41: Neonatal Resuscitation Following Caesarean Section: A Retrospective Chart Review
Notice bibliographique
Résumé
Infants delivered by elective caesarean section have similar need for resuscitation as infants delivered by spontaneous vaginal deliveries. Approximately 10% of deliveries are estimated to require neonatal resuscitation with 1% requiring extensive measures. A health care provider certified by the Neonatal Resuscitation Program but without advanced airway skills is therefore considered sufficient at low risk deliveries. We undertook this study to determine the use of resuscitation and the health care providers in attendance at caesarean section deliveries in our centre. A retrospective chart review of 200 emergent and elective caesarean section deliveries was conducted in a small urban centre between January 2012 and 2013. Indications for caesarean section delivery were recorded. Health care providers present, whether the infant received suctioning, bag/mask ventilation, oxygen, intubation, or compressions, and APGARS at 1 and 5 minutes were recorded. χ2 tests used to determine potential differences between health care provider type and the use of resuscitation or not. Odds ratios are presented as a measure of effect size. The non-parametric Mann-Whitney test was used to examine differences in Apgar scores by group (resuscitation or not) to account for the significant skew in the distribution of APGAR scores at both 1 and 5 minutes. 220 infants were delivered through 200 caesarean section deliveries. Indications for caesarean section were maternal request (2%), failure to progress (18%), fetal distress (24%), previous caesarian section (35%), fetal indicators (18%), and maternal illness indicators (3%). 108/220 (49%) infants received suctioning, 26/220 (12%) received bag/mask ventilation, 23/220 (10%) received oxygen, and 15/220 (7%) were intubated. No infants required chest compressions. APGARs were lower in the group that received any form of resuscitation (1 minute z=−3.78, P<0.001; 5 minute z=−3.35, P<0.001). Gestational age (P=0.94), multiple fetuses (P=0.86), fetal heart rate (P=0.33), and prolonged rupture of membranes (P=0. 80) were not significantly associated with infants receiving resuscitation. Meconium in liquor (P<0.05) and fetal decelerations (P<0.005) were significantly associated with receiving resuscitation. Infants were less likely to receive resuscitation if a pediatrician was in attendance (P<0.001, OR=0.32, CI=0.16–0.65) however respiratory therapist attendance at the caesarean section significantly increased rate of resuscitation (P<0.01, OR=2.22, CI=1.23–4.02). The resuscitation rate in our centre was found to be significantly higher than expected. It was found that pediatrician presence at delivery decreased resuscitation requirements and respiratory therapist increased risk for resuscitation. Reasons for these observations need to be explored.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,004 | 0,005 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».