National Pregnancy in Diabetes Audit Report 2020

The National Pregnancy in Diabetes (NPID) Audit, which measures the quality of antenatal care and pregnancy outcomes for women with pre-gestational diabetes, has published its report for 2020.

Overall, there were 4,525 pregnant women with diabetes in 2020 – 325 fewer pregnancies than 2019 – of which, 54% had type 2 diabetes (44% had type 1 diabetes and 2% were recorded as having ‘other diabetes’). Key findings include:

• There are now more pregnancies in women with type 2 diabetes, than in women with type 1 diabetes (54% of diabetes’ pregnancies, compared to 47% in 2014).
• Women with type 2 diabetes face additional healthcare inequalities and are frequently not prepared for pregnancy (reduced use of insulin and folic acid before pregnancy), and
• Despite the additional challenges of supporting women with diabetes during the COVID-19 pandemic, pregnancy outcomes are comparable in 2019 and 2020.

Read the full report here

National Maternity and Perinatal Audit Clinical Report 2021

National Maternity and Perinatal Audit (NMPA), which measures a care and outcomes and provides this data to maternity providers to facilitate quality improvement, has published its third report.

Image source: HQIP

Key clinical findings, when comparing this data to the 2015/16 NMPA clinical report, include:

• The proportion of newborns born small for gestational age at term has declined in Scotland and Wales year-on-year (from 53.8% to 49% in Scotland, and from 62.2% to 57.7% in Wales)
• The proportion of babies born in Scotland and Wales with 5 minute Apgar score of less than 7 has increased (from 1.3% to 1.53% in Scotland, and from 1.1% to 1.24% in Wales), and
• The proportion of women in Scotland and Wales who experience induction of labour at term has increased (from 32.2% to 35.1% in Scotland, and from 32.1% to 34.1% in Wales).

Read the full report here

Perinatal Mortality Review Tool – Third Annual Report

The National Perinatal Mortality Review Tool (PMRT), which aims to provide answers for bereaved parents and their families about why their baby died, has published its third annual report, entitled Learning from Standardised Reviews When Babies Die .

Overall, 3,981 reviews were carried out across England, Scotland, Wales and North Ireland, 97% of which identified at least one issue with care (with an average of four issues per death reviewed, increasing to five issues per death where the baby was born at term). Other key findings include:

• Not all parents for whom a review was conducted were told that it would take place (90% of parents were notified)
• Inadequate fetal growth surveillance was identified as relevant in 9% of deaths reviewed, and remains the most common single issue, and
• Inadequate investigation or management of reduced fetal movement was the second most common single issue (relevant in 8% of deaths reviewed).

Read the full report here

Delivering Midwifery Continuity of Carer at full scale: Guidance on planning, implementation and monitoring 2021/22

This document from NHS England provides guidance for maternity services and Local Maternity Systems on how to develop a local plan for achieving Midwifery Continuity of Carer as the default model of care offered to all women. View the document here

Using Tocilizumab or Sarilumab for hospitalised patients with COVID-19 who are pregnant

This page from the Specialist Pharmacy Service signposts to current guidance on this off-label use of the two medicines from the UK Royal College of Obstetricians and Gynaecologists and UKTIS. Healthcare professionals are encouraged to contact UKTIS should they be considered for use. See also Using Tocilizumab or Sarilumab for hospitalised patients with COVID-19 who are breastfeeding and Breastfeeding with COVID-19 infection 12 October 2021

Genomics in midwifery

Health Education England have created a new resource to support midwives exploring the topic of genomics as it is now included in the NMC standards of proficiency.

Image source: HEE

Tests like non-invasive prenatal testing, newborn bloodspot testing etc all fall into the category of genomic testing, but it is also much wider.

Check out the resource here