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Article ; Online: Estimated blood loss in pregnant women with cardiac disease compared with low risk women: a restrospective cohort study.

Chong, Hsu Phern / Hodson, James / Selman, Tara J / Hudsmith, Lucy E / Thompson, Peter J / Morris, Rachel Katherine / Thorne, Sara

BMC pregnancy and childbirth

2019 Volume 19, Issue 1, Page(s) 325

Abstract: Background: Women with cardiac disease are thought to be at increased risk of post-partum haemorrhage. We sought to assess the estimated blood loss (EBL) in our cohort of women with and without cardiac disease (CD) in a quaternary hospital in the UK. ... ...

Abstract	Background: Women with cardiac disease are thought to be at increased risk of post-partum haemorrhage. We sought to assess the estimated blood loss (EBL) in our cohort of women with and without cardiac disease (CD) in a quaternary hospital in the UK. Our population consisted of both congenital and acquired CD; and low risk women who delivered in our unit between 01/01/2012-30/09/2016. Methods: Data were collected using computerised hospital records. CD was classified according to the modified WHO classification (mWHO). The primary outcome measure was estimated blood loss (mL). Results: A total of 5413 women with a singleton fetus in the cephalic presentation delivered during the study period (159 women with CD and 5254 controls). In the CD group, active management of the third stage of labour was consistent with that used in low risk women in 98% (152/155) of cases. Multivariable analyses demonstrated no significant difference in EBL between women with CD vs controls. The adjusted average blood losses were 247.2 ml, 241.8 ml and 295.9 ml in the control group, mWHO 1-2 and 3-4, respectively (p = 0.165). Conclusions: Women with CD have comparable EBL to low risk women when management of the active third stage of labour is the same.
MeSH term(s)	Adult ; Case-Control Studies ; Cesarean Section ; Cohort Studies ; Delivery, Obstetric ; Female ; Heart Diseases/epidemiology ; Humans ; Labor Stage, Third ; Multivariate Analysis ; Oxytocics/therapeutic use ; Oxytocin/therapeutic use ; Postpartum Hemorrhage/prevention & control ; Pregnancy ; Pregnancy Complications, Cardiovascular/epidemiology ; Retrospective Studies ; United Kingdom/epidemiology ; Young Adult
Chemical Substances	Oxytocics ; Oxytocin (50-56-6)
Language	English
Publishing date	2019-09-04
Publishing country	England
Document type	Journal Article
ISSN	1471-2393
ISSN (online)	1471-2393
DOI	10.1186/s12884-019-2447-8
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Article ; Online: Management of twin-to-twin transfusion syndrome.

Selman, Tara J / Morris, R Katie / Kilby, Mark D

Archives of disease in childhood. Fetal and neonatal edition

2011 Volume 96, Issue 5, Page(s) F318–20

MeSH term(s)	Female ; Fetofetal Transfusion/diagnostic imaging ; Fetofetal Transfusion/therapy ; Fetoscopy ; Humans ; Laser Therapy/methods ; Pregnancy ; Prognosis ; Treatment Outcome ; Ultrasonography, Prenatal/methods
Language	English
Publishing date	2011-06-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2007331-8
ISSN	1468-2052 ; 1359-2998
ISSN (online)	1468-2052
ISSN	1359-2998
DOI	10.1136/adc.2010.207738
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Article ; Online: Influences of experience, case load and stage distribution on outcome of endoscopic laser surgery for TTTS--a review. Ahmed S et al. Prenatal Diagnosis 2010.

Morris, R Katie / Selman, Tara J / Kilby, Mark D

Prenatal diagnosis

2010 Volume 30, Issue 8, Page(s) 808–9; author reply 810

MeSH term(s)	Endoscopy/methods ; Female ; Fetofetal Transfusion/surgery ; Humans ; Laser Therapy/methods ; Pregnancy
Language	English
Publishing date	2010-07-27
Publishing country	England
Document type	Comment ; Letter
ZDB-ID	82031-3
ISSN	1097-0223 ; 0197-3851
ISSN (online)	1097-0223
ISSN	0197-3851
DOI	10.1002/pd.2549
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Article ; Online: The quality of reporting of primary test accuracy studies in obstetrics and gynaecology: application of the STARD criteria.

Selman, Tara J / Morris, R Katie / Zamora, Javier / Khan, Khalid S

BMC women's health

2011 Volume 11, Page(s) 8

Abstract: Background: In obstetrics and gynaecology there has been a rapid growth in the development of new tests and primary studies of their accuracy. It is imperative that such studies are reported with transparency allowing the detection of any potential bias ...

Abstract	Background: In obstetrics and gynaecology there has been a rapid growth in the development of new tests and primary studies of their accuracy. It is imperative that such studies are reported with transparency allowing the detection of any potential bias that may invalidate the results. The objective of this study was to determine the quality of reporting in diagnostic test accuracy studies in obstetrics and gynaecology using the Standards for Reporting of Diagnostic Accuracy--STARD checklist. Methods: The included studies of ten systematic reviews were assessed for compliance with each of the reporting criteria. Using appropriate statistical tests we investigated whether there was an improvement in reporting quality since the introduction of the STARD checklist, whether a correlation existed between study sample size, country of origin of study and reporting quality. Results: A total of 300 studies were included (195 for obstetrics, 105 for gynaecology). The overall reporting quality of included studies to the STARD criteria was poor. Obstetric studies reported adequately > 50% of the time for 62.1% (18/29) of the items while gynaecologic studies did the same 51.7% (15/29). There was a greater mean compliance with STARD criteria in the included obstetric studies than the gynaecological (p < 0.0001). There was a positive correlation, in both obstetrics (p < 0.0001) and gynaecology (p = 0.0123), between study sample size and reporting quality. No correlation between geographical area of publication and compliance with the reporting criteria could be demonstrated. Conclusions: The reporting quality of papers in obstetrics and gynaecology is improving. This may be due to initiatives such as the STARD checklist as well as historical progress in awareness among authors of the need to accurately report studies. There is however considerable scope for further improvement.
MeSH term(s)	Bias ; Checklist ; Diagnostic Techniques, Obstetrical and Gynecological/standards ; Diagnostic Tests, Routine/standards ; Female ; Guideline Adherence ; Humans ; Prospective Studies ; Quality Control ; Research Design/standards ; Review Literature as Topic
Language	English
Publishing date	2011-03-23
Publishing country	England
Document type	Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1472-6874
ISSN (online)	1472-6874
DOI	10.1186/1472-6874-11-8
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Article ; Online: Methodological quality of test accuracy studies included in systematic reviews in obstetrics and gynaecology: sources of bias.

Morris, Rachel K / Selman, Tara J / Zamora, Javier / Khan, Khalid S

BMC women's health

2011 Volume 11, Page(s) 7

Abstract: Background: Obstetrics and gynaecology have seen rapid growth in the development of new tests with research on these tests presented as diagnostic accuracy studies. To avoid errors in judgement it is important that the methodology of these studies is ... ...

Abstract	Background: Obstetrics and gynaecology have seen rapid growth in the development of new tests with research on these tests presented as diagnostic accuracy studies. To avoid errors in judgement it is important that the methodology of these studies is such that bias is minimised. Our objective was to determine the methodological quality of test accuracy studies in obstetrics and gynaecology using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) checklist and to assess sources of bias. Methods: A prospective protocol was developed to assess the impact of QUADAS on ten systematic reviews performed over the period 2004-2007.We investigated whether there was an improvement in study quality since the introduction of QUADAS, whether a correlation existed between study sample size, country of origin of study and its quality. We also investigated whether there was a correlation between reporting and methodological quality and by the use of meta-regression analyses explored for items of quality that were associated with bias. Results: A total of 300 studies were included. The overall quality of included studies was poor (> 50% compliance with 57.1% of quality items). However, the mean compliance with QUADAS showed an improvement post-publication of QUADAS (54.9% versus 61.4% p = 0.002). There was no correlation with study sample size. Gynaecology studies published from the United States of America showed higher quality (USA versus Western Europe p = 0.002; USA versus Asia p = 0.004). Meta-regression analysis showed that no individual quality item had a significant impact on accuracy. There was an association between reporting and methodological quality (r = 0.51 p < 0.0001 for obstetrics and r = 0.56 p < 0.0001 for gynaecology). Conclusions: A combination of poor methodological quality and poor reporting affects the inferences that can be drawn from test accuracy studies. Further compliance with quality checklists is required to ensure that bias is minimised.
MeSH term(s)	Bias ; Diagnostic Techniques, Obstetrical and Gynecological/standards ; Diagnostic Tests, Routine/standards ; Female ; Genital Neoplasms, Female/diagnosis ; Humans ; Prospective Studies ; Quality Assurance, Health Care/methods ; Quality Control ; Review Literature as Topic
Language	English
Publishing date	2011-03-22
Publishing country	England
Document type	Comparative Study ; Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
ISSN	1472-6874
ISSN (online)	1472-6874
DOI	10.1186/1472-6874-11-7
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Article ; Online: Pregnancy Outcomes in Women With Transposition of the Great Arteries After an Arterial Switch Operation.

Stoll, Victoria M / Drury, Nigel E / Thorne, Sara / Selman, Tara / Clift, Paul / Chong, Hsu / Thompson, Peter J / Morris, R Katie / Hudsmith, Lucy E

JAMA cardiology

2018 Volume 3, Issue 11, Page(s) 1119–1122

Abstract: Importance: A growing number of women are approaching childbearing age after arterial switch surgery for transposition of the great arteries. Prepregnancy counseling requires updated knowledge of the additional cardiovascular risks pregnancy poses for ... ...

Abstract	Importance: A growing number of women are approaching childbearing age after arterial switch surgery for transposition of the great arteries. Prepregnancy counseling requires updated knowledge of the additional cardiovascular risks pregnancy poses for this cohort of women and the potential effect on their offspring; however, to our knowledge, this information is currently unknown. Objective: To determine the pregnancy outcomes of women with transposition of the great arteries after an arterial switch operation, as well as the outcomes of their offspring. Design, setting, and participants: This cohort study assessed women who had had arterial switch surgery from 1985 to the present and who were 16 years or older as of January 2018. All women with a previous arterial switch surgery for transposition of the great arteries with completed or ongoing pregnancy were included. Data were collected in a level 1 congenital cardiology center and joint obstetrics-cardiology clinic in Birmingham, United Kingdom. Exposures: Patients were assessed before, during, and after pregnancy. Main outcomes and measures: Adverse maternal cardiac events (arrhythmia, heart failure, aortic dissection, or acute coronary syndrome) and aortic root dilatation, aortic regurgitation, and left ventricular function before and after pregnancy were the main outcomes. Mode of delivery and fetal outcomes were considered secondary outcomes. Results: A total of 25 pregnancies were identified in 15 women; 8 women had had 1 pregnancy, while 7 were multiparous. There were no adverse maternal cardiac events. Before pregnancy, 8 women (53%) had no aortic regurgitation, 1 (7%) had a trivial degree of regurgitation, 4 (26%) had mild regurgitation, and 2 (14%) had moderate regurgitation. After pregnancies, 1 woman (7%) had minor progression of aortic regurgitation. Five women (36%) had mild neoaortic root dilatation prepregnancy, but none developed progressive dilatation in the first year post-partum. A total of 24 pregnancies were completed by the end of the study, with all infants born alive and well. Nineteen modes of delivery were known; there were 7 cesarean deliveries (37%), of which 2 (11%) were recommended for aortic dilatation and 5 (26%) for obstetric indications or maternal choice. Conclusions and relevance: Pregnancy is well tolerated after arterial switch operation; no adverse maternal cardiac events or early progression of neoaortic root dilatation or aortic regurgitation were observed in this study. These results provide evidence to allow reassurance of women with previous arterial switch surgery who are planning pregnancies.
MeSH term(s)	Adult ; Arterial Switch Operation/methods ; Cesarean Section/statistics & numerical data ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; Transposition of Great Vessels/complications ; Transposition of Great Vessels/surgery ; United Kingdom/epidemiology ; Young Adult
Language	English
Publishing date	2018-09-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2380-6591
ISSN (online)	2380-6591
DOI	10.1001/jamacardio.2018.2747
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Article ; Online: Quality of health information for cervical cancer treatment on the internet.

Selman, Tara J / Prakash, Trina / Khan, Khalid S

BMC women's health

2006 Volume 6, Page(s) 9

Abstract: Background: The internet has become a frequently used and powerful tool for patients seeking medical information. This information may not undergo the same quality consideration as the peer-review criteria for publication of information in a journal. ... ...

Abstract	Background: The internet has become a frequently used and powerful tool for patients seeking medical information. This information may not undergo the same quality consideration as the peer-review criteria for publication of information in a journal. The aim of this study is to assess the quality of internet sites providing information on the treatment of cervical cancer, with comparisons between the quality assessments made by an educated lay person and an expert in the field. Methods: A search of the World Wide Web was made by a lay person to identify sites containing information on the treatment of cervical cancer. The credibility and accuracy of these sites was assessed using predefined criteria based on 'Criteria for Assessing the Quality of Health Information on the Internet' and accepted guidelines for the treatment of cervical cancer. The assessment was made independently and in duplicate by the lay reviewer and medical expert in order to allow comparison. Results: 46 relevant websites were assessed. Only one site contained all the credibility and accuracy criteria, with a further website containing all the credibility criteria. The majority of sites, 38/46, were deemed easy to navigate. The agreement between lay person and expert was good with only 6 items in total changed by the expert. Conclusion: This study clearly shows there is wide variation in quality of websites available to patients on the treatment of cervical cancer. Further research and consideration is needed on the effects of website information on gynaecological cancer patients and how steps can be made to insure the posting of good quality information.
Language	English
Publishing date	2006-06-20
Publishing country	England
Document type	Journal Article
ISSN	1472-6874
ISSN (online)	1472-6874
DOI	10.1186/1472-6874-6-9
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Article ; Online: Gynaecologic surgery from uncertainty to science: evolution of randomized control trials.

Selman, Tara J / Johnson, Neil P / Zamora, Javier / Khan, Khalid S

Human reproduction (Oxford, England)

2008 Volume 23, Issue 4, Page(s) 827–831

Abstract: Background: It is now accepted that both medical and surgical practice should be based on reliable and sound clinical evidence. However, randomized control trials comparing surgical interventions have been associated with many problems. The aim of this ... ...

Abstract	Background: It is now accepted that both medical and surgical practice should be based on reliable and sound clinical evidence. However, randomized control trials comparing surgical interventions have been associated with many problems. The aim of this review is to assess if there has been progress made in establishing the evidence base for surgical interventions in gynaecology. Methods: Relevant reviews were identified from Cochrane Database of Systematic Reviews (Issue , 2006) and data from individual randomized control trials extracted. Chi-squared test was used to compare quality pre- and post-Consolidated Standards of Reporting Trials (CONSORT) statement. Meta-regression analyses were performed to test the hypothesis that effect size decreased over time. Further multiple linear regression analyses were used to test the hypothesis that precision increased over time and finally a logistic regression model was used to estimate whether treatment effects differed between trials with and without allocation concealment. Results: Twenty-three relevant reviews were identified, including 94 trials. The proportion of studies reporting allocation concealment significantly increased after the introduction of the CONSORT statement (P = 0.002). There was a trend towards improvement in precision over time. Similarly, there was a reduction in size of treatment effect over time (log of the ratio of odds ratios per year 0.96; 95% confidence interval 0.93-0.99, P = 0.04). Conclusions: Gynaecologic surgical practice appears to be benefiting from improvement in its research base in a subject where practitioners do not participate readily in randomized evaluation.
MeSH term(s)	Bias ; Evidence-Based Medicine ; Female ; Gynecologic Surgical Procedures ; Humans ; Randomized Controlled Trials as Topic
Language	English
Publishing date	2008-04
Publishing country	England
Document type	Comparative Study ; Journal Article
ZDB-ID	632776-x
ISSN	1460-2350 ; 0268-1161 ; 1477-741X
ISSN (online)	1460-2350
ISSN	0268-1161 ; 1477-741X
DOI	10.1093/humrep/dem422
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Article ; Online: A systematic review of tests for lymph node status in primary endometrial cancer.

Selman, Tara J / Mann, Christopher H / Zamora, Javier / Khan, Khalid S

BMC women's health

2008 Volume 8, Page(s) 8

Abstract: Background: The lymph node status of a patient is a key determinate in staging, prognosis and adjuvant treatment of endometrial cancer. Despite this, the potential additional morbidity associated with lymphadenectomy makes its role controversial. This ... ...

Abstract	Background: The lymph node status of a patient is a key determinate in staging, prognosis and adjuvant treatment of endometrial cancer. Despite this, the potential additional morbidity associated with lymphadenectomy makes its role controversial. This study systematically reviews the accuracy literature on sentinel node biopsy; ultra sound scanning, magnetic resonance imaging (MRI) and computer tomography (CT) for determining lymph node status in endometrial cancer. Methods: Relevant articles were identified form MEDLINE (1966-2006), EMBASE (1980-2006), MEDION, the Cochrane library, hand searching of reference lists from primary articles and reviews, conference abstracts and contact with experts in the field. The review included 18 relevant primary studies (693 women). Data was extracted for study characteristics and quality. Bivariate random-effect model meta-analysis was used to estimate diagnostic accuracy of the various index tests. Results: MRI (pooled positive LR 26.7, 95% CI 10.6 - 67.6 and negative LR 0.29 95% CI 0.17 - 0.49) and successful sentinel node biopsy (pooled positive LR 18.9 95% CI 6.7 - 53.2 and negative LR 0.22, 95% CI 0.1 - 0.48) were the most accurate tests. CT was not as accurate a test (pooled positive LR 3.8, 95% CI 2.0 - 7.3 and negative LR of 0.62, 95% CI 0.45 - 0.86. There was only one study that reported the use of ultrasound scanning. Conclusion: MRI and sentinel node biopsy have shown similar diagnostic accuracy in confirming lymph node status among women with primary endometrial cancer than CT scanning, although the comparisons made are indirect and hence subject to bias. MRI should be used in preference, in light of the ASTEC trial, because of its non invasive nature.
MeSH term(s)	Carcinoma, Endometrioid/diagnosis ; Carcinoma, Endometrioid/secondary ; Diagnosis, Differential ; Endometrial Neoplasms/pathology ; Evidence-Based Medicine ; Female ; Humans ; Lymph Nodes/pathology ; Lymphatic Metastasis/pathology ; Magnetic Resonance Imaging ; Neoplasm Staging ; Sensitivity and Specificity ; Sentinel Lymph Node Biopsy ; Tomography, X-Ray Computed ; Women's Health
Language	English
Publishing date	2008-05-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
ZDB-ID	2050444-5
ISSN	1472-6874 ; 1472-6874
ISSN (online)	1472-6874
ISSN	1472-6874
DOI	10.1186/1472-6874-8-8
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Article ; Online: Quality of health information for cervical cancer treatment on the internet

Prakash Trina / Selman Tara J / Khan Khalid S

BMC Women's Health, Vol 6, Iss 1, p

2006 Volume 9

Abstract: Abstract Background The internet has become a frequently used and powerful tool for patients seeking medical information. This information may not undergo the same quality consideration as the peer-review criteria for publication of information in a ... ...

Abstract	Abstract Background The internet has become a frequently used and powerful tool for patients seeking medical information. This information may not undergo the same quality consideration as the peer-review criteria for publication of information in a journal. The aim of this study is to assess the quality of internet sites providing information on the treatment of cervical cancer, with comparisons between the quality assessments made by an educated lay person and an expert in the field. Methods A search of the World Wide Web was made by a lay person to identify sites containing information on the treatment of cervical cancer. The credibility and accuracy of these sites was assessed using predefined criteria based on 'Criteria for Assessing the Quality of Health Information on the Internet' and accepted guidelines for the treatment of cervical cancer. The assessment was made independently and in duplicate by the lay reviewer and medical expert in order to allow comparison. Results 46 relevant websites were assessed. Only one site contained all the credibility and accuracy criteria, with a further website containing all the credibility criteria. The majority of sites, 38/46, were deemed easy to navigate. The agreement between lay person and expert was good with only 6 items in total changed by the expert. Conclusion This study clearly shows there is wide variation in quality of websites available to patients on the treatment of cervical cancer. Further research and consideration is needed on the effects of website information on gynaecological cancer patients and how steps can be made to insure the posting of good quality information.
Keywords	Gynecology and obstetrics ; RG1-991 ; Public aspects of medicine ; RA1-1270
Subject code	302
Language	English
Publishing date	2006-06-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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