Guidelines for Paediatric Presence at Delivery
|Reviewed by Clinical Practice Committee|
Attendance at High Risk Deliveries
Attendance at Low Risk, Elective Caesarean Deliveries
Paediatric resident medical staff and NS-ANP’s are available to attend at risk deliveries and compromised fetuses. Referrals should be made by the LMC attending the mother. In emergencies or situations of urgency, messages can be relayed through clerical staff. Paediatric staff often have to prioritise calls, so accurate information is needed.
In most situations the 1st call locator (usually a paediatric SHO, registrar, or NS-ANP) should be called. Except in the situations set out below when 2nd call registrar or NS-ANP should attend, the 1st call person is responsible for informing other paediatric staff if he/she wants them to attend as well. The registrar/NS-ANP will attend deliveries with a house surgeon at the beginning of a run, until the house surgeon is competent at resuscitation.
The paediatric registrar/NS-ANP will contact the specialist if his/her presence is indicated, unless there is a prior arrangement.
The paediatric service should be informed of women in labour if the baby is likely to require care from the Newborn Service. Communication would normally be to the Neonatal Paediatric Medical team regarding clinical information. Bed status should be checked with the Clinical Charge Nurse. Referrals requesting neonatal paediatric input to the management of pregnancy/labour should be to specialists.
93 5537 or
021 852 598
|Level 2 Registrar-NS-ANP Locator
93 5536 or
021 891 404
Level 3 Registrar-NS-ANP
93 5535 or
021 891 409
light, no fetal distress
|light + fetal distress||Yes|
|Fetal distress||Yes||if severe|
|Preterm 35-36 weeks||Yes|
|Preterm 32-34+6 weeks||Yes|
|Preterm < 32 weeks||Yes||Discuss prior to labour/delivery|
|Term IUGR||Post delivery|
|Term Severe IUGR (<2.2kg)||Yes|
|Suspected fetal infection||Yes|
|Term Multiple pregnancy||Yes|
|LSCS (Elective low risk with regional anaesthetic)||No|
|Urgent or Category 1 LSCS||Yes|
|Low ventouse delivery, no fetal concerns||No|
|Ventouse delivery with fetal distress, meconium, or obstetric concerns||Yes|
|Vaginal Breech delivery||Yes|
|Maternal Substance Use||Post delivery|
|Fetal abnormality likely to affect condition at delivery||Discuss prior to labour/delivery|
|Fetal abnormality other than above||Discuss prior to labour/delivery|
|Haemolytic disease||Discuss prior to labour/delivery|
All three resident paediatric staff answer 777 emergency calls. The 777 call does not go to the specialist on call - a request for specialist attendance will need to be directed through the operator. If a specialist is required urgently, then contact them via their mobile phone.