Author(s) Harrison R.; Mckenzie C.
Source BJOG: An International Journal of Obstetrics and Gynaecology; Jun 2021; vol. 128 ; p. 221
AbstractObjective Women from Black, Asian or Minority ethnic backgrounds have significantly worse health outcomes, with 66% increased risk of neonatal death and stillbirth in Asian ethnicity women compared to white ethnicity women. A document produced by Maternity Action, exploring maternal health inequalities, highlighted language barriers as a key component leading to suboptimal care. The aim of this quality improvement project was to address these inequalities by producing a multi-lingual audio-visual information video for maternity services. Design Semi-structured interviews were conducted with new mothers to assess how patient information in maternity services could be improved. Feedback from this was analysed and a quality improvement project was conducted involving producing a video following a patients experience when seeking advice for reduced fetal movements. Method New mothers, who had recently accessed maternity services, were interviewed about their experience of seeking help for reduced fetal movements and expectations of attending hospital with reduced fetal movements. They were asked about what information would have made a difference to their experience. Content for a patient information video was then written based upon this. Funding for video equipment and backfill for time to develop the project, was funded by the 'Digital Pioneer Scheme' run by Healthier Lancashire and South Cumbria, a partnership between NHS and council organisations. Feedback regarding the video content was sought from healthcare professionals involved in maternity services. A video was produced in the most common languages spoken in the area and published for women and their families to access. Results Positive feedback from semi-structured interviews regarding the use of digital technology to convey patient information was received, with new mothers reporting that this information would have been useful in their pregnancies and lessened anxieties about attending hospital. The group expressed that they felt information was lacking about what to expect when they reported reduced fetal movements and the process followed in hospital when attending an appointment with reduced fetal movements. Positive feedback was received regarding the use of digital technologies in improving patient information from both healthcare professionals and patients. Conclusion The use of digital technology to produce multi- lingual audio-visual patient information leaflets, is a useful tool for addressing inequalities experienced by Black, Asian and Minority Ethnic women, allowing them to access important information and reduced anxieties of seeking medical attention.
Cost-effectiveness of mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage: an economic evaluation based on the MifeMiso trial.
Author(s) Okeke Ogwulu; Williams, EV; Chu, JJ; Devall, AJ; Beeson, LE; Hardy, P; Cheed, V; Yongzhong, S; Jones, LL; La Fontaine Papadopoulos, JH; Bender-Atik, R; Brewin, J; Hinshaw, K; Choudhary, M; Ahmed, A; Naftalin, J; Nunes, N; Oliver, A; Izzat, F; Bhatia, K
Source BJOG: An International Journal of Obstetrics & Gynaecology; Aug 2021; vol. 128 (no. 9); p. 1534-1545
Publication Date Aug 2021
Gynaecological morbidity associated with caesarean niche: increasing awareness, prevention and management
Author(s) Brook A.J.; Clarke F.R.; Bhatia K.
Source Obstetrician and Gynaecologist; Apr 2020; vol. 22 (no. 2); p. 122-130
Key content: Caesarean section rates are rising globally; while obstetric consequences are well defined, long-term gynaecological sequelae are frequently overlooked. Caesarean niche results from poor healing of the uterine scar and is being increasingly reported as an important factor in a variety of new gynaecological symptoms reported after caesarean section. Until recently, a lack of high-quality evidence has hampered diagnostic assessment. Recent publications provide a useful consensus for improved diagnosis and guidance on management, with thoughts that caesarean section technique potentially contributes to niche development. Learning objectives: To describe the gynaecological morbidity associated with caesarean niche. To understand theories regarding caesarean niche development, its sonographic assessment for clinical relevance and subsequent management. To reflect on surgical techniques for caesarean section to minimise niche development. Ethical issues: With rising caesarean section rates, caesarean niche is an emerging clinical problem. Should we advise women of the possibility of long-term gynaecological consequences of the caesarean niche?
The cost-effectiveness of progesterone in preventing miscarriages in women with early pregnancy bleeding: an economic evaluation based on the PRISM trial
Author(s) Okeke Ogwulu C.B.; Goranitis I.; Roberts T.E.; Devall A.J.; Gallos I.D. et al.
Source BJOG: An International Journal of Obstetrics and Gynaecology; May 2020; vol. 127 (no. 6); p. 757-767
Objectives: To assess the cost-effectiveness of progesterone compared with placebo in preventing pregnancy loss in women with early pregnancy vaginal bleeding.
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