5983 Review of compliance with existing trust guidelines for investigation and treatment of babies born to mothers with HIV, Hepatitis B or Syphilis

Objectives To reveal compliance with current guidelines. To design a robust follow up system to ensure timely vaccination, investigation and treatment of babies born to mothers with HIV, Hepatitis B or Syphilis To review current guidelines in line with national updates. Methods A spreadsheet containing details of all women booked at PAH who had tested positive in their antenatal screening blood tests for HIV, Hepatitis B or Syphilis in 2019 – 2022 was obtained from the Antenatal Screening team. All eligible babies were identified and their data analysed retrospectively. From this spreadsheet, babies were identified using Cosmic records of the delivery date. The Cosmic documentation of paediatric plans, vaccination and follow up was analysed ICE was used to access blood results. An Excel spreadsheet was used to collect the data. Auditable standard was set at 100% for each target. Data was analysed using a calculator and presented using MS Power Point Results The compliance results for various healthcare practices are as follows: Hepatitis B screening and vaccination achieved high compliance, with all positive women having paediatric plans and babies born to positive mothers receiving timely vaccinations. However, only 50% of babies receiving HBIG had follow-up. Documentation was at 89% accuracy. In HIV care, most babies received Zidovudine, initial HIV tests, and follow-up, but compliance declined over time with 18-month testing at 38%. For syphilis, paediatric plans were at 81%, and blood tests at birth at 94%, but compliance dropped significantly for subsequent tests at 3, 6, and 12 months, and treatment was only at 12%. Follow-up for syphilis+ babies was 34%. Conclusion HIV There is poor compliance with the trust guideline at present for booking the follow up and timing of blood test, except for prescribing Zidovudine. Paediatric plans need to be more detailed to facilitate infants receiving the correct antiretroviral at birth and should state whether the infant is at very low, low or high risk of HIV transmission. The current trust guideline needs to be updated to the latest guideline to do serology blood check at 6 week,12 weeks, and at 18–24 months Hepatitis B There is good compliance with the current guideline, except for booking follow up appointments for high risk patients who received HBIG. Documentation of the vaccination details should be documented in NIPE SMART. Syphilis There is poor compliance with the trust guideline at present. Data on the indications and administration of benzylpenicillin was incomplete. Paediatric plans need to be more detailed stating whether benzylpenicillin is indicated, that full examination is required to determine if benzylpenicillin is indicated and that completion of Syphilis Birth Plan is required. References British HIV Association guidelines for the management of HIV infection in pregnant women 2018. Clinical Guideline: Management of babies born to mothers who are Hepatitis B positive (NEO-ODN-2023–5). UK national guidelines on the management of syphilis 2015,S16 – Management of Syphilis in Pregnancy guideline.