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Gynaecology Unit (gynaecology + unit)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Pregnancy testing prior to sterilisation

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2000
Asha Kasliwal Specialist Registrar
Objective To determine the incidence of positive pregnancy test on the day of laparoscopic sterilisation. Design Prospective longitudinal observational study. Setting Gynaecology unit in a UK teaching hospital. Sample Between 1 January 1997 and 31 December 1998, eight hundred and two consecutive women were admitted for laparoscopic sterilisation after assessment in the gynaecology clinic. On the day of planned surgery, all women had a pregnancy test performed on a urine sample taken that morning following overnight fasting, immediately prior to operation. Main outcome measures A positive pregnancy test on the day of planned surgery. Results Of 802 women tested, 21 (2.6%) were pregnant. A careful medical history taken before surgery revealed evidence of amenorrhoea and menstrual irregularity in 17 of the pregnant women. Of the 21 pregnant women, 11 underwent termination of pregnancy, six continued the pregnancy, four had a miscarriage and one had an ectopic pregnancy. Conclusion The routine practice of pregnancy testing on the day of laparoscopic sterilisation introduced in our hospital should continue to be part of a thorough clinical assessment before surgery. This may help to reduce the considerable level of existing litigation in a high risk area of gynaecological practice. [source]

Investigating factors associated with nurses' attitudes towards perinatal bereavement care: a study in Shandong and Hong Kong

JOURNAL OF CLINICAL NURSING, Issue 16 2009
Moon Fai Chan
Aims., To explore nurses' attitudes towards perinatal bereavement care and to identify factors associated with these attitudes. Background., It is likely that the attitude of nursing staff can influence recovery from a pregnancy loss and that nurses with positive attitudes to bereavement care can help bereaved parents to cope during their grieving period. Design., Survey. Method., Data were collected through a structured questionnaire; 657 nurses were recruited from Obstetrics and Gynaecology units in Hong Kong and Shandong during 2006. Outcome measures included attitudes towards perinatal bereavement care, importance of hospital policy and training support for bereavement care. Results., The majority of nurses in this study had a positive attitude to bereavement care. Results show that only 21·6% (n = 141) of the nurses surveyed had bereavement-related training. In contrast, about 89·8% (n = 300) believed they needed to be equipped with relevant knowledge, skills and understanding in the care and support of bereaved parents and more than 88·5% (n = 592) would share their experiences with their colleagues and seek support when feeling under stress. A regression model showed that age, past experience in handling grieving parents, recent ranking and nurses' perceived attitudes to hospital policy and training provided for bereavement care were the factors associated with nurses' attitudes to perinatal bereavement care. Conclusions., Nurses in both cities emphasised their need for increased knowledge and experience, improved communication skills and greater support from team members and the hospital for perinatal bereavement care. Relevance to clinical practice., These findings may be used by nursing educators to educate their students on issues related to delivery of sensitive bereavement care in perinatal settings and to enhance nursing school curricula. [source]

A randomised controlled trial of a tailored multifaceted strategy to promote implementation of a clinical guideline on induced abortion care

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2004
R. Foy
Objective To evaluate the effectiveness and efficiency of a tailored multifaceted strategy, delivered by a national clinical effectiveness programme, to implement a guideline on induced abortion. Design Cluster randomised controlled trial. Setting and participants All 26 hospital gynaecology units in Scotland providing induced abortion care. Intervention Following the identification of barriers to guideline implementation, intervention units received a package comprising audit and feedback, unit educational meetings, dissemination of structured case records and promotion of a patient information booklet. Control units received printed guideline summaries alone. Main outcome measures Compliance with five key guideline recommendations (primary outcomes) and compliance with other recommendations, patient satisfaction and costs of the implementation strategy (secondary outcomes). Results No effect was observed for any key recommendation: appointment with a gynaecologist within five days of referral (odds ratio 0.89; 95% confidence interval 0.50 to 1.58); ascertainment of cervical cytology history (0.93; 0.36 to 2.40); antibiotic prophylaxis or screening for lower genital tract infection (1.70; 0.71 to 5.99); use of misoprostol as an alternative to gemeprost (1.00; 0.27 to 1.77); and offer of contraceptive supplies at discharge (1.11; 0.48 to 2.53). Median pre-intervention compliance was near optimal for antibiotic prophylaxis and misoprostol use. No intervention benefit was observed for any secondary outcome. The intervention costs an average of £2607 per gynaecology unit. Conclusions The tailored multifaceted strategy was ineffective. This was possibly attributable to high pre-intervention compliance and the limited impact of the strategy on factors outside the perceived control of clinical staff. [source]

The impact of an assisted conception unit on the workload of a general gynaecology unit

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2002
Joanne McManus
The burden placed on a hospital by the presence of an assisted conception unit has been emphasised only in terms of its impact on neonatal services. This paper examines the previously neglected subject of the gynaecological workload generated by a tertiary fertility centre that provides treatments by assisted conception. As many IVF units operate independently this additional workload may not be appreciated. It has, however, significant practical and financial implications for neighbouring hospitals and trusts. This is of particular relevance in view of the move towards more uniform health service funding of assisted conception throughout the United Kingdom. [source]