Management of Inherited Bleeding Disorders in Pregnancy (RCOG Green-top Guideline No. 71)

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Women who have inherited bleeding disorders may be at significant risk of bleeding following miscarriage, abortion, antenatal procedures and delivery. They require multidisciplinary specialised care tailored to the individual, with cross-specialty communication, including anaesthetists and neonatologists as necessary.

The conditions covered in this guideline are haemophilia A and B, von Willebrand disease (VWD), factor XI deficiency, rare factor deficiencies, fibrinogen disorders, Bernard Soulier Syndrome (BSS), Glanzmann’s thrombasthenia (GT) and other platelet function disorders.

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.  This is the first edition of a combined United Kingdom Haemophilia Centre Doctors’ Organisation (UKHCDO) and Royal College of Obstetricians and Gynaecologists (RCOG) guideline although a previous guideline was written by the UKHCDO in 2006.

Read the full guideline here

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NIHR Signal: Fortified donor breast milk led to similar development for very-low-birthweight babies compared with formula milk

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Providing very-low-birthweight babies with fortified human donor breast milk made no difference to their developmental neurological outcomes at 18 months compared with giving formula.

This randomised controlled trial looked at 363 babies with birth weights of less than 1500g in neonatal intensive care units in Canada. When the mother’s own milk supply was limited, the babies were given either nutrient-enriched donor breast milk or formula developed for premature babies. There was no difference in their understanding, language, or ability to manipulate objects at 18 months.

This finding might help to reduce anxiety about providing formula in areas where donor breast milk is difficult to obtain. However, the research was focussed on developmental outcomes rather than potential effects of donor breast milk on other risks of prematurity, such as immunity or gastrointestinal complications.

This trial will continue to collect data to re-assess developmental outcomes when the children reach five years of age.

Read the full signal here

Breastfeeding prevalence at 6-8 weeks after birth: 2016 to 2017 Q3 data

Public Health England statistics and statistical commentary on the prevalence of breastfeeding.

The aggregate breastfeeding rate for England for Quarter 3 2016/17 (October to December 2016) is 44.1% (with confidence intervals of 43.9 – 44.4%)
 Breastfeeding prevalence can be published for 73 local authorities (passing all 3 stages of validation) and percentages range from 19.0% to 76.9%.

View statistics here

Always Ask – safer pregnancy campaign

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The Royal College of Midwives has endorsed a new campaign called Always ask which is designed to empower pregnant women to overcome fears of asking health professionals questions. The campaign is designed to reduce the number of women who have serious pregnancy complications, or a loss that could have been prevented.  The campaign is joint one by Tommys, Kings College London and BabyCentre.  It centres on two animation co-created with women and health professionals, and follows recent research from Babycentre that shows more than 60% of women worry that they’re wasting midwives’ time, so don’t ask about health concerns.

Click here for more information on the campaign from Tommys and to view the videos.