Preventing sudden unexpected postnatal collapse: a narrative review

Sudden unexpected postnatal collapse (SUPC) is a rare but significant safety issue in the immediate postnatal period, particularly during skin-to-skin contact (SSC). While international guidance suggests that SUPC is potentially preventable with targeted interventions, specific Dutch guidance is lacking. To synthesize national recommendations on SUPC prevention within an international context, a comprehensive search of PubMed, Embase, and relevant online sources (January 1st, 2012 to January 1st, 2025) identified international guidelines addressing SUPC prevention, focusing on SUPC risk factors and preventive measures including observation practices and frequency, standardized monitoring methods, parental involvement, infant positioning, and implementation feasibility taking account of parental privacy and staffing constraints. Twelve documents on SUPC guidance from ten countries were included. Agreement was observed regarding key risk factors and the need for continuous observation of the mother-infant dyad, but practical recommendations differed considerably. Variations were noted in observation duration and frequency, use of standardized monitoring tools, parental participation, and preferred infant positioning. Four guidelines explicitly addressed challenges related to discontinuous monitoring due to privacy or staffing constraints, and two provided post-event management protocols. Conclusion : International publications on SUPC prevention highlight risk factors and emphasise the need for continuous observation of the mother-infant dyad, although practical recommendations diverge markedly. The Dutch guidance on SUPC prevention integrates scientific evidence on SUPC, international guidance, and the clinical and organisational expertise of a multidisciplinary working group, and translates these insights into actionable recommendations for clinical practice before and after both hospital and home birth. What is Known: • International guidelines on SUPC prevention focus on safe SSC and surveillance of mother-infant dyads. • Dutch protocols on SSC including SUPC prevention were scarce and varied widely. What is New: • International guidelines do not agree on the optimal postnatal observation of the mother-infant dyad. • A novel Dutch SUPC prevention guidance provides practical recommendations as well as a clinical work-up after SUPC, applicable to both hospital and home settings.