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Clinical Practice

Birth after previous caesarean section

Planned successful vaginal birth overall presents the fewest complications past 39 weeks' gestation with a single previous caesarean section and remains a suitable and clinically safe option for those...

Motivational interviewing to increase physical activity in women with gestational diabetes

Gestational diabetes mellitus (GDM) is defined as glucose intolerance first identified in pregnancy that resolves postpartum (Basri et al, 2018). It has an increasing prevalence worldwide and is...

A review of third stage of labour care guidance

Active management aims to accelerate delivery of the placenta to reduce blood loss. A prophylactic uterotonic drug (exogenous oxytocin) is given to accelerate the contractility of the uterus, to cause...

A clinical update on hypermobile Ehlers-Danlos syndrome during pregnancy, birth and beyond

For those with hEDS/HSD, pregnancy is generally well tolerated (Karthikeyan and Venkat-Raman, 2018; Volkov et al, 2018). Yet, in terms of getting pregnant, lower rates of fertility have been reported...

Use of ultrasound in the antenatal space

Obstetrician Ian Donald from Glasgow is credited to have designed and used the first practical ultrasound machine in clinical practice in 1958 (Campbell, 2013) (Figure 1). Since then, rapid progress...

Reflecting on why surgical swabs are being left behind and exploring how this could be prevented

In medical literature, retained surgical swabs are referred to as ‘gossypiboma’ (Williams et al, 1978; Zbar et al, 1998; Kiernan et al, 2008). The etymology for gossypiboma appears to derive from...

Digital health innovation to support sensitive enquiry about female genital mutilation

The ‘Let's talk FGM’ app was an MSA project. App development followed the phases and outputs of NHS Innovations South East (2014) as a project guide, namely: planning, developing app content, design...

Enigma of maternity service safety improvements and increasing expression of patient dissatisfaction

Substantial advances have occurred in the science of healthcare of mothers and babies over time. The NHS is said to have been one of the safest places in the world to have a baby; with stillbirths,...

Identifying adverse childhood experiences in maternity services

The aim of the project was to introduce into maternity services a screening tool for women and their partners at booking, in order to identify adverse childhood exper iences (ACEs) and improve...

Can augmentation with oxytocin be ‘too much, too soon’?

The World Health Organization (WHO, 2019a; 2019b) reported a 38% reduction in worldwide maternal mortality rate between 2000–2017 and a 50% reduction in the neonatal mortality rate between 1990–2018....

Skin-to-skin contact following caesarean section: a narrative review

Skin-to-skin contact (SSC), the deliberate placement of an infant on the bare chest of its mother, is commonly performed after normal vaginal delivery because of its numerous benefits (Moore et al,...

A service evaluation of a hospital-based specialist postnatal breastfeeding clinic

Breastfeeding is described as the gold standard of infant feeding and is beneficial to both infant and maternal health Breastfeeding protects infants against diarrhoea and respiratory infections,...

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