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Minerva Obstetrics and Gynecology 2021 Jun 07

DOI: 10.23736/S2724-606X.21.04815-6

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Preventing the human factor: organizational aspects linked to fetal asphyxia

Roberta AMADORI 1 , Sara GRANDIOSO 2, Elena OSELLA 1, Carmela MELLUZZA 1, Carmen I. AQUINO 1, Viviana STAMPINI 1, Raffaele TINELLI 3, Daniela SURICO 1

1 Department of Ostetrics and Gynecology, University of Eastern Piedmont, Novara, Italy; 2 Unit of Midwifery, Department of Ostetrics and Gynecology; University of Eastern Piedmont, Novara, Italy; 3 Unità Operativa di Ginecologia ed Ostetricia, Ospedale Vito Fazzi, Lecce, Italy


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BACKGROUND: Perinatal asphyxia can cause cerebral palsy and hypoxic - ischemic encephalopathy. They are public health problems because they cause permanent disability.
METHODS: This is a retrospective, analytical, observational study. 162 cases of mothers whose children experienced fetal asphyxia were compare to 361 controls where this condition did not occur. The variables analyzed were classified as: prepartum, intrapartum and organizational.
RESULTS: Assisted Reproductive Technology obtained pregnancies, smoking, maternal body mass index, lack of one to one assistance during labor, birth on a day of high volume activity increased the risk of fetal asphyxia, as well as other traditionally linked factors like shoulder distocia or age over 35 years.
CONCLUSIONS: Cerebral palsy cannot always be prevented because it is a syndrome with a multitude of potential causes. But a small number of cases is likely to be linked to acute intrapartum events that could be limited by changing organizational policies such as staff training and implementing team work and discussion. Our paper proposes strategies to try and modify organizational risk factors and therefore limit the incidence of fetal asphyxia.


KEY WORDS: Cerebral palsy; Labor; Asphyxia; Organization of delivery room

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