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Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage

Objectives
To evaluate the observer accuracy and intra-observer test–retest reliability of visual estimation of blood loss by midwives and obstetricians.

Observer accuracy and reproducibility of visual estimation of blood loss in obstetrics: how accurate and consistent are health-care professionals?

Aims
The aim of this study was to describe self-reported oral health, oral hygiene habits, frequency of visits to a dentist and factors associated with dental attendance among pregnant women at a North London Hospital, the majority of whom are immigrants.

Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London.

We evaluated in a prospective observational study the use of a 'uterine sandwich' technique (uterine compression sutures in association with intrauterine tamponade) in women who had had unsuccessful medical treatment for postpartum hemorrhage. Ten of the 11 patients had cesarean sections (complicated by placenta previa and uterine atony) and one had a normal delivery. The median estimated blood loss and units of blood transfused were 1500ml (range 750-4000ml) and two units (range 0-9), respectively. B-Lynch sutures were placed in two patients and Hayman's modification was used in nine. Bakri balloon tamponade was in place for a median of 22 hours (range 17-27 hours), while the median volume infused in the balloon was 300ml (range 150-350ml). The combined technique was successful in avoiding hysterectomy in all cases, and there was no documented postpartum morbidity. This is a simple and quick surgical technique that can be used to treat atonic postpartum hemorrhage, particularly in conjunction with placenta previa.

Application of uterine compression suture in association with intrauterine balloon tamponade (‘uterine sandwich’) for postpartum hemorrhage

We read with great interest the Special Editorial by Dr Thapa and co-authors on the importance of not neglecting emotions of pregnant women during the COVID-19 pandemic1 as maternal mental health can be associated with short and long term risks for their and their children's physical and psychological health. Most studies on COVID-19 in pregnancy have focused on physical effects of the pandemic on infected mothers as well as the possibility of vertical transmission: these tend to eclipse the equally relevant maternal mental health needs during these unprecedented times.

https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/aogs.13928

Wai Yoong

Papers

Peripartum hysterectomy in the UK: management and outcomes of the associated haemorrhage

Observer accuracy and reproducibility of visual estimation of blood loss in obstetrics: how accurate and consistent are health-care professionals?

Self-reported oral hygiene habits, dental attendance and attitudes to dentistry during pregnancy in a sample of immigrant women in North London.

Application of uterine compression suture in association with intrauterine balloon tamponade (‘uterine sandwich’) for postpartum hemorrhage

Anxiety and depression levels among pregnant women with COVID-19.