The effects of obstetric emergency team training on patient outcome: A systematic review and meta-analysis.

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Abstract

Little is known about the optimal simulation-based team training in obstetric emergencies. We aimed to review how simulation-based team training affects patient outcomes in obstetric emergencies.

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Global causes of maternal death: a WHO systematic analysis.

Lale Say, Doris Chou, Alison Gemmill … (2014)

Data for the causes of maternal deaths are needed to inform policies to improve maternal health. We developed and analysed global, regional, and subregional estimates of the causes of maternal death during 2003-09, with a novel method, updating the previous WHO systematic review. We searched specialised and general bibliographic databases for articles published between between Jan 1, 2003, and Dec 31, 2012, for research data, with no language restrictions, and the WHO mortality database for vital registration data. On the basis of prespecified inclusion criteria, we analysed causes of maternal death from datasets. We aggregated country level estimates to report estimates of causes of death by Millennium Development Goal regions and worldwide, for main and subcauses of death categories with a Bayesian hierarchical model. We identified 23 eligible studies (published 2003-12). We included 417 datasets from 115 countries comprising 60 799 deaths in the analysis. About 73% (1 771 000 of 2 443 000) of all maternal deaths between 2003 and 2009 were due to direct obstetric causes and deaths due to indirect causes accounted for 27·5% (672 000, 95% UI 19·7-37·5) of all deaths. Haemorrhage accounted for 27·1% (661 000, 19·9-36·2), hypertensive disorders 14·0% (343 000, 11·1-17·4), and sepsis 10·7% (261 000, 5·9-18·6) of maternal deaths. The rest of deaths were due to abortion (7·9% [193 000], 4·7-13·2), embolism (3·2% [78 000], 1·8-5·5), and all other direct causes of death (9·6% [235 000], 6·5-14·3). Regional estimates varied substantially. Between 2003 and 2009, haemorrhage, hypertensive disorders, and sepsis were responsible for more than half of maternal deaths worldwide. More than a quarter of deaths were attributable to indirect causes. These analyses should inform the prioritisation of health policies, programmes, and funding to reduce maternal deaths at regional and global levels. Further efforts are needed to improve the availability and quality of data related to maternal mortality. © 2014 World Health Organization; licensee Elsevier. This is an Open Access article published without any waiver of WHO's privileges and immunities under international law, convention, or agreement. This article should not be reproduced for use in association with the promotion of commercial products, services, or any legal entity. There should be no suggestion that WHO endorses any specific organisation or products. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

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WHO analysis of causes of maternal death: a systematic review.

Khalid Khan, Daniel Wojdyla, Lale Say … (2006)

The reduction of maternal deaths is a key international development goal. Evidence-based health policies and programmes aiming to reduce maternal deaths need reliable and valid information. We undertook a systematic review to determine the distribution of causes of maternal deaths. We selected datasets using prespecified criteria, and recorded dataset characteristics, methodological features, and causes of maternal deaths. All analyses were restricted to datasets representative of populations. We analysed joint causes of maternal deaths from datasets reporting at least four major causes (haemorrhage, hypertensive disorders, sepsis, abortion, obstructed labour, ectopic pregnancy, embolism). We examined datasets reporting individual causes of death to investigate the heterogeneity due to methodological features and geographical region and the contribution of haemorrhage, hypertensive disorders, abortion, and sepsis as causes of maternal death at the country level. 34 datasets (35,197 maternal deaths) were included in the primary analysis. We recorded wide regional variation in the causes of maternal deaths. Haemorrhage was the leading cause of death in Africa (point estimate 33.9%, range 13.3-43.6; eight datasets, 4508 deaths) and in Asia (30.8%, 5.9-48.5; 11,16 089). In Latin America and the Caribbean, hypertensive disorders were responsible for the most deaths (25.7%, 7.9-52.4; ten, 11,777). Abortion deaths were the highest in Latin America and the Caribbean (12%), which can be as high as 30% of all deaths in some countries in this region. Deaths due to sepsis were higher in Africa (odds ratio 2.71), Asia (1.91), and Latin America and the Caribbean (2.06) than in developed countries. Haemorrhage and hypertensive disorders are major contributors to maternal deaths in developing countries. These data should inform evidence-based reproductive health-care policies and programmes at regional and national levels. Capacity-strengthening efforts to improve the quality of burden-of-disease studies will further validate future estimates.

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Appraising the quality of medical education research methods: the Medical Education Research Study Quality Instrument and the Newcastle-Ottawa Scale-Education.

David A. Cook, Darcy Reed (2015)

The Medical Education Research Study Quality Instrument (MERSQI) and the Newcastle-Ottawa Scale-Education (NOS-E) were developed to appraise methodological quality in medical education research. The study objective was to evaluate the interrater reliability, normative scores, and between-instrument correlation for these two instruments.

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Author and article information

Journal

Journal ID (iso-abbrev): Acta Obstet Gynecol Scand

Title: Acta obstetricia et gynecologica Scandinavica

Publisher: Wiley

ISSN (Electronic): 1600-0412

ISSN (Print): 0001-6349

Publication date (Electronic): Jan 2022

Volume: 101

Issue: 1

Affiliations

[1 ] Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.

[2 ] Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

[3 ] Research Center for Emergency Medicine, Aarhus University Hospital, Aarhus, Denmark.

[4 ] Department of Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

[5 ] Department of Medicine, Randers Regional Hospital, Randers, Denmark.

[6 ] Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.

[7 ] Department of Human Resources, Medical simulation in Central Denmark Region (MidtSim), Aarhus, Denmark.

[8 ] Department of Obstetrics and Gynecology, Randers Regional Hospital, Randers, Denmark.

Article

DOI: 10.1111/aogs.14263

PubMed ID: 34622945

SO-VID: 57bbc007-b0d2-4903-9ba8-bc970d7650f9

History

Keywords: delivery,systematic review,simulation training,brachial plexus,birth,emergency teams,obstetric,postpartum hemorrhage,shoulder dystocia

Data availability:

Keywords: delivery, systematic review, simulation training, brachial plexus, birth, emergency teams, obstetric, postpartum hemorrhage, shoulder dystocia

The effects of obstetric emergency team training on patient outcome: A systematic review and meta-analysis.

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Most cited references 61

Global causes of maternal death: a WHO systematic analysis.

WHO analysis of causes of maternal death: a systematic review.

Appraising the quality of medical education research methods: the Medical Education Research Study Quality Instrument and the Newcastle-Ottawa Scale-Education.

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