Posted on Tuesday 5th April 2011
Perinatal deaths have fallen in north Cumbria
The maternity service at North Cumbria University Hospitals NHS Trust has seen a dramatic drop in perinatal mortality rates over the past five years.
The number of perinatal deaths – when a baby dies between the 24th week of pregnancy and the end of the first week of life – fell by 44% between 2004 and 2009.
Rates for north Cumbria are now significantly lower than the rest of the region. Between 2005 and 2009, each year there were between 3.9 and 6 perinatal deaths per 1,000 live births, while the average for the North East and Cumbria was 7.1 per 1,000.
Prior to this, the average for north Cumbria was around 8 per 1,000 for several years, in line with the regional average, but before 1999 it was often around 10 per 1,000 each year, and consistently above the regional average.
Consultant Obstetrician and Gynaecologist Dr Ruth Lawley, who is Obstetric Lead at the Cumberland Infirmary, said the success was in part due to a number of new and improved practices which had been introduced by the Trust in recent years.
“Changes in practice since 1999 include the development of Maternity Day Units which provide easily accessible obstetric services,” she said.
“Over the past decade maternity services have become more midwifery-based, so expectant mothers now receive most of their care from community midwifery teams rather than their GPs. These community midwives are easily contactable and also have specialist knowledge which GPs may not have.”
Specialist teams dealing with diabetics, multiple pregnancies and substance abusers have also been developed.
Dr Lawley said the improvement in perinatal mortality rates could also be attributed to the adoption of techniques pioneered by the Perinatal Institute, based in the West Midlands. These include the use of different coloured sets of notes which are given to the mother antenatally, during labour and after the birth, which document the progress of mother and baby at regular intervals using a range of measures. These notes include personalised growth charts, so the development of the unborn child is measured according to the mother’s own height and weight, rather than against average population. This has contributed to the identification of small for gestational age babies, allowing prioritisation and focussed interventions.
“I would like to pay tribute to the whole maternity team across north Cumbria,” Dr Lawley added. “These improvements are not just down to one initiative or one member of staff – they come as a result of good team working and a collaborative approach to delivering patient care. They also show we have effective risk management systems in place, providing a safeguard for the maternity service.”
Dr Lawley will be working with the Regional Maternity Survey Office to examine further reasons why north Cumbria’s perinatal mortality rates have improved while remaining static across the region as a whole.