BJOG : an international journal of obstetrics and gynaecology
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We evaluated the impact of the World Health Organization Obstetric Safe Surgery Checklist (WHO Checklist) on perioperative communication between anaesthetists and obstetricians by performing a retrospective audit in a Teaching hospital in London, UK. Caesarean section births from February to March 2009 and April to May 2011 were studied. Caesarean section notes from obstetricians and anaesthetists managing the same woman during the study period were reviewed. ⋯ Grading differences occurred in 24.1% of caesarean sections without checklists compared with 10.3% with checklists (P < 0.001). During emergency caesarean section alone, grading differences between obstetricians and anaesthetists were smaller, although this was not significant (P = 0.222). We conclude that implementation of a WHO Obstetric Safe Surgery checklist improves the communication of caesarean section grade (urgency) between obstetricians and anaesthetists.
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To examine associations between antenatal exposure to Swedish oral moist snuff (which includes essentially only nicotine) and to smoking and risks of small-for-gestational-age (SGA) births and to compare risks among women who stopped or continued using snuff or smoking during pregnancy. ⋯ As both smoking and snuff use influence risk of SGA, both nicotine but above all tobacco combustion products are involved in the mechanisms by which maternal smoking increases the risk of SGA.
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Review Meta Analysis
Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence.
Using misoprostol to prevent postpartum haemorrhage (PPH) in home-birth settings remains controversial. ⋯ The finding that the distribution of oral misoprostol through frontline health workers is effective in reducing the incidence of PPH could be a significant step forwards in reducing maternal deaths in low-resource countries. However, given the limited number of high-quality studies in this review, further randomised controlled trials are required to confirm the association, particularly in different implementation settings. Adverse effects have not been systematically captured, and there has been limited consideration of the potential for inappropriate or inadvertent use of misoprostol. Further evidence is needed to inform the development of implementation and safety guidelines on the routine availability of misoprostol.
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Review Meta Analysis
Decision aids to improve informed decision-making in pregnancy care: a systematic review.
Rapid development in health care has resulted in an increasing number of screening and treatment options. Consequently, there is an urgency to provide people with relevant information about benefits and risks of healthcare options in an unbiased way. Decision aids help people to make decisions by providing unbiased non-directive research evidence about all treatment options. ⋯ Our systematic review showed the positive effect of decision aids on informed decision making in pregnancy care. Future studies should focus on increasing the uptake of decision aids in clinical practice by identifying barriers and facilitators to implementation.
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Randomized Controlled Trial Comparative Study
Self-hypnosis for coping with labour pain: a randomised controlled trial.
To estimate the use of epidural analgesia and experienced pain during childbirth after a short antenatal training course in self-hypnosis to ease childbirth. ⋯ In this large randomised controlled trial of a brief course in self-hypnosis to ease childbirth, no differences in use of epidural analgesia or pain experience were found across study groups. Before turning down self-hypnosis as a method for pain relief, further studies are warranted with focus on specific subgroups.