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Introduction: The aim of this study was to explore the impact of maternal death on maternity professionals, and their related professional and personal needs.Material and Methods: A qualitative study comprising semi-structured interviews in a UK inner-city academic maternity unit with over 5000 deliveries annually. Purposive sampling was utilized and semi-structured face-to-face interviews were performed with 14 healthcare professionals: four midwives, five doctors in training grades (trainees) and five consultant obstetricians. Identification of key themes was derived by textual analysis.Results: Five main themes were identified: professional culture, organizational culture and external expectation; personal blame and debriefing; professional training; shaping the training; support and counseling. Maternal death has a major impact on professionals' feelings of grief, guilt and shame, which they are reluctant to talk about. Maternity professionals expressed a desire for training to prepare themselves to respond effectively in the event of maternal death. There was ambiguity about "debriefing" within a changing institutional culture.Conclusions: Maternal death is a devastating consequence of pregnancy. If these findings are replicated by interviewing a greater number and breadth of maternity professionals, then healthcare institutions need to develop appropriate training to prepare and help staff, which should improve the support they can give to the bereaved and to each other. [ABSTRACT FROM AUTHOR]

The article presents a study which assesses risk factors and outcome of different grades of obstetric anal sphincter injuries (OASIS) after primary repair in Surrey, England. A total of 531 women who sustained OASIS were the subject of the study. Findings of the study stress the importance in identifying the full extent of injury at delivery in women who sustain OASIS and the significance in paying particular attention to repair of internal anal sphincter (IAS).

The article presents a study on the association between crown-rump length (CRL) discrepancy and fetal loss, chorionicity, and birth-weight discordance in 507 twin pregnancies in England. The study used Mann-Whitney U-test, chi-square test, and Kolmogorov test to calculate and analyze CL discrepancy and birth-weight differences and discordance. Results show that fetal loss is prevalent among monochorionic twins while birth weight problem is related to dichorionic twins with CRL discrepancy.

Objective To describe recent trends in prevalence, outcomes and indicators of care for women with pre-existing type I or type II diabetes. Design Regional population-based survey. Setting All maternity units in the North of England. Population A total of 1258 pregnancies in women with pre-existing diabetes delivered between 1996 and 2004. Methods Data from the Northern Diabetic Pregnancy Survey. Outcome of pregnancy cross-validated with the Northern Congenital Abnormality Survey and the Northern Perinatal Mortality Survey. Main outcome measures Perinatal mortality, congenital anomaly and total adverse perinatal outcome (perinatal mortality and live births with congenital anomaly). Results The prevalence of pregestational diabetes increased from 3.1 per 1000 births in 1996–98 to 4.7 per 1000 in 2002–04 (test for linear trend, P < 0.0001), driven mainly by a sharp increase in type II diabetes. Perinatal mortality declined from 48 per 1000 births in 1996–98 to 23 per 1000 in 2002–04 ( P = 0.064). There was a significant reduction in total adverse perinatal outcome rate ( P = 0.0194) from 142 per 1000 in 1996–98 to 86 per 1000 in 2002–04. There were substantial improvements in indicators of care before and during pregnancy and in glycaemic control throughout pregnancy, but indicators of preconceptual care, such as use of folic acid, remained disappointing. Conclusion We observed improvements in pregnancy care and outcomes for women with diabetes in a region with an established audit and feedback cycle. There remains considerable scope for further improvement, particularly in periconceptual glycaemic control. The rising prevalence of type II diabetes presents a challenge to further improvement. [ABSTRACT FROM AUTHOR]

Discusses abstracts of research studies on fetal medicine which were presented during the fifth annual conference of the British Maternal and Fetal Medicine Society in London, England on March 30-31, 2001. Improved early prediction of preterm pre-eclampsia; Platelet activation in the hypertensive disorders of pregnancy; Role of lipid peroxidation in the pathogenesis and evolution of severe pre-eclampsia.

Discusses abstracts of research studies on pregnancy outcomes which were presented during the fifth annual conference of the British Maternal and Fetal Medicine Society in London, England on March 30-31, 2000. Importance of diagnostic studies that reveal the cause of fetal and neonatal death; Outcome of pregnancies complicated by hydramnios in the absence of antenatally diagnosed fetal anomaly.

Lists titles of research studies which were presented during the fifth annual conference of the British Maternal and Fetal Medicine Society in London, England on March 30-31, 2000. Research on fetal medicine; Research on maternal medicine; Research on labor and delivery; Research on pregnancy outcome.

The article reports on an early diagnosis of a complete hydatidiform mole in a twin pregnancy with a viable fetus by researchers from Worthing, England. The incidence of complete or partial hydatidiform moles is 1 per 714 live births in Great Britain. However, the incidence of a hydatidiform mole co-existing with a viable fetus is a much rarer event. The plausibility for a first trimester diagnosis of gestational trophoblastic neoplasia in a twin pregnancy is very rare, even with improved imaging. Researchers recommend referral to national centers for a successful management.

Discusses abstracts of research studies on maternal medicine which were presented during the fifth annual conference of the British Maternal and Fetal Medicine Society in London, England on March 30-31, 2000. Fetal cystoscopy in the management of fetal obstructive uropathy; Outcome of prenatally diagnosed hypoplastic left heart syndrome; Doppler detection of arterio-arterial anastomoses in monochorionic twins.

Discusses abstracts of research studies on maternal labor and childbirth which were presented during the fifth annual conference of the British Maternal and Fetal Medicine Society in London, England on March 30-31, 2000. Association between fetal carriage of tumor necrosis factor[sup *]2 allele with premature membrane rupture: Progesterone withdrawal due to an activation of the nuclear factor kappa B in maternal labor.

The article offers a profile of Stanley Clayton, focusing on his career in obstetrics and gynaecology. He was born on September 13, 1911 and had obtained his medical training at King's College Hospital in England, where he later became a professor of obstetrics and gynaecology until his retirement. It discusses Clayton's achievements, the scientific papers he published, and his tenure as Editor-in-Chief of the "Journal of Obstetrics and Gynaecology of the British Commonwealth" for 10 years.

The article studies unusual rectal trauma due to compound fetal presentation by researchers from London, England. The incidence of failure of midtrimester termination due to extrusion of the fetus into the lower pole of the uterus is very rare. Differential diagnosis for failure of termination includes uterine rupture, anatomical anomalies or extrauterine pregnancy.

Discusses abstracts of research studies on pregnancy outcomes which were presented during the fifth annual conference of the British Maternal and Fetal Medicine Society in London, England on March 30-31, 2000. Link between intrapartum fever and neonatal encephalopathy; Splanchnic circulation in perinatal sepsis; Impact of tumor necrosis factor-alpha-308 polymorphism on neonatal lung disease.