The study shows the preventability of fetal or neonatal adverse outcomes


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A study led by a researcher at Te Herenga Waka – Victoria University of Wellington, shows that more than half of adverse fetal or neonatal outcomes related to women with life-threatening complications during pregnancy could have been prevented.

The study, published in Australian and New Zealand Journal of Obstetrics and Gynecology, fetal or neonatal harm associated with severe maternal morbidity (SMM) was found to be potentially preventable in 54.1 percent of the 85 cases reviewed. Adverse outcomes include death and admission to or special care baby unit.

Prevention was related to prenatal / peripartum maternal care (in utero) in 39% of cases, initial neonatal care (ex utero) in 36% and maternal and neonatal care in 20% of cases. cases.

SMM occurs in 1-2 percent of pregnancies. Although it has been linked to poor outcomes for the baby, there has been limited research on how these outcomes could be prevented.

The study showed that the main contributors to potential prevention were lack of high-risk recognition, delayed diagnosis, or failure in diagnosis and delayed or inappropriate treatment.

Senior Research Professor Bev Lawton (Ngāti Porou), director of Te Tātai Hauora or Hine – Te Wāhanga Tātai Hauora University Women’s Health Research Center at Wellington School of Health, says that when a pregnant mother is ill often the whole focus of attention moves. as far as the big event is going.

“But we have to think about both. We’ve discovered that you could do a lot of things that could give the baby a better result in these very serious situations where the mother is very ill.

“Many of these things are routine. Things like keeping the baby warm, checking the baby’s temperature and the room temperature is correct, this is a recommendation from the World Health Organization, but we know it’s a problem. , check that the baby does not have blood sugar and things like sepsis are simple things.

“In the study, we found that there were mistakes in care. Humans make mistakes, we need to know how to limit them. There are some very enjoyable learnings for people here and we can act on them.”

According to her, protocols such as making sure someone is engaged in caring for the baby during this event would be helpful.

“Some hospitals usually have this overseas, but I don’t think we have it as a protocol here. In smaller hospitals, it’s difficult because of the extra hands needed.”

Professor Lawton says this is the first study of its kind to look at the full pathway of care from maternity to neonatal, identifying opportunities to improve the fetus and at various points.

“It was pretty new, obstetricians, midwives, pediatricians and neonatal nurses looked at this together instead of just in their own area. We found that we could do things to improve the baby’s health, just like we could do with mom.

“This is a preliminary study. We need to review more cases and delve deeper into our practice; see what happens in these circumstances and if there is any protocol we would like to introduce or if we already have it, are we really doing that?”

A previous study showed that nearly half of SMM cases had fetal or neonatal adverse outcomes and mothers were more than 10 times more likely to give birth at less than 32 weeks of gestation.

Simple follow-up of fetal heartbeats is even better for reducing unnecessary cesarean sections

More information:
Beverley Lawton et al, Examining the possibility of preventing possible fetal / neonatal adverse outcomes associated with severe maternal morbidity, Australian and New Zealand Journal of Obstetrics and Gynecology (2021). DOI: 10.1111 / ajo.13404

Citation: The study shows the preventability of adverse fetal or neonatal outcomes (2021, July 14) recovered on July 14, 2021 at html

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