Acta obstetricia et gynecologica Scandinavica
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Acta Obstet Gynecol Scand · Nov 2013
Comparative StudyNonremoval of an abnormally invasive placenta at cesarean section with postoperative uterine artery embolization.
To evaluate the outcome of three different modes of management of abnormally invasive placenta over a 6-year period. ⋯ Nonremoval of an abnormally invasive placenta at cesarean section and prophylactic postoperative uterine artery embolization are an alternative to elective cesarean hysterectomy.
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Acta Obstet Gynecol Scand · Nov 2013
The current state of active third stage management to prevent postpartum hemorrhage: a cross-sectional study.
To investigate the implementation of the International Confederation of Midwives/International Federation of Gynecology and Obstetrics (ICM/FIGO) guideline on active third stage management in vaginal deliveries in daily clinical practice. ⋯ Active third stage management according to the ICM/FIGO guideline is adequately performed in only 48% of all vaginal deliveries. Results of this study call for training programs to increase adherence to the ICM/FIGO guideline.
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Acta Obstet Gynecol Scand · Nov 2013
What makes maternity teams effective and safe? Lessons from a series of research on teamwork, leadership and team training.
We describe lessons for safety from a synthesis of seven studies of teamwork, leadership and team training across a healthcare region. Two studies identified successes and challenges in a unit with embedded team training: a staff survey demonstrated a positive culture but a perceived need for greater senior presence; training improved actual emergency care, but wide variation in team performance remained. ⋯ Focused and directed communication was also associated with better patient-actor perception of care. Focus groups corroborated these findings, proposed that the capability and experience of the leader is more important than seniority, and identified teamwork and leadership issues that require further research.
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Acta Obstet Gynecol Scand · Nov 2013
Comparative StudyTrial of labor compared to repeat cesarean section in women with no other risk factors than a prior cesarean delivery.
To compare outcomes with trial of labor after cesarean (TOLAC) or elective repeat cesarean delivery on maternal request (ERCD-MR). ⋯ TOLAC is an acceptable individualized option for women without major risk factors.