Each baby costs UK hospitals £1000 injury insurance
NHS maternity hospitals are paying out insurance premiums of almost £1000 for each baby they deliver to protect themselves and staff against the cost of medical negligence this Times article reports. Jeremy Hunt last month told a medical conference that 25 babies were injured during birth each week in NHS hospitals with 4-5 of those suffering lifelong brain damage.
Every year more than 50,000 women nearly die in childbirth in the US
50,000 women nearly die each year in the US during childbirth. Of those women that do die over half of the deaths could be prevented. In this video 3 mothers tell the stories of what happened to them.
Risk Factors for hospital readmission due to infection following caesarean section
A study presented at the American college of obstetricians and gynaecologists annual meeting highlighted hospital readmission due to infection following caesarean. Of 3805 women undergoing caesarean delivery, 30 women (0.8%) had readmission due to infection. This was associated with younger maternal age, higher BMI, operative time ≥60 min, and ruptured membrane. Abstract available here.
Second Stage Caesarean Section
Second Stage Caesarean Section (CS) occurs in around 2% of all births and recent data suggests that it is on the rise(1). There is irrefutable evidence that CS carried out at or near full dilation of the cervix leads to higher complications for the mother and her baby(2). All these complications are due to various degrees of difficulty encountered in the delivery of the engaged fetal head.
An assistant pushing from below is the most commonly used technique when difficulty is encountered during delivery at a CS. Other methods are described but these are difficult to perform and teach, often leading to other complications.
I also believe that the degree of difficulty encountered during the delivery of the head is not always possible to predict but is most likely to occur in advanced labour with a deeply engaged head or when an attempt at an instrumental delivery has been made. The cases discussed raise questions about the techniques that were used. A simple solution available to us is Fetal Pillow, an easy to use and effective device. The use of this device has been increasing since the recent publication of a RCT, Australia study and a case controlled study and provides a safer alternative to relying on manual techniques. Find out more here.
Dr R Varma
Consultant Obstetrician & Gynaecologist
About the author
Dr Varma is a consultant Obstetrician & Gynaecologist with 35 years’ experience in the field of O&G. He is the inventor of fetal pillow and a part time Medical Director of Safe Obstetric Systems. He is still in active clinical practice in the field of Urogynaecology.
- Unterscheider J, McMenamin M, Cullinane F. Rising rates of caesarean deliveries at full cervical dilatation: a concerning trend. Eur J Obstet Gynaecol Reprod Biol 2011;157:1414.
- Pergialiotis V, Vlachos, D G, Rodolakis A, Haidopoulos D, Thomakos N, Vlachos G D., First versus second stage C/S maternal and neonatal morbidity: a systematic review and meta-analysis, European Journal of Obstetrics & Gynecology and Reproductive Biology 175 (2014) 1524
- Danylyshyn-Adams K, Young E, Crnosija N. Time from Uterine incision to delivery in cesarean deliveries and associated neonatal outcomes. Proceedings of American College of Obstetricians & Gynaecology annual conference (221) May 2016.