Analyzing Support of Postnatal Transition in Term Infants After C-section

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2014 Jul 12

PMID 25011378

Citations 5

Authors

Dimitrios Konstantelos

Sascha Ifflaender

Jurgen Dinger

Wolfram Burkhardt

Mario Rudiger

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

[Perinatal Networks: Ensuring Regional Care of Pregnant Woman and Newborns].

Rudiger M, Reichert J, Schmitt J, Birdir C Z Geburtshilfe Neonatol. 2024; 228(2):127-134.

PMID: 38365210 PMC: 11014747. DOI: 10.1055/a-2211-7018.

Survey on currently applied interventions in neonatal resuscitation (SCIN): A study protocol.

Eckart F, Kaufmann M, ODonnell C, Mense L, Rudiger M Front Pediatr. 2023; 10:1056256.

PMID: 36699288 PMC: 9868920. DOI: 10.3389/fped.2022.1056256.

Tactile stimulation in the delivery room: past, present, future. A systematic review.

Kaufmann M, Mense L, Springer L, Dekker J Pediatr Res. 2022; 96(3):616-624.

PMID: 35124690 PMC: 11499275. DOI: 10.1038/s41390-022-01945-9.

Video recording in the delivery room: current status, implications and implementation.

Simma B, den Boer M, Nakstad B, Kuster H, Herrick H, Rudiger M Pediatr Res. 2021; 96(3):610-615.

PMID: 34819653 DOI: 10.1038/s41390-021-01865-0.

Analyzing video recorded support of postnatal transition in preterm infants following a c-section.

Konstantelos D, Dinger J, Ifflaender S, Rudiger M BMC Pregnancy Childbirth. 2016; 16:246.

PMID: 27561701 PMC: 5000427. DOI: 10.1186/s12884-016-1045-2.

References

Waltman P, Brewer J, Rogers B, May W . Building evidence for practice: a pilot study of newborn bulb suctioning at birth. J Midwifery Womens Health. 2004; 49(1):32-8. DOI: 10.1016/j.jmwh.2003.10.003. View

McCarthy L, Twomey A, Molloy E, Murphy J, ODonnell C . A randomized trial of nasal prong or face mask for respiratory support for preterm newborns. Pediatrics. 2013; 132(2):e389-95. DOI: 10.1542/peds.2013-0446. View

Davis P, Dawson J . New concepts in neonatal resuscitation. Curr Opin Pediatr. 2012; 24(2):147-53. DOI: 10.1097/MOP.0b013e3283504e11. View

Konstantelos D, Gurth H, Bergert R, Ifflaender S, Rudiger M . Positioning of term infants during delivery room routine handling - analysis of videos. BMC Pediatr. 2014; 14:33. PMC: 3922774. DOI: 10.1186/1471-2431-14-33. View

Te Pas A, Walther F . A randomized, controlled trial of delivery-room respiratory management in very preterm infants. Pediatrics. 2007; 120(2):322-9. DOI: 10.1542/peds.2007-0114. View

. The International Liaison Committee on Resuscitation (ILCOR) consensus on science with treatment recommendations for pediatric and neonatal patients: neonatal resuscitation. Pediatrics. 2006; 117(5):e978-88. DOI: 10.1542/peds.2006-0350. View

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. 2009; 95(1):F78. DOI: 10.1136/adc.2009.168112. View

Kelleher J, Bhat R, Salas A, Addis D, Mills E, Mallick H . Oronasopharyngeal suction versus wiping of the mouth and nose at birth: a randomised equivalency trial. Lancet. 2013; 382(9889):326-30. DOI: 10.1016/S0140-6736(13)60775-8. View

Perlman J, Wyllie J, Kattwinkel J, Atkins D, Chameides L, Goldsmith J . Neonatal resuscitation: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Pediatrics. 2010; 126(5):e1319-44. DOI: 10.1542/peds.2010-2972B. View

10.

Klingenberg C, Sobotka K, Ong T, Allison B, Schmolzer G, Moss T . Effect of sustained inflation duration; resuscitation of near-term asphyxiated lambs. Arch Dis Child Fetal Neonatal Ed. 2012; 98(3):F222-7. DOI: 10.1136/archdischild-2012-301787. View

11.

Clark S, Belfort M, Hankins G, Meyers J, Houser F . Variation in the rates of operative delivery in the United States. Am J Obstet Gynecol. 2007; 196(6):526.e1-5. DOI: 10.1016/j.ajog.2007.01.024. View

12.

Jeffcott S, Mackenzie C . Measuring team performance in healthcare: review of research and implications for patient safety. J Crit Care. 2008; 23(2):188-96. DOI: 10.1016/j.jcrc.2007.12.005. View

13.

APGAR V . A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953; 32(4):260-7. View

14.

Villar J, Carroli G, Zavaleta N, Donner A, Wojdyla D, Faundes A . Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ. 2007; 335(7628):1025. PMC: 2078636. DOI: 10.1136/bmj.39363.706956.55. View

15.

Villar J, Valladares E, Wojdyla D, Zavaleta N, Carroli G, Velazco A . Caesarean delivery rates and pregnancy outcomes: the 2005 WHO global survey on maternal and perinatal health in Latin America. Lancet. 2006; 367(9525):1819-29. DOI: 10.1016/S0140-6736(06)68704-7. View

16.

Rudiger 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(11):749-53. DOI: 10.1016/j.earlhumdev.2011.08.019. View

17.

Kamlin C, ODonnell C, Everest N, Davis P, Morley C . Accuracy of clinical assessment of infant heart rate in the delivery room. Resuscitation. 2006; 71(3):319-21. DOI: 10.1016/j.resuscitation.2006.04.015. View

18.

Kamlin C, Schilleman K, Dawson J, Lopriore E, Donath S, Schmolzer G . Mask versus nasal tube for stabilization of preterm infants at birth: a randomized controlled trial. Pediatrics. 2013; 132(2):e381-8. DOI: 10.1542/peds.2013-0361. View

19.

Tita A, Landon M, Spong C, Lai Y, Leveno K, Varner M . Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med. 2009; 360(2):111-20. PMC: 2811696. DOI: 10.1056/NEJMoa0803267. View