Antenatal optimisation for preterm infants less than 34 weeks: a quality improvement toolkit

The British Association of Perinatal Medicine (BAPM) and the National Neonatal Audit Programme (NNAP) are collaborating on four quality improvement toolkits to support perinatal staff to implement the evidence around perinatal optimisation. This article presents the Antenatal Optimisation Toolkit. The evidence for key interventions is described alongside a quality improvement journey, which supports staff to choose improvement solutions most suitable for the local context.

Lauren Shaw
Neonatal Grid Trainee, East Deanery, Scotland

Julie-Clare Becher
Lead for Quality, BAPM and Consultant Neonatologist, Royal Infirmary of Edinburgh,
julie-clare.becher@nhslothian.scot.nhs.uk

On behalf of the BAPM Antenatal Optimisation Toolkit Group

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Keywords

aplasia cutis congenita; skin disorder; congenital; placental infarct; fetus papyraceus

Key points

Extensive ACC lesions on the trunk and limbs are rare.
ACC can be associated with placental infarcts or the in utero death of a twin fetus, as in the case presented here.
Obstetric history should review maternal medications/infections during pregnancy, determine an initial multiple pregnancy with death of a co-twin and investigate any placental anomalies.
Despite their large size, truncal and limb ACC lesions usually resolve within the first few months of life.

Also published in Infant:

VOLUME 16/ISSUE 4, JULY 2020

A neonate with congenital nephrotic syndrome

A male infant who was born in poor condition exhibited a persistently raised creatinine level over the first 14 days of life but showed no neurological signs of a significant hypoxic insult. A diagnosis of Finnish-type congenital nephrotic syndrome was eventually made by genetic testing. For neonates presenting with unusual or rare underlying pathologies there may be a period of time in which their signs and symptoms are attributed to a more common pathology. This case report illustrates that alternative more unusual diagnoses must be considered and explored when symptoms and results do not follow an expected course.