What is birth asphyxia?
Considerable variation exists in the ways birth asphyxia, a major tragedy for the newborn and his or her family, is defined. Different medical specialties consider different indicators as diagnostic: for instance, the obstetrician looks at meconium staining (contents of the fetal intestine released into the amniotic fluid) and fetal acidosis (a disturbance of acid-base balance), while the neonatologist may rely more on Apgar scores and latency after birth until breathing begins. Many physicians feel that most cases of cerebral palsy and all cases of uncomplicated mental handicap are not caused by birth asphyxia. Prenatal tests to gauge the risk of brain damage from asphyxia include fetal heart monitoring, which has a high false-positive rate. Criteria other than acidosis are not much better in predicting cerebral palsy accurately: low Apgar scores, delay in beginning to breathe, or the need for resuscitation are often present in infants who do not develop this disease. Newer predictive tests include the identification of hypoxic-ischemic encephalopathy (HIE), a clinical condition characterized by abnormalities of muscle tone, feeding, consciousness, and, in extreme cases, by seizures and coma. Infants with mild encephalopathy (no seizures) have good outcomes, while between 20 percent and 30 percent of those who are moderately affected (with seizures) will develop a severe handicap. Most infants with severe encephalopathy (coma) will die. HIE is a good predictor of outcome, regardless of Apgar scores or acidosis. Some infants develop the disorder without abnormalities on these tests. This may reflect a brain injury received some time before birth that went undetected, with the encephalopathy developing during this latent period. Infants who develop HIE may be prone to do so because of placental insufficiency. Until a consensus can be reached concerning the term 'birth asphyxia', its use should be limited. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: British Journal of Obstetrics and Gynecology
Completeness of ascertainment of prenatal smoking using birth certificates and confidential questionnaires
Birth certificate data are frequently used for smoking detection during pregnancy. Researchers conducted a study to estimate the completeness of ascertainment of prenatal smoking on birth certificates and on confidential questionnaires in six US states. The results revealed that the completeness of ascertainment ranged between 70.6% and 82% in birth certificates and 86.2% and 90.3% in confidential questionnaires.
Publication Name: American Journal of Epidemiology
Push for birth control guidance in schools
It is important that young people are aware that they can obtain confidential advice about contraception from community and school nurses, according to Brook Advisory Centres. At present, many young people fear that these nurses will inform their parents if they seek contraception. Brook Advisory Centres aims to halve the present level of eight in 1,000 young women aged 13-15 becoming pregnant.
Publication Name: Nursing Times
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