BACKGROUND Maternal intrapartum ampicillin has been recommended for the prevention of neonatal group B streptococcal disease. OBJECTIVES To assess the effect of this practice, if any, on neonatal early-onset Escherichia coli infection and to delineate the clinical characteristics of infected neonates. PATIENTS AND METHODS All neonates with early-onset E coli infection who were born at Cook ...

Group B streptococcus is a leading cause of serious neonatal infection. Most neonatal GBS infections can be prevented through the use of intrapartum antimicrobial prophylaxis in women who are at increased risk for transmitting the infection to their newborns. However, despite clinical trials that demonstrate the effectiveness of intrapartum antibiotic prophylaxis, prevention strategies have not...

BACKGROUND Quality of intrapartum care is an important intervention towards increasing clients' utilization of skilled attendance at birth and accelerating improvements in newborn's and maternal survival and wellbeing. Ensuring quality of care is one of the key challenges facing maternal and neonatal services in Uganda. The study assessed quality of intrapartum care services in the general labo...

Central nervous system (CNS) lesions resulting from hypoxia-ischemia (H-1) during gestation and the perinatal period, and from intrapartum trauma form the subjects of this review. Whereas mechanical factors are primarily responsible for the traumatic lesions, a wide spectrum of complex physiologic disturbances and pathologic sequelae are associated with H-1. CNS damage most commonly occurs amon...

AIM This paper is a report of an analysis of the concept of watchful waiting. BACKGROUND Little is known about differences between the intrapartum care processes of midwives and physicians. In this time of growing rates of surgical birth outcomes, intrapartum care processes are a key area for research and improvement. Watchful waiting is a common care plan used by both midwives and physicians...

OBJECTIVES To evaluate the impact of maternal BMI on intrapartum interventions and adverse outcomes that may influence choice of planned birth setting in healthy women without additional risk factors. DESIGN Prospective cohort study. SETTING Stratified random sample of English obstetric units. SAMPLE 17,230 women without medical or obstetric risk factors other than obesity. METHODS Mult...

BACKGROUND Continuity of care by a primary midwife during the antenatal, intrapartum and postpartum periods has been recommended in Australia and many hospitals have introduced a caseload midwifery model of care. The aim of this paper is to evaluate the effect of caseload midwifery on women's satisfaction with care across the maternity continuum. METHODS Pregnant women at low risk of complica...

OBJECTIVE Neonatal encephalopathy (NE) is the third leading cause of child mortality. Preclinical studies suggest infection and inflammation can sensitise or precondition the newborn brain to injury. This study examined perinatal risks factor for NE in Uganda. DESIGN Unmatched case-control study. SETTING Mulago National Referral Hospital, Kampala, Uganda. METHODS 210 term infants with NE ...

BACKGROUND Several key policy documents have advocated 24-hour consultant obstetrician presence on the labour ward as a means of improving the safety of birth. However, it is unclear what published evidence exists comparing the outcomes of intrapartum care with 24-hour consultant labour ward presence and other models of consultant cover. OBJECTIVES To collate and critically appraise evidence ...

BACKGROUND Recent studies have shown that the most important risk factors for perinatal mortality in developing countries are not detectable during antenatal care but can be observed only shortly before or during labour. Although 60% of perinatal deaths in these countries are stillbirths, few epidemiological studies focus on them. We tested the hypothesis that the risk factors for late stillbir...