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| credit: whattoexpect.com |
"In their latest report a team of academics, clinicians and charity representatives, called MBRRACE-UK, has looked at the quality of care for stillbirths and neonatal deaths of babies born at term who were alive at the onset of labour, singletons (sole births) and who were not affected by a major congenital anomaly. This type of death occurred in 225 pregnancies in 2015 in the UK. It is important to study the deaths of these babies as any normally formed baby who is alive at the onset of labour at term would be expected to be alive and healthy at birth.
A random representative sample of 78 of these babies who were born in 2015 was selected. The care provided for these mothers and babies was reviewed in detail against national care guidelines by a panel of clinicians, including midwives, obstetricians, neonatologists, neonatal nurses and pathologists who considered every aspect of the care.
Professor Elizabeth Draper, Professor of Perinatal and Paediatric Epidemiology at University of Leicester said: "The premise of the enquiry was that these babies would be born alive and healthy. Findings from the panels indicated that improvements in care may have made a difference to the outcome for almost 80% of cases.
"The main issues identified were care before labour was established including induction, monitoring during labour, delay in expediting birth, heavy workload of the units, a lack of joint obstetric and neonatal input into bereavement care and a lack of rigour in the local review of the deaths."
Main findings from the expert enquiry included:
'service capacity' affected over a fifth of the deaths reviewed.
heavy workload contributed to delays in induction in one third of cases being induced
there was a significant delay in both the decision to expedite the birth and in actually achieving birth in approximately a third of the deaths reviewed.
there was a failure to recognise the transition to the active phase of labour and to institute appropriate monitoring in one-eighth of cases
there were errors in the method, interpretation, escalation and response to fetal monitoring during labour.
* two fifths of babies had intermittent auscultation. This was not compliant with national guidance in a third of cases in the first stage of labour and a quarter in the second stage.
* continuous electronic fetal monitoring was not commenced in a quarter of cases where abnormalities were detected by intermittent auscultation
* there were delays in referral in nearly half of cases where escalation was required..."
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A random representative sample of 78 of these babies who were born in 2015 was selected. The care provided for these mothers and babies was reviewed in detail against national care guidelines by a panel of clinicians, including midwives, obstetricians, neonatologists, neonatal nurses and pathologists who considered every aspect of the care.
Professor Elizabeth Draper, Professor of Perinatal and Paediatric Epidemiology at University of Leicester said: "The premise of the enquiry was that these babies would be born alive and healthy. Findings from the panels indicated that improvements in care may have made a difference to the outcome for almost 80% of cases.
"The main issues identified were care before labour was established including induction, monitoring during labour, delay in expediting birth, heavy workload of the units, a lack of joint obstetric and neonatal input into bereavement care and a lack of rigour in the local review of the deaths."
Main findings from the expert enquiry included:
'service capacity' affected over a fifth of the deaths reviewed.
heavy workload contributed to delays in induction in one third of cases being induced
there was a significant delay in both the decision to expedite the birth and in actually achieving birth in approximately a third of the deaths reviewed.
there was a failure to recognise the transition to the active phase of labour and to institute appropriate monitoring in one-eighth of cases
there were errors in the method, interpretation, escalation and response to fetal monitoring during labour.
* two fifths of babies had intermittent auscultation. This was not compliant with national guidance in a third of cases in the first stage of labour and a quarter in the second stage.
* continuous electronic fetal monitoring was not commenced in a quarter of cases where abnormalities were detected by intermittent auscultation
* there were delays in referral in nearly half of cases where escalation was required..."
Learn more:
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