International journal of gynaecology and obstetrics : the official organ of the International Federation of Gynaecology and Obstetrics
-
Int J Gynaecol Obstet · Mar 2013
Multicenter StudyAdvancing obstetric anesthesia practices in Georgia through clinical education and quality improvement methodologies.
To determine whether an integrated program of clinical education and improvement methods regarding the safe use of regional anesthesia for obstetrics would result in improved and sustained practice change in Georgia. ⋯ A structured program of education and quality improvement led to an increase in the use of regional anesthesia for vaginal and cesarean deliveries. Achievements were sustained during periods of economic and political turmoil.
-
Int J Gynaecol Obstet · Dec 2012
Reduced postpartum hemorrhage after implementation of active management of the third stage of labor in rural Honduras.
To assess outcomes after auxiliary nurses were trained and given resources to use active management of the third stage of labor (AMTSL) for all women giving birth in a low-resource, low-risk, rural, public birth center setting in northern rural Honduras. ⋯ Training auxiliary nurses to perform AMTSL using oxytocin in this birth center setting was effective in reducing the rate of postpartum hemorrhage; however, increased use of intrapartum oxytocin may be an unintended outcome of the increased accessibility of oxytocin.
-
Int J Gynaecol Obstet · Dec 2012
Misoprostol for the management of postpartum bleeding: a new approach.
Excessive postpartum hemorrhage (PPH) is a leading cause of maternal death globally. Current approaches to address PPH at the community level focus on reducing the incidence of PPH, but often fail to address the issue of PPH treatment. ⋯ If shown to be effective and feasible, this approach could support policy changes and avoid the need to provide uterotonics to all women after delivery. This Special Communication discusses some of the benefits and limitations of current community approaches using misoprostol for PPH prevention and explains why it is now opportune to translate clinical knowledge into pragmatic PPH service delivery strategies.
-
Int J Gynaecol Obstet · Nov 2012
Randomized Controlled Trial Comparative StudyThe effect of post-cesarean rectal misoprostol on intestinal motility.
To determine whether rectally administered misoprostol can induce intestinal motility compared with oxytocin infusion when used to prevent primary postpartum hemorrhage after cesarean delivery. ⋯ After cesarean delivery, rectal misoprostol had the added benefit of inducing intestinal motility. Misoprostol might be considered in a clinical setting where postoperative ileus is anticipated.