Obstetric dating and assessment
Simplified methods for GA assessment had poor diagnostic accuracy for identifying preterm births (community health worker prematurity scorecard [sensitivity/specificity: 70%/27%]; Capurro [5%/96%]; Eregie [75%/58%]; Bhagwat [18%/87%], foot length CONCLUSIONS: Newborn clinical assessment of GA is challenging at the community level in low-resource settings.Anthropometrics are also inaccurate surrogate markers for GA in settings with high rates of fetal growth restriction.
Until further evidence is available, a reasonable approach is to perform an initial evaluation with the cord attached.Pregnancy dating is frequently uncertain in low-resource settings due to late presentation for antenatal care, challenges of last menstrual period (LMP) recall, and unavailability of ultrasonography.In high-income countries, postnatal clinical assessment of infant physical and neurologic maturity was commonly used to estimate GA before ultrasound was widely available.BACKGROUND: Gestational age (GA) is frequently unknown or inaccurate in pregnancies in low-income countries.Early identification of preterm infants may help link them to potentially life-saving interventions.In addition, the Megacode does not test competence - it tests the ability to perform in a simulation based learning activity.
Revised: May 1, 2014Confidentiality: All information in the database is confidential; however the CPS will share NRP data with provincial and national NRP organizations to enable them to monitor the availability of Instructor Trainers and Instructors as well as the provision and number of courses within their area.
If clinical signs indicate a need for resuscitation (ineffective respiratory effort or bradycardia despite gentle stimulation), the cord should be clamped and respiratory support initiated as per NRP guidelines.
Alternatively, resuscitation with the cord intact may be considered as part of a clinical trial, or if institutional policy, staff training and birth set-up support this practice.
Additionally, neurologic examinations may be influenced by other morbidities, such as birth asphyxia, infection, or congenital anomalies.
Simplified methods to identify premature infants that rely on fewer characteristics, have been described and developed for lower resource settings.
If you have questions that are not answered here, email us at [email protected] call at 613-526-9397, ext. They would need to successfully complete skills stations, integrated skills stations, Megacodes, and simulation and debriefing exercises relevant to these learning needs.