The morbidly adherent placenta: diagnosis and management options.

Purpose Of Review: Randomized controlled trials and large cohort studies regarding the diagnosis and management of placenta accreta are lacking. This review examines the available evidence.

Recent Findings: Avoiding the placenta and leaving it attached at time of elective caesarean section to proceed with either delayed hysterectomy or conservative management is currently recommended.

Multidisciplinary obstetric simulated emergency scenarios (MOSES): promoting patient safety in obstetrics with teamwork-focused interprofessional simulations.

Introduction: We describe an example of simulation-based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined.

Methods: Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England.

Faking it? Simulation in the training of obstetricians and gynaecologists.

Purpose Of Review: This paper discusses the use of simulation as a training tool in obstetrics and gynaecology.

Recent Findings: Modern medical training and patient pressure for treatment by more experienced clinicians have contributed to a reduction in the training opportunities available to junior doctors. Advances in information technology have led to the successful introduction of simulator-based training in many safety-critical industries such as aviation and nuclear power.

Cardiac disease in pregnancy.

Congenital heart disease in pregnancy is increasingly common because of the advances in surgery and medical therapy which have taken place over the last 30 years, which means that more affected women are surviving into the reproductive age. Antenatal counselling needs to be tailored to the specific lesion, with pulmonary hypertension and cyanotic disease presenting a risk of maternal mortality of up to 50%. The use of anticoagulants in women with artificial valves presents a particular challenge, heparin being safer for the baby and warfarin for the mother.

Uterine rupture after a single vaginal 2 mg prostaglandin gel application in a primiparous woman.

We report a case of a primiparous woman who was induced for post-term pregnancy with 2mg intravaginal prostaglandin gel. She developed hyperstimulation and ruptured her uterus. The pathogenesis and treatment of hyperstimulation is discussed.