Contributory factors and potentially avoidable neonatal encephalopathy associated with acute peripartum events: An observational study
| Autor: | Suzanne Miller, Malcolm R. Battin, Vicki Masson, Hillary F Bennett, Jutta van den Boom, Lynn Sadler, Sue Belgrave |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Databases Factual Infant Newborn Diseases 03 medical and health sciences Shoulder dystocia 0302 clinical medicine Neonatal emergencies Pregnancy Risk Factors medicine Humans 030212 general & internal medicine Intensive care medicine Brain Diseases 030219 obstetrics & reproductive medicine Placental abruption Neonatal encephalopathy business.industry Infant Newborn Obstetrics and Gynecology General Medicine Delivery Obstetric medicine.disease Dystocia Quality Improvement Perinatal Care Preparedness Female Observational study National database Risk assessment business New Zealand |
| Zdroj: | Australian and New Zealand Journal of Obstetrics and Gynaecology. 59:699-705 |
| ISSN: | 1479-828X 0004-8666 |
| DOI: | 10.1111/ajo.12957 |
| Popis: | Background In 25% of affected babies, neonatal encephalopathy results from acute peripartum events, but rigorous review of these cases for quality improvement is seldom reported. New Zealand has maintained a national database of all babies diagnosed with Sarnat moderate and severe neonatal encephalopathy since 2010 under the Perinatal and Maternal Mortality Review Committee. Aims To determine the rate of contributory factors, potentially avoidable mortality or morbidity, and to identify key areas for improvements to maternity and neonatal care among cases of neonatal encephalopathy following an acute peripartum event. Materials and methods Sarnat moderate and severe cases identified from the national collection of neonatal encephalopathy with a history of an acute peripartum event were reviewed using a standardised independent multidisciplinary methodology and a tool for assessing contributory factors and potential avoidability, with the addition of a human factors lens. Results Forty-seven cases from 2013 to 2015 were reviewed. The most common acute peripartum events were placental abruption (12) and shoulder dystocia (11). Contributory factors were identified in 89%, and the severity of outcome was potentially avoidable in 66%. Key modifiable areas included dynamic risk assessment, preparedness for obstetric and neonatal emergencies, best practice for maternal and fetal surveillance in labour, and documentation. Conclusions There is significant potential to improve quality and safety in acute peripartum care to reduce the risk of neonatal encephalopathy. Human factors were not well captured by the clinical notes or review tool. Attention to human factors by improved methodology can enhance review of neonatal encephalopathy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text