Most Proposed Topic :
Enhancing Partnership with Patients and Community (projects initiated to engage patient and improve patient communication)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors: (including presenting author): :
Kwong KM (1), Tin T(1), Hiu KK(1), Chan HK(1), Wong SC(3), Seto TY(1), Cheung KW(1)(2)
Affiliation: :
(1) Department of Obstetrics & Gynaecology, Queen Mary Hospital, (2) Department of Obstetrics & Gynaecology, The University of Hong Kong,
(3) Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital
Introduction: :
Hypothermia in newborns is common across institutional birth (1). Newborns can lose heat quickly if they are not thermally protected. In the first 10-20 minutes after birth, newborns can experience a body temperature drop of between 2°C to 4°C if they are not properly dried and covered (1)(2). Evidence shows higher hypothermia rates in infants born by Caesarean section than vaginal birth (3). Existing evidence shows the use of active warming devices could reduce shivering and optimise newborn temperatures at birth (3)(4). The thermal outcome of newborns after Skin To Skin Contact (STSC) with the use of an active warming device (thermal blanket) in operation room has not been systematically investigated.
Objectives: :
To compare thermal outcomes using the thermal blanket and passive insulation versus passive insulation (warm towels) only during and after STSC in operation room. Hypothesizing the use of thermal blankets can reduce the incidences of newborn hypothermia without interrupting the mother-baby STSC after Caesarean delivery at 20 minutes or until completion of operation.
Methodology: :
A single centre randomised controlled trial with sample size of 120 is proposed. Enrolment will take place in the pre-operative outpatient clinic. All expectant mothers scheduled for elective Caesarean sections fulfilling the inclusion criteria will be eligible. Immediately after birth, newborns will be dried while practicing delayed cord clamping for 60 seconds (5). Newborn will be placed on mother’s bare chest for STSC. Newborns’ (skin, rectal or axillary) temperature will be measured before and after STSC. STSC will begin after delivery and will last for 20 minutes unless interrupted or until completion of operation, whichever is earlier. Hypothermia is defined as core body temperature below 36.5°C.
Result & Outcome: :
This study has started since November 2023 and still ongoing.12 clients were recruited with 2 dropped off. The mean newborn skin temperature has improved by 0.1°C after using the thermal blanket. Newborn core temperature is significantly different with the use of thermal blanket (p=0.01, paired t-test). 5 out of 6(83%) newborns in intervention group has observed skin temperature improvement after using the thermal blanket. There was no hypothermia observed in intervention group. One newborn from control group has hypothermia (50%).
