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Showing results for tags 'Obstetrics and gynaecology/ Maternity'.
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Content ArticleWhat health condition affects some 200 million people around the world, yet remains woefully misunderstood, underfunded, and barely addressed in medical-school curricula? Endometriosis is a disease that the World Health Organization estimates affects 1 in 10 women and girls globally. And yet the National Institute of Health allocates a whopping 0.038% of its research resources to the disorder. Endometriosis, which involves tissue similar to uterine tissue growing elsewhere in the body, has myriad symptoms, including GI distress, migraines, discomfort during sex and abdominal pain that can range from debilitating to excruciating. Countless women miss days of school and work, lose their jobs, and suffer depression as a result of the illness. Experts say endometriosis could be the underlying cause of 50% of infertility cases. L Despite efforts to raise awareness, it persists as an underground topic, and many doctors are ill equipped to help those afflicted or don’t even believe their patients. “It’s a perfect storm of undervaluing women and women’s health, inequities in health care, menstrual taboo, gender bias, racial bias, and financial barriers to healthcare,” said Shannon Cohn, the director of Below the Belt: The Last Health Taboo, a searing one-hour documentary set to premiere on PBS.
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Content Article
Symptoms of group B Strep infection in babies
Patient_Safety_Learning posted an article in Maternity
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In the UK, up to two-thirds of GBS infection in babies are of early onset (showing within the first 6 days of life). Read more about the symptoms and download an awareness poster via the link below to the Group B Strep Support website. -
Content ArticleDelays in the detection or treatment of postpartum haemorrhage can result in complications or death. A blood-collection drape can help provide objective, accurate, and early diagnosis of postpartum haemorrhage, and delayed or inconsistent use of effective interventions may be able to be addressed by a treatment bundle. Authors of this study, published in the New England Journal of Medicine, conducted an international, cluster-randomized trial to assess a multicomponent clinical intervention for postpartum haemorrhage in patients having vaginal delivery. The intervention included a calibrated blood-collection drape for early detection of postpartum haemorrhage and a bundle of first-response treatments (uterine massage, oxytocic drugs, tranexamic acid, intravenous fluids, examination, and escalation), supported by an implementation strategy (intervention group).
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Content ArticlePostpartum haemorrhage is a leading cause of maternal deaths. Now a new study points to a surprisingly simple and inexpensive solution. If the woman lies on a plastic sheet with a small transparent pouch at the other end to collect the blood, the medical team has an immediate sense of how much danger she's in and can take swift action. Read the full article, published by NPR, via the link below.
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Content ArticleNew research showed how a national quality improvement programme called PReCePT (Preventing Cerebral Palsy in Pre Term labour) accelerated maternity units’ use of Magnesium sulphate for pre-term labour. The programme could serve as a blueprint for future efforts to get clinical guidelines into practice in other areas of care. The quality improvement programme involved training staff on the benefits of magnesium sulphate, and having a local midwife dedicated to encouraging and monitoring use of the medicine at their maternity unit. The programme was supported by Academic Health Science Networks (a regional and national organisation that encourages improvement and innovation in healthcare). This article from the National Institute for Health and Care Research provides a plain English summary and short film about the project.
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Content ArticleThis is a plain English summary from the National Institute for Health and Care Research (NIHR). Many women who have an assisted vaginal birth (using forceps or a vacuum cup) develop infections. A previous study showed that a single dose of preventive antibiotics protected women; this research led to a change in UK and WHO guidelines. However, most women in the study had an episiotomy (surgical cut), so it was unclear if antibiotics also protected those with a tear of the perineum (the area between vagina and anus). To address this uncertainty, researchers re-analysed the ANODE study data. They found that preventive antibiotics reduced infections after an assisted vaginal birth, irrespective of whether women had a perineal tear, an episiotomy, or both. Read the article in full and access the research via the link below.
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Content ArticleThis report was prepared by the Endometriosis Task and Finish Group and submitted to the Welsh Government on 16 April 2018. Authors propose a robust care pathway based on NICE guidance using a life course approach to ensure that symptoms are recognised and responded to promptly and appropriately, as they emerge.
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Content ArticleThe Women's Health Strategy for England was developed and published in 2022 in response to the growing recognition of the unique health needs and challenges faced by women in England (and the U.K.) and was brought forward to address longstanding gaps in women's healthcare and to promote better health outcomes for women across the country. This Forbes article looks at why women’s health should be included in every government’s agenda. The author speaks to Professor Dame Lesley Regan, Women's Health Ambassador for England about the progress of the strategy and Dr. Ranee Thakar, President of the Royal College of Obstetricians and Gynaecologists about the need to ensure underrepresented groups are included in the strategy.
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Content ArticlePublished in BMC Health Services Research, this is the first review to theorise how open disclosure (OD) works, for whom, in what circumstances, and why. Authors identify and examine from the secondary data the five key mechanisms for successful OD and the three contextual factors that influence this. The next study stage will use interview and ethnographic data to test, deepen, or overturn their five hypothesised programme theories to explain what is required to strengthen OD in maternity services.
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Content ArticleIn this blog Paul Whiteing, Chief Executive of AvMA, reflects on the recent report by the House of Commons Women and Equalities Committee on Black maternal health. Paul questions why these racial health disparities, that have long been reported on, have been allowed to continue over many decades and highlights the need for more challenging conversations as to wider root causes.
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Content Article
Aortic Dissection is a catastrophic tear in the main artery carrying blood from the heart to the brain, limbs and vital organs. In this webinar, hosted by THINK AORTA, Dr Stephanie Curtis presents on aortic dissection in pregnancy. We also hear from Haleema Saadia, survivor of an aortic dissection, awareness campaigner and Vice-Chair of the National Patient Association for Aortic Dissection. -
News Article
I travelled to the US and paid £19,000 to have mesh implant removed
Patient Safety Learning posted a news article in News
Anne Monie is one of hundreds of Scottish women to have suffered painful, life-changing side effects from mesh implants. She was fit and healthy when she went to her doctor with anterior prolapse and mild stress incontinence in 2010. But an operation to fit transvaginal mesh left her in agony. With nowhere to turn for help in Scotland, the 69-year-old spent £19,000 travelling to the US to get her implant removed. Anne spoke to BBC Scotland as the Scottish Parliament looks set to pass a bill which would see her and others reimbursed for the cost of private surgery. That may bring financial concerns to an end - but she is by no means cured. And she worries about other women still trying to go through the mesh-removal process. Anne was offered a simple "gold standard" transvaginal mesh procedure when she first sought medical help 12 years ago. But after the operation to fit it, she began to suffer from a range of problems and was left in chronic pain. After years of frustration, she paid to go to Missouri to have mesh removal surgery with world-renowned expert Dr Dionysios Veronikis. "It's a massive amount of money to be paying out, especially when you're retired. But then, what price do you put on health?" Read full story Source: The Guardian, 25 January 2022 -
News Article
Cervical cancer: New screenings will save lives, says top doctor
Patient Safety Learning posted a news article in News
Changes in cervical cancer screenings will help save lives, not put them at risk, according to a top gynaecologist. Prof Alison Fiander said people should not be worried screenings have dropped from every three to every five years in Wales as tests are "more effective". Public Health Wales (PHW) said the new rules were for people aged 25 to 49. More than 1.2 million people backed calls for a rethink in a UK petition and politicians in Wales will debate it after 30,000 signed a Senedd petition. Women and people with a cervix - as it could also affect trans men too - who had not tested positive for human papillomavirus (HPV) will now wait two more years between tests. Health chiefs in Wales said they changed the interval between screenings to the same time as those in Scotland because tests are now more accurate. Cervical screening gaps in England and Northern Ireland remain at three years. But Wales' public health body did publicly apologise for causing "concern", and admitted health chiefs "hadn't done enough to explain the changes". Prof Fiander, a clinical lead at the Royal College of Obstetricians and Gynaecologists, said PHW had "missed an opportunity" to help educate people but reassured the public the change was safe and not a cost-cutting exercise. Read full story Source: BBC News, 18 January 2022 -
News Article
Urgent debate over cervical cancer screenings
Patient Safety Learning posted a news article in News
An urgent debate has been called in the Senedd over a move to extend routine cervical screenings in Wales from every three years to five years. Public Health Wales (PHW) said those aged 25-49 who had not tested positive for human papillomavirus (HPV) would now wait two more years between tests. PHW said it was because the screening tests are now more accurate. However, 30,000 people signed a petition against it, citing the risk it could cause an increase in deaths. Particularly concerned are those who have not received the HPV vaccine, a national immunisation programme for which began in 2008 for girls aged 12 to 13. The number of signatures on the official petition on the Welsh Parliament's website was more than enough to trigger the issue to be looked at. The change follows a recommendation from the UK National Screening Committee. Last week, Public Health Wales apologised for causing "concern" over how it explained changes to screenings following its announcement. Read full story Source: BBC News, 10 January 2022 -
News Article
Ministers pledge to ‘reset the dial’ on women’s health in England
Patient Safety Learning posted a news article in News
Ministers have pledged to “reset the dial” on women’s health to tackle decades of gender inequality in England, with plans to appoint a women’s health tsar, eradicate medical taboos, boost menopause support and ban harmful “virginity repair” operations. The Department of Health and Social Care has published its Vision for Women’s Health strategy after 100,000 women came forward to share their healthcare concerns. Maria Caulfield, the minister for women’s health, described some of their experiences as “shocking”. The vision document sets out initial government commitments on women’s health, recognising that “systemwide changes” are needed to tackle “decades of gender health inequality”. The final plan – the Women’s Health Strategy – will be published in spring 2022. On Wednesday night, ministers pledged to introduce legislation criminalising hymenoplasty or any procedure to rebuild or repair the hymen. Such surgery creates scar tissue so that a woman will bleed the next time she has intercourse, making it appear she has never had sex. Young women can be forced to prove they are “pure” on their wedding night. Doctors have called for a ban on the surgery for years, saying it can never be justified on health grounds and is harmful. Separately, the government will appoint a women’s health ambassador to raise the profile of key issues and boost awareness of taboo topics. Ministers will also establish a UK-wide menopause taskforce to investigate how women going through the menopause can be better supported. The cost of hormone replacement therapy (HRT) prescriptions will also be cut by implementing longer prescribing cycles so women will need fewer prescriptions and therefore pay less. The consultation provided “stark and sobering insights” into women’s experiences of health and care and highlighted entrenched problems within the NHS, officials said. Ministers are also considering compulsory training for GPs on women’s health after the idea was raised by women who came forward. The vision document said: “We also heard about a lack of awareness amongst some GPs of the causes of infertility, miscarriages and their relationship with infertility, and the reasons for in vitro fertilisation (IVF) failure.” Read full story Source: The Guardian, 22 December 2021 Related reading Gender bias: A threat to women’s health (August 2020) Dangerous exclusions: The risk to patient safety of sex and gender bias Patient Safety Learning: Women’s Health Strategy Consultation Response -
News Article
Mesh implant patients challenge government over surgery delays
Patient Safety Learning posted a news article in News
Women requiring the surgical removal of mesh implants have said "very little" has happened since a landmark Scottish government announcement in the summer. The pledge means patients can now receive free treatment from specialists in America and England. But campaigners said initial assessments in Glasgow were taking up to two years. The Scottish government said it was working with NHS Specialist Services to improve waiting times. Implant use was stopped in Scotland after hundreds of women were left with painful, life-changing side effects. In July, the Scottish government announced surgery and travel costs to Spire Health Care in Bristol and the Mercy Hospital in Missouri in the United States would be covered. The cost of each procedure is estimated to be £16,000 to £23,000. Marian Kenny, who is waiting on surgery to remove a mesh implant. joined the protest outside the New Victoria Hospital and admitted she felt "deflated" by the lack of progress in recent months. She told BBC Scotland: "For so much of this fight, we have been fighting to get it stopped and this is the only time we have been fighting for ourselves. We don't want to be guinea pigs any more." Health Secretary Humza Yousaf acknowledged the pain, suffering and distress mesh survivors have been through. He said he hoped to finalise contracts with the clinics in Bristol and Missouri "as quickly as we possibly can". Mr Yousaf added: "I would hope to have an update relatively soon. "I know they have been waiting too long and I promise them I don't want them to be waiting any longer than they have to." Read full story Source: BBC News, 24 November 2021 -
News Article"What has happened to us is home-grown, institutionalised female genital mutilation," says Mary Lodato, 63, a mother of three and a university researcher, from Kettering in Northamptonshire. "It has been a systemic failure in health and care and it was totally avoidable." What Mary is referring to are complications due to implanted surgical mesh, designed to treat post-childbirth pelvic damage in women, which has left thousands effectively crippled as the material disintegrated inside their bodies, and sheared into the tissue, causing a range of devastating symptoms including pain, difficulty walking and sexual dysfunction. An eight-year Good Health campaign to get official recognition of the problem led to the establishment of a government inquiry under the leadership of former Conservative health minister Baroness Julia Cumberlege. Although the inquiry report was published in July 2020, some of its key recommendations have still not been implemented, leaving thousands of women suffering and not getting the help they need. Seven specialist NHS mesh removal clinics were meant to open in April this year in London, Cambridge, Manchester, Newcastle, Nottingham, Sheffield and Leicester. But the affected women claim a shortage of specialists has meant that only two are functioning — at University College London Hospital and Southmead Hospital in Bristol (which was not on the original list). They also say that it's extremely difficult to get a referral to one of these new centres and even if they do, waiting times can stretch into years. "To the doctors who originally treated us, these operations weren't anything major — but to us it was a catastrophically painful loss of work, family life and intimacy," says Mary. Mary's story is one familiar to almost 10,000 women who have joined an anti-mesh group called Sling the Mesh, and a number of other support organisations. Read full story Source: Mail Online, 1 November 2021 Blogs from Kath Sansom, Sling the Mesh Regulatory flaws: Women were catastrophically failed in the mesh, Primodos and Sodium Valproate tragedies Ineffective medical device recalls are a patient safety scandal
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News Article
Royal Derby Hospital: Gynaecologist investigation affects 382 women
Patient Safety Learning posted a news article in News
The number of women involved in an investigation into a consultant gynaecologist who "unnecessarily harmed" patients has risen to 382. University Hospitals of Derby and Burton NHS Foundation Trust has written to another 110 women who were treated by Daniel Hay. Mr Hay is under investigation after eight women treated by him were found to have been "unnecessarily harmed". The latest women have been told there are "no concerns" for their health. Staff at the Royal Derby Hospital raised concerns about the consultant's care in late 2018. An initial review of 58 cases involving Mr Hay identified the eight lapses of care for which he and the trust have apologised. A broader investigation was launched and another 135 women, who had undergone surgery, were contacted to say their care was being reviewed. In September the trust wrote to a further 79 women who had received intermediate care. It has now said 110 more women, all outpatients at Ripley Hospital between April 2017 and July 2018, have now been contacted. Dr Magnus Harrison, executive medical director, said: "We have widened the review to a specific outpatient clinic... to understand the care being provided there. We are doing this proactively, rather than in response to any specific concerns, so that the review is as thorough as possible." "Each of the women have been informed that there are no concerns regarding their current health." Read full story Source: BBC News, 11 December 2020 -
News Article
Essure: Women in England take legal action against sterilising-device maker
Patient Safety Learning posted a news article in News
Lawyers have begun legal action on behalf of 200 UK women against the makers of a sterilisation device, after claims of illness and pain. The device, a small coil called Essure, was implanted to prevent pregnancies. Manufacturer Bayer has already set aside more than $1.6bn (£1.2bn) to settle claims from almost 40,000 women in the US. It has withdrawn the device from the market for commercial reasons but says it stands by its safety and efficacy. The metal coil was inserted into the fallopian tube to cause scarring, blocking the tube and preventing pregnancy. Introduced in 2002, it was promoted as an easy, non-surgical procedure - a new era in sterilisation. But many women who had the device fitted have now either had hysterectomies or are waiting for procedures to remove the device. Tracey Pitcher, who lives in Hampshire, felt she had completed her family and did not want any more children. Her doctor strongly encouraged her to have an Essure device fitted, she says. But after it had been, she began to feel very unwell. "I just started to have heavy periods, migraines, which I had only ever had when I was pregnant so they were hormonal," she says. "My back was so painful I'd wake up crying in the middle of the night with pains in my hips and my back." Tracey says she battled to persuade doctors to take her symptoms seriously. But the only information she received was from a Facebook group. "... there's nobody there, there's no support apart from people that we've found ourselves, no-one will listen, because it's just 'women's things'." Read full story Source: BBC News, 15 November 2020 -
News Article
Trusts offering controversial trauma ‘treatment’ to new mums
Patient Safety Learning posted a news article in News
Several NHS trusts are offering a ‘treatment’ for birth trauma which uses a technique which lies outside national guidelines and which is criticised by specialists as potentially causing ‘more harm than good’. The ‘Rewind’ technique is promoted as a fast treatment for post-natal post-traumatic stress disorder (PTSD) – also known as birth trauma - which involves the “reprocessing” of painful memories. HSJ has learned of several trusts, including East and North Herts Trust, Chelsea and Westminster Hospital Foundation Trust and James Paget University Hospital FT, where the therapy is being offered. It is thought there are other trusts which are providing it or have explored it. Typically, it is provided by midwives who have undergone training in the technique. But Nick Grey, a clinical psychologist who was on the National Institute for Health and Care Excellence panel which looked at PTSD, said it was “absolutely clear cut” that it was bad practice to offer the technique as a branded therapy for PTSD, although he said it could be embedded as part of other treatments. He told HSJ: “It should not be offered to mothers with PTSD… they are being done a disservice if they are not given evidence-based treatment. There is no evidence that this [provides] treatment for sub-clinical PTSD or trauma,” he said. Read full story (paywalled) Source: HSJ, 11 November 2020 -
News ArticleIn ‘Invisible Women: Exposing Data Bias in a World Designed For Men’ author Caroline Criado Perez writes about Rachael, a woman who suffered years of severe and incapacitating pain during her period. It takes, on average, eight years for women in the UK to obtain a diagnoses of endometriosis. In fact, for over a decade, there has been no improvement in diagnostic times for women living with the debilitating condition. You might think, given the difficulty so many women experience in having their symptoms translated into a diagnosis, that endometriosis is a rare condition that doctors perhaps don’t encounter all that often. Yet it is something that affects one in ten women – so what is going wrong? Read the full article here in The Scotsman
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News Article
Endometriosis care needs urgent improvement, MPs say
Patient Safety Learning posted a news article in News
Endometriosis care across the UK needs urgent improvement and diagnosis times need to be cut in half, a report by MPs says. It found an average wait for a diagnosis was eight years and that has not improved in more than a decade. Endometriosis affects one in 10 women in the UK and causes debilitating pain, very heavy periods and infertility. Nadine Dorries, minister for women's health, said awareness was increasing but there was still a long way to go. More than 10,000 people took part in the All-Party Political Group inquiry which found that 58% of people visited the GP more than 10 times before diagnosis and 53% went to A&E with symptoms before diagnosis. The majority of people also told MPs their mental health, education and careers had been damaged by the condition. About 90% said they would have liked access to psychological support but were never offered it, with 35% having a reduced income due to endometriosis. Helen-Marie Brewster, 28, from Hull, has been told by doctors that her only remaining treatment option is a full hysterectomy. She had symptoms throughout secondary school but was only diagnosed when she left education. "GPs ask me to explain to them what endometriosis is, because they don't know. They're the ones who are meant to help." "Last year I visited the A&E department 17 times trying to find help and pain relief for this condition, even for just a few days so I can keep going. The wait time for diagnosis is so long that in that time it's spreading and doing more damage the longer it is left untreated... We can't carry on like this." Read full story Source: BBC News, 19 October 2020 Read press release -
News Article
Consultant who carried out unauthorised research loses challenge over dismissal
Patient Safety Learning posted a news article in News
A consultant at St Luke’s Hospital in Kilkenny who carried out unauthorised research on five female patients during routine gynaecological procedures has failed in a High Court challenge to prevent his dismissal by the HSE. Consultant gynaecologist Ray O’Sullivan claimed a decision by the HSE’s chief executive, Paul Reid, on December 23rd, 2019 to recommend his dismissal was “fatally flawed” for reasons including a failure to allow him the opportunity to comment on an expert’s report into his professional performance. The hospital began an investigation after nursing staff expressed concern about the risk of infection from a procedure carried out on five patients on September 4th and 5th, 2018 under the direction of Prof O’Sullivan. A catheter and small pressure pad was placed, without their consent and without seeking approval from the hospital’s ethics committee, inside the vagina of five patients who were having a hysteroscopy. This was done as part of a feasibility study designed to see if certain procedures could be carried out without the use of a speculum (a device commonly used in vaginal exams) . The court heard the five patients, who were tested for infection including HIV, were greatly shocked and upset when St Luke’s informed them about what happened at open disclosure meetings. Read full story Source: The Irish Times, 27 April 2021 -
News Article
Miscarriage rates 'over 40% higher' in black women
Patient Safety Learning posted a news article in News
Black women face a significantly higher risk of having a miscarriage than white, research suggests. The Lancet analysis of data on 4.6 million pregnancies in seven countries suggests being black increases miscarriage risk by 43%. It calls for people in the UK to be given support after their first pregnancy loss. Currently, referral to specialist clinics usually occurs after three consecutive losses only. Most countries, including the UK, do not collect statistics, but researchers estimate: 15% of pregnancies end in loss 1% of women will experience recurrent miscarriage. Some estimates of miscarriage rate are higher, but this is due to differences in how countries define pregnancy loss, which can be from a positive pregnancy test or from a scan. The report also found that women who suffered miscarriage, from all ethnic backgrounds, are more vulnerable to long-term health problems, such as blood clots, heart disease and depression. Read full story Source: BBC News, 27 April 2021 -
News Article
Royal Derby Hospital: Women's care reviewed over gynaecology concerns
Patient Safety Learning posted a news article in News
Nearly 400 women who were treated by a consultant gynaecologist who "unnecessarily harmed" some patients are being invited to have their care reviewed by an independent expert. University Hospitals of Derby and Burton NHS Trust is writing to 383 patients treated by Daniel Hay. His conduct has been under investigation since 2019 after hospital colleagues raised concerns. The trust has said at least eight of his patients had been harmed. It has not provided any further information on the nature of the harm. Mr Hay worked at the Royal Derby Hospital and Ripley Hospital between 2015 and 2018. The trust initially reviewed his patients who had undergone major surgery such as hysterectomies, before being expanded to include intermediate care, including diagnostic tests. By December, 383 former patients had been included in the review. Now the trust has pledged to invite each one for a virtual meeting with an independent consultant gynaecologist to discuss their care outcome, starting with those who underwent major surgery. Read full story Source: BBC News, 22 April 2021
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