Critical Outcome And Hypoxic Ischemic Encephalopathy - A Quality Assurance Issue

The study evaluates the predictive value of the critical status of a newborn as to the risk of developing hypoxic ischemic encephalopathy (HIE).Methods On the basis of the data set from the perinatal survey in Hesse, Germany, in the year 2016, including 52,122 live births (singleton, 37 + 0 GA), cases of critical newborns were identified. A conjoined analysis with the data set of the neonatal survey from the identical period provided the basis to evaluate the relationship to cases compromised by HIE.Results The incidence of cases with a critical outcome (n = 11) and those with HIE (n = 29) was low. The sensitivity of the status of the newborn for detecting a risk of HIE was 10.34 %. The specificity was 99.98 %. The positive predictive value was 27.35 %. The negative predictive value was 99.95 %. The detailed, confidential single-case analysis indicated the ability to avoid negative outcomes in about one third of cases with a critical status of the newborn (4/11) and HIE (9/29).Discussion and conclusion The likelihood of developing encephalopathy (HIE) increases after a critical outcome after birth. Intensified monitoring of these newborns is justified. A single-case analysis identifies the potential ways to improve perinatal outcomes. Measures of external quality assurance should integrate the analysis of both perinatal and neonatal surveys as a basis for quality management (QM).