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Found 549 results
  1. Content Article
    The purpose of this investigation by the Healthcare Safety Investigation Branch (HSIB) was to consider the management and care of preterm labour and birth of twins. Preterm birth—defined as babies born alive before the completion of 37 weeks of pregnancy—is one of the main causes of death, long-term conditions and disability in under-fives worldwide, and 60% of twin pregnancies result in premature birth. The reference event for this investigation was the case of Sarah, who was pregnant with twins and was overseen by an obstetrician during her pregnancy. Sarah was assessed as having a higher-risk pregnancy as she had had previous medical intervention on her cervix and was pregnant with twins. Shortly after having been discharged from a hospital with a specialist neonatal unit following suspected early labour, she went to her local maternity unit at 29+2 weeks with further episodes of abdominal tightening. Her labour did not progress as expected and a caesarean section was required to deliver the babies at 29+6 weeks. The twin girls were born well, but 23 days after their birth a scan revealed brain injury in both babies. The investigation identified several findings to explain the experience of the mother in the reference event, including the lack of scientific evidence or specific guidelines and the uncertainty associated with the clinical decision making in this scenario. This highlighted the need for further research into preterm labour as a recognised risk factor for twin pregnancies. As part of the investigation, HSIB identified that since 2019 a large volume of national work and research in the area of twin pregnancy and preterm birth has been undertaken. The investigation report sets out the work currently in progress and seeks to understand if it will address gaps in knowledge.
  2. Content Article
    This report by Best Beginnings, Home-Start UK and the Parent-Infant Foundation highlights the impact Covid-19 and measures introduced to control its spread have had on babies. It highlights a “baby blindspot” in Covid-19 recovery efforts and a shortage of funding for voluntary sector organisations and core services like health visiting to offer the level of support required to meet families’ needs. The authors of the report spoke to mothers of babies born during the pandemic and surveyed professionals and volunteers who work with babies and their families.
  3. Content Article
    Infant mental health describes the social and emotional wellbeing and development of children in the earliest years of life. It reflects whether children have the secure, responsive relationships that they need to thrive. However, services supporting infant mental health are currently limited; only 42% of CCGs in England report that their CAMHS service will accept referrals for children aged 2 and under. This briefing by the Parent-Infant Foundation is aimed at commissioners looking to set up specialist infant mental health support.
  4. News Article
    Senior health officials are to face questioning over why pregnant women are still being prescribed sodium valproate despite its known risks as a cause of birth defects or developmental delays. Campaigners for families affected by the drug will also give evidence to the Health and Social Care Committee in a one-off session later this month. Alongside campaigners on sodium valproate, the Committee will also hear from campaigners from Association for Children Damaged by Hormone Pregnancy Tests and on behalf of “Sling the Mesh” campaign. MPs will examine government progress on recommendations made in the Independent Medicines and Medical Devices Safety (IMMDS) Review, which specifically looked into sodium valproate, hormone pregnancy tests and vaginal mesh. An update by Ministers on progress to implement the government’s response was due this summer. A Minister from the Department of Health and Social Care has been invited to appear before the Committee. The IMMDS Review’s report called for better communication to inform women of the risks of sodium valproate in pregnancy. Despite an NHS ‘valproate pregnancy prevention programme’, 247 women since April 2018 were found to have been prescribed the drug in a month in which they were pregnant, 25 as recently as April to September last year. Health and Social Care Committee Chair Jeremy Hunt MP said: “It is incredibly concerning to know that women of child-bearing age can still be prescribed the epilepsy drug sodium valproate despite its known risks as a cause of birth defects or developmental delays. It has been two years since Baroness Cumberlege called for urgent action to prevent this happening. However, dozens of pregnant women were prescribed the drug last year while data published last month has shown that safety requirements were not being fully met. We’re calling in a Minister and senior health officials as well as campaigners to address our concerns.” Read full story Source: UK Parliament, 2 September 2022
  5. News Article
    Guidelines for confirming death in very young babies are being reviewed amid concerns about a case in which a baby boy started to breathe after a diagnosis of brain stem death. Guy’s and St Thomas’ NHS Foundation Trust applied to the High Court in June for a declaration that A, who was born in April, was dead and for authorisation to withdraw his ventilation, ancillary care, and treatment. Aged 2 months, he had sustained a profound hypoxic ischaemic brain injury after a cardiac arrest that happened shortly after he was found limp in his cot with abnormal breathing. But before the case came to court a nurse observed him breathing spontaneously, and the trust rescinded the declaration of brain stem death. Read full story (paywalled) Source: BMJ, 31 August 2022
  6. Content Article
    This article and video tell the story of Rihan Neupane, a baby born prematurely in Dhapasi, Nepal, who was left in a vegetative state following a series of medical errors including a missed diagnosis of meningitis. His parents had chosen a private international hospital for their maternity care, but were let down by a series of medical errors including Rihan being mistakenly given a massive paracetamol overdose. Although external hospital safety inspectors found the hospital negligent on many counts, the hospital continued to deny any wrongdoing or responsibility for Rihan's condition. Rihan's father Sanjeev Neupane talks about his family's experience in the embedded video.
  7. Content Article
    In this article, Maryanne Demasi looks at the continued prescription of Makena, an injectable synthetic hormone approved by the US Food and Drug Administration (FDA) to women who are at high-risk of premature delivery. Makena claims to reduce the risk of pre-term birth and was approved in 2011 on an accelerated pathway by the FDA following an initial trial that showed positive outcomes. However, Demasi explains, the study has been discredited as flawed in its methods and findings, and a confirmatory trial conducted by the manufacturer showed that Makena does not actually prevent preterm birth. In spite of this, and in the face of known risks, Makena is still being prescribed to pregnant women as the manufacturer has refused to withdraw it from the market. She highlights the dangers of the FDA not taking stronger action against the manufacturer of Makena, by looking at the example of Diethylstilbestrol (DES), a synthetic hormone use by women from the 1930's to the 1970s to prevent miscarriages and premature births. DES was later found to cause cancers, immune and cardiovascular disorders and other abnormalities in pregnant women, their children and their grandchildren.
  8. News Article
    Dozens of referrals to specialist care for women with serious mental health problems during or after pregnancy are being turned down because no bed was available, data collected by HSJ reveals. HSJ submitted freedom of information requests to 19 trusts running mother and baby units (MBUs) – which are inpatient services where women who experience serious mental health problems during or after pregnancy can stay with their child – asking for the “total number of referrals… which could not be admitted because no bed was available”. Although all of the 19 trusts HSJ sent freedom of information requests to responded, many said they did not hold this information. However, five – Cumbria, Northumberland, Tyne and Wear Foundation Trust, Essex Partnership University FT, Greater Manchester Mental Health FT, Hertfordshire Partnership University FT, and Nottinghamshire Healthcare FT – together identified 197 referrals which were rejected. Greater Manchester identified a further three which were turned down in the calendar year 2022, although it did not specify which financial year this was. Several experts told HSJ the figures reflected a lack of capacity for mothers with serious mental health problems. Maternal Mental Health Alliance campaign manager Karen Middleton said MBUs offered “the best outcomes” for new mothers who needed inpatient treatment". Ms Middleton continued: “When a much-needed MBU bed isn’t available, women instead face admission to general adult psychiatric wards, separating them from their newborn babies at a crucially important time for relationship development. These wards lack appropriate facilities and expertise to support postnatal mothers with their specific physical and emotional needs.” Read full story (paywalled) Source: HSJ, 16 August 2022
  9. Content Article
    This article in The BMJ examines the case for vaccinating children under five against Covid, following the US recently recommending that children aged six months to five years should receive Covid-19 vaccines. It looks at the risks and benefits of vaccination for young children, citing recent Moderna and Pfizer trials. It highlights that children are more likely than adults to experience asymptomatic Covid-19 or very mild illness, and are much less likely to have severe disease requiring hospital admission. But for children with underlying health conditions, such as long term neurological disease, vaccination may be beneficial in preventing severe disease.
  10. Content Article
    Neonatal intensive care unit (NICU) admission among term neonates is associated with significant morbidity and mortality, as well as high healthcare costs. This study in the Journal of Clinical Medicine aimed to identify and quantify risk factors and causes of NICU admission of term neonates. The study looked at NICU admission for term babies at a maternity unit in Israel. The authors suggest that a comprehensive NICU admission risk assessment that uses an integrated statistical approach may be used to build a risk calculation algorithm for this group of neonates prior to delivery.
  11. Content Article
    The Birth Injury Help Center is a US-based online resource centre that provides information on birth injuries, as well pregnancy and childbirth. This article provides information for pregnant women about foods, drinks, medications and activities to avoid during pregnancy.
  12. Content Article
    This report draws on data from the National Child Mortality Database (NCMD) to investigate how illness around the time of birth affects the health of children up to the age of 10, and to draw out learning and recommendations for service providers and policymakers. This report aims to understand patterns and trends in child deaths where an event before, or around, the time of birth had a significant impact on life, and the risk of dying in childhood.
  13. Content Article
    Is good-quality health care being provided for women in prison? As the government proceeds with plans to build 500 more prison places for women, this new Nuffield Trust analysis uses HES data to look at women prisoners' use of hospital services, finding that they face a series of challenges and risks in prison because of barriers to accessing health and care services.
  14. News Article
    A two-day old baby died just days after his mother begged doctors to assess her ahead of a c-section despite her pregnancy being deemed high risk. Davi Heer-Do Naschimento was born via emergency caesarean section during the early hours of 29 September 2021, after doctors at Royal London Hospital failed to communicate crucial details during handover meetings. An inquest at Poplar Coroners Court heard that his parents, Ruth Heer and Tiago Do Naschimento, had asked numerous times for assistance and were not seen by the obstetrics team the day before her planned caesarean. Tragically, after becoming "feverish" during the night, she was rushed into theatre with Devi sadly dying two days later. Speaking on behalf of the family, Francesca Kohler said that there had been “multiple occasions” throughout the day when Ms Heer and her partner had called for assistance and had raised concerns, but were not attended. She had also not been seen by the obstetrics team and had not been spoken to about the upcoming caesarean section. Read full story Source: My London, 4 July 2022
  15. Content Article
    The Breastfeeding Friend, a digital tool from Start for Life, has lots of useful information and advice on breastfeeding. And because it's a digital tool, it's available whenever you need it 24 / 7. All the information provided is NHS-approved and based on questions asked by thousands of new mums. Whether you're experiencing breastfeeding difficulties, you've got sore nipples, or you want to know about vitamins and what you should include in your diet – if it's a breastfeeding related question, the Breastfeeding Friend is ready to help you.
  16. Content Article
    The maternity services at the Royal Devon and Exeter NHS Foundation Trust share their infographic which informs their staff of the 15 Immediate and Essential Actions from the Ockenden report and the action plan needed to implement these.
  17. Content Article
    When critically ill premature infants require transfer by ambulance to another hospital, they frequently require mechanical ventilation. This observational study investigated acceleration during emergency transfers and looked at whether they result from changes in ambulance speed and direction, or from vibration due to road conditions. It aimed to assess how these forces impact on performance of neonatal ventilators and on patient-ventilator interactions. The authors found that infants are exposed to significant acceleration and vibration during emergency transport. Although these forces do not interfere with overall maintenance of ventilator parameters, they make the pressure-volume loops more irregular.
  18. Content Article
    Derek Richford shares Harry's Story from last year's HSJ Patient Safety Congress. Derek is grandfather of Harry Richford who died seven days after an emergency delivery at  East Kent Hospitals Trust. Derek is joined by Donna Ockenden, Chair of the Independent review of maternity services at Shrewsbury & Telford Hospital, and Sarah-Jane Marsh, Chair of NHS England's Maternity transformation programme, in the 'Actioning recommendations from the Ockenden report' session at the Congress.
  19. News Article
    A leading NHS hospital failed to publicly disclose that four very ill premature babies in its care were infected with a deadly bacterium, one of whom died soon after, the Guardian has revealed. St Thomas’ hospital did not admit publicly that it had suffered an outbreak of Bacillus cereus in the neonatal intensive care unit (NICU) of its Evelina children’s hospital in late 2013 and early 2014. It occurred six months before a well publicised similar incident in June 2014 in which 19 premature babies at nine hospitals in England became infected with it after receiving contaminated baby feed directly into their bloodstream. Three of them died, including two at St Thomas’. Leaked documents show that both the first outbreak and newborn baby’s death were investigated but never publicly acknowledged by the NHS trust that runs the hospital. GSTT insists that it did not acknowledge the baby’s death publicly in any reports because it believed the child had died of other medical conditions, not the bacteria. However, it declined to say if it had told the baby’s parents that it had become infected with Bacillus cereus. Read full story Source: The Guardian, 23 June 2022
  20. News Article
    Women including refugees, asylum seekers, and undocumented migrants are being charged as much as £14,000 to give birth on the NHS in England, a report by Doctors of the World (DOTW) has found. The report, which examined inequalities in maternity care among migrant pregnant women and babies, gathered the experiences of 257 pregnant women accessing DOTW’s services from 2017 to 2021. It found that over a third (38%) who accessed its services had been charged for healthcare, often inappropriately. The women were charged £296 to £14 000, and half of them were billed over £7000. The report said that inequalities in access to antenatal care experienced by migrant women were likely to lead to poorer outcomes for their pregnancy and the health of their children. The evidence highlights the need for urgent action to address the inequalities experienced by migrant pregnant women and their babies. There is a pressing need for immigration status to be considered as part of the ethnic and racial health inequalities agenda and for independent action to be taken to review the impact of NHS charging policy. Read full story (paywalled) Source: BMJ, 20 June 2022
  21. Content Article
    Despite an increased focus in maternity services on ethnic and racial inequalities resulting in poorer outcomes, the experience of migrant women is often hidden from these data, research and improvement programmes. To understand these inequalities and their impact further, Doctors of the World UK (DOTW UK) analysed data collected through provision of health support to 257 pregnant women accessing their service between 2017 and 2021
  22. News Article
    More than 80% of UK medical certificates recording stillbirths contain errors, research reveals. More than half the inaccurate certificates contained a significant error that could cause medical staff to misinterpret what had happened. The study, published in the International Journal of Epidemiology, also shows that three out of four stillbirths certified as having an "unknown cause of death" could, in fact, be explained. A team from the Universities of Edinburgh and Manchester examined more than 1,120 medical certificates of stillbirths, which were issued at 76 UK obstetric units in 2018. Of the 421 which were resolved, 195 were re-designated as foetal growth restriction (FGR), and 184 as placental insufficiency. Dr Michael Rimmer, clinical research fellow at Edinburgh University’s MRC Centre for Reproductive Health, said: “This study shows some medical certificates of stillbirths contain significant errors. "Reducing these errors and accurately recording contributing factors to a stillbirth is important in shaping research and health policies aimed at reducing the number of stillbirths. Read full story Source: The Herald, 21 June 2022
  23. Content Article
    The Medical Certificate of Stillbirth (MCS) records data about a baby’s death after 24 weeks of gestation but before birth. Major errors that could alter interpretation of the MCS were widespread in two UK-based regional studies. A multicentre evaluation was conducted, examining MCS issued 1 January 2018 to 31 December 2018 in 76 UK obstetric units. A systematic case-note review of stillbirths was conducted by Obstetric and Gynaecology trainees, generating individual ‘ideal MCSs’ and comparing these to the actual MCS issued. Anonymized central data analysis described rates and types of error, agreement and factors associated with major errors. The study demonstrates widespread major errors in MCS completion across the UK. MCS should only be completed following structured case-note review, with particular attention on the fetal growth trajectory. Correct stillbirth cause classification is crucial for families and society; when ‘unexplained’, conditions’ true perinatal mortality contributions are uncounted and preventative strategies cannot be appropriately targeted.
  24. Content Article
    Family Integrated Care (FICare) is an approach to neonatal care which aims to involve parents as equal partners in the care of their babies while in the Neonatal Intensive Care Unit (NICU). FICare aims to minimise separation, support parent-child bonding and promote parental decision-making. In this blog, Katie Cullum, Lead Nurse for Innovation and Quality Improvement at East of England Neonatal Operational Delivery Network, talks about the proven benefits of Family Integrated Care and why all NICUs should be implementing the model to improve outcomes.
  25. News Article
    A clinical trial to test pregnant women for Group B Strep (GBS) – the most common cause of life-threatening infection in newborn babies – will fail unless the Government intervenes, experts have warned. Some 80 hospitals are needed for the trial to go ahead but only 32 have committed to it, with a deadline for registering of September. The trial is being funded by the National Institute for Health Research (NIHR) and will look at whether testing women for Group B Strep reduces the risk of babies dying or suffering harm. Now Dr Jane Plumb, chief executive of Group B Strep Support, who lost her son Theo to the infection, is calling on the Government and NHS England to intervene to make sure the trial goes ahead. She said: “The reality is that unless a further 48 hospitals sign up for this trial, then it will fail. “The Government is waiting for the results from this trial to determine whether to test pregnant women for Group B Strep. “Yet there seems to be little acknowledgement that this trial is heading towards failure. “We need more hospitals on board and we need to make sure that the investment in this trial is not wasted. “This is about saving the lives of babies, and it really is now or never.” Read full story Source: The Independent, 20 June 2022
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