BJOG : an international journal of obstetrics and gynaecology
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Multicenter Study
Specific second-line therapies for postpartum haemorrhage: a national cohort study.
To describe the characteristics, management and outcomes of women undergoing specific second-line therapies for postpartum haemorrhage (PPH). ⋯ Overall, a quarter of women treated had a hysterectomy as a rescue therapy. Uterine compression sutures and interventional radiological techniques have higher success rates than rFVIIa and pelvic vessel ligation. However, cases managed with rFVIIa and ligation tend to be more clinically complex.
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Randomized Controlled Trial Multicenter Study
The impact of mode of anaesthesia on postoperative recovery from fast-track abdominal hysterectomy: a randomised clinical trial.
to determine whether the duration of hospital stay after abdominal hysterectomy in a fast-track setting differed between women operated under general anaesthesia or in spinal anaesthesia with intrathecal morphine. ⋯ in a fast-track model the duration of hospitalisation after abdominal hysterectomy was < 50 hours, independent of the mode of anaesthesia. Spinal anaesthesia reduced the need for postoperative morphine compared with general anaesthesia. In order to improve patient recovery after gynaecological surgery further studies based on fast-track programmes are needed.
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Multicenter Study Comparative Study
Critical illness with AH1N1v influenza in pregnancy: a comparison of two population-based cohorts.
To compare admissions to intensive care units (ICUs) with confirmed AH1N1v influenza in pregnancy in Australia, New Zealand and the UK. ⋯ The difference in admission risk may reflect a second phase effect from successful clinical and public health interventions, as well as differences in population characteristics between the countries. The overall severity of the AH1N1v influenza infection in pregnancy is evident, and emphasises the importance of an ongoing immunisation programme in pregnant women in both northern and southern hemispheres.
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China's economic reforms have raised concerns over rising inequalities in maternal mortality, but it is not known whether the gap across socio-economic regions has increased over time. ⋯ China's extraordinary economic growth has not adversely affected disparities in MMR across socio-economic regions over time, but poor rural women remain at disproportionate risk. Other emerging economies can learn from China's focus on the supply and quality of maternity services along with more general health systems strengthening.
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Randomized Controlled Trial Multicenter Study
More to teamwork than knowledge, skill and attitude.
To assess whether team performance in simulated eclampsia is related to the knowledge, skills and attitudes of individual team members. ⋯ The knowledge, manual skills and attitudes of the individuals comprising each team, measured by established methods, did not correlate in this study with the team's clinical efficiency in the management of simulated eclampsia. The inference is that unidentified characteristic(s) play a crucial part in the efficiency of teams managing emergencies. Any emphasis of training programmes to promote individual knowledge, skills and attitudes alone may have to be re-examined. This highlights a need to understand what makes a team efficient in dealing with clinical emergencies.