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You are requested by the midwifery team to attend the delivery of a term neonate as there is an antenatal history of polyhydramnios. Local guidelines state that a nasogastric tube (NGT) should be passed at birth and position confirmed by either pH testing or X-ray. At birth the baby appears clinically very well and the mother questions whether the procedure is still indicated.
Structured clinical question
In neonates born to mothers with polyhydramnios (patient), where antenatal scans are otherwise normal, is the passage of a NGT (intervention) indicated in all cases to exclude or confirm oesophageal atresia (outcome) or should it be targeted to those with other suggestive features on ultrasound scan?
A PubMed search using the terms ‘polyhydramnios’ combined with ‘NG’ or ‘nasogastric’ and then ‘oesophageal atresia’ was undertaken. This gave 15 and 90 results, respectively, six of which were relevant to the clinical question; three other papers contained related data but focused on other …
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