Midwifery
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near-miss case reviews are one of a number of audit approaches currently being used and evaluated by those with an interest in reducing high rates of maternal mortality in developing countries. Researchers are beginning to take an interest in issues relating to the sustainability of audits. ⋯ implementing and sustaining audit is a complex intervention that requires careful planning and consideration. It is important to consider both the content and the context in which audit takes place when developing strategies for sustainability.
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to provide basic information on the distribution (public/private and geographically) and the nature of maternity health provision in Lebanon, including relevant health outcome data at the hospital level in order to compare key features of provision with maternal/neonatal health outcomes. ⋯ there is a need for greater interaction between maternal/neonatal health, health system specialists and policy makers on how the health system can support both the adoption of evidence-based interventions and, ultimately, better maternal and perinatal health outcomes.
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obstetric haemorrhage remains a significant cause of maternal morbidity and mortality worldwide and is significant in terms of patient safety and quality of care. One drastic outcome of haemorrhage is the need for peripartum hysterectomy. A classification system that can be used to audit severe events such as peripartum hysterectomy would be a useful adjunct to patient safety systems, but it would need to account for pre-existing risk factors, such as previous caesarean section. One system that accounts for important risk factors is the Robson Ten Group Classification System (TGCS). The aim of this study was to examine whether the TGCS could be extended in a novel way to classify who required peripartum hysterectomy. ⋯ the TGCS can be used in a novel way, that is, to examine an outcome other than caesarean section, and could be part of a new system to monitor patient safety. Population-based data were used as an example of how an existing classification system could be used in a different way from that for which it was created, and could make comparisons across institutions and countries while adjusting for case mix in a simple manner. The TGCS may not necessarily be a useful way to monitor other events in childbirth. Further work is needed to develop other classification systems which could be used as a benchmarking tools to monitor patient safety in maternity care.
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to explore women's views surrounding the use of nicotine replacement therapy (NRT) to aid smoking cessation. ⋯ the findings of this study add to the available research surrounding the efficacy of NRT in pregnancy. There is little evidence that the views of pregnant women have been taken into account prior to this study; as such, this report offers a different dimension to the available evidence. Although these findings could be adopted and utilized by practitioners, there is still the need for further research in this area on a larger scale.