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Delivery Suite (delivery + suite)
Selected AbstractsRectal analgesia for the relief of perineal pain after childbirth: a randomised controlled trial of diclofenac suppositoriesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 10 2004Jodie M. Dodd Objective To evaluate rectal diclofenac in the relief of perineal pain after trauma during childbirth. Design A randomised, double-blind trial. Setting Delivery Suite, Women's and Children's Hospital, South Australia. Population Women with a second-degree (or greater) perineal tear or episiotomy. Methods Women were randomly allocated to either diclofenac or placebo suppositories (Anusol), using a computer-generated randomisation schedule with stratification for parity and mode of birth. Treatment packs contained two × 100 mg diclofenac or two placebo suppositories, the first being inserted when suturing was complete, and the second 12,24 hours after birth. Women were asked to complete questionnaires at 24 and 48 hours after birth relating to their degree of perineal pain using the validated Short Form McGill Pain Questionnaire. Main outcome measures Pain scores at 24 and 48 hours after birth. Results A total of 133 women were recruited, with 67 randomised to diclofenac suppositories and 66 to placebo. Women in the diclofenac group were significantly less likely to experience pain at 24 hours while walking (RR 0.8; 95% CI 0.6 to 1.0), sitting (RR 0.8; 95% CI 0.6 to 1.0), passing urine (RR 0.6; 95% CI 0.4 to 1.0) and on opening their bowels (RR 0.6; 95% CI 0.2 to 0.9) compared with those women who received placebo. These differences were not sustained 48 hours after birth. Conclusions The use of rectal non-steroidal anti-inflammatory drug suppositories is a simple, effective and safe method of reducing the pain experienced by women following perineal trauma within the first 24 hours after childbirth. [source] Doctors and doulas in the labor and delivery suiteACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2007K. M. Kuczkowski No abstract is available for this article. [source] Category-1 caesarean section: a survey of anaesthetic and peri-operative management in the UK,ANAESTHESIA, Issue 4 2010S. M. Kinsella Summary A national survey of anaesthetic and peri-operative management of category-1 caesarean section was sent to 245 consultant-led maternity units. There was a 70% response rate. The median (IQR [range]) general anaesthetic rate was 51% (29%,80% [6%,100%]), 12% (9%,16% [3%,93%]), 4% (2%,5% [<1%,18%]), for category-1 caesarean section, categories 1,3 (non-elective/emergency) and category-4 (elective) caesarean section, respectively. The main operating theatre for caesarean section is on the delivery suite in 151 (88%) units, and 112 (66%) units also have a second theatre in the same location. One hundred and thirty-nine (81%) use the standard urgency classification described in the NICE caesarean section guideline. However, only 72 (42%), 24 (14%), and 16 (9%) units comply with this guideline's recommended decision-delivery intervals for category-1 (, 30 min), category-2 (, 30 min) and category-3 (, 75 min) caesarean sections, respectively. Practice in the smaller units was similar to that in the larger units, although there was less availability of a dedicated anaesthetist, intra-uterine resuscitation guidelines and operating theatres on the delivery suite in the smaller units. [source] Medical and midwifery students: how do they view their respective roles on the labour ward?AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 4 2002Julie A Quinlivan ABSTRACT Background It has been suggested that much of the medical and midwifery student curricula on normal pregnancy and birth could be taught as a co-operative effort between obstetric and midwifery staff. One important element of a successful combined teaching strategy would involve a determination of the extent to which the students themselves identify common learning objectives. Aim The aim of the present study was to survey medical and midwifery students about how they perceived their respective learning roles on the delivery suite. Methods A descriptive cross-sectional survey study was undertaken. The study venue was an Australian teaching and tertiary referral hospital in obstetrics and gynaecology. Survey participants were medical students who had just completed a 10 week clinical attachment in obstetrics and gynaecology during the 5th year of a six year undergraduate medical curriculum and midwifery students undertaking a one year full-time (or two year part-time) postgraduate diploma in midwifery. Results Of 130 and 52 questionnaires distributed to medical and midwifery students, response rates of 72% and 52% were achieved respectively. The key finding was that students reported a lesser role for their professional colleagues than they identified for themselves. Some medical students lacked an understanding of the role of midwives as 8%, 10%, and 23% did not feel that student midwives should observe or perform a normal birth or neonatal assessment respectively. Of equal concern, 7%, 22%, 26% and 85% of student midwives did not identify a role for medical students to observe or perform a normal birth, neonatal assessment or provide advice on breastfeeding respectively. Summary Medical and midwifery students are placed in a competitive framework and some students may not understand the complementary role of their future colleagues. Interdisciplinary teaching may facilitate co-operation between the professions and improve working relationships. [source] A pilot study for a randomised controlled trial of waterbirth versus land birthBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2004Joanne Woodward Objectives To assess the feasibility of undertaking an adequately powered multicentre study comparing waterbirth with land birth. To assess whether women are willing to participate in such a trial and whether participation has a negative effect on their birthing experience. Design A randomised controlled trial (RCT) with ,preference arm'. Setting District general hospital with 3600 deliveries annually. Population Women with no pregnancy complications and no anticipated problems for labour/delivery. Methods Women were recruited and randomised between 36 and 40 weeks of gestation. Comparison of randomised and ,preference arm' to assess any impact of randomisation on women's birthing experience. Main outcome measures Data were collected at delivery concerning the labour, the pool water and baby's condition at birth and six weeks of age. The main outcome measures are means and standard deviation of cord O2, CO2, haemoglobin, haematocrit and base excess; medians and ranges of time to first breathe and cord pH; bacterial growth from pool water samples and neonatal swabs; and maternal satisfaction. Results Eighty women participated,60 women were randomised. Twenty women participated in a non-randomised ,preference arm'. The babies randomised to a waterbirth demonstrated a significantly lower umbilical artery pCO2 (P= 0.003); however, it is recognised that this study is underpowered. Women were willing to participate and randomisation did not appear to alter satisfaction. Conclusion This small study has shown that a RCT is feasible and demonstrated outcome measures, which can be successfully collected in an average delivery suite. [source] Fetal activin A: associations with labour, umbilical artery pH and neonatal outcomeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2004Stephen Tong Objective To define the ontogeny of umbilical artery activin A at term and to evaluate activin A as a potential marker of perinatal hypoxia. Design A cohort study. Setting A university teaching hospital delivery suite. Population A convenience sample of 141 term pregnancies. Methods At delivery, umbilical artery and vein bloods were collected for blood gas measurements and subsequent measurement of activin A. Activin A levels were correlated with blood gas measurements and with labour and neonatal outcomes. Main outcome measures Umbilical arterial activin A and pH. Results The median (95% CI) umbilical arterial activin A level at delivery was 1.38 (1.34,1.70) ng/mL. Levels varied significantly across gestation (P= 0.03), increasing from 36 to 38 weeks, thereafter decreasing to a nadir at 41 weeks. In 60 matched samples, the median (95% CI) venous and arterial activin A levels were 0.89 (0.81,1.06) ng/mL and 1.38 (1.21,1.61) ng/mL, respectively (P < 0.0001). Mean umbilical arterial pH was 7.20 (7.06,7.38; 5,95th centiles) and was not significantly correlated with log10 activin A (r=, 0.01; P= 0.68). Compared with healthy controls, there was no difference in arterial activin A in neonates identified as having suffered significant intrapartum asphyxia (P= 0.96). Fetal activin A levels were significantly lower in cases delivered by emergency caesarean section for complications during the first stage of labour compared with cases delivered vaginally (P= 0.003). Conclusions Umbilical artery activin A does not appear to be a sensitive marker of fetal oxygenation or of risk of hypoxic,ischaemic encephalopathy. [source] Working together: neonatal nurse practitioners in practiceACTA PAEDIATRICA, Issue 2 2002ME Redshaw The aim of this study was to examine the relatively new role of neonatal nurse practitioners (NNPs) in the United Kingdom, comparing practice in different types of neonatal units and work undertaken by junior medical staff (JMS). Diary checklists sent to the total population of qualified NNPs in neonatal units (NNUs) and JMS in six regional centres with qualified NNPs were returned from 68 out of 109 qualified NNPs (62%), working in 50 different NNUs and from 25 out of 48 JMS (52%). Direct observations (totalling 263.5 h) were made by an experienced neonatal nurse researcher on 30 different NNPs. Frequencies of activities and specific procedures were compared between groups. Observational measures included type and duration of activity and interactions with other members of staff. NNPs were found to be undertaking a range of activities: in the NNU, which usually involved blood sampling, siting of intravenous cannulae, presenting at ward rounds and teaching. Outside the unit, NNPs attended the delivery suite and the postnatal ward. Significant differences were found in the nature and organization of their work in different types of NNUs. A comparison between NNPs and JMS showed similar activities, with greater direct involvement by NNPs in the NNU and in teaching. The diary data were supported by observations and together these are evidence of current NNP practice. Conclusion: To a large extent there is an overlap in the work of JMS and NNPs in neonatal units, but although the clinical work and areas of activity are similar, there are differences in emphasis and in work organization. [source] Anti-infective measures and Entonox® equipment: a surveyANAESTHESIA, Issue 2 2000R. R. Bajekal We surveyed 102 maternity suites to investigate whether the guidelines of the Association of Anaesthetists of Great Britain and Ireland, for the use of anti-infective filters or fully disposable anaesthetic breathing systems for each patient, were being followed with regard to Entonox® equipment on labour wards. Of 100 units giving information (98%), only seven used filters and only two replaced tubing between cases. Our survey shows that the recommended policy is not being applied to Entonox apparatus in delivery suites. [source] Management of labour among women with epidural analgesiaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2003Christine L. Roberts Abstract To assess current practices in the labour management of low risk primiparous women with epidural analgesia we surveyed delivery suites in New South Wales (NSW) that annually provide at least 100 epidurals to ,standard primipara'. Epidural rates among ,standard primipara' at these hospitals ranged from 14 to 85% (median 46%). Continuous epidural infusion was the most commonly used technique (63%). For ,standard primipara' with an epidural 62% of units usually augmented labour with oxytocin, 89% discontinued the epidural in second stage and 67% had policies of delayed pushing. There is wide variation in epidural availability and in labour management, perhaps reflecting the limited evidence for effective interventions to reduce any unintended effects of epidural analgesia. [source] | ||||||||||||||||||||||