic review of cerebral palsy cases, incentivising safer care in maternity, further development of the Early Notification scheme and work to support the Getting it Right First Time (GIRFT) team at NHS Improvement.
The full report is available here with maternity information beginning on page 74.
Australian stillbirth rates – 56% reduction in road deaths but stillbirth rates remain unchanged
Data from 1996 to 2015 has shown that over the period road deaths have reduced by 56% but the rate of still births remains unchanged with twice as many stillborn compared to the number of people dying on the road.
Six babies are stillborn in Australia each day a rate that has remained relatively unchanged for a number of years. This article looks into why there is such limited awareness and draws on the work being conducted in the UK that has the potential to be applied across all higher income countries.
Cochrane Review – Vaginal preparation with antiseptic solution before caesarean section for preventing postoperative infections
The results of a Cochrane review into the use of antiseptic solution to prepare the vagina before caesarean section have been published. 11 randomised controlled studies were included involving 3403 women undergoing caesarean section. The study conclude:
‘Vaginal preparation with povidone-iodine or chlorhexidine solution compared to saline or not cleansing immediately before cesarean delivery probably reduces the risk of post-cesarean endometritis. Subgroup analysis could not rule out larger reductions in endometritis with antiseptics in women who were in labor or in women whose membranes had ruptured when antiseptics were used.’
It suggested that it was a simple, inexpensive way of lowering a women's chance of developing infection following caesarean section. Full review available here.
Preventing cerebral palsy in babies – A Case Study
Prevention of Cerebral Palsy in PreTerm Labour (PReCePT) is a scheme developed from a neonatologists proposal to increase use of magnesium sulphate as a treatment to protect the brain in pre-term babies. Up to 1 in 5 extremely preterm babies will develop cerebral palsy. A 2009 study showed magnesium sulphate was effective in reducing cerebral palsy. The scheme across 3 NHS trusts has increased uptake of magnesium sulphate from 30% to 85% with estimates that it will reduce cerebral palsy in 15 – 20 children per year. Find out more here.
Alterations in maternally perceived fetal movement and their association with late stillbirth – Study
A study covering 41 maternity units in the UK has looked into the association between maternally perceived fetal movements and late still birth. The study concluded
‘Increased strength of fetal movements and fetal hiccups is associated with decreased risk of stillbirth. Alterations in frequency of fetal movements are important in identifying pregnancies at increased risk of stillbirth, with the greatest risk in women noting a reduction in fetal activity. Clinical guidance should be updated to reflect that increase in strength and frequency of fetal movements is associated with the lowest risk of stillbirth, and that decreased fetal movements are associated with stillbirth.’
The full study can be accessed here.
Finding the root cause – video
This video from the National Perinatal Epidemiology Unit highlights how to address contributory factors that are identified at perinatal mortality review. The video uses examples to identify causes and strategies that are needed to effectively address them. It focuses on fetal growth scans in cases where small gestational age has not been identified antenatally.
Birth Trauma Awareness Week – 1st – 8th July
Each year many women experience a traumatic birth experience which can have a long-lasting impact on their health. Birth trauma can be both physical and mental and can also affect partners. This week birth trauma associations and support groups have been highlighting the impact of birth trauma. A new website has been launched - www.makebirthbetter.org - for women and their partners to find information throughout their pregnancy and share stories. It also has resources for care providers giving good practice examples.
A video has also been released from the UK Birth Trauma Association. In it Vice President of the RCOG Dr Alison Wright highlights the causes, symptoms and treatments for birth trauma and discusses what those who provide the care can do to help prevent it.
Refining standards of maternal-fetal care - Report
Health care professionals at Northwestern medicine in the US are working together to advance research in maternal-fetal medicine. obstetricians, neonatologists, psychiatrists plus biomedical engineers, pharmacologists and developmental psychologists are all collaborating on research. This article outlines some of their work including:
Happy 70th Birthday to the NHS
This week marks the celebrations for the 70th birthday of the NHS. Over the last 70 years Maternity teams have helped to deliver more than 50 millions babies. Over that period there has been significant progress in maternity care: