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Search results for "perinatal"
6 records
found from year 2006
| View search results from other years: 2005 2004 |
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| Wednesday, 12 July 2006 10:32 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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The premature baby charity Bliss has major concern over the way premature and sick babies are being cared for.
Research carried out by the National Perinatal and Epidemiology Unit (NPEU) at Oxford University, for Bliss, surveyed 64% of all neonatal units in the UK; every neonatal network (a cluster of hospitals in a region that provide a wider coverage of neonatal care) in England, and 216 parents.
It revealed the situation in neonatal care was getting worse compared with a similar report carried out last year.
The survey found 78% of neonatal units had to turn babies away, mainly because of a shortage of nurses and cots, a rise of 8% on the figure for 2005.
And it discovered 90% of intensive care units - the departments that provide the highest level of care to the sickest babies - had to close their doors on new arrivals.
That represented an increase from 80% in 2005.
The survey also showed the nurse-to-baby ratio was well below the optimum required in intensive care units.
Only 3% of trusts said they managed to operate at the recommended level of one nurse to each baby.
Rob Williams, the chief executive of Bliss, said: "It is unacceptable that a life-saving service is unable to provide the appropriate level of care for vulnerable babies because of financial constraints.
"Babies are being transferred huge distances. We have anecdotal evidence that deaths have occurred because of transfers. Thankfully we don't think it is that common, but we are risking more deaths and health problems in later life by not making sure there are enough cots and staff to avoid transfers”.
Health Minister Ivan Lewis denied that there was a "national crisis" but acknowledged there were challenges.
He said: "There are problems that have to be tackled with staff and other issues."
But he said the Government had taken action to improve access to cots and insisted infant mortality rates were at their lowest ever.
"In many cases there are cots lying empty in some areas whilst in others the ward or the facility is full.
"Getting that supply and demand right has to be sorted out at a local level which is why we've developed these local clinical networks.
"I will be having a close look at what is happening on the ground because it is very, very important - there is nothing more important actually than we look after babies who are at risk at this stage in their lives”.
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| Sunday, 02 July 2006 09:14 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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An NHS watchdog has calculated that as many as 20 babies are dying every year because mothers choose to deliver their children in birth centres run by midwives rather than in hospitals.
The National Institute for Clinical Excellence (Nice), experts estimate that between one baby in every 1,000 and one in every 5,000 will die needlessly because of the extra risk associated with the centres.
The alarming findings are based on a study of births in midwife-led units in Norway. Even after taking into account the differences between healthcare arrangements in Norway and Britain, Nice's experts were surprised by the increased risk at birth centres.
The newspaper The Sunday Telegraph can also reveal that the Nice guidance on birth centres is itself at the centre of controversy over claims that it was "watered down" at the request of the Department of Health, because of fears that it would conflict with government policy to promote births outside hospital.
Yesterday, Beverly Beech, of the Association for Improvements in Maternity Services (Aims), a campaign group, said: "Many women do not want to go to the obstetric baby factory and we still feel there is not enough evidence out there to say that birth centres are unsafe."
Nice's draft guidance, which included a recommendation for all pregnant women to be told of a "trend towards a reduction in perinatal mortality" in hospitals, was submitted to the Department of Health nearly a fortnight ago.
Several days later - and ahead of its publication on June 23 - it was altered by Andrew Dillon, chief executive of Nice, after concerns were raised by the Department of Health. To the fury of his own experts, who felt that their message was being diluted, the wording was changed to: "There may be a risk of lower perinatal mortality" in hospital.
A source told The Sunday Telegraph: "There was an angry phone call between Andrew Dillon and representatives of the guideline development group.
"Concern over the safety of mothers and babies in midwife-led units was watered down. Many of the group felt this was totally unacceptable, but, because they are bound by confidentiality clauses, they cannot speak out publicly".
A spokeswoman for Nice confirmed that changes were made after representations from the Department of Health, but insisted that the alterations had not been ordered.
She said: "The Department of Health contacted us before publication of our draft guideline to say they had concerns and they were wondering whether the evidence accurately supported the recommendation on risks outside consultant-led units.
"We took some advice and then Andrew Dillon himself made the changes. He did what he felt needed to be done to our guidance, but he was not told to do it by the Department of Health".
A Department of Health spokesman said: "Our officials did not interfere with wording and presentation of Nice guidance. Nice looked at the wording and determined independently that changes should be made".
However, Michael Summers, of the Patients' Association, said: "Nice is supposed to be an independent body with medical experts and lay people who make guidance that patients can trust. That trust is eroded when you hear things like this".
Andrew Lansley, the shadow health secretary, said: "If the Government is interfering with the conclusions reached by Nice, then this is very serious.
"Although services are commissioned by the Government, Nice is an independent body and its recommendations should always reflect clinical and cost effectiveness, not the political interests of government".
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| Friday, 23 June 2006 10:51 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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Women who give birth at home may be putting their baby at risk, the National Institute for Health and Clinical Excellence (Nice) is set to warn.
The advice is the first official acknowledgement that domestic deliveries could be unsafe.
The draft guidance appears to contradict a Department of Health drive to encourage home births and last night prompted accusations of scare mongering.
However, obstetricians have welcomed the warning. Peter Bowen-Simpkins, a leader in the field, said: “Every woman needs to know that giving birth at home is not without hazard.”
The Nice guidance on care during labour says that women should be free to choose where the give birth, but should be aware of the risks associated with different settings.
Where the child is born outside the traditional labour ward, these risks include an increased risk of perinatal mortality – death of the baby during or shortly after birth.
The guidance states: “There may be a lower risk of perinatal mortality when care is delivered in a consultant-led unit.”
The document says that, although women who give birth at home are more likely to have a natural delivery, without the use of foreceps and pain-killing epidural injections, they are further away from the specialised care and equipment that would be on hand in a hospital ward.
The National Childbirth Trust, the pregnancy charity, said Nice does not have any firm evidence that home births are riskier.
Chief executive Belinda Phipps said: “If it was really dangerous, the data would be there.
“There is no anecdotal or other screaming evidence that says this is dangerous. There just isn't concrete evidence that it is safe.
“This is just the medical profession being ultra-cautious and it will lead to women being worried unnecessarily.”
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| Friday, 16 June 2006 10:25 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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The risk of death and major birth defects are still high in babies born to women with diabetes, despite an international strategy to raise standards of diabetes care, a study has revealed.
Researchers warn that these problems will get worse as the number of young women diagnosed with type 1 and type 2 diabetes continues to rise.
Scientists analysed deaths shortly after birth (perinatal mortality) and congenital anomalies in babies born to women with type 1 or type 2 diabetes who delivered between 1 March 2002 and 28 February 2003 in England, Wales, and Northern Ireland.
Of 2,359 women with diabetes, 1,707 had type 1 diabetes and 652 had type 2 diabetes. Women with type 2 diabetes were more likely to come from an ethnic minority group and from a deprived area.
Perinatal mortality was similar in babies of women with type 1 (31.7 per 1000 births) and type 2 diabetes (32.3 per 1000 births), and was nearly four times higher than that in the general maternity population.
The rate of major congenital anomaly (mainly heart and nervous system defects) was 46 per 1000 births in women with diabetes (48 per 1000 births for type 1 diabetes and 43 per 1000 for type 2 diabetes), more than double than that in the general maternity population.
Because of this increased risk, the researchers say that women with diabetes should take a higher than usual dose (5 mg) of folic acid from before conception up to week 12 of pregnancy. They also suggest that pregnant women with diabetes should be routinely screening for heart defects.
In the past, type 2 diabetes has been viewed as a less serious condition than type 1 diabetes and may have been subject to less vigilant care, add the team.
However, in view of these findings, and the increasing prevalence of type 2 diabetes in young adults, raised awareness of the increased risk of adverse pregnancy outcomes in this group of women is needed.
This study is substantially larger than any previous ones in this field, but more work is needed to find out how women with either type of diabetes can best be enabled to improve the outcomes of their pregnancy, they conclude.
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| Monday, 20 February 2006 10:06 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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A chronic shortage of midwives is posing a serious threat to the lives of women and their unborn children, the government was warned yesterday.
Around 10 per cent of NHS midwifery jobs has been vacant for at least three months and more than three quarters of maternity units say they are having problems recruiting more staff. At least 10,000 more recruits are needed to avert a crisis, the Royal College of Midwives (RCM) said.
George Georgiou, employment relations officer at the RCM, said: "This is of major concern to us.
"The research has shown that women who are left alone during labour or do not have continuous care from a midwife are more likely to suffer complications and to need interventions such as forceps and caesarean deliveries."
Labour’s election manifesto last year included a promise that by 2009 all women would have a choice over the kind of unit they had their baby in and alternatives over pain relief. The government also stated: "We want every woman to be supported by the same midwife throughout her pregnancy."
However, the RCM has revealed that midwife numbers have declined by 6.2 per cent since 2000 and by 25 per cent over the last 12 years.
A survey found that a quarter of midwifery units were finding it harder to fill vacancies and only one in four midwifes believed their unit was adequately funded.
Last month, the NHS Queen Charlotte’s and Chelsea Hospital in London offered women the chance to be treated by the same midwife throughout their pregnancy and Labour – for a charge of £4,000.
Dame Karlene Davis, general secretary of the RCM, said: "This compromises the RCM's belief that every women is entitled to high quality, one-to-one care with a midwife. This care should never be rationed by a woman's ability to pay."
A study in the British Journal of Obstetrics and Gynaecology has also found that more than half of perinatal deaths in England (deaths of babies immediately before or after birth) could be due to sub-standard care – the highest rate in Europe.
A spokesman for the Department of Health said: "There are almost 2,500 more midwives working in the NHS than there were in 1997 and the number of students entering training has increased by 41%. There are shortages but these are being addressed in a number of ways including the provision of affordable housing and childcare."
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| Friday, 06 January 2006 10:10 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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Exposure to certain viral infections shortly before and after birth (the perinatal period) is associated with cerebral palsy, a study has revealed.
The findings support the theory that infections during this period can trigger brain damage and the development of cerebral palsy.
The study took place at the Adelaide Women’s and Children’s Hospital in Australia and involved 443 children with cerebral palsy and 883 control babies. All babies were born to white mothers between 1986 and 1999.
Blood samples taken within a few days of birth were used to test for the presence of neurotropic viruses - a group of viruses including herpes viruses, which can all cross the placenta and infect the foetus.
Exposure to viral infection was common in all newborn babies, especially in preterm babies, suggesting that infection before birth may also be linked to preterm delivery.
Herpes group B viruses were found more often in babies who were later diagnosed with cerebral palsy than in control babies. In fact, the risk of cerebral palsy was nearly doubled with exposure to herpes group B viruses.
The study shows that perinatal exposure to neurotropic viruses is associated with preterm delivery and cerebral palsy, say the authors. Future studies are planned to investigate the possible causes of this link, they conclude.
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