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Neonatal Education Day, "No Womb at the Inn" An Introduction to Developmental Care

The following handouts are from the Neonatal Education Day, held on February 26, 2010.

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Fetal Movement Count Chart

The Notice of Revisions to the Fetal Movement Count Chart and Fetal Movement Count Chart Form HS0001-132 are available.  Note that a copy of the Notice of Revision will be provided with each new order of the Fetal Movement Count Chart - Form HS0001-132. The forms will be available from Service Alberta by June 17, 2009 .   Ordering information is included on the notice.  If you have any questions please contact the Alberta Perinatal Health Program at 780.735.1000


To obtain a supply of the Fetal Movement Count Chart - Form HS0001-132 :

On-line at https://secure5.datagroup.ca/acsc/request_ext.asp register as a new user if you have not registered already (preferred method)

OR

Fax order to 780.422.1695 with name, organization, complete address including postal code, contact name and phone number, form name and number and number required.

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Majority of Canadian Women Satisfied with Maternity Experience

The Honourable Leona Aglukkaq, Minister of Health (2009, March 24), released new findings on how women experience pregnancy, labour and birth, as well as the early months of motherhood. The information gathered with the Maternity Experiences Survey is available in two reports: “What Mothers Say: The Canadian Maternity Experiences Survey” and “Mothers' Voices —What women say about pregnancy, childbirth and early motherhood.” These reports provide an overview of maternity experiences as reported by women themselves.

WHAT MOTHERS SAY: THE CANADIAN MATERNITY EXPERIENCES SURVEY

(also available in French)

 MOTHERS’ VOICES—WHAT WOMEN SAY ABOUT PREGNANCY, CHILDBIRTH AND EARLY MOTHERHOOD

(also available in French)

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Universal Prenatal Syphilis Rescreeing: Recommendations for Enhanced Prenatal Syphilis Screening

In response to the ongoing syphilis outbreak in Alberta and a resurgence in cases of congenital syphilis, Alberta Health and Wellness is recommending that all pregnant women be rescreened for syphilis at mid-gestation (24-28 weeks) and again at the time of labour/delivery.

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Health Canada Advises the Canadian Public that the Safest Place for a Baby to Sleep is in a Crib

Health Canada reminds parents and caregivers that the safest place for an unsupervised baby to sleep is alone in a crib. Babies and young children should never be placed to sleep in products that are not
specifically designed to accommodate an unattended sleeping baby, such as car seats, strollers and change tables.

For more information, please visit:

http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2009/2009_48-eng.php

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Srategies for Teaching Obstetrics to Rural and urban Caregivers (STORC) is a standardized perinatal education for nurses new to obstetrics. It is meant to complement existing orientation to the obstetrical area at each site. The Alberta Perinatal Health Program partnered with all the Alberta Health Regions and the North West Territories to develop this program.  A revised workbook has been distributed to all 9 health regions and is currently in use. 

New e-Learning Program for Provincial Perinatal Health Providers

http://aphp.dapasoft.com/default.aspx

On Nov. 1, 2008, the Alberta Perinatal Health Program (APHP) launched the Strategies for Teaching Obstetrics to Rural and Urban Caregivers (STORC) self-learning program.  The e-learning format for the content is available through site and regional educators

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Neonatal Education Day: Ins and Outs of GI Care

The registration form for this March 5, 2009 date is available here. The following handouts will be used during the day, please print off copies here:

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The 4th Edition of the Fundamentals of Fetal Health Surveillance is now available for ordering on the BC Perinatal Health Program website.  The manual is the culmination of work from many contributors across the country as well as provincial partners of the Canadian Perinatal Programs Coalition. Endorsement from Society of Obstetricians and Gynecologists of Canada, The College of Family Physicians of Canada and the Canadian Association of Midwives were received for this edition. 

The manuals can be ordered from the British Columbia Perinatal Health Program website at a cost of $28 per manual plus 15% shipping and handling. Your order can be placed online or if you prefer by mail or fax. Attached is an electronic link to the order form:  http://www.bcphp.ca/Fetal%20Health%20Surveillance.htm

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News Release - Fish Consumption Limit Established for Lac la Nonne and Lac Ste. Anne

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Too Early, Too Small: A Profile of Small Babies Across Canada
(also available in French)

The Canadian Institute for Health Information (CIHI) released (2009, January 29) a new report "Too Early, Too Small: A profile of small babies across Canada". Babies who are born preterm (before 37 weeks of gestation) or small for their gestational age (SGA) are at increased risk of mortality and morbidity (CIHI, 2009, January 29). This report examines the relationship between selected factors and preterm and SGA births for all provinces and territories except Quebec. Data from CIHI's 2006-2007 Discharge Abstract Database (2006-2007) was used. The report also provides information on the hospital costs of preterm, SGA, and low birth weight newborns.
English: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=PG_1791_E&cw_topic=1791&cw_rel=AR_1106_E
French: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=PG_1791_F&cw_topic=1791&cw_rel=AR_1106_F

Related News Articles

Mothers with hypertension or diabetes up to six times more likely to deliver preterm
(also available in French)
English: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_2009_01_29_e
French: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=media_2009_01_29_f

Delayed child-bearing, fertility therapy may be pusing up early birth rates
http://www.cbc.ca/health/story/2009/01/29/preterm-births.html?ref=rss

Study sees increase in premature Canadian births

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090129/preterm_births_090129/20090129?hub=TopStories

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There is a newer Vitamin D preparation available to purchase over the counter. It is called "Ddrops" and is a very concentrated formulation. It is available in an adult dose of 1000IU per drop and in a children's dose of 400 IU per drop.  Many parents are purchasing this product for infant use.

Until recently, most of the other Vit D preparations available (such as D-visol) had 400 IU in one mL (usually one whole dropper full).

We have been made aware of one situation in the community of a parent giving the infant one mL of the Ddrops which is about 35 drops or 14000 IU. Fortunately, the infant had just a few doses and no negative health effects.

Please share with your colleagues to ensure they are aware of the new product. The Healthy Beginnings nurses here are discussing the different preparations with parents when educating them about the Vit. D recommendations here in our area.

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Health Canada is warning Canadians, especially expectant mothers, not to use two vitamin C products sold under the brand names New Roots Herbal Vitamin C8 and Vitazan Professional Vitamin C Advanced Ascorbate.

For more information, please visit: http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2008/2008_168-eng.php

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Health Canada is warning consumers not to use Eros Fire, a product promoted to enhance sexual performance, as this product may pose serious health risks.

For more information, please visit: http://www.hc-sc.gc.ca/ahc-asc/media/advisories-avis/_2008/2008_169-eng.php

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The Consensus Statement on Depression in Adults: How to Improve Prevention,
Diagnosis and Treatment on October 17th, 2008 has been released and is available on the Institue of Health Economics website:

Press release: http://www.ihe.ca/news-events/news/panel-calls-for-prompt-action-to-address-human-impact-of-depression-in-canada/

 Consensus Statement: http://www.ihe.ca/publications/library/2008/consensus-statement-on-depression-in-adults-how-to-improve-prevention-diagnosis-and-treatment/

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Alberta New Release - Alberta Expands Health Care Coverage to Midwifery

Expectant mothers will have more choice and improved access to care....read more

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Catch the Health Benefits of Eating Fish

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"Jaundice for newborns" handout for parents http://www.caringforkids.cps.ca/pregnancy&babies/Jaundice.htm

"Guideline for detection , management and prevention of hyperbilirubinemia
in term and late term newborn infants " Canadian Pediatric Society
http://www.cps.ca/english/statements/fn/fn07-02.htm

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SOGC Position Statement: Bill C-484, Unborn Victims of Crime Act

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Update on Listeriosis Outbreak from the Public Health Agency of Canada

Listeriosis Advisory from Alberta Health Services

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Verification of Cytogenetic Results of Prenatal Diagnosis

Effective July 1, 2008, the Alberta Children's Hospital Cytogenetic Laboratory will no longer be performing confirmatory cytogenetic studies for non-mosaic abnormal karyotypes detected prenatally. Read the complete memo.

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The risk of unexplained antepartum stillbirth in second pregnancies following caesarean section in the first pregnancy, Wood SL. Chen S. Ross S. Sauve R.

BJOG: An International Journal of Obstetrics & Gynaecology. 115(6):726-31, 2008 May. www.blackwellpublishing.com/journal.asp?ref=1470-0328&site=1

Unexplained stillbirth not linked to prior cesarean section
Source: BJOG: International Journal of Obstetrics and Gynecology 2008; 115: 726-31

Investigating the proposed association between cesarean section in first pregnancy and the risk of unexplained antepartum stillbirth in second pregnancy.

MedWire News: The risk of unexplained antepartum stillbirth in second pregnancies is not explained by cesarean section in the first pregnancy, Canadian study findings indicate.

Stephen Wood, from the University of Calgary in Alberta, and colleagues examined data on 157,929 second births from a perinatal database, which provided information on demographics, pregnancy complications, maternal medical conditions, previous cesarean section, and pregnancy outcomes.

In all, 127,819 women included in the study had no previous cesarean section. These women had an average age of 28.6 years compared with 30.1 years in those with previous cesarean section, while the average gestational age was 39.1 weeks versus 38.8 weeks.

The crude rate of antepartum stillbirth was no higher among women with previous cesarean section than those with previous vaginal delivery, at 3.0 per 1000 births versus 2.7 per 1000 births.

Multivariate analysis that took into account maternal age, weight, smoking during pregnancy, pre-pregnancy hypertension, and diabetes revealed that previous cesarean section was not significantly associated with unexplained antepartum stillbirth, at an odds ratio of 1.27.

The team says: "As the association between previous cesarean section and total stillbirth or unexplained stillbirth had not been consistently observed, we think it would be very premature to conclude a causal association exists."

List Master: Michael  C.  Klein mklein@interchange.ubc.ca
List address: MCDG@list.cfpc.ca
Web Resources: www.cfpc.ca/MCDGResource
Subscribe: MCDG-subscribe@list.cfpc.ca
Unsubscribe: MCDG-unsubscribe@list.cfpc.ca

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In June 2008, Alberta Health and Wellness released Prenatal HIV: Public Health Guidelines for the Management and Follow-up of HIV Positive Pregnant Women and their Infants . These guidelines and related documents are available on our website at the following links:

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The Alberta Government released a news released on June 12, 2008. The Alberta Government approves vaccine program to protect girls from cancer.

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New documents from the Institute of Health Econonmics, Alberta Canada (IHE) have been published on Using Fetal Fibronectin to Diagnose Pre-term Labour and on the Actim™ Partus Versus the TLIIQ® System as Rapid Response Tests to Aid in Diagnosing Preterm Labour in Symptomatic Women Please visit the links to view the reports.

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Changes to Perinatal Forms

As of May 2008, revised versions of the Delivery Record (Form HS0001-126-2) and Stillborn Examination and Investigation Record (Form HS0001 -128) will be received when you place an order for either form. Changes have been made to reflect the changing practice environment.  Please note the following changes:

Delivery Record (Form HS0001-126

  1. A “ nil” box has been added to the sections:
    • Assisted conception
    • Anaesthesia
    • Medications Section: This box should be checked if no medications have been given.
  2. The Fetal Health Surveillance Section: The changes reflect the Society of Obstetricians and Gynecologists of Canada Fetal Health Surveillance: Antepartum and Intrapartum Consensus Guideline which was released in September 2007.  Options include:
    • Method of fetal heart rate surveillance
      • Nil
      • Auscultation
      • Electronic – External
      • Electronic – Internal
    • Fetal monitoring interpretation, including space for comments:
      • Normal
      • Atypical
      • Abnormal
  3. Resuscitative Measures Section. Changes reflect the 2006 Canadian Pediatric Society Neonatal Resuscitation Program. This includes options:
      • Bag & mask with room air
      • O2 Free Flow with space to indicate percent
      • Bag / Mask with space to indicate percent
      • Chest compressions 
  4. Laceration Section: Includes periurethral and vaginal sidewall options.
  5. Placental Section: Includes the type of placenta delivery.

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Stillborn Examination and Investigation Record - Form HS0001-128
For an update of the stillbirthprotocol, please visit the Alberta Medical Association web site.  

  1. Identifying information - The form should be stamped with the mother’s identifying information and the name of the baby documented in the space provided.  Also note that a copy of this form should be stored on the mother’s chart.  The reason for this is because the stillborn does not have a separate chart.
  2. Part 1 – Prenatal History:   Space to document cytogenetics and ultrasound results.  This information is helpful in determining further investigations for congenital anomalies and/or to confirm results.
  3. Part 2 – Physical Examination:
    • number 13. Abdomen:  Omphalocele and Gastroschisis added.
    • number 16. Arms:  Contractures and Absent added.
    • number 17.  Feet:  Abnormal positioning added.
  4. Stillbirth Investigation:  Changes to the stillbirth investigation requirements reflect international standards and are made in consultations with the Alberta Perinatal Health Program Stillbirth Investigation working group:
    • The practice of taking fetal cord blood on stillborns has been discontinued. Cord blood is difficult to obtain and has not contributed to investigations due to insufficient samples of blood. 
    • Placenta and cord – no change.
    • Autopsy – reformatting, note that x-rays and clinical photographs can be requested as part of a limited autopsy.  Other should include if parents agree to a focused autopsy, i.e. cardiac, external clinical examination by pathologist
    • Maternal investigations:  Reformatting with addition of: Anticardiolipin antibodies, lupus anticoagulant, APC resistance
    • Documentation to pathologist  - no change
    • Follow-up arrangements: Additional information on follow-up for Thrombophilia work –up.  It should be indicated and communicated to the parents who will review and discuss investigation results with them.  A follow-up appointment should be made in advance if possible.
  5. Back of Form:  Information for Health Care providers which includes information on Obtaining Consent for Autopsy, Contacts for case consultation, Follow-up information and Thrombophilia work-up.

For questions or clarification please contact: Grace Guyon at (780)735-1006; grace.guyon@capitalhealth.ca

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Health-Related Maternity Leave: Reference Guide for Albertan Healthcare Providers

“Health-related maternity leave” is the period of time during which a woman is considered unable to work, or is advised not to work, for maternity-related health reasons at any time during pregnancy, childbirth or postpartum.

The issue of health-related maternity leave was identified through legal judgments, namely a 1989 ruling by the Supreme Court of Canada (Brooks v. Canada Safeway Ltd.)1 and a subsequent court case in Alberta (Alberta Hospital Association v. Parcels)2 which held that some portion of every woman’s maternity leave is health related, and that for this period, the employee must be compensated by her employer as generously as she would be if she were sick or disabled. She is entitled to have her absence reclassified from a voluntary leave to a health-related leave for the period of time in which she is deemed unfit to work due to pregnancy, childbirth and recovery postpartum.

Alberta physicians and healthcare providers are often tasked to determine the lengths of health-related maternity leave for expectant moms. Unfortunately there are no evidence- based guidelines or standards governing the timing or duration of health-related maternity leave in Alberta, or nationally, particularly for uncomplicated pregnancy and childbirth. In order to assist healthcare providers with their decision making, the health- related maternity leave working group of the Alberta Perinatal Health Program recently conducted an environmental scan which included a survey of Alberta physicians and midwives. This scan disclosed that recommendations for length of health- related maternity leave varies provincially, nationally and internationally.  In response the working group developed the Health-Related Maternity Leave Reference Guide. Its goal is to inform Albertan practitioners about the medical, social and legal context in Alberta for determining health-related maternity leave in uncomplicated pregnancies, and to enhance clinical decision-making and communication with women throughout pregnancy and postpartum care.

Health-Related Maternity Leave: Reference Guide for Albertan Healthcare Providers

Quick Reference Guide, Health-Related Maternity Leave

Hard copies of this resource are available by contacting the Alberta Perinatal Health Program by Fax 780-735-1024 or email vida.boyeowusu@capitalhealth.ca 

1. Brooks v. Canada Safeway Ltd. (1989) 59 DLR 321 (S.C.C.)
2. Alberta Hospital Association v. Parcels (1992) 17 C.H.R.R. D/167 (Alta. Q.B.)    Alberta Hospital Association et al v. Parcels (1992), 1 Alta. L.R. (2d) 332 (Q.B.)  

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Health Benefits for Albertans with Limited Incomes

Through the Alberta Works initiative of the Government of Alberta, many individuals and families with limited incomes can access free health benefits through a variety of programs:

Alberta Adult Health Benefit (AAHB) – recently expanded to provide health benefits to women during pregnancy if they have limited household incomes, and to households with ongoing high prescription drug costs in relation to their income. The AAHB is also intended to help people make the transition from Income Support to employment, by providing continued health benefits coverage.

Alberta Child Health Benefit (ACHB) – for all children in families with limited incomes.

Income Support – all eligible individuals and families receiving Income Support also receive health benefits.

How can front-line health professionals help?
As a health professional you play a critical role in establishing contact with individuals and families. You can help ensure that people have the knowledge and support they need to apply for these health benefit programs.

Most people who have signed up in the past found out about the programs through word-of-mouth. Your efforts to share information with eligible families can make a positive difference. Please contact the Alberta Works Health Benefits Contact Centre if you have questions or would like to order brochures and application kits for the AAHB and ACHB programs. You can also suggest to individuals that they contact the centre directly.

Alberta Works Health Benefits Contact Centre

1-877-469-5437 toll-free
780-427-6848 in Edmonton

More information about these health benefit programs is available in the attached brochure or online at www.employment.alberta.ca/hb.

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Lactation Suppression - Use of Bromocriptine, A Medication Safety Concern

The Alberta Medical Association Committee on Reproductive Care functioning under the Alberta Perinatal Health Programme in its quality assurance role in the study of perinatal mortality and morbidity has identified a patient safety concern regarding the use of bromocriptine [Parlodel®] for lactation suppression for women experiencing a stillbirth or neonatal death. Read the full article....

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Plastic Baby Bottles--Are they Safe? Environmental Public Health Services at Capital Health (Edmonton Area) published the Food Council News in January 2007 with an article regarding the migration of chemicals from various plastic food containers into the food.

In February 2008, Dr. Predy was asked about these issues and his message is as follows:

At this point, the experts say that there's not enough Biphenol A to pose a health risk to infants. Even warming the bottle will not significantly increase the risk. Nor will the act of boiling bottles to sterilize or putting bottles in the dishwasher.

If you would like further information on this topic, please contact Environmental Public Health Services at (780)413-7936.

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Researchers tackle Alberta's high premature-birth rate; Rate runs at 9.1% here, but 7.8% nationwide
Source: EDM - Edmonton Journal
Jan 16, 2008 04:06

Page: A1 / FRONT
Section: News
Edition: Early
Dateline: EDMONTON
Byline: Jodie Sinnema


EDMONTON - As soon as Janette Mailo found out she and her husband Kevin were having twins, she knew the stork might arrive sooner rather than later.

"We were excited to have twins, but we knew there would be complications," Janette said. Mailo, 30, developed jaundice because of liver problems, and Alexander and Leyli were born by C-section on Sept. 27, about three weeks ahead of schedule.

For some reason, it's a story more likely to happen in this province than anywhere else in the country. The Alberta rate is 9.1 per cent of all births, compared with a national average of 7.8 per cent.

That means one in every 11 Alberta babies is born before 37 weeks, some as early as 26 weeks. Now a research team -- supported with a $5-million research grant over five years from the Alberta Heritage Foundation for Medical Research -- hopes to quell the province's rate of preterm births.

The team of nurses, pediatricians, occupational therapists and scientists across Alberta hopes to figure out why so many women go into premature labour.

Led by Dr. David Olson at the University of Alberta and a colleague at the University of Calgary, researchers want to learn to predict and prevent premature births and get Alberta's preterm birth rate down to the national average.

They will focus especially on some of the less-premature babies, born one month to six weeks early. These newborns may seem healthy, only to develop problems when they hit school.

"We're finding deficits at ages where we never found them before, so the risk is always there," said Olson, a professor of obstetrics, gynecology, pediatrics and physiology.

Other premature babies may not be able to breathe on their own, and can face sight problems, developmental delays, and behavioural and learning disabilities far into the future. Premature births are associated with more than 75 per cent of infant
death and long-term disability.

"We know we're not going to be able to stop all preterm births," Olson said, but "all of these people are working together to study Alberta women and Alberta babies, so we're going to do something about the problem here in Alberta."

Olson said several factors could be driving up Alberta's preterm birth rate. Women could be responding to the hot economy by staying in the workforce longer and delaying having families until they're older. Once a woman hits age 35, she
has a one-in-eight chance of having a premature baby.

The province's prosperity is also making in vitro fertilization more affordable for more women, but the procedure often results in twins and triplets born earlier than planned.

Yet Olson said these factors only explain a small proportion of preterm births, leaving almost 80 per cent of them unexplained.

Olson's team will take blood samples from women to see if there are genetic differences in those who give birth early. Researchers will look for ways to reduce uterine contractions and keep babies in the womb longer.

Support groups will be set up for women to talk about how to stay healthy and stress-free during pregnancy. Researchers will also examine differences in the way parents treat their premature babies compared with those born after a full nine months.

"By improving that parent-child interaction and optimizing it, the outcomes for the babies will be the best they possibly can be," he said.

The Alberta Heritage Foundation for Medical Research awarded three other $5-million team grants for research on: - How nutrient deficiencies during pregnancy affect the mental health of mothers and babies; - Lab-on-a-chip technology to help with health and disease tests in remote areas; and - Vaccines for respiratory infections in children.

jsinnema@thejournal.canwest.com
PHOTO/IMAGE: Colour Photo: Rick MacWilliam, The Journal / Like an unusually large number of Alberta babies,
15-week-old-twins Leyli, left, and Alexander Mailo were born prematurely. ; Colour Photo: Rick MacWilliam, The Journal / Kevin and Janette Mailo with their 15 week-old-twins, Leyli, left, and Alexander. ;

This media story is protected by copyright. e-Clips users are licensed to copy, review and redistribute the content for the purpose of delivery of government programs and services only. Any other use is strictly forbidden. Content may be
archived for 90 days.

Received Id 20080116EDM313882 on Jan 16 2008 04:02

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Changes in Prenatal Blood Group Testing with First Pregnancies

New recommendations regarding prenatal testing during pregnancy follow a recent Canadian Blood Services (CBS) prenatal program review of literature.

Tests for ABO and Rh should be done twice for a first pregnancy, on the initial visit and again at 26-28 weeks.

Having two blood group determinations will ensure all Rh-negative women are identified in time to receive a prophylactic dose of Rh-immune globulin.

Testing at 26-28 weeks gestation is also recommended if the patient has been transfused or has a history of unexpected antibodies. The revised standard will include a request for an additional sample at 26-28 weeks gestation from Rh-positive women if this is a first pregnancy or if there is no other blood group on file.

Currently, additional samples at 26-28 weeks gestation are requested from all Rh-negative women only.

For more information, please contact Dr. Judy Hannon, Medical Director (780)431-8714 or judy.hannon@blood.ca or Jean Ashdown, Patient Services Laboratory Manager, (780)431-8727 or jean.ashdown@blood.ca.

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Midwifery Education Status Report Update #2 issued by Brenda Hendrickson from Mount Royal College in Calgary on April 28, 2008. This report provides an overview of the progress towards developing Midwifery Education in Alberta.

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Enhancements to the Alberta Prenatal Record - Introduction of Healthy Mother, Healthy Baby Quesionnaire

The Alberta Perinatal Health Program (APHP) has worked collaboratively over the last two years to revise the Alberta Prenatal Record with the aim to:

  • Expand the concept of prenatal care from the traditional medical approach (history, physical exam, laboratory, prenatal visits) to include lifestyle (behavioral), psychosocial and environment risk assessment and risk for specific birth outcomes.
  • Incorporate risk assessment tools as enhancements to the ‘paper’ form.
  • Provide specifications for the development of the electronic version within the various vendor Electronic Medical Record (EMR) software products in physician clinics through the Physician Office System Program (POSP) initiative.

The changes to the record are based on input from a broad set of stakeholders, including the Alberta Medical Association (AMA) Committee on Reproductive Care, physicians, obstetricians, perinatologists, midwives, representatives from health regions and the Toward Optimized Practice (TOP) program. The Healthy Mother, Healthy Baby Questionnaire (HMHB−Q) was developed and piloted by the Southern Alberta Child and Health Youth Network. This form is provided as a tool for obtaining information on health determinants that affect pregnancy and baby health.

 Changes Highlighted

  • Demographics include education level and ethnicity.
  • History is reformatted to include that of the biological father and extended family.
  • The HMHB−Q form is to be completed by the mother or used as an interview tool. A link to an expanded lifestyle, psychosocial and environmental history is on the Alberta Prenatal Record.
  • Reformatting of laboratory investigations and results, including space for documentation of prenatal screening.
  • Risk profile that identifies odds ratio for specific birth outcomes. It is anticipated that this tool, once validated, will be used for risk identification and may be expanded to include other birth outcomes.

 Contacts for assistance with implementation

  1. Questions specific to the Alberta Prenatal Record and Healthy Mother, Healthy Baby Questionnaire contact the Alberta Perinatal Health Program – North Office:

    Contact:  Grace Guyon, Coordinator
    Phone: 780.735.1000
    Email: grace.guyon@capitalhealth.ca

  2. Physicians wanting assistance with workflow in implementing the revised Alberta Prenatal Record and HMHB−Q in their clinic are invited to contact the Toward Optimized Practice program:

    Contact: Arley Nelson, Practice Change Support Services
    Phone: 780.482.0319 or 780.482.0321
    Toll Free: 1.866.505.3302

  3. To order forms: Alberta Prenatal Record (HS0001-125) and the Healthy Mother, Healthy Baby Questionnaire (HS0285) order on-line −

    https://secure5.datagroup.ca/acsc/request_ext.asp or
    Fax request to: 780.422.1695

  4. For information on Electronic Alberta Prenatal Record contact Physician Office Support Program at:

    Contact: 780. 452.1616 or
    Toll Free: 1.866.817.3875 extensions 225, 231, 237
    Email: posp@albertadoctors.org

New forms available April 9, 2007. Please destroy your old prenatal forms once you receive your stock.

Vendor specifications for the electronic Prenatal Record will be provided to vendors by the end of June 2007.

Supporting information to facilitate implementation

  • The Alberta Prenatal Care Providers Guide and Resource includes: Guidelines for documentation on the Alberta Prenatal Record, and the Healthy Mother, Healthy Baby Questionnaire. A Community Resource for Pregnancy and Baby Health by Alberta health regions is provided as a source for information and referral.

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The Maternity Experiences Survey (MES)

The Maternity Experiences Survey (MES), conducted by Statistics Canada on behalf of the Public Health Agency of Canada, explored Canadian women's experiences, attitudes and practices surrounding conception, pregnancy, birth and the early months of parenthood. Its goal was to identify areas of strength and those in need of strengthening in Canadian maternity health services from the perspective of women. Interviews were conducted with 6,421 mothers when babies were, on average, seven months of age. The average age of the mothers at the time of the interview was 30. A full report on the MES will be available from the Public Health Agency of Canada in May 2008.

For more information on the survey and the results of the survey, visit www.publichealth.gc.ca/mes

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2007 Health Canada Advisory for women of reproductive years and children in regards to fish consumption and Mercury.

The complete results of Health Canada's reassessment of mercury and retail fish is now available on their website. In addition, there is a somewhat extensive "Questions and Answers" page and a number of technical supporting documents. As these documents were very recently posted to the website on March 28, 2007, there is a link in the "News Releases" section of the home page of Health Canada's website. The documents may also be accessed through the following Health Canada webpage (english and french respectively):

http://hc-sc.gc.ca/fn-an/securit/chem-chim/mercur/index_e.html

Health Canada advises specific groups to limit their consumption of canned albacore tuna.

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Fetal Fibronectin (fFN) Assay in the Management of Suspected Preterm Labour.

Alberta Health and Wellness has completed a provincial review of Rapid Fetal Fibronectin (fFN) Assay in the Management of Suspected Preterm Labour. The Deputy Minister recently wrote the Chief Executive Officers indicating that all health regions should make fFN testing available to pregnant women in Alberta when preterm labour is suspected. Given that regions will have to work within existing budgets and address various implementation details, they have until April 1, 2008 to introduce fFN testing. Each health region may determine the service delivery model that will best serve the needs of its residents.

Questions regarding the fFN review and implementation of this decision should be directed to Mr. Henry Borowski, Director, Health Technologies and Services Policy by phone at (780)415-2855 or by email at henry.borowski@gov.ab.ca or Ms. Brenda Petzold, Nurse Consultant, Health Technologies and Services Policy at (780)415-2647 or by email at brenda.petzold@gov.ab.ca.

What is Fetal Fibronectin (fFN)? Fetal Fibronectin (fFN) is a glycoprotein produced by the chorionic membranes and is localized to the deciduas basalis adjacent to the intervillous space. Its primary purpose appears to be that of an adhesion molecule (tissue glue) which helps bind the chorionic membranes to the underlying maternal decidua. It is normally found in cervico-vaginal secretions until 22 weeks gestation but is virtually never found between 24 and 34 weeks gestation unless the cervix has undergone premature effacement and dilatation, usually in association with symptomatic uterine contractions. It can also be released in response to inflammation or separation of amniotic membranes from the deciduas. There is a strong association between the presence of Fetal Fibronectin in cervico-vaginal secretions and preterm labour after 24 weeks gestation.

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Alberta Health and Wellness has announced that the current Alberta Newborn Metabolic Screening (NMS) Program will be expanded from three to 17 metabolic conditions in newborns. This includes the introduction of province-wide Cystic Fibrosis screening (the first Canadian jurisdiction to do so).

Previously routine screening was limited to three conditions: phenylketonouria (PKU), congenital hypothyroidism (CH) and biotinidase deficiency (BIOT). As indicated in the News Release, Alberta Health and Wellness will be providing additional funding to support expansion of newborn metabolic screening and introduction of CF screening. The News Release is available on the Alberta Health and Wellness website.

Parent brochure:
http://www.health.gov.ab.ca/public/NMS_PublicBrochure.pdf

Health professional materials:
http://www.health.gov.ab.ca/public/NMS_ProfessionalBrochure.pdf

http://www.health.gov.ab.ca/professionals/NMS_FactSheets.html

The following 13 conditions will be added to Alberta's newborn screening list by April 1, 2007

  • Medium-chain acyl-CoA dehydrogenase deficiency (MCAD)
  • Trifunctional protein deficiency (TFP)
  • Carnitine uptake deficiency (CUD)
  • Long-chain 3-OH acyl-CoA dehydrogenase deficiency (LCHAD)
  • Very long-chain 3-OH acyl-CoA dehydrogenase deficiency (VLCAD)
  • Congenital adrenal hyperplasia (CAH)
  • Citrullnemia (CIT)
  • Maple syrup urine disease (MSUD)
  • Glutaryl-CoA dehydrogenase deficiency/glutaric aciduria type 1 (GA 1)*
  • Isovaleric academia (IVA)*
  • 3-hydroxy 3 methyl glutaric aciduria (HMG)*
  • Methylmalonic academia (Mutase) (Cbl A,B) (MMA)*
  • Propionic academia (PA)*

A test to screen for cystic fibrosis will also be added.

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The Alberta Breastfeeding Directory has been revised and can be found on the Alberta Medical Association website. The directory is a resource for health professionals and women to lactation consultants and breastfeeding resources. The directory was updated with assistance from the Alberta Breastfeeding Committee.

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BCC Board endorses Global Strategy for Infant and Young ChildFeeding
and WHO Growth Charts The Breastfeeding Committee for Canada Board of Directors has officially endorsed both the WHO Global Strategy for Infant and
Young Child Feeding and the WHO Growth Charts. A motion was passed at the most recent Board meeting held August 10, 2006. CLCA has also endorsed the WHO Growth Charts and has written to other organizations encouraging them to do so.

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