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Article ; Online: Survey of obstetricians' approach to the issue of reinfibulation after childbirth in women with prior female genital mutilation.

Naz, Aliya / Lindow, Stephen W

AJOG global reports

2021 Volume 1, Issue 2, Page(s) 100010

Abstract: Background: The procedure of reinfibulation is the resuturing (usually after vaginal childbirth) of the incised scar tissue in women with previous female genital mutilation. Many authorities do not recommend the practice of reinfibulation.: Objective!# ...

Abstract	Background: The procedure of reinfibulation is the resuturing (usually after vaginal childbirth) of the incised scar tissue in women with previous female genital mutilation. Many authorities do not recommend the practice of reinfibulation. Objective: We sought to assess physicians' approach to the practice of reinfibulation. Study design: A structured online, anonymous questionnaire was sent to 130 practicing obstetricians and gynecologists through Survey Monkey. Results: The questionnaire was completed by 98 respondents (75.4%).This survey showed that 76% of obstetricians (74 of 98) agree with a standard policy of not performing reinfibulation. However, 37% of those who refused to perform reinfibulation (27 of 74) would agree to undertake it if the woman insisted because she feared marital problems or divorce, and 73% of them (54 of 74) would offer treatment from an obstetrician with a different view. Conclusion: The complex nature of reinfibulation is discussed and an alternative approach is suggested.
Language	English
Publishing date	2021-03-24
Publishing country	United States
Document type	Journal Article
ISSN	2666-5778
ISSN (online)	2666-5778
DOI	10.1016/j.xagr.2021.100010
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Article: Preterm Birth: Screening and Prediction.

Creswell, Lyndsay / Rolnik, Daniel Lorber / Lindow, Stephen W / O'Gorman, Neil

International journal of women's health

2023 Volume 15, Page(s) 1981–1997

Abstract: Preterm birth (PTB) affects approximately 10% of births globally each year and is the most significant direct cause of neonatal death and of long-term disability worldwide. Early identification of women at high risk of PTB is important, given the ... ...

Abstract	Preterm birth (PTB) affects approximately 10% of births globally each year and is the most significant direct cause of neonatal death and of long-term disability worldwide. Early identification of women at high risk of PTB is important, given the availability of evidence-based, effective screening modalities, which facilitate decision-making on preventative strategies, particularly transvaginal sonographic cervical length (CL) measurement. There is growing evidence that combining CL with quantitative fetal fibronectin (qfFN) and maternal risk factors in the extensively peer-reviewed and validated QUanititative Innovation in Predicting Preterm birth (QUiPP) application can aid both the triage of patients who present as emergencies with symptoms of preterm labor and high-risk asymptomatic women attending PTB surveillance clinics. The QUiPP app risk of delivery thus supports shared decision-making with patients on the need for increased outpatient surveillance, in-patient treatment for preterm labor or simply reassurance for those unlikely to deliver preterm. Effective triage of patients at preterm gestations is an obstetric clinical priority as correctly timed administration of antenatal corticosteroids will maximise their neonatal benefits. This review explores the predictive capacity of existing predictive tests for PTB in both singleton and multiple pregnancies, including the QUiPP app v.2. and discusses promising new research areas, which aim to predict PTB through cervical stiffness and elastography measurements, metabolomics, extracellular vesicles and artificial intelligence.
Language	English
Publishing date	2023-12-21
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2508161-5
ISSN	1179-1411
ISSN	1179-1411
DOI	10.2147/IJWH.S436624
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Article ; Online: Assisted vaginal delivery in the obese patient.

McTiernan, Aoife M / Ruprai, Chetan K / Lindow, Stephen W

Best practice & research. Clinical obstetrics & gynaecology

2023 Volume 91, Page(s) 102403

Abstract: Appropriate use of ventouse or obstetric forceps as options in the management of the second-stage of labor is good medical practice. The instruments are not inherently dangerous, however, the manner in which they are used may be. In addition to a working ...

Abstract	Appropriate use of ventouse or obstetric forceps as options in the management of the second-stage of labor is good medical practice. The instruments are not inherently dangerous, however, the manner in which they are used may be. In addition to a working knowledge of the instruments, the operator must have the willingness to abandon an unsuccessful procedure. Awareness that failure of assisted vaginal delivery is more likely in women with BMI >30, hence, gives pause to consider trial in theatre with early recourse to cesarean delivery if unsuccessful Awareness that obesity is associated with increased risk of intrapartum complications, such as the need for second-stage assistance to achieve delivery, shoulder dystocia and postnatal complications, such as obstetric anal sphincter injury and febrile morbidity.
MeSH term(s)	Pregnancy ; Female ; Humans ; Delivery, Obstetric ; Cesarean Section/adverse effects ; Labor, Obstetric ; Obesity/complications ; Obesity/therapy ; Parturition
Language	English
Publishing date	2023-08-22
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2050090-7
ISSN	1532-1932 ; 1521-6934
ISSN (online)	1532-1932
ISSN	1521-6934
DOI	10.1016/j.bpobgyn.2023.102403
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Article ; Online: Midwives' personal and professional attitudes towards women's delivery choices, interventions and neonatal care.

Duffy, Ailbhe / Maculey, Chloe / Lindow, Stephen W / O'Connell, Michael P

Journal of perinatal medicine

2022 Volume 51, Issue 3, Page(s) 392–395

Abstract: Objectives: Caesarean section (CS) rates in middle- and high-income countries are rising partly due to maternal request. This study aimed to explore the personal and professional attitudes of midwives and nurses towards women's delivery choices, ... ...

Abstract	Objectives: Caesarean section (CS) rates in middle- and high-income countries are rising partly due to maternal request. This study aimed to explore the personal and professional attitudes of midwives and nurses towards women's delivery choices, interventions and neonatal care. Methods: Midwifery and nursing staff at the Coombe hospital were asked to complete a questionnaire concerning decisions for elective CS and neonatal care. The midwives' responses were divided into multiparous and nulliparous according to their own parity. Results: Multiparae and nulliparae did not differ on their personal preferences for their own baby. Only 3% wanted an elective CS in a normal, healthy pregnancy but this increased to 80.2% when there was a breech presentation and 42% if the estimated fetal weight was >4.5 kg. These numbers and trends were very close to the midwives' professional recommendations under the same circumstances. The lower threshold for full resuscitation and ICU care was at 23 and 24 weeks gestation for both personal and professional recommendations. In the case of severely premature babies or babies with a poor prognosis, 54% stated that the approach to neonatal care was correct. Conclusions: Overall, midwives' professional views reflected what they would want for themselves and their babies. Only 3% recommended an elective CS in a normal, healthy pregnancy making it unlikely that midwives' attitudes are driving the rise in CS rates in Ireland.
MeSH term(s)	Infant, Newborn ; Humans ; Pregnancy ; Female ; Midwifery ; Cesarean Section ; Parity ; Prenatal Care ; Attitude of Health Personnel ; Nurse Midwives
Language	English
Publishing date	2022-09-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123512-6
ISSN	1619-3997 ; 0300-5577 ; 0936-174X
ISSN (online)	1619-3997
ISSN	0300-5577 ; 0936-174X
DOI	10.1515/jpm-2022-0165
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Article ; Online: Reducing maternal mortality: a 10-year experience at Mpilo Central Hospital, Bulawayo, Zimbabwe.

Ngwenya, Solwayo / Mhlanga, Simangele / Moyo, Sikhangezile / Lindow, Stephen W

Journal of perinatal medicine

2022 Volume 51, Issue 2, Page(s) 208–212

Abstract: Objectives: Maternal mortality is one of the major Sustainable Development Goals (SDGs) of the global health community. The aim of the SDG 3.1 is to reduce global maternal mortality ratio considerably by 2030. The objective of this study was to document ...

Abstract	Objectives: Maternal mortality is one of the major Sustainable Development Goals (SDGs) of the global health community. The aim of the SDG 3.1 is to reduce global maternal mortality ratio considerably by 2030. The objective of this study was to document the epidemiological trends in maternal mortality for Mpilo Central Hospital. Methods: This was a 10 year retrospective study using readily available data from the maternity registers. The International Classification of Diseases-Maternal Mortality (ICD-MM) coding system for maternal deaths was used. Results: The maternal mortality ratio (MMR) declined from 655 per 100,000 live births in 2011 to 203 per 100,000 live births by 2020. The commonest groups of maternal mortality during the period 2011-2020 were hypertensive disorders, obstetric haemorrhage, pregnancy-related infection, and pregnancies with abortive outcomes. There were 273 maternal deaths recorded in the period 2011-2015, and 168 maternal deaths in the period 2016-2020. There was also a decline in maternal deaths due to obstetric haemorrhage (53 vs. 34). Maternal deaths due to pregnancy-related infection also declined (46 vs. 22), as well as pregnancies with abortive outcomes (40 vs. 26). Conclusions: There was a 69% decline in the MMR over the 10 year period. The introduction of government interventions such as malarial control, the adoption of life-long Option B+ antiretroviral treatment for the pregnant women, the training courses of staff, and the introduction of strong clinical leadership and accountability were all associated with a significant decline in the causes of maternal deaths.
MeSH term(s)	Female ; Pregnancy ; Humans ; Maternal Mortality ; Maternal Death ; Zimbabwe/epidemiology ; Retrospective Studies ; Hospitals
Language	English
Publishing date	2022-10-05
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123512-6
ISSN	1619-3997 ; 0300-5577 ; 0936-174X
ISSN (online)	1619-3997
ISSN	0300-5577 ; 0936-174X
DOI	10.1515/jpm-2022-0399
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Article ; Online: Assessment of operating room team members' ability to identify other team members in the operating room, a quality improvement exercise.

Scott, Evelyn / Lindow, Stephen W / Duffy, Caoimhe C

Irish journal of medical science

2021 Volume 191, Issue 1, Page(s) 491–493

MeSH term(s)	Checklist ; Humans ; Operating Rooms ; Patient Care Team ; Quality Improvement
Language	English
Publishing date	2021-02-07
Publishing country	Ireland
Document type	Letter
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-021-02521-6
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Article: The Histological Spectrum Reported on Evacuated Endometrial Tissue From Patients With Secondary Postpartum Hemorrhage: A Pilot Study.

Babarinsa, Isaac A / Al Hyassat, Samir A / Abu Yacoub, Salwa M / Lindow, Stephen W

Cureus

2022 Volume 14, Issue 8, Page(s) e28308

Abstract: Background/aim This study sought to explore the possible yield of pathology requests on tissue obtained in uterine evacuation for secondary postpartum hemorrhage (SPPH) at our institution over five years. Material and methods A content categorization of ... ...

Abstract	Background/aim This study sought to explore the possible yield of pathology requests on tissue obtained in uterine evacuation for secondary postpartum hemorrhage (SPPH) at our institution over five years. Material and methods A content categorization of histological reports on endo-uterine tissue obtained from patients with secondary postpartum hemorrhage was undertaken. The aggregate tissue dimensions were also recorded. Additional information on the time elapsed between delivery and hospital presentation was deduced from medical records. Results From the 53 tissue samples reported, we clustered 114 descriptive mentions of phrases and terms and categorized them based on parent tissue, changes, and background cellularity. Inflammation and/or inflammatory changes were mentioned 18.4% of the time, no tissue was identified in 5.8% of instances, whilst placental tissue was encountered in 9.7% of specimens. Separately or in variable combination, decidua, decidualized tissue, hemorrhagic tissue, fibrinous material, and membranous tissue amounted to 48.5% of mentions. There was no correlation between aggregate tissue measurements and time elapsed since delivery. Conclusion Nearly half of the content of histological reports on tissue evacuated SPPH patients were consistent with expected findings on a postpartum endometrium. Remnants of placental tissue were mentioned in about 10% of instances.
Language	English
Publishing date	2022-08-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.28308
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Article ; Online: A retrospective cohort study of pregnancy outcomes during the pandemic period of the SARS-CoV-2 omicron variant: A single center's experience.

Floyd, Ruairí / Hunter, Samuel / Murphy, Niamh / Lindow, Stephen W / O'Connell, Michael P

International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics

2022 Volume 159, Issue 2, Page(s) 605–606

MeSH term(s)	COVID-19 ; Female ; Humans ; Pandemics ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Outcome ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-07-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	80149-5
ISSN	1879-3479 ; 0020-7292
ISSN (online)	1879-3479
ISSN	0020-7292
DOI	10.1002/ijgo.14312
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Article: A Meta-Analysis of the Global Stillbirth Rates during the COVID-19 Pandemic.

Mohan, Manoj / Appiah-Sakyi, Kwabena / Oliparambil, Ashok / Pullattayil, Abdul Kareem / Lindow, Stephen W / Ahmed, Badreldeen / Konje, Justin C

Journal of clinical medicine

2023 Volume 12, Issue 23

Abstract: COVID-19 has been shown to have variable adverse effects on pregnancy. Reported data on stillbirth rates during the pandemic have, however, been inconsistent-some reporting a rise and others no change. Knowing the precise impact of COVID-19 on ... ...

Abstract	COVID-19 has been shown to have variable adverse effects on pregnancy. Reported data on stillbirth rates during the pandemic have, however, been inconsistent-some reporting a rise and others no change. Knowing the precise impact of COVID-19 on stillbirths should help with the planning and delivery of antenatal care. Our aim was, therefore, to undertake a meta-analysis to determine the impact of COVID-19 on the stillbirth rate. Databases searched included PubMed, Embase, Cochrane Library, ClinicalTrials.gov, and Web of Science, with no language restriction. Publications with stillbirth data on women with COVID-19, comparing stillbirth rates in COVID-19 and non-COVID-19 women, as well as comparisons before and during the pandemic, were included. Two independent reviewers extracted data separately and then compared them to ensure the accuracy of extraction and synthesis. Where data were incomplete, authors were contacted for additional information, which was included if provided. The main outcome measures were (1) stillbirth (SB) rate in pregnant women with COVID-19, (2) stillbirth rates in pregnant women with and without COVID-19 during the same period, and (3) population stillbirth rates in pre-pandemic and pandemic periods. A total of 29 studies were included in the meta-analysis; from 17 of these, the SB rate was 7 per 1000 in women with COVID-19. This rate was much higher (34/1000) in low- and middle-income countries. The odds ratio of stillbirth in COVID-19 compared to non-COVID-19 pregnant women was 1.89. However, there was no significant difference in population SB between the pre-pandemic and pandemic periods. Stillbirths are an ongoing global concern, and there is evidence that the rate has increased during the COVID-19 pandemic, but mostly in low- and middle-income countries. A major factor for this is possibly access to healthcare during the pandemic. Attention should be focused on education and the provision of high-quality maternity care, such as face-to-face consultation (taking all the preventative precautions) or remote appointments where appropriate.
Language	English
Publishing date	2023-11-21
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12237219
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Article ; Online: External cephalic version - A 10-year review of practice.

Hakem, Emmanuel / Lindow, Stephen W / O'Connell, Michael P / von Bünau, Günther

European journal of obstetrics, gynecology, and reproductive biology

2021 Volume 258, Page(s) 414–417

Abstract: Introduction: Following the term breech trial (TBT), the incidence of Caesarean section secondary to breech presentations increased, from 76.9 % to 89.7 %. External Cephalic Version (ECV) is a safe effective method to reduce non-cephalic presentation at ...

Abstract	Introduction: Following the term breech trial (TBT), the incidence of Caesarean section secondary to breech presentations increased, from 76.9 % to 89.7 %. External Cephalic Version (ECV) is a safe effective method to reduce non-cephalic presentation at time of delivery. Methods: Retrospective audit of all the ECV procedures performed at a tertiary women's hospital between Jan 2010 and Jan 2020. Results: The success rate of ECV was 54.5 %. The rate of vaginal birth following successful ECV was 73.6 % and rate of Caesarean 26.4 %, compared to 96.4 % for those with unsuccessful ECV (P < 0.0001). Factors found to be associated with increased success rates was the use of Intravenous terbutaline (P = 0.03), fetal birth weight ≥3.5 kg (P = 0.0001) and when the procedure is performed by an experienced operator who performed over 20 ECV procedures (P < 0.0001). Conclusion: ECV is a safe and effective procedure to reduce Caesarean section rates secondary to breech presentation. A dedicated ECV clinic with experienced operators and the use of intravenous terbutaline could improve success rate of ECV and reduce the number of Caesareans for breech presentation.
MeSH term(s)	Breech Presentation ; Cesarean Section ; Delivery, Obstetric ; Female ; Humans ; Pregnancy ; Retrospective Studies ; Version, Fetal
Language	English
Publishing date	2021-01-29
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2021.01.044
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