Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstétrique et gynécologie du Canada : JOGC
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J Obstet Gynaecol Can · Dec 2019
Measuring Maternal Mortality in Canada: An Update on the Establishment of a Confidential Enquiry System for Preventing Maternal Deaths #savingmoms #savingbabies.
A reduction in maternal mortality has traditionally been used as a critical measure of progress in improving maternal health, and the maternal mortality ratio is one of the main indicators of a country's status in the area. In Canada, maternal mortality is infrequent yet devastating. In many cases, there were no interventions that could have saved the mother's life, but in others, there were opportunities for prevention. ⋯ Recommendations for definitions, processes, knowledge translation tools, and programs that raise awareness about maternal mortality in Canada have been developed and are being piloted. It is anticipated that, with the appropriate support and appropriate leadership, Canada will have the foundation of a national confidential enquiry system into maternal deaths very soon. This is an update on progress.
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J Obstet Gynaecol Can · Dec 2019
ReviewA Review of Enhanced Recovery After Surgery Principles Used for Scheduled Caesarean Delivery.
There is an increasing body of evidence to support the success of Enhanced Recovery After Surgery (ERAS) for a wide range of surgical procedures. There has been little formalized application, however, of ERAS principles in obstetrical surgery. The aim of this review was to examine the evidence base of perioperative care for patients undergoing Caesarean delivery (CD) and to determine the feasibility of developing an ERAS Society guideline for this obstetrical care plan. ⋯ These elements include patient education, preoperative optimization, prophylaxis against thromboembolism, antimicrobial prophylaxis, postoperative nausea and vomiting prevention, hypothermia prevention, perioperative fluid management, postoperative analgesia, ileus prevention, breastfeeding promotion, and early mobilization. ERAS has the potential to be successfully implemented in CD on the basis of the evidence obtained from this review. Knowledge transfer and implementation will require multidisciplinary coordination in the preoperative, intraoperative, and postoperative phases and the development of a formalized ERAS guideline.