BJOG : an international journal of obstetrics and gynaecology
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To derive nationally representative incidence rates of postpartum haemorrhage (PPH), and to investigate trends associated with method of delivery, blood transfusion and morbidly adherent placenta (accreta, percreta and increta). ⋯ Increasing rates of atonic PPH highlight the pressing need for research and for clinical audit focusing on aetiological factors, preventative measures and quality of care, to guide current clinical practice.
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Historical Article
Historical trends in the timing of informed consent for research into intrapartum complications.
Obtaining informed consent for clinical trials involving the management of intrapartum complications is complex. This article describes the strategies used to obtain consent over the last 60 years using data from the Cochrane Library. ⋯ Of the remainder, 74% sought consent only when the complication developed, 11% sought consent from all women in early labour, and 13% gave all women antenatal information and then sought written consent when the complication arose. Despite the existence of ethics guidelines for intrapartum consent, many studies fail to follow their advice.
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To record any physiological changes in lung function during healthy pregnancies, and evaluate the influence of parity, pregestational overweight, and excessive weight gain. ⋯ Forced vital capacity (FVC) increases significantly after 14-16 weeks of gestation. The FVC% is significantly higher in parous compared with primigravida women, suggesting that the changes in FVC occurring during pregnancy persist postpartum. PEF increases significantly during healthy pregnancies, and should be interpreted cautiously in pregnant women with impaired lung function.