ORIGINAL ARTICLE   

Minerva Obstetrics and Gynecology 2022 June;74(3):288-93

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

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

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 Obstetrics and Gynecology, University of Eastern Piedmont, Novara, Italy; ² Unit of Midwifery, Department of Obstetrics and Gynecology, University of Eastern Piedmont, Novara, Italy; ³ Unit of Obstetrics and Gynecology, Vito Fazzi Hospital, Lecce, Italy

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. Overall, 162 cases of mothers whose children experienced fetal asphyxia were compared 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 dystocia 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 teamwork 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; Obstetric labor; Asphyxia neonatorum; Delivery rooms