Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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The monitoring of the time interval from decision to operate to delivery of the fetus (DDI) for emergency caesarean sections has become an important part of an obstetric department's continuous auditing and clinical governance. The accepted standard is that the DDI for emergency caesarean sections should be 30 minutes. ⋯ This study, the largest of its kind with 1000 subjects, shows that it is not feasible for busy obstetric units to reach this target in all emergency caesarean sections. Explanations for lengthy DDI and possible improvements are proposed.
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A retrospective study of Jehovah Witness women between January 1994 and December 2003 was performed. Gynaecologists are concerned about operating on Jehovah's Witnesses because of the potential for haemorrhage during surgery. Jehovah's Witnesses do not accept donor blood but some will permit their own blood to be stored pre-operatively and administered during surgery if deemed necessary. ⋯ There were 64 procedures (14 major, 18 intermediate and 32 minor) in 53 women with a median age of 42 years. There were no perioperative deaths, but postoperative anaemia was common. Our study showed that major, intermediate and minor gynaecological procedures can be performed without significant morbidity on Jehovah's Witnesses but a protocol should be available to outline management of those who refuse blood.
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The study investigated postpartum emotional distress including depression among 47 Nigerian women who had a caesarean section by comparing them at 6-8 weeks following childbirth with 47 matched controls who had normal vaginal delivery. Analysis of scores on the General Health Questionnaire (GHQ-30) and the Beck Depression Inventory (BDI) showed that women that delivered by caesarean section were significantly different from the controls on the GHQ and BDI scores in the postpartum period. Apart from marital status, other sociodemographic variables did not significantly contribute to psychopathology in this group of women. This observation is in support of the view that caesarean childbirth may predispose Nigerian women to adverse psychological sequelae.