A Norwich hospital says is it revising clinical guidelines and training, as well as considering introducing a new test and day assessment unit, following a review into stillbirths.

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The Norfolk and Norwich University Hospital had 35 stillbirths in 2011, a rise from 21 the year before, and while this still did not put the hospital above the national average for the rate of stillbirths, it decided to call in some expert help as an extra precaution.

Members of the Royal College of Obstetricians and Gynaecologists conducted an external review in January and made recommendations regarding improving documentation processes, departmental changes in role, standardising guidelines and revising training.

The obstetric department says it is now considering the introduction of foetal fibronectin testing for pre-term labour. Testing for the presence of fibronectin can be used as part of the assessment of whether a woman has entered pre-term (or premature) labour.

It is revising some local clinical guidelines, with greater electronic access to guidelines, and making changes to its current clinical training programme.

It is also redistributing some responsibilities within the department and is considering creating a day assessment unit.

The stillbirth rate has since reduced and is currently at 3 per thousand for 2012 so far for the N&N, where there are 6,200 babies born each year.

The latest available national statistics indicate that there are between 3,150 and 3,686 stillbirths each year in England and Wales at a rate of 5.1 stillbirths per 1,000 births.

Chief executive Anna Dugdale said: “Our stillbirth numbers have never been above the national average and have now fallen even further to three per thousand.

“We know that in over half of all stillbirths it is not possible to determine the underlying cause although it can be affected by a range of factors including congenital abnormality, smoking, obesity and problems with the placenta.

“We want to do everything we can to minimise the risks for families as part of our commitment to provide the best quality of care for our patients. Any stillbirth is a tragedy and our staff will continue to provide support to affected families.”

8 comments

  • Dave , you really don't know what you are talking about. T o say that " NO KNOWN CAUSE IS FOUND EVEN AFTER AUTOPSY, which means that no tobacco is found to have caused it " shows an alarming lack of understanding of epidemiology. Statistically , mothers and households that smoke are more likely to suffer a SIDS. Work out the logical conclusion from that. There may have been a post war baby boom but there was also much higher level of smoking related pregnancy problems than now.The introduction of the smoking ban has been linked to a dramatic reduction in the number of premature and low birthweight babies . A study by academics at Glasgow University has revealed that the number of mothers-to-be who smoked dropped from 25.4 per cent of pregnant women to 18.8 per cent following the launch of the ban in March 2006. Meanwhile, the number of overall pre-term deliveries – babies born before 37 weeks gestation – fell by 10 per cent over the same period, while there was also a 5 per cent drop in the number of infants born small for gestational size, and a drop of 8 per cent of the number of babies born “very small” for gestational size. But if you want to smoke yourself to death in the privacy of your own home , that's fine by me.

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    LARSON.E. WHIPSNADE

    Friday, June 1, 2012

  • If I was having my family now, amongst my concerns would be the way hospitals do not seem to admit women in labour until their labour is more advanced than was the normal practice some years ago. Another concern would be how women in labour who are booked into a hospital may find that when they call the hospital to be admitted they are diverted to other maternity facilities some distance away-Yarmouth or Lynn instead of Norwich, or Bury St Edmunds instead of the Rosie Unit in Cambridge. So they then have to travel further whilst their labour is becoming more advanced and they are more likely to be in need of medical assistance. Overcrowding, routine understaffing and failing to make adequate provision for the expected deliveries-maybe that should be troubling the hospitals.

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    Daisy Roots

    Thursday, May 31, 2012

  • Mr Erskine ,some doctors smoke . But none of them thinks it is good for you and none of them would be mad enough to advice a pregnant woman to smoke.

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    LARSON.E. WHIPSNADE

    Friday, June 1, 2012

  • The quote from Dave Copeland is complete rubbish , actually written by a pro-smoking fanatic and based on disputed " research " from over 20 years ago. There is not a single doctor in the UK who would agree with its contents. If you smoke during pregnancy, you have a higher risk of having a baby with a low birth weight. This is in addition to the increased risk of heart disease and cancer that you have as a smoker. Babies born to women who smoke during pregnancy are, on average, significantly smaller than those born to women who don't smoke. Low birth weight is one of the main causes of illness and disability in babies, and also increases the risk of your baby being stillborn. Smoking in pregnancy increases the risk of cot death by four times if you have between one and nine cigarettes a day. This rises to an eight times higher risk of cot death if you smoke 20 cigarettes or more a day. Other harmful effects of smoking include: ectopic pregnancy miscarriage premature labour placental abruption vaginal bleeding Smoking during pregnancy may affect your child's mental development and behaviour, leading to a short attention span and hyperactivity. Your baby may also be more prone to certain birth defects. There's a strong link between smoking in pregnancy and babies born with a cleft lip and palate. The further into pregnancy you smoke, the greater your risk of complications. If you stop smoking during the first half of your pregnancy, the baby is likely to have a healthy birth weight.

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    LARSON.E. WHIPSNADE

    Friday, June 1, 2012

  • In more rational times, before the anti-tobacco hysteria began in earnest, women who smoked continued to smoke and enjoy other normal pleasures of life without guilt during their pregnancies. Many even smoked during labour to help them relax and take the edge off their pain. If their doctors mentioned smoking at all, it would be to advise them to perhaps cut down if they were heavy smokers, something which most did intuitively because they didn’t “feel” like smoking as much. But pity the poor smoker today who becomes pregnant, because she will be told that if she continues to smoke at all (or have any alcohol or caffeine) during her pregnancy, she is putting her developing fetus at high risk of death or disability. Nothing could be further from the truth.. Though there is considerable evidence showing that on average the babies of women who smoke during pregnancy weigh on average a few ounces less than babies of women who do not smoke and that the rate of low birthweight babies is somewhat higher for smokers, there is no credible evidence for the hyperbolic claims that the babies of smokers have a higher mobidity and mortality rate. Quite the contrary, the babies of women who smoke during pregnancy have a better survival rate ounce for ounce, a somewhat lower rate of congenital defects, a lower rate of Down’s syndrome, a lower rate of infant respiratory distress syndrome and a somewhat lower rate of childhood cancer than do the babies of non-smokers. Dr. Richard L. Naeye, a leading obstetrical researcher who studied more than 58,000 pregnancies, states unequivocally: “We recently found no significant association between maternal smoking and either stillbirths or neonatal deaths when information about the underlying disorders, obtained from placental examinations, was incorporated into the analyses. Similar analyses found no correlation between maternal smoking and preterm birth. The most frequent initiating causes of preterm birth, stillbirth, and neonatal death are acute chorioamnionitis, disorders that produce chronic low blood flow from the uterus to the placenta, and major congenital malformations. There is no credible evidence that cigarette smoking has a role in the genesis of any of these disorders.”

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    Dave Copeland

    Thursday, May 31, 2012

  • larson you should follow the words" not a single doctor will"with the word publicly .a friend of mine happens to be a doctor who smokes more than me he is told to toe the line and tell smokers to stop i suspect he is not alone, but is afraid to say otherwise

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    Stephen Erskine

    Friday, June 1, 2012

  • You say that "Smoking in pregnancy increases the risk of cot death by four times if you have between one and nine cigarettes a day. This rises to an eight times higher risk of cot death if you smoke 20 cigarettes or more a day".........this is typical scaremongering propaganda from the zealots at tobacco control. One of the most despicable lies is the attack on grieving smoker parents who lose babies to SIDs - just as non smokers do. The meaning of SIDS is that NO KNOWN CAUSE IS FOUND EVEN AFTER AUTOPSY, which means that no tobacco is found to have caused it. It is only in the hateful mean spirited minds of bigoted anti-smokers, pushing their cause via abuse of the most vulnerable. They should be ashamed of themselves and quite frankly, I find it disgusting.

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    Dave Copeland

    Friday, June 1, 2012

  • Larson E Whipsnade......makes you wonder how there was a baby boom in the 40's and 50's when every man and his dog were smokers :)

    Report this comment

    Dave Copeland

    Friday, June 1, 2012

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