Why the maternal history is important for the NIPE practitioner in performing a safe and through examination
Tracey Jones in The Student Guide to the Newborn Infant Physical Examination, 2019
This chapter focuses on the importance of obtaining a detailed, accurate and factual history before undertaking the newborn infant physical examination. The aim of antenatal care is to monitor the health of the mother and fetus, screen for potential abnormalities, and provide information and education to the mother and family in preparation for parenthood. Retrieving a comprehensive intrapartum history will highlight potential risk factors for the newborn, promote vigilance for potential abnormalities and prepare practitioners for parental concerns and questions. Taking account of the intrapartum journey also affords the opportunity to verify appropriate newborn aftercare, investigations and referral. Colonised mothers are offered intrapartum antibiotic prophylaxis (IAP) to reduce the incidence of EOGBS disease. A Cochrane review identified reduced incidence of EOGBS with IAP in colonised mothers; the numbers of deaths were too small to assess the impact on mortality. Check intrapartum documentation for: preterm birth, prolonged rupture of the membranes, pyrexia or suspected maternal intrapartum infection.
Preterm labour
David M. Luesley, Mark D. Kilby in Obstetrics & Gynaecology, 2016
This chapter describes several mechanisms for the pathogenesis of preterm birth. Activation of the fetal hypothalamic-pituitary-adrenal axis, long hypothesised as a potential initiating mechanism in normal labour, may also be implicated in preterm labour. Assisted reproduction techniques are responsible for up to one third of twin pregnancies and three quarters of triplets, leading to an increasing burden of preterm births. In those pregnancies affected by higher-order multiples, multifetal reduction has been shown to reduce the risk of preterm birth and should always be considered. Serious infective illnesses such as pyelonephritis, appendicitis and pneumonia are associated with preterm labour. Intercurrent illness may also result in iatrogenic indicated preterm birth for maternal or fetal reasons. Owing to limited resources and a paucity of beneficial interventions in low-risk women, most aspects of prematurity prevention should be targeted at women with major risk factors for preterm birth.
Neonatal nursing
Nathan Wilson, Peter Lewis, Leanne Hunt, Lisa Whitehead in Nursing in Australia, 2020
This chapter offers the reader a description of the key concepts directing nursing of sick babies. It outlines the most important neonatal nursing practices to prevent developmental consequences for the baby and provides a brief overview of challenges to neonatal nursing and nurses who practice in the neonatal intensive care unit. An understanding of the unique breastfeeding situation that comes with giving birth to a preterm or sick baby is crucial. The impact on how neonatal critical care issues are addressed and resolved in practice requires further inquiry to direct theory, research, practice, education, legislation and organisational systems. Monitoring for the consequences of a preterm birth requires a holistic multi-systems multi-disciplinary collaborative team approach where treatment, support and care correlate to the gestational and developmental age, characteristics of the newborn and family that is aligned to the baby's normal developmental growth albeit within an external environment.
The impact of inter-pregnancy interval on subsequent risk of preterm birth
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2018
Vid Janša, Isaac Blickstein, Miha Lučovnik, Vesna Fabjan-Vodušek, Ivan Verdenik, Nataša Tul
Objective: The aim of the study was to assess optimal time to conceive after previous delivery associated with smallest risk of preterm birth. Methods: We selected all women (n = 2723) with their first and second singleton delivery between the years 2004 and 2012. Inter-pregnancy interval was defined as that between live birth and subsequent conception. We performed logistic regression analyses to assess the risk of preterm birth adjusted for maternal age and body mass index. Results: Association between inter-pregnancy interval and the natural logarithm of the adjusted relative risk of preterm birth had a J-shaped curve with lowest risk at 15 months after last birth. Conclusion: The optimal time to conceive after a previous delivery is 15 months, as longer or shorter interval are associated with increased risk of preterm birth. Women with short or long inter-pregnancy intervals were 1.6 times more likely to experience preterm birth.
Examining the association between Medicaid coverage and preterm births using 2010–2013 National Vital Statistics Birth Data
Published in Journal of Children and Poverty, 2017
Anne Rossier Markus, Shannon Krohe, Nicole Garro, Maya Gerstein, Cynthia Pellegrini
Reducing the number of preterm births is a high public health priority in the U.S. Preterm birth, affecting an estimated 380,000 infants annually, is a leading cause of infant mortality and morbidity and is associated with individual and systemic characteristics. Preterm birth is estimated to cost society $26 billion annually. Despite an elevated financial burden caused by preterm birth, very little is known about who bears these costs. This study seeks to understand the relationship between Medicaid and private insurance payment for preterm birth, using multiple years of vital statistics data, which for the first time since 2010 include information on payment source. The nationwide data cover births that occur in all settings, including non-hospital settings, and many maternal characteristics not available in other datasets, improving upon previous analyses. These data can be used to promote better Medicaid coverage of interventions known to be effective in reducing preterm births.
Preterm birth in ancient Greece: a synopsis
Published in The Journal of Maternal-Fetal & Neonatal Medicine, 2017
This report refers to preterm birth in Ancient Greece based on mythological, historical and archeological data. The two antique goddesses, patronesses of labor and birth, Artemis and Eileithyia, cared for full-term, as well as preterm infants, among them for the mythological preterms Dionysos and Eurystheus. The former was rapidly transported by Hermes and received special care by the nymphs Hyades in a mountain cave with “incubator” properties. Historical data are related to the nine months duration of a normal pregnancy, to the definition of “Elitomina” (preterms), the lower limit of viability, the causes for preterm birth, the existence of small for gestational age infants and relevant causes, the physical examination of neonates and postpartum care. Lastly, excavations in Athens and Astypalaia discovered burials – in wells or pots – of preterm infants with gestational age 24–37 weeks.
Related Knowledge Centers
- Birth
- Childbirth
- Fetus
- Tocolysis
- Pregnancy
- Obstetric Labor
- Premature Infant