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Endocrinol Diabetes Metab Case Rep 2019 Mar 15;2019. Epub 2019 Mar 15.

Department of Internal Medicine F, Soroka University Medical Center, Beer Sheva, Israel.

A previously healthy 24-year-old female underwent an emergent caesarean section without a major bleeding described. During the first post-operative days (POD) she complained of fatigue, headache and a failure to lactate with no specific and conclusive findings on head CT. On the following days, fever rose with a suspicion of an obstetric surgery-related infection, again with no evidence to support the diagnosis. Read More

Ann Glob Health 2018 Apr 30;84(1):198-203. Epub 2018 Apr 30.

College of Medicine and Health Sciences, Debre Markos University, ET.

Introduction: The partograph is a vital tool used to reduce maternal and fetal mortality and morbidity and to prevent prolonged and obstructed labor, as well as postpartum hemorrhage and fistula formation. This study explored the use and barriers of the partograph among obstetric caregivers in East Gojam Zone, Northwest Ethiopia.

Methods And Materials: A cross-sectional study design consisting of both quantitative and qualitative methods was utilized. Read More

Gynecol Obstet Fertil Senol 2019 Mar 11. Epub 2019 Mar 11.

Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire de Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux, France.

Objective: The aim of the study was to assess the impact of the introduction of training workshops on the quality of prevention and management of Post-Partum Hemorrhage (PPH) in a type III university center.

Materials And Methods: A clinical audit was carried out in our type III university center before and after the introduction of training workshops on the prevention and management of PPH, in two periods between January 1 to December 31 2011 and March 1 and August 1, 2015. Training workshops were according to the recommendations for clinical practice of the National College of Gynecologists-Obstetricians French published in 2014, and included a theoretical portion and a simulation of low fidelity manikin. Read More

JBI Database System Rev Implement Rep 2019 Mar;17(3):414-428

The Brazilian Centre for Evidence-informed Healthcare: a Joanna Briggs Institute Centre of Excellence, São Paulo, Brazil.

Objectives: The aim of this project was to develop and implement strategies to promote standardization and formal documentation of increased bleeding within the first 24 h after birth, in compliance with best practice.

Introduction: Official data from Brazil shows a maternal mortality rate of around 52 to 75 deaths per 100,000 live births, 8% of which are caused by hemorrhage. Early diagnosis is promoted through standardization and formal documentation of the first signs of hemorrhage. Read More

Obstet Gynecol 2019 Mar 11. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York; and the Department of Neurological Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California.

Objective: To analyze risk factors, temporality, and outcomes for women readmitted postpartum for a hypertensive indication who did not have a hypertensive diagnosis during their delivery hospitalization.

Methods: The Healthcare Cost and Utilization Project's Nationwide Readmissions Database for 2010-2014 was used to evaluate risk for postpartum readmission for preeclampsia and hypertension within 60 days of discharge from a delivery hospitalization among women without these diagnoses during delivery in this cohort study. Obstetric, medical, demographic, and hospital factors associated with postpartum readmission were analyzed. Read More

Glob Health Sci Pract 2019 Mar 13;7(Suppl 1):S168-S187. Epub 2019 Mar 13.

U.S. Agency for International Development, Kampala, Uganda.

Background: Uganda's maternal and newborn mortality remains high at 336 maternal deaths per 100,000 live births and 27 newborn deaths per 1,000 live births. The Saving Mothers, Giving Life (SMGL) initiative launched in 2012 by the U.S. Read More

BMC Res Notes 2019 Mar 12;12(1):128. Epub 2019 Mar 12.

Department of Midwifery, College of Medicine and Health Sciences (CMHS), Debre Brhan University, Debrebrhan, Ethiopia.

Objective: Obstructed labor had different maternal outcomes such as uterine rupture, postpartum hemorrhage, puerperal sepsis, Vesico-Vaginal fistula (VVF), recto-vaginal fistula can leads to death. Besides fetal outcomes including birth asphyxia, still birth, neonatal jaundice and umbilical sepsis can occur. Identifying maternal and fetal outcomes of obstructed labor among women who gave birth at Suhul general Hospital, Shirie town, Tigray, Ethiopia has been done using a retrospective review of delivery charts and registration book. Read More

BMC Surg 2019 Mar 11;19(1):33. Epub 2019 Mar 11.

Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Background: We developed a dedicated blunt straight needle with No. 2 polydioxanone sutures (2-Monodiox®) for uterine compression sutures (UCSs) and aimed to assess the outcomes and complication rates of UCSs for postpartum hemorrhage by comparing with commercially available needle and suture types.

Methods: A retrospective analysis was performed between January 2010 and February 2018. Read More

BMC Pregnancy Childbirth 2019 Mar 13;19(1):91. Epub 2019 Mar 13.

Department of Obstetrics and Gynecology, Bordeaux University Hospital, Bordeaux, France.

Background: Postpartum haemorrhage (PPH) is a major cause of maternal morbidity and one of the leading causes of maternal mortality worldwide. Many medical treatments and interventions are available nowadays, but surgical treatment is sometimes required when less invasive methods are unsuccessful. This study aimed to assess the theoretical and practical knowledge of French residents of Obstetrics and Gynecology concerning the surgical treatment of postpartum haemorrhage. Read More

Blood Transfus 2019 Feb 6. Epub 2019 Feb 6.

Department of Anaesthesiology, Université de Montréal, Montreal, QC, Canada.

Patient blood management (PBM) is the timely application of evidence-informed medical and surgical concepts designed to maintain haemoglobin concentration, optimise haemostasis, and minimise blood loss in an effort to improve patient outcomes. The aim of this consensus statement is to provide recommendations on the prevention and treatment of postpartum haemorrhage as part of PBM in obstetrics. A multidisciplinary panel of physicians with expertise in obstetrics, anaesthesia, haematology, and transfusion medicine was convened by the Network for the Advancement of Patient Blood Management, Haemostasis and Thrombosis (NATA) in collaboration with the International Federation of Gynaecology and Obstetrics (FIGO), the European Board and College of Obstetrics and Gynaecology (EBCOG), and the European Society of Anaesthesiology (ESA). Read More

Med Sci Monit 2019 Mar 10;25:1814-1821. Epub 2019 Mar 10.

Department of Anesthesiology and Reanimation, SBU Kanuni Sultan Suleyman Education and Training Hospital, Istanbul, Turkey.

BACKGROUND Postpartum hemorrhage (PPH) is related to several factors but is frequently associated with coagulopathy with maternal mortality. Fibrinogen is a very important agent for bleeding. When its concentration is decreased, severe surgical blood loss may occur. Read More

BMJ Open 2019 Mar 8;9(3):e024017. Epub 2019 Mar 8.

Department of Physiotherapy, University of Maiduguri Medical College, Maiduguri, Nigeria.

Introduction: Adolescent motherhood (childbearing below 18 years of age) is a major global health and social problem. Understanding the impact of early motherhood on maternal and child health indices is important to community and population health promotion in developing countries. This study examined the association between adolescent motherhood and maternal and child health indices in Maiduguri, Nigeria. Read More

Reprod Biomed Online 2018 Dec 23. Epub 2018 Dec 23.

Dijon University Hospital, Reproductive Biology Department, Dijon F-21000, France.

Research Question: Does mode of conception influence placental volume and other first-trimester outcomes?

Design: This retrospective single-centre case-control study led in Dijon University Hospital included 252 singleton pregnancies (84 IVF with either fresh embryo transfer or frozen-thawed embryo transfer [FET] and 168 natural conceptions). First-trimester placental volume, uterine artery pulsatility index and maternal serum PAPP-A and beta-HCG were measured. Statistical analyses were adjusted for gestational age, the newborn's gender, maternal age, parity, body mass index and smoking status. Read More

Eur J Cancer 2019 Mar 5;111:126-137. Epub 2019 Mar 5.

MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK. Electronic address:

Background: Observational studies have suggested that perinatal outcomes are worse in offspring of cancer survivors. We conducted a systematic review and meta-analysis to examine the risks of perinatal complications in female cancer survivors diagnosed before the age of 40 years.

Methods: All published articles on pregnancy, perinatal or congenital risks in female cancer survivors were screened for eligibility. Read More

Curationis 2019 Jan 21;42(1):e1-e7. Epub 2019 Jan 21.

Discipline of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal.

Background:  The need to use innovative teaching and learning strategies in the nursing pedagogy is important in the 21st century. The challenges of clinical sites and opportunities for nursing students to gain clinical experience are a growing concern for many nurse educators. High-fidelity human patient simulators (HFHPS) are computerised mannequins that replicate a real-life patient, and when integrated into classroom teaching they allow students to become fully immersed into an almost real-life scenario. Read More

J Matern Fetal Neonatal Med 2019 Mar 5:1-6. Epub 2019 Mar 5.

a Division of Maternal-Fetal Medicine , North Shore University Hospital, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell , Manhasset , NY , USA.

Objective: To identify maternal and peripartum characteristics in twin gestations that are associated with postpartum hemorrhage (PPH) in which one or more units of packed red blood cells (PRBCs) were either administered or recommended but declined (PPH + PRBC).

Methods: This retrospective cohort study evaluated all women with twin gestations who delivered at greater than 23 weeks of gestational age at a single, tertiary medical center from 2011 to 2016. Patients were included if they had documentation of estimated blood loss (EBL) at delivery and complete inpatient medical records available for review. Read More

Int Urogynecol J 2019 Mar 5. Epub 2019 Mar 5.

School of Public Health, Lanzhou University, 199 Donggang West Road, Lanzhou, 730000, China.

Introduction And Hypothesis: There is conflicting evidence on whether intermittent catheterization (IC) is less associated with urinary tract infection (UTI) and more likely to prevent urinary retention than continuous catheterization (CC). We aimed to compare the effect of IC with that of CC on the incidence of postpartum UTI, urinary retention and hemorrhage in laboring women with epidural analgesia.

Methods: Electronic searches were performed in PubMed, EMBASE and Cochrane Library from their inception to October 2018. Read More

Anesth Analg 2019 Feb 27. Epub 2019 Feb 27.

From the Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: The use of in vitro fertilization is increasing. The incidence of adverse outcomes is greater for women who undergo in vitro fertilization, potentially leading to intensive care unit admission. This study aimed to assess the etiology and course of intensive care unit admission in women who underwent in vitro fertilization compared to those who did not, with specific focus on intensive care unit admission due to postpartum hemorrhage. Read More

Clin Exp Reprod Med 2019 Mar 1;46(1):30-35. Epub 2019 Mar 1.

Department of Obstetrics and Gynecology, Suleymaniye Maternity, Research and Training Hospital, University of Health Sciences, Istanbul, Turkey.

Objective: Bilateral uterine artery ligation (UAL) is a fertility-preserving procedure used in women experiencing postpartum hemorrhage (PPH). However, the long-term effects of this procedure on ovarian function remain unclear. The aim of this study was to investigate whether bilateral UAL compromised ovarian reserve and ovarian blood supply. Read More

Health Technol Assess 2019 Feb;23(9):1-356

Tommy's National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylactic uterotonic drugs can reduce blood loss and are routinely recommended. There are several uterotonic drugs for preventing PPH, but it is still debatable which drug or combination of drugs is the most effective. Read More

J Matern Fetal Neonatal Med 2019 Mar 1:1-5. Epub 2019 Mar 1.

a Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center , Boston , MA , USA.

Objective: Our objective was to compare women with and without invasive placentation for whom the massive transfusion protocol (MTP) was activated. In addition, we evaluated the differences in clinical management and blood product utilization between the two groups and described the activation of MTP over time.

Study Design: This is a retrospective cohort study of women for whom the MTP was activated from January 2012 through July 2016. Read More

J Obstet Gynaecol 2019 Mar 1:1-5. Epub 2019 Mar 1.

a Department of Obstetrics and Gynaecology , North Middlesex University Hospital , London , UK.

This retrospective study evaluates the effects of a massive postpartum haemorrhage (PPH) on maternal outcomes in an inner-city London hospital. One hundred and eighty-four cases of a massive primary PPH (>2000 mL) were identified over a seven-year period. A sub-group analysis was performed to assess whether 2000-3000 mL blood loss (134 cases) was associated with specific maternal characteristics or reduced adverse outcomes compared with >3000 mL blood loss (50 cases). Read More

Medicine (Baltimore) 2019 Mar;98(9):e14488

Department of Obstetric and Gynecologic, West China Second University Hospital, Sichuan University, Sichuan, China.

Placenta previa accreta is an obstetrical complication that severely affects the heath of the fetus and the mother due to massive hemorrhage during pregnancy. This study reported a new suture technique called "cervical internal os plasty" to control obstetrical hemorrhage in cesarean delivery for patients with placenta previa accreta and retrospectively evaluated the safety and effectiveness of the new technique.From January 2012 to May 2018, we collected 56 patients with this new suture technique, which repaired the damaged weak area with bleeding from the placental attachment site in the lower uterine segment, and restored the damaged anatomic internal os of the cervix. Read More

Int J Gynaecol Obstet 2019 Feb;144 Suppl 1:42-50

Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.

Objective: To describe doctors' and specialist physicians' availability to manage obstetric complications in hospitals in six provinces of Indonesia.

Methods: Data from a nonrandomized, quasi-experimental pre-post evaluation study were used to describe the distribution of providers by each cadre of worker and assess the availability of doctors and obstetrician/gynecologists (ob/gyns) for consultations for women experiencing postpartum hemorrhage or pre-eclampsia/eclampsia, disaggregated by hospital type, province, referral status, and by time of day of provider consultation.

Results: Among hospitals that should have comprehensive emergency obstetric and newborn care (CEmONC) services available 24 hours a day, 7 days a week, many did not have a doctor available to manage obstetric complications as they presented, despite there being an average of seven ob/gyns and four doctors registered for service across all facilities. Read More

BMJ Open Qual 2019 31;8(1):e000491. Epub 2019 Jan 31.

Health Intervention and Technology Assessment Program, Nonthaburi, Thailand.

Variation in practices of and access to health promotion and disease prevention (P&P) across geographical areas have been studied in Thailand as well as other healthcare settings. The implementation of quality standards (QS)-a concise set of evidence-informed quality statements designed to drive and measure priority quality improvements-can be an option to solve the problem. This paper aims to provide an overview of the priority setting process of topic areas for developing QS and describes the criteria used. Read More

J Obstet Gynaecol India 2019 Feb 22;69(1):31-36. Epub 2018 Mar 22.

Department of Obstetrics and Gynaecology, Lokmanya Tilak Municipal Medical College, Sion, Mumbai, 400022 India.

Background: Incidence of jaundice in pregnancy, including underlying chronic liver diseases, is 3-5%. However, the maternal mortality rate in some conditions can be as high as 18% in acute fatty liver of pregnancy and 22% in hepatitis E in pregnancy.

Objectives: This is an observational study of the demographics, obstetrical profile, aetiology, maternal morbidity, mortality and neonatal outcomes in pregnancies complicated with jaundice. Read More

Reprod Health 2019 Feb 27;16(1):24. Epub 2019 Feb 27.

Hospital e Maternidade Santa Joana, Centro de Ensino, Pesquisa e Inovação, Rua Dr. Eduardo Amaro 225, São Paulo, SP, CEP 04104 080, Brazil.

Background: Lack of skills on how to diagnose and manage obstetric emergencies contribute to substandard institutional care and preventable maternal deaths in Brazil. Simulation-based obstetric emergency team training can reduce adverse maternal outcomes. However, this type of training is expensive and not widely available, especially in low resource settings. Read More

BJOG 2019 Feb 27. Epub 2019 Feb 27.

Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, United Kingdom.

Objective: Pregnancies in women with Loeys Dietz Syndrome (LDS) are rare, and typically documented in case reports only. Early reports suggested high rates of maternal complications during pregnancy and the puerperium, including aortic dissection and uterine rupture, but information on fetal outcomes was very limited.

Design: A retrospective cohort study. Read More

Am J Obstet Gynecol 2019 Feb 23. Epub 2019 Feb 23.

Inserm CIC 1413, Nantes University Hospital, Nantes, France.

Background: To assess both severe maternal and neonatal mortality and morbidity after attempted operative vaginal deliveries by residents under supervision and by attending obstetricians.

Study Design: Secondary analysis of a five-year prospective study with cross-sectional analysis including 2192 women with live singleton term fetuses in vertex presentation who underwent an attempted operative vaginal delivery in a tertiary care university hospital. Obstetricians who attempted or performed an operative vaginal delivery were classified into two groups according to their level of experience: attending obstetricians (who had 5 years or more of experience) and obstetric residents (who had less than 5 years of experience) under the supervision of an attending obstetrician. Read More

Saudi J Kidney Dis Transpl 2019 Jan-Feb;30(1):194-201

Department of Nephrology, The Kidney Centre Postgraduate Training Institute, Karachi, Pakistan.

Acute kidney injury (AKI) in pregnancy is associated with significant maternal morbidity and mortality. Several studies from worldwide have shown different frequencies of the causes of pregnancy-related AKI (PRAKI). The present study aimed to provide local data on frequency of causes of PRAKI. Read More

Am J Cardiol 2019 Jan 25. Epub 2019 Jan 25.

Banner University Medical Center, Phoenix, Arizona.

Acute myocardial infarction (AMI) during pregnancy is rare but fatal complication. Recent incidence of pregnancy related AMI and trends in the related outcomes are unknown. The Nationwide Inpatient Sample database was utilized from years 2005 to 2014. Read More

BJOG 2019 Feb 24. Epub 2019 Feb 24.

Inserm UMR 1153 Obstetrical, Perinatal and Pediatric Epidemiology Research Team (EPOPé), Centre for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France.

Objective: To investigate the association between IVF and severe maternal morbidity (SMM) and to explore the role of multiple pregnancy as an intermediate factor.

Design: Population-based cohort-nested case-control study.

Setting: 6 French regions in 2012-2013. Read More

Transfusion 2019 Feb 23. Epub 2019 Feb 23.

Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China.

Background: The ability to predict risk factors for blood transfusion after postpartum hemorrhage could enhance the performance of lifesaving procedures in patients who experience postpartum hemorrhage. Therefore, this study aimed to evaluate these risk factors and create a scoring system for blood transfusion evaluations and risk in obstetric patients.

Study Design And Methods: Diagnosis and blood transfusion data of 14,112 women who delivered between January 1, 2015, and December 31, 2015, were analyzed. Read More

Acta Obstet Gynecol Scand 2019 Feb 24. Epub 2019 Feb 24.

Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.

Introduction: Adverse pregnancy outcomes are related to two opposite maternal factors, youth and aging. However, the change in trend of specific outcomes with childbearing age is unknown. The aim of this study was to investigate the changing trend of various maternal and neonatal outcomes with maternal age from 17 to 44 years. Read More

Eur J Obstet Gynecol Reprod Biol 2019 Feb 4;235:49-56. Epub 2019 Feb 4.

Sanquin Research, Center for Clinical Transfusion Research and Jon J van Rood Center for Clinical Transfusion Science, Leiden University Medical Center, Leiden, the Netherlands(1); Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address:

Objective: To determine the association between increasing volumes of crystalloids and colloids administered before transfusion of packed red blood cells in women with persistent postpartum haemorrhage and adverse maternal outcomes.

Study Design: Retrospective cohort study in the Netherlands. Women with persistent postpartum haemorrhage and known clear fluids volume for resuscitation were included. Read More

Midwifery 2019 May 7;72:14-22. Epub 2019 Feb 7.

Department of Paediatrics, Monash University, Melbourne, Australia.

Background: The developing world has a significantly high risk of women and babies dying during childbirth. Interprofessional simulation training has improved birth practices and outcomes by impacting clinical and non-technical skills like communication, teamwork, leadership and effective use of resources. While these programs have become a training requirement in many high-income countries, they have not been widely introduced in the low-income, low-resource settings. Read More

BJOG 2019 Feb 16. Epub 2019 Feb 16.

School of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland, Switzerland.

Objective: Little is known about how teams' non-technical performance influences clinical performance in obstetric emergencies like postpartum haemorrhage.

Design: Video review - observational study.

Setting: A university hospital (5,000 deliveries) and a regional hospital (2,000 deliveries) in Denmark. Read More

Acta Obstet Gynecol Scand 2019 Feb 15. Epub 2019 Feb 15.

Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.

Introduction: The impact of placenta previa on pregnancy, delivery and infant outcomes has been extensively studied. However, less is known about the possible association of placental location other than previa with pregnancy outcomes. The aim of this study was to investigate if placental location other than previa is associated with adverse pregnancy, delivery and infant outcomes. Read More

J Ultrason 2018 ;18(75):310-315

Trakya University, Faculty of Medicine, Department of Perinatology , Edirne , Turkey.

: To prospectively determine the sonographic findings of the postpartum uterus 24 hours after vaginal delivery and cesarean section. : Women who had uneventful vaginal delivery or cesarean section from July 2015 to May 2018 in a tertiary care hospital were prospectively included. Uterine lengths, endometrium, amout of free fluid, the distance between the uterine fundus-promontorium and uterine fundus-L5 were evaluated 24 hours after delivery. Read More

Acta Obstet Gynecol Scand 2019 Feb 14. Epub 2019 Feb 14.

Norwegian National Advisory Unit on Women's Health, Rikshospitalet, Oslo University Hospital, Oslo, Norway.

Introduction: Complete uterine rupture, a rare peripartum complication, is often associated with a catastrophic outcome for both mother and child. However, few studies have investigated large datasets to evaluate maternal outcomes after complete ruptures, particularly in unscarred uteri. This paucity of studies is partly due to the rarity of both the event and the serious outcomes, such as peripartum hysterectomy and maternal death. Read More

PLoS One 2019 13;14(2):e0212001. Epub 2019 Feb 13.

Department of Clinical Sciences, Obstetrics and Gynaecology, Umeå University, Umeå, Sweden.

Background: There is limited knowledge on the women's experiences of pregnancy-related complications in Rwanda. This study aimed to investigate women's experiences and perceptions of specific complications during pregnancy and delivery and the consequences of these complications on postpartum health and family situation.

Methods: Data were collected through individual in-depth interviews (N = 15). Read More

Mymensingh Med J 2019 Jan;28(1):44-48

Dr Anonya Talukder, Junior Consultant, Department of Obs. and Gynae, Mymensingh Medical College Hospital, Mymensingh, Bangladesh.

Eclampsia is a well-recognized major cause of maternal and perinatal morbidity and mortality. Patient's age, occupational status, socioeconomic status, educational status, regular ANC (antenatal care) and gravidity may affect the outcome of mother and foetus. The purpose of this study is to see the fetomaternal outcome in eclampsia in relationship with gravidity. Read More

Cochrane Database Syst Rev 2019 02 13;2:CD007412. Epub 2019 Feb 13.

School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, Ireland.

Background: Active management of the third stage of labour involves giving a prophylactic uterotonic, early cord clamping and controlled cord traction to deliver the placenta. With expectant management, signs of placental separation are awaited and the placenta is delivered spontaneously. Active management was introduced to try to reduce haemorrhage, a major contributor to maternal mortality in low-income countries. Read More

PLoS One 2019 12;14(2):e0211955. Epub 2019 Feb 12.

Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé) Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in pregnancy, Paris Descartes University, Paris, France.

Objectives: Most indicators proposed for assessing quality of care in obstetrics are process indicators and do not directly measure health effects, and cannot always be identified from routinely available databases. Our objective was to propose a set of indicators to assess the quality of hospital obstetric care from maternal morbidity outcomes identifiable in permanent hospital discharge databases.

Methods: Various maternal morbidity outcomes potentially reflecting quality of obstetric care were first selected from a systematic literature review. Read More

Obstet Gynecol 2019 Mar;133(3):507-514

Division of Global Women's Health, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas; the American College of Obstetricians and Gynecologists, Washington, DC; and Kamuzu Central Hospital, Lilongwe, Malawi.

Objective: To evaluate maternal mortality and changes in the culture of safety before and after the implementation of the Alliance for Innovation on Maternal Health (AIM) Malawi program.

Methods: This was a prospective cohort study at a central hospital and a district health center in Malawi from March 2016 to November 2017. The AIM Malawi program included classroom didactics on obstetric hemorrhage, teamwork protocols, skills laboratory activities, and simulation training. Read More

J Matern Fetal Neonatal Med 2019 Feb 27:1-6. Epub 2019 Feb 27.

a International Peace Maternity and Child Health Hospital, School of Medicine , Shanghai Jiao Tong University , Shanghai , China.

Objective: We aimed to evaluate the relationship between mode of first delivery with subsequent placenta previa, placenta accreta/increta, and significant postpartum hemorrhage (PPH).

Method: This retrospective cohort study included women with two consecutive singleton deliveries between 2007 and 2017 at our institution if the women were nulliparous and delivered at term at the time of first delivery. The first pregnancy delivery mode was classified as (1) vaginal delivery, (2) antepartum cesarean delivery (CD) without labor, or (3) intrapartum CD after the onset of labor. Read More

Int J Gynaecol Obstet 2019 Feb 9. Epub 2019 Feb 9.

Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, Japan.

Aust N Z J Obstet Gynaecol 2019 Feb 7. Epub 2019 Feb 7.

Department of Obstetrics and Gynaecology, Royal Prince Alfred Hospital and The Canterbury Hospital, Sydney, Australia.

Background: Female genital mutilation (FGM) and its impact on women's health are becoming relevant in Australia due to increases in numbers of refugees and migrants from affected countries. Notwithstanding the psychological trauma from FGM, there is a broad range of sequelae relevant to obstetrics and gynaecology, particularly related to maternal morbidity from labour and delivery.

Aims: To assess the prevalence of FGM in our unit and document its effect on maternal and neonatal outcomes. Read More