Acta obstetricia et gynecologica Scandinavica
-
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.
-
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.
-
Acta Obstet Gynecol Scand · Oct 2013
Venous thromboembolism in pregnancy and the puerperal period: a study of 1210 events.
The aim of this study was to describe venous thromboembolism (VTE) in pregnancy and the puerperal period, and to validate diagnoses of VTE. ⋯ The vast majority of women with a registered diagnosis of VTE had relevant symptoms. Diagnoses of VTE were confirmed in the medical records in two of three women. VTE diagnoses were most often confirmed when made in the first trimester and in the puerperal period. Left-sided deep venous thrombosis was the predominant type of VTE in pregnancy and the puerperal period.
-
Cesarean hysterectomy is considered the reference standard treatment for placenta accreta. In young women who want the option of future pregnancy and agree to close follow-up monitoring, conservative treatment is a valid option. ⋯ In cases of placenta percreta with bladder involvement, conservative treatment may be the optimal management. Regardless of the chosen option, the woman and her partner should be warned of the high risk of maternal complications related to an abnormally invasive placenta.
-
Acta Obstet Gynecol Scand · Oct 2013
Randomized Controlled TrialSimulator training and non-technical factors improve laparoscopic performance among OBGYN trainees.
To investigate how simulator training and non-technical factors affect laparoscopic performance among residents in obstetrics and gynecology. ⋯ Simulator training and non-technical factors appear to improve the laparoscopic performance among trainees/residents in obstetrics and gynecology.