International journal of obstetric anesthesia
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Int J Obstet Anesth · Aug 2019
Readability, content, quality and accuracy assessment of internet-based patient education materials relating to labor analgesia.
With over 90% of parturients searching the internet for health information, the quality of information is important. Web-based patient education materials (PEMs) related to labor analgesia are frequently of low readability. This study compares the readability, content, quality and accuracy of labor analgesia-related PEMs from relevant healthcare society websites and the top internet search results. ⋯ Google search results for labor analgesia lead to PEMs of variable quality and readability. For readers to be better informed, web-based PEMs should be improved or women directed to society PEMs. Inaccurate information may lead to incorrect expectations and conflict during labor, with potentially lower maternal satisfaction.
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Int J Obstet Anesth · Aug 2019
Serious adverse events attributed to remifentanil patient-controlled analgesia during labour in The Netherlands.
During labour, remifentanil patient-controlled analgesia is used as an alternative to neuraxial analgesia. Remifentanil is associated with hypoventilation and respiratory depression but the frequency of serious maternal and neonatal adverse events is unknown. The aim of this study was to estimate the number of serious adverse events attributed to the use of remifentanil patient-controlled analgesia during labour in The Netherlands and to investigate the circumstances (e.g. monitoring, practice deviations) of these events and the subsequent management. ⋯ The risk of a potentially life-threatening serious adverse event attributed to remifentanil patient-controlled analgesia seems to be low. All patients recovered without deficit. Adherence to strict monitoring and the attendance of trained healthcare providers is required to safely use remifentanil for labour analgesia.
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Int J Obstet Anesth · Aug 2019
Design errors in vital sign charts used in consultant-led maternity units in the United Kingdom.
Paper-based charts remain the principal means of documenting the vital signs of hospitalised pregnant and postnatal women. However, poor chart design may contribute to both incorrect charting of data and clinical responses. We decided to identify design faults that might have an adverse clinical impact. ⋯ We recommend the urgent development of an evidence-based, standardised obstetric observation chart, which integrates 'human factors' and user experience. It should have a clear layout and style, appropriate colour scheme, correct language and labelling, and the ability for vital signs to be documented accurately and quickly. It should incorporate a suitable early warning score to guide clinical management.