b
Please be careful when you read the Smith et al 2004 BMJ article as a particular aspect of the discussion is of particular importance for midwives.
Yes, there is evidence presented to link prostaglandins with increased risk of uterine rupture and this is key data.
However " The findings that units with high throughput had lower rates of perinatal death due to uterine ruptutre is plausible. Hospitals with greater throughput are more likely to have resident obstetric, anaesthetic, and neonatal services as well as a dedicated obstetric operating theatre. These factors would allow a faster response to fetal distress due to uterine rupture, which in turn would allow more rapid delivery and ressuscitation of the neonate. We did not have information on the structure of the services at each unit over the period of study. Howevever the factors are LIKELY TO CORRELATE ...being interdependent..."
Please read with care and ask yourself if there is enough evidence for this statement as the implications for VBAC and midwife-led care are being seriously challenged!
bw
marlene
-----Original Message-----
From: jenny hall <[log in to unmask]>
To: [log in to unmask]
Date: Wed, 3 Nov 2004 10:06:17 -0000
Subject: Re: Uterine rupture
You may have already got these Belinda- but here you are anyway!
Smith, Gordon C S professor 1; Pell, Jill P consultant 2; Pasupathy,
Dharmintra specialist registrar 3; Dobbie, Richard senior statistician 4
Factors predisposing to perinatal death related to uterine rupture
during attempted vaginal birth after caesarean section: retrospective
cohort study. BMJ. 329(7462):375-379, August 14, 2004.
Ofir, Keren BMS a; Sheiner, Eyal MD a,*; Levy, Amalia PhD b; Katz,
Miriam MD a; Mazor, Moshe MD a Uterine rupture: Differences between a
scarred and an unscarred uterus. American Journal of Obstetrics &
Gynecology. 191(2):425-429, August 2004.
Best wishes
Jen
Jennifer Hall
The Practising Midwife
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-----Original Message-----
From: A forum for discussion on midwifery and reproductive health
research. [mailto:[log in to unmask]] On Behalf Of
Belinda Cox
Sent: 30 October 2004 14:32
To: [log in to unmask]
Subject: Uterine rupture
Apologies for cross posting.
Dear all,
Does anyone have any info (with references) for maternal and neonatal
outcomes after uterine rupture? i.e. How many mothers died, had
hysterectomies etc, and how many infants died or had other consequences?
I need this urgently for my MSc dissertation!
Thanks in anticipation,
Belinda
Dr. Marlene Sinclair
Senior Lecturer in Midwifery
Course Director MSc Advanced Nursing and Midwifery
School of Nursing
University of Ulster
Jordanstown
BT37OQB
Tel 02890 366362
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