American journal of perinatology最新文献

{"title":"The Yield of Amnioinfusion in the Prevention of Postpartum Hemorrhage.","authors":"Keren Zloto, Eyal Sivan, Rakefet Yoeli-Ullman, Shali Mazaki-Tovi, Suneet P Chauhan, Michal Fishel Bartal","doi":"10.1055/a-2535-8109","DOIUrl":"10.1055/a-2535-8109","url":null,"abstract":"<p><p>Although amnioinfusion decreases the rate of uterine atony, its effect on postpartum hemorrhage (PPH) is uncertain. This study aimed to assess whether amnioinfusion reduces the risk of PPH in laboring individuals.A retrospective study of all laboring singletons at a tertiary center between January 2013 and December 2022 at ≥34 weeks. Individuals with known major fetal anomalies, stillbirths, or missing delivery records were excluded. The primary outcome was PPH. Neonatal and secondary maternal outcomes were also explored. Adjusted odds ratios (aOR) were estimated using multivariable regression models.Out of 113,816 deliveries during the study period, 83,152 (77.1%) met inclusion criteria, and among them 4,597 (4.03%) had amnioinfusion. Laboring individuals with amnioinfusion were more commonly nulliparous, had more polyhydramnios, oligohydramnios, preeclampsia, gestational diabetes, and fetal growth restriction. Furthermore, individuals with amnioinfusion had a higher rate of labor induction (54.54 vs. 27.8%; <i>p</i> < 0.01) and a higher cesarean rate (36.9 vs. 9.5%; <i>p</i> < 0.01). Following multivariable regression, there was no significant difference in the rate of PPH among individuals who had an amnioinfusion (2.6%) versus those who did not (3.1%; aOR: 0.95, 95% confidence interval [CI]: 0.87, 1.27). The rates of endometritis (aOR: 1.4; 95% CI: 1.04-1.89) and postpartum fever (aOR: 1.70; 95% CI: 1.36-2.12) were higher in those who had amnioinfusion compared with those that did not.Among laboring individuals ≥ 34 weeks, intrapartum amnioinfusion was not associated with a reduction in the rate of PPH and was associated with a higher likelihood of infectious morbidity. · PPH stands as the foremost contributor to maternal mortality.. · There is limited information regarding the yield of amnioinfusion in the reduction of PPH.. · We evaluate whether amnioinfusion reduces the rate of PPH in laboring individuals ≥ 34 weeks..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of First-Trimester Low Percentile Nuchal Translucency Association with Adverse Perinatal Outcomes and Fetal Congenital Anomalies.","authors":"Mefkure Eraslan Sahin, Erdem Sahin, Mehmet M Kirlangic, Seyma Daglituncezdi Cam, Serhan Kutuk, Havva Can Ozdemir, Emre Genc","doi":"10.1055/a-2544-9078","DOIUrl":"10.1055/a-2544-9078","url":null,"abstract":"<p><p>This study aimed to evaluate the association of first-trimester low percentile nuchal translucency (NT) thickness values with adverse perinatal outcomes and fetal congenital anomalies.In this retrospective study, 2,150 pregnant women who screened first trimester NT and delivered at Kayseri City Hospital were divided into three groups based on their fetal NT thickness percentiles as follows: third percentile NT group (<i>n</i>: 101), 3rd to 10th percentile NT group (<i>n</i>: 242), and 10th to 90th percentile NT group (<i>n</i>: 1,807).First-trimester NT thickness was analyzed in 5 mm intervals according to gestational age, and the mean NT value was 0.76 mm in the third percentile, 0.95 mm in the 3rd to 10th percentile, 1.51 mm in the 50th percentile, and 2.36 mm in the 90th percentile. Fetal birth weight was significantly decreased in the third percentile NT group and 3rd to 10th percentile NT group compared with the 10 to 90th percentile NT group. Small for gestational age, intrauterine growth restriction with abnormal Doppler value and second-trimester spontaneous abortion rates were significantly increased in the third percentile NT group and the 3rd to 10th percentile NT group compared with the 10th to 90th percentile NT group. The study did not find an increased risk for fetal congenital anomalies in the third percentile group or the 3rd to 10th percentile group.The results indicated that first-trimester NT thickness values below the 10th percentile were associated with low fetal birth weight and adverse perinatal outcomes. Additionally, low percentile first-trimester NT thickness was not a risk factor for fetal congenital abnormalities. · First trimester NT screening is a well-explained phenomenon.. · There is little information regarding decreased NT below the 10th percentile.. · NT thickness values below the 10th percentile were associated with adverse perinatal outcomes..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reoperation following Cesarean Birth: An Analysis of Incidence, Indications, and Procedures Using a National Surgical Database.","authors":"Luke P Burns, Jourdan E Triebwasser, Christopher X Hong","doi":"10.1055/a-2542-9318","DOIUrl":"10.1055/a-2542-9318","url":null,"abstract":"<p><p>This study aimed to determine the incidence of reoperation after uncomplicated cesarean birth, describe the types of procedures and indications for reoperation, and identify risk factors associated with reoperation using a national surgical database.A retrospective cross-sectional study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database, encompassing data from January 1, 2019, to December 31, 2021. A total of 43,492 patients who underwent cesarean birth were included. Patients who underwent concurrent nongynecologic procedures or hysterectomies were excluded. The primary outcomes measured were the incidence of unplanned reoperation within 30 days of cesarean birth, types of reoperative procedures, indications for reoperation, and associated risk factors. Statistical analyses included Student's <i>t</i>-test, Wilcoxon rank-sum test, chi-squared test, and multivariable logistic regression.Out of 43,492 cesarean deliveries, 397 (0.9%) required unplanned reoperation. Significant risk factors for reoperation included smoking (adjusted odds ratio [aOR]: 1.96, 95% confidence interval [CI]: 1.49-1.56), hypertension (aOR: 1.83, 95% CI: 1.27-2.62), bleeding disorders (aOR: 2.11, 95% CI: 1.15-3.89), American Society of Anesthesiologists (ASA) class > 3 (aOR: 2.23, 95% CI: 1.29-3.84), and concurrent myomectomy (aOR: 4.39, 95% CI: 1.06-18.2). The most common indications for reoperation were postpartum hemorrhage (47%), wound disruption or infection (18%), and hematoma or hemoperitoneum (14%). The most frequently performed reoperative procedures were exploratory laparotomy without hysterectomy (27%), uterine curettage (23%), and wound debridement or drainage (22%).Reoperation following cesarean birth is a relatively uncommon but significant event, occurring in 0.9% of cases. Key risk factors include smoking, hypertension, bleeding disorders, ASA class > 3, and concurrent myomectomy. This study provides comprehensive data on the clinical characteristics and indications for reoperation following cesarean birth in a diverse, multi-institutional US cohort. The findings highlight the need for enhanced perioperative monitoring and targeted interventions for high-risk patients to improve maternal outcomes. · In this retrospective cross-sectional study of 43,492 cesarean deliveries, the incidence of unplanned reoperation was found to be 0.9%.. · Significant risk factors for reoperation included smoking, hypertension, bleeding disorders, American Society of Anesthesiologists (ASA) class > 3, and concurrent myomectomy at the time of cesarean birth.. · The most common indications for reoperation were postpartum hemorrhage, wound disruption or infection, and hematoma or hemoperitoneum.. · The most common reoperative procedures were exploratory laparotomy without hysterectomy, uterine curettage, and wound debridement or drainage..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Surgical Morbidity following Planned Hysterectomy versus Conservative Management for Placenta Accreta Spectrum: A Systematic Review and Meta-analysis\".","authors":"Lakshmi Thangavelu","doi":"10.1055/a-2523-2247","DOIUrl":"10.1055/a-2523-2247","url":null,"abstract":"","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Risk-Adjusted Associations between Prenatal Care Utilization and Obstetric Outcomes in a Commercially Insured Patient Population.","authors":"Adina Rachel Kern-Goldberger, Natalie E Sheils, Rachell Vinculado, Ana Jane Paderanga, David A Asch, Sindhu Srinivas","doi":"10.1055/a-2559-7261","DOIUrl":"10.1055/a-2559-7261","url":null,"abstract":"<p><p>This study examined associations between prenatal care utilization and adverse obstetric outcomes including severe maternal morbidity (SMM), preterm birth, and stillbirth in a large, commercially insured U.S. patient population. This is a retrospective cohort study using an insurance claims database evaluating associations between prenatal care utilization and obstetric outcomes over four years (2017 - 2020). Prenatal care utilization was characterized based on the Adequacy of Prenatal Care Utilization (APNCU) index. The primary outcome was SMM (as per Centers for Disease Control). Secondary outcomes included preterm birth < 37 weeks and stillbirth. Associations between exposure and outcome were investigated using logistic regression models in designated \"low\" and \"medium\" maternal risk groups, defined based on obstetric co-morbidity index (OB-CMI) scores modeled at the time of the first trimester and at delivery. 297,453 patients were included: 78,100 in the sub-group who remained low-risk throughout pregnancy and 49,920 in the sub-group who remained medium-risk. The largest number of patients overall (29.9%) received \"adequate plus\" care, as defined by the APNCU index, while a plurality of low- and medium-risk patients received \"intermediate\" care (35.6% and 29.9%, respectively). 1.77% of patients experienced SMM, 8.63% delivered preterm, and 0.88% had stillbirth. Adjusted analysis comparing volume of prenatal care with these outcomes demonstrated no statistically significant associations, with the exception of preterm birth, which was positively associated with \"adequate\" and \"adequate plus\" care in low- and medium-risk patients. \"Inadequate care\" was not associated with any of the studied outcomes. Overall volume of prenatal care was not associated with a reduction in adverse obstetric outcomes. Clinical quality improvement and health policy efforts to improve prenatal care delivery models may need to bypass adherence to established guidelines in terms of gross visit number as a key metric and instead work to revise practices based on more meaningful clinical outcomes.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time To Hemorrhage Response After Implementation of Obstetric Hemorrhage Bundle.","authors":"Akanksha Srivastava, Michelle Wang, Sara Young, Swetha Tummala, Diana Abbas, Megan Alexander, Lindsey Claus, Ronald Iverson, Ashley Comfort","doi":"10.1055/a-2559-1837","DOIUrl":"10.1055/a-2559-1837","url":null,"abstract":"<p><p>Objective To evaluate the time to uterotonic administration before and after the implementation of an obstetric hemorrhage bundle. Study Design This is a retrospective cohort study of deliveries at an urban tertiary care hospital before and after implementation of an obstetric hemorrhage bundle. Two groups were compared on time from delivery to first dose of postpartum uterotonic intervention. Secondary outcomes included total number of uterotonics, transfusion rates, and utilization of non-uterotonic hemorrhage interventions including uterine artery embolization and balloon tamponade. Results Of the 4,275 deliveries of live births included in this study, 1944 occurred pre-intervention and 2,331 occurred post-intervention. Mean time to oxytocin decreased from 12.2 minutes to 5.9 minutes after implementation of the bundle (p<0.01). Post-intervention deliveries received significantly more second line uterotonics when compared to pre-intervention deliveries (p<0.01). Conclusion Implementation of an obstetric hemorrhage bundle was associated with improved management as reflected in faster and increased delivery of uterotonic interventions for hemorrhage. Future studies should continue to explore the effect of hemorrhage bundle protocols on hemorrhage-related process measures.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence risk of preterm birth in successive pregnancies based on its subtypes.","authors":"Iris T Smith, Michael John Fassett, David A Sacks, Nehaa Khadka, Nana Mensah, Morgan Peltier, Vicki Y Chiu, Fagen Xie, Jiaxiao M Shi, Darios Getahun","doi":"10.1055/a-2552-9058","DOIUrl":"https://doi.org/10.1055/a-2552-9058","url":null,"abstract":"<p><strong>Objective: </strong>Preterm birth (PTB) remains one of the biggest public health challenges with both obstetric and perinatal implications. While a prior PTB is a known risk factor for recurrence, the understanding of the influence of factors such as race/ethnicity, gestational age, PTB subtypes, and interpregnancy intervals (IPI) remains limited. This study aimed to assess whether these factors modify PTB recurrence risk.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of singleton pregnancies in Kaiser Permanente Southern California (2009-2022) using electronic health record data from 82,610 women with two pregnancies and 14,925 women with three. PTB subtypes, spontaneous (sPTB) and indicated (iPTB), were identified through natural language processing. Logistic regression was used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>A first PTB was associated with a 6-fold increased risk of PTB in the second pregnancy compared to an uncomplicated pregnancy (23.29% vs. 4.98%, respectively; aOR, 5.60, 95% CI: 5.23-5.99). Those with a history of sPTB (aOR: 5.32, 95% CI: 4.87, 5.81) and iPTB (aOR: 8.26, 95% CI: 7.18, 9.50) had increased risk for the same respective subtype at their second pregnancy. PTB recurrence risk persisted across race/ethnicity categories. In women with PTB in both prior pregnancies, the risk for PTB in a third pregnancy was significantly higher (aOR 14.59, 95% CI 11.28-18.88). The recurrence of PTB between 1st and 2nd pregnancy was substantially higher for those who delivered at 20-33 weeks of gestation, regardless of PTB subtype. Non-Hispanic Black and Asian/Pacific Islander women had higher recurrence risk compared to non-Hispanic Whites.</p><p><strong>Conclusion: </strong>These findings highlight disparities in PTB recurrence by race/ethnicity and PTB subtype among a large integrated healthcare system in Southern California, underscoring the need for targeted interventions, particularly for sPTB.</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Growth Velocity Using a New Liquid Human Milk Fortifier in Very Low Birth Weight Infants: A Multicenter, Retrospective Study.","authors":"Fernando Moya, Jennifer Fowler, Adrian Florens, Jennifer Dombrowski, Olivia Davis, Tiffony Blanks, Austin Gratton","doi":"10.1055/a-2527-4638","DOIUrl":"10.1055/a-2527-4638","url":null,"abstract":"<p><p>This study aimed to compare growth outcomes and tolerance among very low birth weight (VLBW) infants receiving a new, liquid human milk fortifier (LHMF-NEW) or a human milk fortifier-acidified liquid (HMF-AL).Retrospective, multicenter study of 515 VLBW infants in three regional neonatal intensive care units. The primary objective was to compare growth velocity (g/kg/d) during fortification between groups by repeated measures regression. Secondary outcomes of interest were feeding tolerance and the incidence of late-onset sepsis, necrotizing enterocolitis, and metabolic acidosis. Student's <i>t</i>, analysis of variance, Wilcoxon, and Kruskal-Wallis tests were used for numeric variables, or chi-squared and Fisher's exact test for categorical variables.No demographic differences were identified between the groups (HMF-AL, <i>n</i> = 242; LHMF-NEW, <i>n</i> = 273). Growth velocity during fortification was significantly higher in the group receiving LHMF-NEW, despite relatively similar total fluid, calorie, or protein intake (<i>p</i> = 0.001). Feeding intolerance was comparable between fortifiers. Necrotizing enterocolitis and late-onset sepsis did not differ between groups and metabolic acidosis was diagnosed less frequently with the LHMF-NEW. Anthropometric measures at discharge and length of stay were comparable.Infants receiving human milk fortified with the LHMF-NEW had faster growth velocity during fortification, similar tolerance, and less metabolic acidosis compared with an earlier cohort of infants who received human milk fortified with an HMF-AL. · Among VLBW infants, using an LHMF-NEW resulted in a faster growth velocity in weight during several weeks of fortification than using the previous HMF-AL.. · The incidence of feeding intolerance (stopping feeds >8 hour) in any given week of fortification was low and not different between groups. Also, late-onset sepsis and necrotizing enterocolitis were uncommon with no differences between groups, whereas the incidence of metabolic acidosis was lower in infants receiving the LHMF-NEW.. · No differences in length of stay or anthropometrics at discharge were identified..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Coronavirus Disease 2019 on the Incidence of No Prenatal Care.","authors":"Takaki Tanamoto, Misa Hayasaka, Lindsay Robbins, George Saade, Tetsuya Kawakita","doi":"10.1055/a-2535-8309","DOIUrl":"10.1055/a-2535-8309","url":null,"abstract":"<p><p>This study aimed to examine the impact of coronavirus disease 2019 (COVID-19) on the racial disparity in prenatal care utilization in the United States before and during the pandemic.This was a cross-sectional study using the National Vital Statistics Data from 2018 to 2022. Our focus was on low-risk individuals who delivered singleton pregnancies at term. The analysis was restricted to Black and White individuals to explore racial disparities. The study periods based on the last menstrual period (LMP) were prepandemic (March 2018-February 2020) and pandemic (March 2020-February 2022). The primary outcome was the rate of no prenatal care. We employed interrupted time series analysis, negative binomial regression models, adjusting for confounders, seasonality, and autocorrelation. We conducted postestimation analyses to calculate the counterfactual and actual incidences of outcomes for individuals with an LMP in March 2020 and February 2022. Difference-in-difference (DID) with 95% confidence intervals (95% CI) was estimated.The analysis included 3,511,813 individuals in the prepandemic period and 5,163,486 in the pandemic period. For individuals with LMP in March 2020, the actual incidences of no prenatal care per 100 births were 3.2 (95% CI: 3.0, 3.3) for Black individuals and 1.6 (95% CI: 1.2, 2.0) for White individuals. The difference between counterfactual and actual no prenatal care rates per 100 births for Black individuals was 0.4 (95% CI: 0.2, 0.5), indicating a significant increase in no prenatal care. Conversely, there was no significant difference for White individuals. DID analysis further demonstrated that this increase was greater in Black individuals compared with White individuals (DID per 100 births 0.3 [95% CI: 0.1, 0.5]). For individuals with LMP in February 2022, this difference in disparity further worsened (DID per 100 births 0.8 [95% CI: 0.4, 1.2]).The COVID-19 pandemic increased the incidence of no prenatal care, which disproportionately affected Black individuals. · The COVID-19 pandemic increased racial disparities.. · The increase in no prenatal care among Black individuals.. · White individuals are lower affected during this period..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving First-Attempt Intubation Success Rate in a Level IV Neonatal Intensive Care Unit Through the Use of a Video Laryngoscope: A Quality Improvement Initiative.","authors":"Stephanie Martinez, Monika Bhola, Nori Mercuri Minich, Charlene Nauman, Kathleen Deakins, Allison Oliverio, Gulgun Yalcinkaya","doi":"10.1055/a-2533-2465","DOIUrl":"https://doi.org/10.1055/a-2533-2465","url":null,"abstract":"<p><p>There is increasing evidence that the use of a video laryngoscope improves first-attempt intubation rates in neonates. The goal of this quality improvement initiative was to improve the first-attempt intubation success rate from 45 to 65% in 2.5 years through the introduction and increased use of a video laryngoscope in a level IV neonatal intensive care unit (NICU).We utilized the Model for Improvement with plan-do-study-act cycles targeted at increasing buy-in and comfort with the use of a video laryngoscope. Data on 418 intubations were collected from November 2021 to April 2024.Through increasing routine use of the video laryngoscope, achieved via a staggered introduction of the device, creation of reference materials, and coaching workshops, we improved the overall first-attempt intubation success rate from 45 to 57% during the intervention period.We increased the first-attempt success rate of intubations in the NICU by effectively implementing the use of a video laryngoscope into daily practice. · Neonatal intubations have low success rates, but video laryngoscopy improves success especially for those with less experience.. · This study shows that video laryngoscopy adoption in a neonatal ICU improved first-attempt intubation rates.. · This study contributes to neonatal intubation and video laryngoscopy literature from a quality improvement perspective..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}