Cytomegalovirus (CMV), a member of the human herpesvirus family, is the most common viral cause of congenital infection, affecting 0.2–2.2% of all live births. It is responsible for significant morbidity, especially in infants who are symptomatic in the neonatal period. It is the leading non-genetic cause of sensorineural hearing loss and a major cause of neurological disability. Around 10–15% of neonates with congenital CMV will be symptomatic at birth, with a similar percentage developing problems later in childhood.
This Scientific Impact Paper summarises the issues around screening, diagnosis and treatment of CMV in pregnancy, utilising the best available evidence and highlighting recent advances.
Khalil A, Heath P, Jones C, Soe A, Ville YGon behalf of the Royal College of Obstetricians and Gynaecologists. Congenital Cytomegalovirus Infection: Update on Treatment. Scientific Impact Paper No. 56. BJOG2017; DOI: 10.1111/1471-0528.14836.
The Twins and Multiple Births Associations (Tamba) has published Twin pregnancy and neonatal care in England: a Tamba report November 2017. This report includes information from neonatal networks for stillbirth rates, neonatal death rates, NICE compliance and neonatal admissions for twins. The authors suggest admissions of twins to neonatal units could be reduced by a third per year if all neonatal networks had the lowest admission rate.
Giving low dose aspirin to high-risk women reduced their risk of pre-eclampsia before 37 weeks of pregnancy. Preterm pre-eclampsia developed in 1.6% of women given 150mg aspirin daily compared with 4.3% who took a placebo.
Pre-eclampsia is a condition which can harm mother and baby. In the mother, it causes high blood pressure and protein in the urine, which can show in pregnancy after 20 weeks. Women with risk factors, such as previous pre-eclampsia, diabetes or high blood pressure, are often prescribed 75mg aspirin from 12 weeks onwards. This study aimed to test double this dose (still classified as a `low dose’) after using a new risk assessment with additional clinical tests to better identify those at high risk of the condition. Aspirin did not affect other pregnancy outcomes and didn’t increase the risk of adverse effects.
This research adds to current knowledge about the range of doses that is effective and refines the definition and detection of women at high risk. The research did not compare 75mg with 150mg doses.
For the first time these statistics from NHS Digital will combine reporting from two data sources for maternity information – Hospital Episode Statistics (HES) and Maternity Services Data Set (MSDS) – to give a fuller picture of NHS maternity activity for deliveries in 2016/17. This publication was previously named Hospital Maternity Activity.
• There were 636,401 deliveries in NHS hospitals during 2016-17, a decrease of 1.8 per cent from 2015-16.
• The proportion of deliveries with a spontaneous onset of labour has decreased from 68.7 per cent in 2006-07 to 55.1 per cent in 2016-17.
• The proportion of deliveries where labour was induced has increased from 20.3 per cent in 2006-07 to 29.4 per cent in 2016-17.
• In 2016-17, 355,850 deliveries were recorded within the MSDS by 111 maternity service providers.
• 80.0 per cent of women with babies born at 37 weeks gestation or more had skin-to-skin contact within one hour of the birth.
• 11.6 per cent of women with a recorded smoking status at their booking appointment were smokers.
The Royal College of Nursing has published Clinical nurse specialist in early pregnancy care. This document outlines the key skills and knowledge required to develop the role of the clinical nurse specialist in early pregnancy care. It is intended to provide direction for commissioners and managers when creating roles to support best practice in local service provision for women and their families.
Annual birth statistics from the Office for National Statistics, including birthweight, place of birth, multiple births and stillbirths. According to the Royal College of Midwifes (RCM) ONS’ latest figures show that in 2016, the stillbirth rate for England and Wales fell to 4.4 per 1000 total births; the lowest rate since 1992 when it was 4.3.
The data also revealed that the percentage of women having home births in 2016 was 2.1% – a small decrease compared with 2012 to 2015 when it was 2.3%.
Of the 696,271 live births in 2016, 7% (48,490) were low birthweight (under 2.5kg), which has remained the same since 2011.
Newborn blood spot screening failsafe solution (NBSFS) is a new IT system that minimises the risk of babies missing, or having delayed, newborn blood spot (NBS) screening. This guide from Public Health England explains how to use the NBSFS.
Download a quick reference guide, training guides and forms here