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. 2015 Jun 9;54(3):184-93.
doi: 10.1515/sjph-2015-0027. eCollection 2015 Sep.

Neonatal Prophylaxis: Prevention of Vitamin K Deficiency Haemorrhage and Neonatal Ophthalmia

Anita Jug Došler  1 , Petra Petročnik  1 , Ana Polona Mivšek  1 , Teja Zakšek  1 , Metka Skubic  1
Affiliations

Neonatal Prophylaxis: Prevention of Vitamin K Deficiency Haemorrhage and Neonatal Ophthalmia

Anita Jug Došler et al. Zdr Varst. .

Abstract
in English, Slovenian

Introduction: The aim of the study was to explore two aspects of neonatal prophylaxis: the application of the vitamin K injection to the newborns and the prophylaxis against chlamydial and gonococcal eye infections, comparing Slovenian and Croatian practices.

Methods: A causal non-experimental method of quantitative empirical approach was used. The data was collected by means of predesigned questionnaires. The questionnaires were sent to 14 Slovenian and 32 Croatian birth hospitals. The data was analysed with descriptive statistics and the Kullback test.

Results: Vitamin K is applied to all newborns in 9 (out of 14) Slovene and 22 (out of 32) Croatian birth hospitals that returned the questionnaire. The prophylaxis against chlamydial gonococcal eye infections is applied to all newborns in 9 Slovene and 16 Croatian birth hospitals that offered answers to the questionnaire. The majority of Slovene and Croatian birth hospitals perform these procedures in the first hour after birth. The majority of Slovene birth hospitals still apply vitamin K in the gluteal muscle, whereas the majority of Croatian birth hospitals usually use the thigh as an injection site. In Slovenia, 1 % Targesin is used for the prophylaxis against chlamydial and gonococcal eye infections, whereas in Croatia the prevailing medicine is Erythromycin.

Conclusions: The possibility of oral vitamin K application should be offered to parents, and pain management in practice should be discussed. The form of written informed consent could be offered to parents. Health professionals should provide intimacy and exclude routine procedures in the first couple of hours after birth. However, more research is needed as delayed administration might be related to lower efficacy and, as a consequence of that, the safety of newborns is questionable.

Uvod: Namen opisane raziskave je bil proučiti določene vidike neonatalne profilakse: prakso aplikacije vitamina K novorojenčkom in profilakse proti klamidijski in gonokokni okužbi oči v slovenskih in hrvaških porodnišnicah.

Metode: V raziskavi je bila uporabljena kavzalna neeksperimentalna metoda kvantitativnega empiričnega načina raziskovanja. Podatki so bili pridobljeni z vnaprej pripravljenimi vprašalniki, ki so bili razdeljeni v 14 slovenskih in 32 hrvaških porodnišnicah. Analiza podatkov je potekala z uporabo deskriptivne statistike in Kullbackovega preizkusa.

Rezultati: Ugotovili smo, da se praksa v slovenskih in hrvaških porodnišnicah glede raziskovanih parametrov neonatalne profilakse razlikuje. Devet slovenskih porodnišnic (od vseh 14) in 22 hrvaških (od vseh 32), ki so sodelovale v raziskavi, aplicira vitamin K vsem novorojenčkom. Profilaktično zaščito proti klamidijskim ali gonokoknim očesnim okužbam pa izvajajo v 9 slovenskih in 16 hrvaških porodnišnicah (od vseh sodelujočih v raziskavi). Večina slovenskih in hrvaških porodnišnic opravi oba posega v prvi uri po rojstvu. Večina slovenskih porodnišnic aplicira vitamin K v glutealno mišico, medtem ko je na Hrvaškem pogostejša aplikacija v stegensko mišico. V slovenskih porodnišnicah pri apliciranju profilakse proti klamidijskim in gonokoknim okužbam oči prevladuje 1-odstotni Targezin, v hrvaških pa Eritromicin.

Zaključek: Staršem je treba ponuditi možnost oralne aplikacije vitamina K. Dobro bi bilo spregovoriti o lajšanju bolečine ob tovrstnem posegu ter hkrati starše spodbuditi, da pisno in informirano privolijo v poseg. Naloga zdravstvenih delavcev je, da družini v prvih urah po porodu zagotovijo intimnost ter v tem času poskusijo odložiti rutinske postopke. Za slednje pa so potrebne dodatne raziskave, saj lahko kasnejša administracija vodi v manjšo učinkovitost profilakse in hkrati zmanjšuje varnost novorojenčkov.

Keywords: neonatal prophylaxis; newborn; ophtalmia; postpartum care; vitamin K.

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