BJOG : an international journal of obstetrics and gynaecology
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Observational Study
The DiPEP study: an observational study of the diagnostic accuracy of clinical assessment, D-dimer and chest x-ray for suspected pulmonary embolism in pregnancy and postpartum.
To identify clinical features associated with pulmonary embolism (PE) diagnosis and determine the accuracy of decision rules and D-dimer for diagnosing suspected PE in pregnant/postpartum women DESIGN: Observational cohort study augmented with additional cases. ⋯ Clinical decision rules and D-dimer are not helpful for diagnosing pregnant/postpartum women with suspected PE.
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Postpartum haemorrhage (PPH), especially resulting from placenta accreta spectrum (PAS), has become a worldwide concern in maternity care. We describe a novel method of uterine compression sutures (the 'Nausicaa' technique) as an alternative to hysterectomy for patients who have suffered from major PPH. We applied this technique in 68 patients with major PPH during caesarean section (including 43 patients with PAS, 20 patients with placenta praevia totalis, and five patients with uterine atony), and none of these patients required further hysterectomy. We conclude that our Nausicaa suture is a simple and feasible alternative to hysterectomy in patients suffering from major PPH.
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To explore differences in the vaginal microbiome between preterm and term deliveries. ⋯ Largest study of its kind finds certain species of vaginal Lactobacillus + Bifidobacterium may relate to lower risk of preterm birth.
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Develop a core outcome set of international consensus definitions for severe maternal morbidities. ⋯ Consensus definitions for eight morbidity conditions were successfully developed using the Delphi process.
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To develop core outcome sets (COS) for studies evaluating interventions for (1) prevention and (2) treatment of postpartum haemorrhage (PPH), and recommendations on how to report the COS. ⋯ Core outcome sets for PPH: nine core outcomes for PPH prevention and 12 core outcomes for PPH treatment.