Paediatrician Standby at Deliveries - A Reappraisal of the Current Indications

Abstract

To evaluate the validity of the recommended indications for paediatric standby at delivery in Hospital Authority hospitals, a retrospective analysis of all deliveries within one training Obstetric unit over a three-year period was performed. The one and five minute Apgar scores of the babies were used as an endpoint to indicate the need for active resuscitation at birth. Apart from small number variations due to the limited sample size in some categories, all the recommended indications listed were associated with significantly increased risks of neonatal depression at birth. The highest risks were apparently associated with premature deliveries or low birthweight babies, vaginal breech deliveries, cases with cord prolapse and babies with congenital malformations. The recommended indications for paediatric standby in Hospital Authority training units should represent a minimal list of high-risk deliveries during which paediatrician attendance is well justified. (HKJGOM 2000; 1:36-39)