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

Abstract

BackgroundWhereas 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.MethodsDR- 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.Results186 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.ConclusionsThe 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.

Analyzing video recorded support of postnatal transition in preterm infants following a c-section

“…We have recently described great variations concerning the time needed for IV-placement in term newborns [22]. The present study shows similar results for preterm infants.…”

Mask CPAP during neonatal transition: too much of a good thing for some term infants?

“…Konstantelos et al 7 recently reported that 25% of term infants delivered by C-section received some form of respiratory support in the delivery room. This, and the sixfold increase in the use of positive pressure support following the revision of neonatal guidelines reported by Hishikawa et al, 1 raises the question if all these infants would have only recovered with such support, or may these high rates also reflect a trend towards overtreatment?…”

Suctioning habits in the delivery room and the influence on postnatal adaptation – a video analysis

“…The section of the recorded image was chosen in such a way as to hide the identity of the caretaker. In the present study, all recordings of planned c-section of term and preterm infants born between January 2012 and April 2013 were analyzed [11,12].…”

“…The video analysis of the recorded videos was performed using the software Interact (Mangold International GmbH, Arnstorf, Germany), an observation-based software [11,12]. Analysis started with the arrival of the newborn at the reanimation table.…”

“…Video recording of DR management was performed by two webcameras (Microsoft Corporation, Redmond, USA) as described previously [11,12]. One camera was attached on the upper left side of the radiant warmer and one in front of the pulse oximeter monitor.…”