Group B streptococcal disease guideline

Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36) | The Royal College of Obstetricians and Gynaecologists. 

Group B Streptococcal Disease (GBS) is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. There is variation in practice across the UK regarding the best strategies to prevent EOGBS disease.

In 2015, the incidence of EOGBS in the UK and Ireland was 0.57/1000 births (517 cases), a significant increase from the previous surveillance undertaken in 2000 where an incidence of 0.48/1000 was recorded.

The purpose of this guideline is to provide guidance for obstetricians, midwives and neonatologists on the prevention of early-onset (less than 7 days of age) neonatal group B streptococcal (EOGBS) disease and the information to be provided to women, their partners and families.

Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36)

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NHS maternity services in England

Under pressure?  NHS maternity services in England | Kelly, E. & Lee, T | Institute of Fiscal Studies

Admission to hospital to give birth is the single largest cause of admission to NHS hospitals in England. In common with many NHS services, providers of maternity care are reporting pressures from increased demand, staffing shortages and programmes to improve the quality of care. How units respond to these challenges carries important implications for the health of mothers and babies, and the finances of NHS Acute Trusts.

This briefing note reviews the evidence on the long-run pressures faced by maternity units. While the number of maternity cases has remained largely constant since 2010, the case mix continues to change, with women giving birth later in life and with more complex health conditions. There are implications for MUs if this evolving case mix of mothers requires more care in terms of staffing or other resources.

Full briefing available here

Folic acid may mitigate autism risk from pesticides

Researchers at UC Davis and other institutions have shown that mothers who take recommended amounts of folic acid around conception might reduce their children’s pesticide-related autism risk | ScienceDaily

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Image source: FedEx – Flickr // CC BY-NC-ND 2.0

In the paper, which used data from the Childhood Autism Risks from Genetics and the Environment (CHARGE) study, researchers looked at 296 children between 2 and 5 who had been diagnosed with ASD and 220 who had developed typically. Mothers were interviewed about their household pesticide exposure during pregnancy, as well as their folic acid and B vitamin intake. The team also linked data from California Pesticide Use reports, which provide important details about agricultural spraying, with the mothers’ addresses.

Mothers who took less than 800 micrograms and encountered household pesticides had a much higher estimated risk of having a child who developed an ASD than moms who took 800 micrograms of folic acid or more and were not exposed to pesticides. The associated risk increased for women exposed repeatedly. Women with low folic acid intake who were exposed to agricultural pesticides during a window from three months before conception to three months afterward also were at higher estimated risk.

Smoking cessation in secondary care: acute and maternity settings

Self-assessment framework for NHS acute trusts to develop local action to reduce smoking prevalence and the use of tobacco | Public health England

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The self-assessment tool breaks down the NICE guidance into 4 areas:

  • systems required to implement the guidance
  • communication required
  • training that will help staff to successfully implement the recommendations
  • treatments that should be available to support staff and service users

This self-assessment tool supports all of the recommendations applicable to acute services in the NICE guidelines on Smoking cessation in secondary care.

Please save the self-assessment file to your computer and click ‘enable editing’ before using it.

Public Health England has also developed a suite of resources including a self-assessment tool to support the implementation of NICE guidance in mental health settings.

View the full framework here

State of maternity services

The Royal College of Midwifery has published State of Maternity Services Report 2016.

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Image source: http://www.rcm.org.uk

The report examines emerging issues and trends in relation to maternity services.  It highlights that over a third of the UK’s NHS midwives are nearing retirement age; the increase in births to older mothers, who may require more care throughout their pregnancies;  and rates of obesity which are placing additional demands on maternity services.

Women’s experiences of maternity services

“Only 55% of women who made a decision about their birthplace achieved their choice” | The Women’s Institute

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Image source: The WI

This report presents the findings of the NFWI’s and NCT’s second survey of women’s experiences of maternity care, providing insights into key aspects of the experiences of 2,500 women who gave birth in England or Wales in 2014, 2015, and the first half of 2016. Since the publication of our last maternity services report in 2013, the maternity policy landscape has changed significantly. Most notably, the National Maternity Review report – Better Births – has recommended significant changes to how maternity services are organised.

Read the full overview here

Read the full report here

UK maternity care

MBRRACE-UK has published Saving Lives, Improving Mothers’ Care: Surveillance of maternal deaths in the UK 2012–14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009–14.

The report presents the findings of maternal mortality surveillance 2012 to 2014 in the UK and the lessons learned from the confidential enquiries into maternal deaths from cardiovascular causes, blood pressure disorders of pregnancy, early pregnancy causes together with messages for critical care.

MBRRACE-UK Maternal Report 2016 – Full Report

MBRRACE-UK Maternal Report 2016 – Lay Summary

Additional link: RCOG press release