DO NOT USE FOR CLINICAL PRACTICE
Please use current guidelines available on the UHNM intranet for patient treatment
Please use current guidelines available on the UHNM intranet for patient treatment
LABOUR WARD CALLS
- Encourage obstetric team to warn neonatal team of expected problems well in advance
- Decide who should attend (e.g. first on-call, middle grade or consultant), and degree of urgency
Neonatal team should attend the following deliveries:
- Non-reassuring electronic fetal monitoring trace, as assessed by obstetric team
- Significant fresh meconium in liquor
- Major congenital abnormalities (minor abnormalities will wait until working hours)
- Vacuum extraction or instrumental deliveries performed for fetal reasons (see below)
- Preterm delivery <36 weeks’ gestation
- Severe pre-eclampsia with seizures
- Antepartum haemorrhage
- Moderate-to-severe Rhesus disease
- Unexpected breech delivery
- Any delivery under general anaesthesia
It is not necessary for neonatal team to attend the following deliveries:
- Elective caesarean section under regional anaesthesia
- Meconium staining of liquor
- Planned breech delivery (including caesarean section under regional anaesthesia)
- Twins (>36 weeks)
- Pre-eclampsia without seizures
The following factors may require neonatal team to attend birth or assess baby soon after birth (see antenatal plan in maternal notes)
- Maternal illness likely to affect baby:
- diabetes mellitus
- thyroid disease
- systemic lupus erythematosus
- myasthenia gravis
- myotonic dystrophy
- hepatitis B carriage
- intrapartum antibiotics indicated but not given, or given <4 hr before delivery
- HIV
- HELLP syndrome
- suspected sepsis treated with IV antibiotics
- Maternal medications that may affect baby e.g. antidepressants
- Maternal substance abuse
- Neonatal alerts:
- abnormal antenatal scans
- low-birth-weight baby <2.5 kg
- Pregnancy and past history
- prolonged rupture of membranes
- polyhydramnios
- previous baby/perinatal death
- family history of genetic or metabolic abnormalities