Video analysis of real-life shoulder dystocia to assess technical and non-technical performance.

Introduction: Managing obstetric shoulder dystocia requires swift action using correct maneuvers. However, knowledge of obstetric teams' performance during management of real-life shoulder dystocia is limited, and the impact of non-technical skills has not been adequately evaluated. We aimed to analyze videos of teams managing real-life shoulder dystocia to identify clinical challenges associated with correct management and particular non-technical skills correlated with high technical performance.

Team performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams.

Introduction: Vacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician's technical abilities (1-3). Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions.

Developing the TeamOBS-vacuum-assisted delivery checklist to assess clinical performance in a vacuum-assisted delivery: a Delphi study with initial validation.

Introduction: In Northern Europe, vacuum-assisted delivery (VAD) accounts for 6-15% of all deliveries; VAD is considered safe when conducted by adequately trained personnel. However, failed vacuum extraction can be harmful to both the mother and child. Therefore, the clinical performance in VAD must be assessed to guide learning, determine a performance benchmark, and evaluate the quality to achieve an overall high performance.

Healthcare providers' perceptions and expectations of video-assisted debriefing of real-life obstetrical emergencies: a qualitative study from Denmark.

Objectives: Video-assisted debriefing (VAD) of real-life obstetrical emergencies provides an opportunity to improve quality of care, but is rarely used in clinical practice. A barrier for implementation is the expected mental reservations among healthcare providers. The aim of this study was to explore healthcare providers' perceptions and expectations of VAD of real-life events.

Women and partners' experience of major postpartum haemorrhage: a qualitative study.

Objective: To examine women and their partners' experience of major postpartum haemorrhage (PPH).

Design: A qualitative interview study.

Setting: Two Labour and Delivery Units in Denmark.

Teamwork and Adherence to Guideline on Newborn Resuscitation-Video Review of Neonatal Interdisciplinary Teams.

Background: Little is known about the importance of non-technical skills for the adherence to guidelines, when teams of midwives, obstetricians, anesthesiologists, and pediatricians resuscitate and support the transition of newborns. Non-technical skills are competences underpinning successful teamwork in healthcare. These are usually referred to as leadership, situational awareness, communication, teamwork, decision making, and coping with stress and fatigue.

Noise as a risk factor in the delivery room: A clinical study.

Introduction: We aimed to investigate whether noise in delivery rooms is associated with impaired performance of obstetric teams managing major (≥1000 mL) postpartum hemorrhage.

Material And Methods: We included video recordings of 96 obstetric teams managing real-life major postpartum hemorrhage. Exposure was noise defined as the occurrence of sound level pressures (SPL) above 90 dB.

The importance of non-technical performance for teams managing postpartum haemorrhage: video review of 99 obstetric teams.

Objective: Little is known about how teams' non-technical performance influences clinical performance in obstetric emergencies such as postpartum haemorrhage.

Design: Video review - observational study.

Setting: A university hospital (5000 deliveries) and a regional hospital (2000 deliveries) in Denmark.

Development of the TeamOBS-PPH - targeting clinical performance in postpartum hemorrhage.

Introduction: This study aimed to develop a valid and reliable TeamOBS-PPH tool for assessing clinical performance in the management of postpartum hemorrhage (PPH). The tool was evaluated using video-recordings of teams managing PPH in both real-life and simulated settings.

Material And Methods: A Delphi panel consisting of 12 obstetricians from the UK, Norway, Sweden, Iceland, and Denmark achieved consensus on (i) the elements to include in the assessment tool, (ii) the weighting of each element, and (iii) the final tool.

[Stimulation of labour with oxytocin and ventouse deliveries are inadequately documented].

A retrospective sample of 180 records from four regional hospitals and five university hospitals in Denmark was collected and the documentation for use of oxytocin in augmentation of labour and ventouse deliveries according to the national guidelines was registered. Only approximately half of the elements in the national guidelines were documented. This shows that there is a potential for improvement in the ongoing Danish national quality improvement project Safe Deliveries (Sikre Fødsler).

Predictive and prognostic values of cancer-associated serum antigen (CASA) and cancer antigen 125 (CA 125) levels prior to second-look laparotomy for ovarian cancer.

CA 125 and cancer-associated serum antigen (CASA) were measured prior to second-look laparotomy (SLL) to investigate their predictive and prognostic values in 93 patients treated for epithelial ovarian cancer FIGO stage II, III, or IV. Residual tumor was diagnosed at the SLL in 58 patients (62%). The optimal cutoff level was 15 U/ml for CA 125 and 8 U/ml for CASA.

Association between colposcopic findings and histology in cervical lesions: the significance of the size of the lesion.

The relation between eight specific colposcopic diagnostic findings and the histologic grade of a cervical lesion in 896 women was evaluated. The size of the transformation zone (TZ), the size of the lesion, the intensity of the color tone, distinct margins, the pathology of the vessels, and the presence of micropapillae as single findings were highly statistically correlated to the histologic grade (P < 0.0001).

Diagnostic accuracy of cytology and colposcopy in cervical squamous intraepithelial lesions.

Objective: To evaluate the diagnostic accuracy of cytology and colposcopy in women with an abnormal cervical smear using histology as the 'gold standard'.

Design: Survey of consecutively referred women with abnormal smear.

Setting: The out-patient colposcopical clinic of Herning Hospital, Denmark.

Effect of previous frequency of headache, duration of fasting and caffeine abstinence on perioperative headache.

We have examined the relationship between perioperative headache and various factors in 219 patients who fasted from midnight and underwent minor surgery under general anaesthesia. Four to six hours after operation all patients completed a questionnaire on previous frequency of headache, daily consumption of caffeine and occurrence of perioperative headache. The duration of fasting, type of surgery, premedication and anaesthetic agents used were obtained from the anaesthetic record.

[Duration of breast feeding after mandatory early discharge].

A trial arrangement for mandatory early discharge for all normal multiparae was started in 1990 and the duration of breastfeeding was investigated by a questionnaire. 89 mothers who stayed at the hospital were compared to 113 mothers who were discharged within 24 hours after delivery. The latter group was also compared to 122 early discharged mothers who delivered 14-17 months after the trial arrangement had started.

[Ambulatory labor--experience from the first 2 years].

A trial arrangement for mandatory early discharge for all normal multiparae in 1990 and 1991 was evaluated. 63.4 percent of 1661 multiparous women were discharged within 24 hours of giving birth.

Ring chromosome 20 with loss of telomeric sequences detected by multicolour PRINS.

A ring chromosome 20 in a male infant with epileptic seizures, mental and somatic growth retardation, and behavioural disturbances is described. Conventional cytogenetics revealed the karyotype to be 46,XY,r(20)(pter-->qter) and no signs of mosaicism were found. Fluorescence in situ hybridisation using the clone p20Z1 identified the ring to be derived from chromosome 20.

[Prognosis for infants with birth weights less than 1,501 g treated in a central hospital].

The mortality, morbidity and major sequelae for children with very low birth weight (< 1501 grams) born in the county of Ringkoebing, from 1981 to 1990 were reviewed retrospectively. Ventilator treatment was not used in the neonatal period. Neonatal survival was 63% (143 of 227 infants); the excess mortality compared with contemporary investigations was found in the group 1251-1500 grams and was mainly due to respiratory distress syndrome, which, in the whole population, was an important factor in 62% of neonatal deaths.

[Screening for gestational diabetes in Denmark].

A questionnaire regarding the screening procedure for gestational diabetes was sent to all maternity hospitals in Denmark in 1990. Only 15 out of 51 departments used the screening procedure as proposed by Guttorm & Pedersen. Glucosuria was a clinical risk factor in 49 of 51 departments.

[Efficiency of a screening program for gestational diabetes].

From 1.1.1991-31.

[Sick-leave during pregnancy--focusing on textile workers].

In order to illustrate the conditions involved in sick-leave during pregnancy, 593 consecutive parturient women received a questionnaire on the day after delivery. 48% of the pregnant women were certified as sick and 16% were admitted to hospital during pregnancy. The most common reasons for sick-leave were threatening abortion (19%), haemorrhage (18%) and threatening premature delivery (15%).

[The course of postpartum period after mandatory ambulatory labor].

Mandatory early discharge for all normal multiparae was introduced as a trial arrangement in the County of Ringkøbing from 1.1.1990.