Development of regional guidelines: the way forward for neonatal networks?

Cornette, Luc; Miall, Lawrence

doi:10.1136/adc.2005.088047

Cited by 9 publications

(10 citation statements)

References 9 publications

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“…The intraamniotic infection can affect maternal tissues such as decidua and myometrium, and also fetal tissues such as amniotic and chorionic membranes (chorioamnionitis), amniotic liquid (amnionitis), umbilical cord (funisitis) and placenta (vilitis) [8]. The microorganisms can arrive to the amniotic cavity through the blood system of the placenta, by invasive procedures during gestation (amniocentesis, etc) and by an ascending pathway [9].…”

Section: Early Onset Neonatal Sepsismentioning

confidence: 99%

Neonatal Sepsis by Bacteria: A Big Problem for Children

Soto¹

2012

Clin Microbial

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Section: Early Onset Neonatal Sepsismentioning

confidence: 99%

Neonatal Sepsis by Bacteria: A Big Problem for Children

Soto¹

2012

Clin Microbial

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“…The debate on the optimal organisation of care for these babies continues. Since our study in 2003, regionalisation of care was set up in Trent with a neonatal network 24,25 . The conditions of operation for the most specialised perinatal centres were reinforced in Germany in 2007 and more active intervention for births before 26 weeks, including in utero transfer, was recommended in the Netherlands 26 …”

Section: Discussionmentioning

confidence: 99%

“…Since our study in 2003, regionalisation of care was set up in Trent with a neonatal network. 24,25 The conditions of operation for the most specialised perinatal centres were reinforced in Germany in 2007 and more active intervention for births before 26 weeks, including in utero transfer, was recommended in the Netherlands. 26 Given differences in the consensus on where extremely preterm babies or babies 30 and 31 weeks of gestation should be born, comparisons of births at 28-29 weeks of gestation are a better test of the capacity of each system to achieve regionalisation because policies target this group in each country, with the exception of Denmark (where the subgroup of interest is deliveries <28 weeks) and excluding Trent (which had no defined level III units in 2003).…”

Section: Discussionmentioning

confidence: 99%

Organisation of obstetric services for very preterm births in Europe: results from the MOSAIC project

Blondel

Papiernik

Delmas

et al. 2009

BJOG

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Objective To study the impact of the organisation of obstetric services on the regionalisation of care for very preterm births.Design Cohort study.Setting Ten European regions covering 490 000 live births.Population All children born in 2003 between 24 and 31 weeks of gestation.Method The rate of specialised maternity units per 10 000 total births, the proportion of total births in specialised units and the proportion of very preterm births by referral status in specialised units were compared.Main outcome measure Birth in a specialised maternity unit (level III unit or unit with a large neonatal unit (at least 50 annual very preterm admissions).Results The organisation of obstetric care varied in these regions with respect to the supply of level III units (from 2.3 per 10 000 births in the Portuguese region to 0.2 in the Polish region), their characteristics (annual number of deliveries, 24 hour presence of a trained obstetrician) and the proportion of all births (term and preterm) that occur in these units. The proportion of very preterm births in level III units ranged from 93 to 63% in the regions. Different approaches were used to obtain a high level of regionalisation: high proportions of total deliveries in specialised units, high proportions of in utero transfers or high proportions of high-risk women who were referred to a specialised unit during pregnancy.Conclusion Consensus does not exist on the optimal characteristics of specialised units but regionalisation may be achieved in different models of organisation of obstetric services.

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“…Within the Trent and Yorkshire Networks, we have prioritised clinical guidelines covering neonatal transfer, early care for the very preterm baby, and preoperative care as important areas where working together can be achieved. 24 Quality standards Published national standards provide important foundation standards for the structure, organisation and monitoring of neonatal intensive care in the UK. 8 Neonatal Networks have a role in the maintenance of these standards but also in developing local targets for access and outcomes, monitoring the effect of local service redesign, and in the development of clinical pathways and care bundles which provide auditable quality measures of care.…”

Section: Coordination Of Activitymentioning

confidence: 99%