The Division of Neonatal Medicine is represented by staff working across three hospital sites at Groote Schuur Hospital (GSH), Mowbray Maternity Hospital (MMH), New Somerset Hospital (NSH) and 6 Midwife Obstetric Units in the Peninsula Maternal and Neonatal Service.
The division functions as a multidisciplinary team with close cooperation between the three hospitals and the midwifery led obstetric units.
There are also close working relationships with the sub specialty disciplines at RXH and the fetal and obstetric departments within each hospital.
The Department is responsible for delivering neonatal services to the Metro West area which has a delivery rate of about 40 000 infants per annum. The range of infants cared for span those requiring intensive care through to kangaroo mother care.
Close liaison and referral protocols are adhered to, ensuring that infants are cared for in the most appropriate units, depending on their level of care and medical complexity.
Weekly multidisciplinary meetings occur to discuss complex fetal cases. These meetings comprise representation from neonatal medicine, obstetrics, fetal medicine, paediatric surgery and genetics.
Developmental and medical follow up of all medium and high risk neonates within the service is conducted in a designated centre with multidisciplinary input from all three hospitals.
The division is responsible for delivering effective neonatal care to the midwifery led obstetric units and providing seamless referral pathways for infants requiring escalating care.
Teaching and training
The division has a strong reputation and ethos for both undergraduate and postgraduate training programmes. Each of the three hospitals has established teaching programmes which include formal teaching, bedside tutorials, journal clubs, morbidity reviews and case based discussions. Trainees are encouraged to take an evidenced based approach to their learning and to regularly reflect on their practice by making use of mentors and clinical supervisors.
Senior consultants within the division are involved in continuing medical education programmes both nationally and internationally. Members are actively involved in the production and dissemination of national protocols and guidelines on care of the newborn infant.
The unit is accredited by the HPCSA to provide a two year higher training programme for entry into the sub specialist grade of neonatal medicine.
Problems at birth remain a major health issue for South Africa and affected infants are drawn disproportionately from disadvantaged populations. Birth asphyxia remains a major cause of death in developing countries and preterm deliveries are commoner amongst the disadvantaged. Indeed, a major international survey found that unequal income distribution and lack of political representation was more strongly associated with low birthweight and infant mortality than any other health outcome.
Research within the division is currently focused on addressing these issues to the benefit of our population of infants both through ongoing collaboration and individual projects.
Projects are underway in the diagnosis, severity grading, outcomes and novel treatment regimes in neonatal hypoxic ischaemic encephalopathy. This work has already produced a number of international publications and continues to gain ongoing interest in further collaboration.
Studies are currently also underway into our extremely preterm infant population, addressing ways in which to improve morbidity and mortality outcomes and develop metrics to quantify this. These include respiratory modalities of care, feeding regimes, kangaroo mother care initiatives and developmental outcomes.
Research projects are carried out on all three hospital sites with all staff actively encouraged to participate.
The department has a well established outreach programme which supports the delivery of safe and effective neonatal care beyond Cape Town