NHS Improvement has published A guide to support maternity safety champions. This guide is for maternity safety champions at the frontline, trust board and regional levels. It outlines broad role descriptions and responsibilities, suggests activities to promote best practice and signposts existing safety initiatives and improvements.
This is the second edition of this guidance which was previously published in June 2010 under the title Surgical Evacuation of the Uterus for Early Pregnancy Loss.
This paper provides advice for health professionals obtaining consent from women undergoing surgical management of miscarriage with electric or manual vacuum aspiration. It is also intended to be appropriate when surgical intervention is indicated for an incomplete termination of pregnancy, incomplete or delayed miscarriage, or partially retained placenta after delivery. After careful discussion with the woman, the consent form should be edited under the heading ‘Name of proposed procedure or course of treatment’ to accurately describe the exact procedure to be performed.
In 2014, the previous surveillance decision was that the guideline should be updated but that the update should wait until the following reports had published:
Scientific Advisory Committee on Nutrition (SACN) working group review of the dietary reference values for vitamin D intake.
NICE public health guideline on vitamin D.
The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) report on assessing the health benefits and risks of the introduction of peanut and hen’s egg into the infant diet before six months of age in the UK.
SACN sub-group on Maternal and Child Nutrition (SMCN) report on feeding in the first year of life.
The first 3 listed reports have published, and the SACN’s report on feeding in the first year of life is expected to publish in mid-2018. Additionally, several of NICE’s maternity-related guidelines are currently being updated and there are plans to update NICE guidance on weight management before during and after pregnancy.
After considering all the evidence and views of topic experts, it was decided that a full update is necessary for this guideline.
Read the full details on evidence and reasoning behind the proposed update here
The World Health Organization has published Intrapartum care for a positive childbirth experience. This guideline brings together new and existing WHO recommendations that, when delivered as a package, will ensure good-quality and evidence-based care irrespective of the setting or level of health care. It highlights the importance of woman-centred care to optimize the experience of labour and childbirth for women and their babies. It includes 56 evidence-based recommendations on what care is needed throughout labour and immediately after for the woman and her baby.
Delays to clamping the umbilical cord of about a minute can reduce hospital mortality for preterm infants by around 32%. Delayed clamping also reduced the proportion of infants needing a blood transfusion by 10%.
This review adds more precise data on survival from new trials including a large Australian trial (over 1,600 babies) to a previous Cochrane 2012 review of trails including 738 infants and provides new more precise data on the survival benefit.
These findings are consistent with current guidelines which recommend delayed clamping in preterm infants.
“Cheap, quick and effective interventions in medicine are rare, but delayed clamping of the umbilical cord at birth appears to be just that.
A systematic review of 18 trials including almost 3,000 preterm babies confirms that delaying cord clamping by 60 seconds reduces mortality before hospital discharge. It also makes it less likely that babies will need blood transfusions, and there is no apparent increase in morbidity for mother or baby.
On a worldwide scale, given the large number of babies born before 37 weeks of gestation, the potential benefits of waiting patiently for just one minute are huge.”
Dr Elaine Boyle, Associate Professor in Neonatal Medicine, University of Leicester; Honorary Consultant Neonatologist, University Hospitals of Leicester NHS Trust
Do you work with women with learning disabilities? Can you help PHE with their online survey? Publishing easy guides is one way PHE aims to reduce inequalities, by allowing everybody to get the information they need to make informed decisions about screening.
With support from PHE Screening, NHS England is beginning an evaluation of how information on antenatal and newborn screening is provided to women with learning disabilities in London. They would like feedback on the ‘Screening tests for you and your baby: easy guides’ from anyone involved in the antenatal and newborn screening pathway. Please complete the short survey which closes on 1 March 2018.
More information and the survey link is available here
A new study, by Queen Mary University of London and the School of Advanced Study, University London, shows that the maximum suggested intake of folate (1mg/day) is based on ‘flawed’ analysis. The RCOG responded to this article in terms of its significance in helping to remove barriers to folic acid fortification of foods such as flour.
Public health failure in the prevention of neural tube defects: time to abandon the tolerable upper intake level of folate. Nicholas J. Wald, Joan K. Morris, Colin Blakemore. Public Health Reviews 201839:2 https://doi.org/10.1186/s40985-018-0079-6
The full text article is available on open access here