• Quality of care in the management of major obstetric haemorrhage.

      Johnson, S N; Khalid, S; Varadkar, S; Fleming, J; Fanning, R; Flynn, C M; Byrne, B; Coombe Women and Infant's University Hospital, Dolphin's Barn, Dublin 8. (2012-02-01)
      Substandard care is reported to occur in a large number of cases of major obstetric haemorrhage (MOH). A prospective audit was carried out by a multidisciplinary team at our hospital over a one year period to assess the quality of care (QOC) delivered to women experiencing MOH. MOH was defined according to criteria outlined in the Scottish Audit of Maternal Morbidity (SAMM). 31 cases were identified yielding an incidence of 3.5/1000 deliveries. The predominant causes were uterine atony 11 (35.4%), retained products of conception 6 (19.3%) and placenta praevia/accreta 6 (19.3%). Excellent initial resuscitation and monitoring was noted with a high level of senior staff input. Indicators of QOC compared favourably with the SAMM. Areas for improvement were identified. This pilot study demonstrates the feasibility of detailed prospective data collection in MOH in a busy Dublin obstetric unit with a view to developing a national audit. Standardization of definitions allows for international comparisons.
    • The thickness and volume of LLETZ specimens can predict the relative risk of pregnancy-related morbidity.

      Khalid, S; Dimitriou, E; Conroy, R; Paraskevaidis, E; Kyrgiou, M; Harrity, C; Arbyn, M; Prendiville, W; RCSI Department of Gynaecology, Coombe Women & Infants University Hospital, Dublin, Ireland. (2012-05)
      The aim of this study was to determine if the individual physical characteristics of the extirpated transformation zone after large loop excision of the transformation zone (LLETZ) might predict the relative risk of adverse obstetric outcome, specifically preterm labour (PTL).