Programme content

• Element 1: Very brief advice on smoking for pregnant woman and A SmokeFree Pregnancy

  Element 1: Very brief advice on smoking for pregnant woman and A SmokeFree Pregnancy

  These two sessions focus on the delivery of very brief advice (VBA) on smoking to pregnant women, including carbon monoxide (CO) screening. The National Institute for Health and Care Excellence (NICE) guidance recommends that all women are CO screened at antenatal appointments, with those having elevated levels referred for specialist support to stop smoking. This session is aimed at helping members of the midwifery team to deliver VBA on smoking to their patients.

  By the end of the session learners will be able to:

  • describe the main effects of smoking on the health of mother and baby
  • understand the patterns and prevalence of smoking among pregnant women
  • provide an overview of VBA (ask, advise, act) and where this fits into the care pathway
  • establish smoking status including CO screening (ask)
  • Advise women on the best way of stopping smoking or managing their exposure to smoke (advise)
  • support women to quit or manage their exposure to smoke (act)
  • deal with issues as they arise
  • complete a short assessment to consolidate your knowledge

  Duration: 60 minutes

• Element 2: Detection and surveillance of fetal growth restriction

  Element 2: Detection and surveillance of fetal growth restriction

  This session is designed to accompany element 2 of the SBLCBv3. It will provide an understanding of the core principles of the stillbirth risks associated with FGR and the element’s suggested measures to reduce this by improving detection and management.

  By the end of the session learners will be able to:

  • describe different features of early and late onset FGR
  • explain how pregnancies are assessed for the risk of FGR using risk factors and findings in pregnancy
  • describe the different risk surveillance strategies once pregnancies have been risk assessed
  • describe how fetal growth and wellbeing can be monitored when early and late FGR have been diagnosed
  • discuss intervention in the form of early delivery for fetal growth restriction

  Prerequisites:

  Before commencing this session learners should have:

  • read ‘Element 2′ of the Saving Babies’ Lives Care Bundle Version 3, including appendices C and D [1]
  • familiarity with symphysis-fundal height (FH) measurement and antenatal care aimed at FGR detection
  • an understanding of how ultrasound can be used to assess fetal size
  • an understanding of what is meant by estimated fetal weight centile and birth weight centile

  Duration: 30 minutes

• Element 3: Reduced fetal movements

  Element 3: Reduced fetal movements

  This session will provide maternity healthcare professionals with knowledge to understand the association between (RFM) and late stillbirth (greater to or equal to 28 weeks gestation) and information about the impact of different management strategies.

  By the end of the session learners will be able to:

  • describe the association between reduced RFM and late stillbirth by understanding physiology and pathophysiology
  • demonstrate awareness of evidence about the contribution of suboptimal care of RFM to late stillbirth
  • give information to women about normal patterns of fetal movements and when they should present to maternity care with RFM
  • describe the recommended management plan for women presenting with RFM after 28 weeks gestation
  • evaluate care given for RFM from a multidisciplinary perspective

  Prerequisites:

  Before commencing this session learners should have knowledge of:

  • the standard pathway (recommended by NICE) for antenatal care in low risk and high risk pregnancies
  • usual maternal perception of RFM
  • the interpretation of antenatal cardiotocography (CTG) and late pregnancy ultrasound scanning for fetal biometry, liquor volume and umbilical artery Doppler with reference to growth centiles

  Duration: 20 minutes

   

• Element 4: Effective fetal monitoring during labour

  Element 4: Effective fetal monitoring during labour

  This session provides an introduction to key principles of risk assessment at the onset of labour in order to determine the optimum method of fetal monitoring in labour. The session also addresses the reassessment of risk factors and use of ‘fresh eyes’ as an opportunity for risk assessment at regular intervals in labour.

  By the end of this session learners should be able to:

  • describe a risk assessment at the onset of labour to decide the recommended mode of fetal monitoring in labour
  • explain the significance of regular reassessments of risk in labour
  • identify the risk factors that appear in labour and recommend continuous fetal monitoring in labour
  • identify the factors to consider when CTG changes are noted in labour
  • explain the role of buddy system/‘fresh eyes’ in intrapartum fetal monitoring

  Prerequisites:

  Before commencing this session learners should have:

  • completed annual training in fetal monitoring within their maternity unit
  • basic knowledge of fetal physiology
  • knowledge of local guideline for CTG interpretation

  Duration: 20 minutes

• Element 5: Prediction, prevention and perinatal optimisation of preterm birth

  Element 5: Prediction, prevention and perinatal optimisation of preterm birth

  This session provides guidance on the effective prediction, prevention and preparation for preterm birth, which are all key aspects of the Saving Babies’ Lives Care Bundle version 3.

  By the end of the session learners will be able to:

  • demonstrate awareness of the incidence, causes and consequences of preterm birth
  • describe the ways in which effective prediction and prevention can be incorporated into clinical practice
  • explain how to optimise perinatal care for women and their babies at the time of preterm birth

  Prerequisites:

  Before commencing this session learners should have:

  • Basic knowledge of the causes and management of preterm birth

  Aiming to reduce mortality and morbidity from preterm births by focussing on 3 intervention: prediction and prevention of preterm birth and perinatal optimisation when preterm birth is unavoidable.

  Duration: 20 minutes

• Element 6: Diabetic ketoacidosis (DKA) in pregnancy

  Element 6: Diabetic ketoacidosis (DKA) in pregnancy

  This session provides guidance on ‘Diabetes in Pregnancy’, the newly added element 6 in the Saving Babies’ Lives Care Bundle version 3. It is designed to focus on DKA because this has been highlighted as an important cause of maternal death in the 2022 MBRRACE report.

  By the end of the session learners will be able to:

  • understand the precipitating factors of DKA in pregnancy
  • diagnose DKA in pregnancy by recognising and acting on the acute symptoms and signs
  • instigate immediate management of this emergency
  • arrange appropriate initial investigations for these women
  • counsel women at risk of this before it happens so that they know when to seek urgent help

  Prerequisites:

  Before commencing this session learners should have:

  • basic knowledge of diabetes in pregnancy, particularly type 1 diabetes
  • basic knowledge of carbohydrate metabolism and the role of insulin in this process

  Duration: 50 minutes

• Ultrasound: Saving Babies’ Lives course

  Ultrasound: Saving Babies’ Lives course

  Please note: These eLearning sessions introduce and explain the ultrasound components of the Saving Babies’ Lives Care Bundle Version 2. Refer to the Version 3 document for the most up to date information.

  • The 1st session, Introduction, explores FGR and associated risks. It also provides an overview of how to evaluate fetal biometry and estimated fetal weight charts.
  • The 2nd session, Uterine Artery Doppler Assessment, describes the technique for assessing uterine arteries using Doppler. Appropriate equipment settings will be discussed along with how to interpret and report waveforms.
  • The 3rd session, Middle Cerebral Artery Doppler, describes the technique for assessing middle cerebral arteries using Doppler.
  • The 4th session, Cervical Length Assessment, demonstrates appropriate equipment settings to optimise the image and discuss how to report cervical length.