National Sentinel CS Audit showed an overall CS rate of 21.5% in UK, 10% of which were elective. Midwives are routinely trained on Neonatal Life Support (NLS) courses to perform neonatal resuscitation. This enables them to manage uncomplicated deliveries and support the paediatric team. Despite this paediatricians routinely attend elective CS deliveries in many neonatal units.
Our aim was to evaluate the outcome of children born by elective CS under GA in the context of resuscitation requirements at the time of delivery in a District General Hospital setting.
We identified all elective CS deliveries under GA from 1996–2006 from the maternal theatre list. Resuscitation was defined as any assistance at delivery. Data was retrospectively collected using case notes and the Hospital Information Support System. 184 children from 181 deliveries (3 twins) were identified were excluded. Data from 178 patients after exclusion of children below 35+0 weeks of gestational age (6/184) was analysed (table).
99% children required either no assistance or only O2/bag and mask, which can be easily provided by NLS trained midwives. Our study demonstrates that routine paediatric attendance is not required for elective CS under GA. Implementation of this policy will have a significant impact on the day-to-day work load of paediatricians in a busy neonatal unit.