SGH, NUH to enhance monitoring of higher-risk babies following infant’s death at KKH

This applies to babies who are not admitted to the neonatal intensive care units, but may still benefit from closer monitoring. PHOTO ILLUSTRATION: PEXELS

SINGAPORE - Singapore General Hospital and the National University Hospital are following in the footsteps of KK Women’s and Children’s Hospital (KKH) in reviewing and enhancing monitoring measures for higher-risk infants.

This applies to babies who are not admitted to the neonatal intensive care unit (ICU) but may still benefit from closer monitoring, Senior Minister of State for Health Janil Puthucheary told Parliament on Tuesday.

He was responding to a parliamentary question by Ms Hany Soh (Marsiling-Yew Tee GRC), who had asked whether other hospitals also intend to review and improve their monitoring procedures for newborns, specifically for those born prematurely or with medical conditions.

Ms Soh had also asked how many hospitals here currently practise continuous monitoring of the vital signs of babies in neonatal ICUs and special care nurseries.

A special care nursery looks after infants who require medical attention or observation after being stabilised in the neonatal ICU.

“Continuous monitoring of vital signs is routinely performed for all infants admitted to neonatal intensive care units in all acute hospitals with neonatal care services,” Dr Janil said.

KKH said on Jan 27 that it will continuously monitor the vital signs of babies admitted to its special care nursery, following a review of its processes after an 11-day-old baby in its care died of a brain injury in April 2021.

The baby had been delivered with the umbilical cord wound tightly three times around his neck. The cord was removed immediately, and he was placed on a resuscitator and given assisted ventilation and other medical help until his vital signs improved.

The baby began moving vigorously after this, but his condition later deteriorated and he was taken back into the operating theatre.

A nurse placed him back on the resuscitator with assisted ventilation, and his blood oxygen level and heart rate were monitored. The nurse also activated a Code Blue emergency alert, used when a patient is in cardiac or respiratory arrest.

The baby was later transferred to the neonatal ICU and connected to a ventilator, but his condition continued to deteriorate. An ultrasound indicated swelling of the brain and signs of severe brain disease.

By the fifth day after the baby’s birth, his condition had worsened further, and his parents agreed to withdraw care after discussions with the medical staff. The baby was pronounced dead at about 12.30pm on April 12, 2021.

State Coroner Adam Nakhoda, who reported in January that the baby had died of natural causes, noted that the baby’s vital signs were not recorded from the seventh minute after birth until he was taken back to the operating theatre.

He said this lack of continuous documentation was “not ideal”.

A senior consultant at KKH’s department of neonatology said in a medical report that the baby’s vital signs were not documented as he was initially stable.

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