Reducing baby deaths and injuries

Each baby counts

The Royal College of Obstetricians and Gynaecologists has published Each Baby Counts: 2015 Summary Report.  This report provides a detailed analysis of all stillbirths, neonatal deaths and brain injuries that occurred during childbirth in 2015 and identifies the key clinical actions needed to improve the quality of care and prevent future cases. These clinical actions include: improving fetal monitoring; enhancing neonatal care; and reducing human factors by understanding ‘situational awareness’ to ensure the safe management of complex clinical decisions.

Click to read the report here
Read the RCOG press release here
RCM press release here

 

NIHR signals: A dose of corticosteroids benefit most women anticipating a preterm delivery

Preterm baby - pixabay
Image Source: Pixabay

Giving corticosteroids to most women who are anticipating labour before completing 37 weeks of pregnancy helps reduce immediate health problems in the baby compared with placebo or no intervention. Deaths around the time of birth were reduced by 28% and babies were a third (34%) less likely to develop respiratory distress syndrome.

A corticosteroid dose is already used for women who go into labour or if waters break before 37 weeks or where delivery is planned for other reasons. The drug accelerates the development of the baby’s lungs and reduces breathing difficulties at birth. This recommendation followed decades of research.

This review supports current practice of using a dose of corticosteroids in high-income settings and was designed to include more recent research and to look in more depth at new questions, such as the risk of infection. Evidence is still lacking in low-income settings and some very high-risk groups, like twins. There is also remaining uncertainty about the best corticosteroid, its dose and timing.

Read the full signal here

Supporting women’s health: resources for primary care

Pregnant woman wikimedia
Image Source: Wikimedia

The Royal College of General Practitioners has launched the Women’s Health Educational Framework. This is a new library of resources for women’s health, relevant for continuous professional development for GPs and other primary healthcare professionals. It contains the following sections:  maternal health; sexual and reproductive Health; pre-menopause; and peri/post-menopause. The resources include eLearning modules, national guidance, courses, workshops, journal articles and reviews on clinical or managerial topics of relevance to GPs and other primary healthcare professionals.

Visit the Women’s Health Educational Framework here

NIHR Signal: Induction of labour within 24 hours, if waters break at 37 weeks of pregnancy, can reduce womb infection

Newborn_infant_by_Bonnie_Gruenberg
Image Source: Wikimedia

Inducing labour may halve the risk of infection in the womb when waters break from 37 weeks. The procedure was started within 24 hours and was compared to waiting for labour to start on its own.

Waters breaking at full term without the onset of labour is called pre-labour rupture of membranes. This can increase risks of maternal and neonatal infection and the need for caesarean section. As most women deliver spontaneously within a day, NICE recommend that women are offered an informed choice of either induction 24 hours after premature rupture of membranes or to watch and wait.

This updated Cochrane review included new evidence and suggests that induction before 24 hours may reduce infections without increasing caesarean sections, but there remains some uncertainty. This is due to low study quality, lack of longer term outcomes, and too few participants in trials to compare the numbers of any rare serious events.

These findings may help inform shared decisions about induction by providing more information to help women understand the risks.

Read the full Signal here