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Published in: BMC Pregnancy and Childbirth 1/2014

Open Access 01-12-2014 | Research article

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

Authors: Dimitrios Konstantelos, Sascha Ifflaender, Jürgen Dinger, Wolfram Burkhardt, Mario Rüdiger

Published in: BMC Pregnancy and Childbirth | Issue 1/2014

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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.
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Literature
1.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
2.
go back to reference 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.CrossRef 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.CrossRef
3.
go back to reference 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-CrossRef 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-CrossRef
4.
go back to reference 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.CrossRefPubMedPubMedCentral 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.CrossRefPubMedPubMedCentral
5.
go back to reference 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-CrossRefPubMed 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-CrossRefPubMed
6.
go back to reference 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.CrossRef 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.CrossRef
7.
go back to reference 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. 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.
go back to reference 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-CrossRefPubMedPubMedCentral 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-CrossRefPubMedPubMedCentral
9.
go back to reference Apgar V: A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953, 32 (Suppl 4): 260-267.PubMed Apgar V: A proposal for a new method of evaluation of the newborn infant. Curr Res Anesth Analg. 1953, 32 (Suppl 4): 260-267.PubMed
10.
go back to reference Davis PG, Dawson JA: New concepts in neonatal resuscitation. Curr Opin Pediatr. 2012, 24 (Suppl 2): 147-153.CrossRefPubMed Davis PG, Dawson JA: New concepts in neonatal resuscitation. Curr Opin Pediatr. 2012, 24 (Suppl 2): 147-153.CrossRefPubMed
11.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
12.
go back to reference Rüdiger M, Aguar M: Newborn assessment in the delivery room. Neoreviews. 2012, 13: e336-e342.CrossRef Rüdiger M, Aguar M: Newborn assessment in the delivery room. Neoreviews. 2012, 13: e336-e342.CrossRef
13.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
14.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
15.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
16.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
17.
go back to reference Taeusch HW, Ballard RA, Gleason CA, Avery ME: Elsevier Health Sciences. Avery’s Diseases of the Newborn. 2004 Taeusch HW, Ballard RA, Gleason CA, Avery ME: Elsevier Health Sciences. Avery’s Diseases of the Newborn. 2004
18.
go back to reference 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.CrossRef 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.CrossRef
19.
go back to reference 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.CrossRef 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.CrossRef
20.
go back to reference 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.PubMed 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.PubMed
21.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
Metadata
Title
Analyzing support of postnatal transition in term infants after c-section
Authors
Dimitrios Konstantelos
Sascha Ifflaender
Jürgen Dinger
Wolfram Burkhardt
Mario Rüdiger
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2014
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-14-225

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