Obstetric education and neonatal resuscitation at birth: an Italian survey.

INTRODUCTION: Approximately 10% of infants at birth require some assistance to breathe and 1% require vigorous resuscitation. As such, midwives need appropriate education and training on newborn life support (NLS) techniques. METHODS: We conducted a survey on Italian territory about the correlation between obstetric education and the management of the neonatal resuscitation in the delivery room. The study was led through a web survey based on 23 questions, given anonymously online through the Google Drive platform. RESULTS: 272 women aged from 19 to 59 years answered the questions (83% midwives and 17% midwifery students). 93% of them attended an NLS course before graduation, while only 57% have repeated it afterwards once or more times. The midwives working in hospitals with neonatal intensive care units (NICUs) experienced more involvement within the emergency neonatal resuscitation team than the others working in other kind of hospitals (hospital with NICU 79%, hospital without NICU 57%, private hospital 48%; p < .001). Moreover, the midwives' years of experience at work are much more related to the prompt execution of primary resuscitation maneuvers (more than 10 years of experience 74%, 5-10 years 48%, less than 5 years 30%; p < .001). Power analysis showed an adequate sample size of the study population. CONCLUSIONS: In spite of NLS techniques are taught to near all midwives, only working in hospitals within a NICU and longer work experience are directly related with greater involvement of a midwife in the neonatal resuscitation team.

First year follow-up of extremely low birth weight premature sextuplets: case report.

High order gestation rates have increased in many western countries in the last decades, which is mostly attributable to a contemporaneous increase in maternal age and infertility treatment. Multiple births have been associated with increased maternal and foetal morbidity and mortality during pregnancy and delivery, including the higher risk for spontaneous abortion, preeclampsia, hydramnios, and maternal haemorrhage. A higher frequency of preterm infants and low birth weight infants have also been reported, as well as a higher rate of malformations, abnormal growth, and trauma at delivery, than in singleton pregnancies. We describe herein the case of six ELBW newborns delivered at 27 weeks and their first year follow-up. All the sextuplets survived and did not have extra uterine growth retardation (EUGR) when discharged from hospital. A developmental delay was detected in five infants at 12 months corrected age (CA), but none of them showed cerebral palsy or severe neurosensorial disabilities.