National Institute for Health Research Signal – General surgery is mostly safe during pregnancy
Routine data from English hospitals show that general surgery during pregnancy, such as removing the appendix or gallbladder, does not commonly harm mother or baby. This suggests that surgery in pregnant women is generally safe, but that mothers could be provided with more specific estimates of the risks.
This large observational study assessed the “real world” outcomes of nearly 6.5 million pregnancies at hospitals in England over a 10-year period.
Women who had surgery during pregnancy for a condition unrelated to pregnancy were slightly more likely to experience miscarriage, preterm or caesarean delivery or a long stay in hospital. Babies were more also slightly more likely to be low birthweight or stillborn.
However, the actual risks of negative outcomes were small. For example, 287 pregnant women would need to have surgery for one to experience a stillbirth and it was not possible to balance the benefits of their surgery against this as procedures were so varied.
There isn’t any guidance on surgery in pregnancy in the UK, so these findings may be useful when discussing surgery and the associated risks with pregnant women.
The National Federation of Women’s Institutes (NFWI) and National Childbirth Trust have published Support overdue: women’s experiences of maternity services 2017. This report presents the findings of the NFWI’s and NCT’s second survey of women’s experiences of maternity care, providing insights into key aspects of the experiences of 2,500 women. Women are generally positive about the maternity care they receive and many praised the professionalism of the staff who cared for them but some findings gave cause for concern.
The Newborn Blood Spot Failsafe Solution (NBSFS) IT system, which flags up babies who may have missed screening, is now complete in all parts of England. The NHS Newborn Blood Spot (NBS) Screening Programme uses a heel prick test to screen newborn babies for 9 rare but serious conditions. Babies who test positive can then be treated early, improving their health and, in some cases, preventing severe disability or even death. For some time, the system has been able to identify babies who have had no NBS screening at all, but until now it couldn’t always track babies who needed a repeat test.
Link to Public Health England Blood Spot Screening Programme here
The project is the establishment of a specialist antenatal clinic, which takes a multi-disciplinary team approach to the care and management of women with chronic hypertension in pregnancy. It took place at Guy’s & St Thomas’ NHS Foundation Trust, and is based on NICE guideline CG107 (Hypertension in pregnancy: diagnosis and management) and Quality Standard 35 (Hypertension in pregnancy)
The Mums and Babies in Mind (MABIM) team have launched their first toolkit to support the development of Specialist Perinatal Mental Health Community Teams. The toolkit is a set of example documents, templates and tools from existing perinatal mental health community services and is for anyone setting up or running a specialist perinatal mental health community service.
Alongside this, a compilation of Leaders’ Top Tips from the first MABIM masterclass in October is also available to download.
Toolkit and Leaders’ Top Tips report available to download here
A new way forward – by Jennie Walker, Assistant Head of Patient Choice
“By the end of this financial year there will be women in sites across the country benefiting from a more open and transparent conversation about the choices available to them and choosing how they are supported in each stage of their maternity and birth journey.”