Analyzing support of postnatal transition in term infants after c-section

BMC Pregnancy and Childbirth

Mario Rüdiger¹  Wolfram Burkhardt¹  Jürgen Dinger¹  Sascha Ifflaender¹  Dimitrios Konstantelos¹ 

[1] Department of Neonatology and Pediatric Intensive Care, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Fetscherstraße 74, Dresden 01307, Germany

关键词: Transition;    Video recording;    Delivery room;   

Others  :  840658
DOI  :  10.1186/1471-2393-14-225

 received in 2014-04-22, accepted in 2014-07-09,  发布年份 2014

【 摘 要 】

Background

Whereas good data are available on the resuscitation of infants, little is known regarding support of postnatal transition in low-risk term infants after c-section. The present study was performed to describe current delivery room (DR) management of term infants born by c-section in our institution by analyzing videos that were recorded within a quality assurance program.

Methods

DR- management is routinely recorded within a quality assurance program. Cross-sectional study of videos of term infants born by c-section. Videos were analyzed with respect to time point, duration and number of all medical interventions. Study period was between January and December 2012.

Results

186 videos were analyzed. The majority of infants (73%) were without support of postnatal transition. In infants with support of transition, majority of infants received respiratory support, starting in median after 3.4 minutes (range 0.4-14.2) and lasting for 8.8 (1.5-28.5) minutes. Only 33% of infants with support had to be admitted to the NICU, the remaining infants were returned to the mother after a median of 13.5 (8-42) minutes. A great inter- and intra-individual variation with respect to the sequence of interventions was found.

Conclusions

The study provides data for an internal quality improvement program and supports the benefit of using routine video recording of DR-management. Furthermore, data can be used for benchmarking with current practice in other centers.

【 授权许可】

   
2014 Konstantelos et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Perlman JM, Wyllie J, Kattwinkel J, Atkins DL, Chameides L, Goldsmith JP, Guinsburg R, Hazinski MF, Morley C, Richmond S, Simon WM, Singhal N, Szyld E, Tamura M, Velaphi S: Neonatal Resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Pediatrics 2010, 126(Suppl 5):e1319-e1344.
• [2]International Liaison Committee on Resuscitation: The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: neonatal resuscitation. Pediatrics 2006, 117(Suppl 5):e978-e988.
• [3]Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A, Velazco A, Bataglia V, Langer A, Narváez A, Valladares E, Shah A, Campodónico L, Romero M, Reynoso S, de Pádua KS, Giordano D, Kublickas M, Acosta A: Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ (Clin Res ed) 2007, 335:1025.
• [4]Tita AT, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, Moawad AH, Caritis SN, Meis PJ, Wapner RJ, Sorokin Y, Miodovnik M, Carpenter M, Peaceman AM, O'Sullivan MJ, Sibai BM, Langer O, Thorp JM, Ramin SM, Mercer BM: Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med 2009, 360:111-120.
• [5]Farchi S, Di Lallo D, Polo A, Franco F, Lucchini R, De Curtis M: Timing of repeat elective caesarean delivery and neonatal respiratory outcomes. Arch Dis Child Fetal Neonatal Ed 2010, 95(Suppl 1):F78.
• [6]Clark SL, Belfort MA, Hankins GD, Meyers JA, Houser FM: Variation in the rates of operative delivery in the United States. Am J Obstet Gynecol 2007, 196(Suppl 6):526.e1-526.e5.
• [7]Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A, Shah A, Campodónico L, Bataglia V, Faundes A, Langer A, Narváez A, Donner A, Romero M, Reynoso S, de Pádua KS, Giordano D, Kublickas M, Acosta A: Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet 2005, 2006(367):1819-1829.
• [8]Konstantelos D, Gurth H, Bergert R, Ifflaender S, Rüdiger M: Positioning of term infants during delivery room routine handling - analysis of videos. BMC Pediatr 2014, 14:33.
• [9]Apgar V: A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg 1953, 32(Suppl 4):260-267.
• [10]Davis PG, Dawson JA: New concepts in neonatal resuscitation. Curr Opin Pediatr 2012, 24(Suppl 2):147-153.
• [11]Rüdiger M, Braun N, Gurth H, Bergert R, Dinger J: Preterm resuscitation I: clinical approaches to improve management in delivery room. Early Hum Dev 2011, 87(Suppl 11):749-753.
• [12]Rüdiger M, Aguar M: Newborn assessment in the delivery room. Neoreviews 2012, 13:e336-e342.
• [13]Jeffcott SA, Mackenzie CF: Measuring team performance in healthcare: review of research and implications for patient safety. J Crit Care 2008, 23(suppl 2):188-196.
• [14]Klingenberg C, Sobotka KS, Ong T, Allison BJ, Schmölzer GM, Moss TJ, Polglase GR, Dawson JA, Davis PG, Hooper SB: Effect of sustained inflation duration; resuscitation of near-term asphyxiated lambs. Arch Dis Child Fetal Neonatal Ed 2013, 98(Suppl 3):F222-F227.
• [15]Kamlin CO, O'Donnell CP, Everest NJ, Davis PG, Morley CJ: Accuracy of clinical assessment of infant heart rate in the delivery room. Resuscitation 2006, 71(Suppl 3):319-321.
• [16]te Pas AB, Walther FJ: A randomized, controlled trial of delivery-room respiratory management in very preterm infants. Pediatrics 2007, 120(Suppl 2):322-329.
• [17]Taeusch HW, Ballard RA, Gleason CA, Avery ME: Avery’s Diseases of the Newborn. 2004. [Elsevier Health Sciences]
• [18]Kamlin CO, Schilleman K, Dawson JA, Lopriore E, Donath SM, Schmölzer GM, Walther FJ, Davis PG, Te Pas AB: Mask versus nasal tube for stabilization of preterm infants at birth: a randomized controlled trial. Pediatrics 2013, 132(Suppl 2):381-388.
• [19]McCarthy LK, Twomey AR, Molloy EJ, Murphy JF, O'Donnell CP: A randomized trial of nasal prong or face mask for respiratory support for preterm newborns. Pediatrics 2013, 132(Suppl 2):389-395.
• [20]Waltman PA, Brewer JM, Rogers BP, May WL: Building evidence for practice: a pilot study of newborn bulb suctioning at birth. J Midwifery Womens Health 2004, 49(Suppl 1):32-38.
• [21]Kelleher J, Bhat R, Salas AA, Addis D, Mills EC, Mallick H, Tripathi A, Pruitt EP, Roane C, McNair T, Owen J, Ambalavanan N, Carlo WA: Oronasopharyngeal suction versus wiping of the mouth and nose at birth: a randomised equivalency trial. Lancet 2013, 382:326-330.