Optimal Cord Management (OCM)
Preterm babies born at less than 34 weeks gestation. This is where the umbilical cord is cut after one minute of birth. Waiting for one minute significantly improves survival by reducing the risk of brain haemorrhage as well as the need for blood transfusion.
The number of eligible babies receiving OCM was:
During 2022/23 348 babies received optimal cord management. Based on data published by BAPM which suggests that the number of babies needing to receive OCM to prevent a death is around 30-50 overall (and may be as low as 20 in the least mature babies) 6-11 babies lives have been saved.
Intapartum Antibiotics (at least one dose)
Preterm babies born at less than 34 weeks gestation. The use of antibiotics can significantly reduce the risk of Group B Streptococcus sepsis. During 2022/23 178 eligible babies (< 34 weeks) received intrapartum antibiotics, the percentage of babies receiving antibiotics has increased as follows:
Q4 data for 2021/22: 49%
Q4 data for 2022/23: 66%
For 2022/23 the programme has been focusing on seven interventions which impact on preterm births (<34 weeks gestation):
- Administration of intrapartum antibiotics – as above
- Optimal cord management – as above
- Optimising place of birth – Babies born in the correct unit significantly improves survival and neurodevelopment outcomes
- Administration of antenatal steroids – Improves survival by reducing the risk of preterm lung disease, brain haemorrhage, necrotising enterocolitis (NEC) and sepsis
- Administration of magnesium sulphate (<30 weeks gestation) – When administered within 24 hours prior to birth this significantly reduces the risk of cerebral palsy
- Temperature within one hour of birth – Hypothermia increases the risk of mortality and brain haemorrhage, necrotising enterocolitis and sepsis
- Maternal breast milk – This significantly improves survival by reducing the risk of sepsis and necrotising enterocolitis
In the NENC area the team has made improvements across all seven interventions thereby improving the survival rates and detrimental impacts of preterm births.
There has been a strong regional focus on this work. All Hospital Trusts have fully engaged in looking at data accuracy, understanding what their data is telling them, as well as making improvements to increase the number of interventions delivered. Progress has been shared at many events and meetings to promote learning and changes in practice, with Trusts being supported by MatNeoSIP as well as the Maternity and Neonatal Networks, Local Maternity and Neonatal Systems and the Preterm Birth Group in NENC.