Belfast Telegraph

New hospital guidelines praised

Hospitals are adopting ne w guidelines on the care of small babies in the womb on the back of groundbreaking research which has challenged international thinking.

Medics are being given revised advice on when to intervene in pregnancies to prevent serious health complications in babies, improve survival rates and hopefully reduce stress among mothers-to-be.

The findings of a study of 1,100 babies experiencing growth restriction, first published last year, are being used as the basis for a new policy on how mothers-to-be are being cared for in Irish hospitals.

The issue is one of the most common, controversial and complex problems in modern obstetrics - identifying small babies at risk from growth restrictions in the womb.

Dr Mairead O Driscoll, director of research strategy and funding at the Health Research Board (HRB), praised the quick adoption of the research.

"These new guidelines provide health professionals with appropriate and accurate interventions which will help improve survival rates and outcomes for small babies and hopefully reduce stress among mothers-to-be," she said.

"It will also ensure resources are used in the most effective way."

One of the mothers involved in the study, Grainne Foley, gave birth to her son John who was accurately diagnosed with fetal growth restriction and born 11 weeks premature.

He weighed 2lbs and six ounces but is now a healthy two-year-old.

"Taking part in the study was a bit of a no-brainer really," she said.

"Knowing that there was potential for some difficulties was a real worry for me.

"But it was very reassuring and eased the stress knowing I was able to avail of all the expert advice, ongoing monitoring and surveillance that the research team brought to the hospital.

"I now have a healthy and happy two-year-old."

The guidelines, issued at the Rotunda Hospital along with latest findings from the HRB Perinatal Ireland Network, have changed thinking on increased monitoring of mothers with babies whose weight falls into the bottom 10%.

Dr Julia Unterscheider, lead researcher on the study and RCSI Fellow in Maternal Fetal Medicine, said they were traditionally considered at the highest risk of developing complications.

"These mothers and babies usually receive increased surveillance and monitoring," she said.

"However, our study questions whether this is necessary for all cases.

"Our research found that the majority of babies whose weight falls into the bottom 10% from a weight perspective go on to be a healthy baby that is simply small for its gestational age.

"We discovered that the highest risk for adverse outcomes are in the group of babies that fall into the bottom 3% by weight and who have an abnormal reading on a particular ultrasound test.

"It is this group that need the special monitoring or intervention."

It is hoped the clinical guidelines will help standardise and improve antenatal care of pregnancies affected by fetal growth restriction.

Professor Fergal Malone, chairman of Perinatal Ireland, consultant obstetrician and gynaecologist at the Rotunda, said access to a large patient population transformed the ability to do research.

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