Substandard care in delivery-related asphyxia among term infants: prospective cohort study.
Acta Obstet Gynecol Scand
; 92(1): 85-93, 2013 Jan.
Article
en En
| MEDLINE
| ID: mdl-22994792
ABSTRACT
OBJECTIVE:
To assess substandard care factors in the case of delivery-related asphyxia.DESIGN:
Prospective cohort study.SETTING:
Catchment area of the Neonatal Intensive Care Unit (NICU) of the University Medical Center Utrecht; a region in the middle of the Netherlands covering 13% of the Dutch population. POPULATION Term infants, without congenital malformations, who died intrapartum or were admitted to the Neonatal Intensive Care Unit due to asphyxia.METHODS:
During a two-year period, cases were prospectively collected and audited by an expert panel. MAIN OUTCOMEMEASURES:
Substandard care factors.RESULTS:
37 735 term infants without congenital malformations were born. There were 19 intrapartum deaths, and 89 NICU admissions of which 12 neonates died. In 63 (58%) cases a substandard care factor was identified that was possibly (n= 47, 43%) or probably (n= 16, 15%) related to perinatal death or NICU admission. In primary care, substandard care factors were mainly the low frequency of examination during labor and delay in referral to secondary care. In secondary care, misinterpretation of cardiotocography and failure to respond adequately to clinical signs of fetal distress were the most common substandard care factors.CONCLUSIONS:
Substandard care is present in a substantial number of cases with delivery-related asphyxia resulting in perinatal death or NICU admission. Improving the organization of obstetric care in the Netherlands as well as training of obstetric caregivers might reduce adverse outcomes.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
11_ODS3_cobertura_universal
/
2_ODS3
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de salud:
11_delivery_arrangements
/
2_muertes_prevenibles
/
7_neonatal_care_health
/
7_non_communicable_diseases
Asunto principal:
Calidad de la Atención de Salud
/
Asfixia Neonatal
/
Parto Obstétrico
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
/
Newborn
/
Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
Acta Obstet Gynecol Scand
Año:
2013
Tipo del documento:
Article
País de afiliación:
Países Bajos