STORC safety initiative: a multicentre survey on preparedness & confidence in obstetric emergencies.

Background: Patient safety is a national and international priority. The purpose of this study was to understand clinicians' perceptions of teamwork during obstetric emergencies in clinical practice, to examine factors associated with confidence in responding to obstetric emergencies and to evaluate perceptions about the value of team training to improve preparedness.

Methods: An anonymous survey was administered to all clinical staff members who respond to obstetric emergencies in seven Oregon hospitals from June 2006 to August 2006.

Effect of mode of delivery on the incidence of urinary incontinence in primiparous women.

Objective: To estimate the effect of mode of delivery on the incidence of urinary incontinence in primiparous women.

Methods: A population-based survey was mailed to all Oregon women who delivered a liveborn neonate in a 1-year period. Data were collected on urinary incontinence, childbirth experience, and other risk factors for incontinence at 3-6 months postpartum.

Validation of a tool to measure and promote clinical teamwork.

Objective: Human factors and teamwork are major contributors to sentinel events. A major limitation to improving human factors and teamwork is the paucity of objective validated measurement tools. Our goal was to develop a brief tool that could be used to objectively evaluate teamwork in the field during short clinical team simulations and in everyday clinical care.

Does cesarean protect against fecal incontinence in primiparous women?

The objective of this study was to identify factors associated with new onset of postpartum fecal incontinence in primiparous women. A population-based study was conducted that surveyed all women delivering between 2002 and 2003 in Oregon. Factors associated with fecal incontinence were identified using logistic regression analysis.

Examining the value of electronic health records on labor and delivery.

Objective: The objective of the study was to evaluate the impact of an electronic health record (EHR) on documentation completeness and patient care in a labor and delivery unit.

Study Design: We conducted a pre- and postintervention study to compare documentation quality and workflow before and after EHR implementation. Documentation was compared using chi(2) and Fisher's exact tests.

Incidence of fecal incontinence after childbirth.

Objective: Fecal incontinence is an embarrassing and disabling condition of which the epidemiology is poorly understood. Our goal is to estimate the incidence of fecal incontinence after childbirth.

Methods: A population-based survey was mailed to all women who delivered a liveborn infant in the state of Oregon between April 2002 and September 2002.

The benefits and risks of inducing labour in patients with prior caesarean delivery: a systematic review.

Objective: To evaluate the risks and benefits of inducing labour in women with a prior caesarean delivery.

Design: Systematic review.

Sample: Pregnant women with prior caesarean delivery.

Evidence-based vaginal birth after Caesarean section.

Caesarean section rates are rising globally. Whether vaginal birth after Caesarean (VBAC) is safe and under what circumstances is increasingly important. This chapter reviews the literature about the risks of VBAC, patient and management factors that may alter risk, and discusses ongoing research as well as suggestions for improving future research.

Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section.

Objective: To evaluate the incidence and consequences of uterine rupture in women who have had a delivery by caesarean section.

Design: Systematic review.

Data Sources: Medline, HealthSTAR, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, National Centre for Reviews and Dissemination, reference lists, and national experts.

Childbirth preferences after cesarean birth: a review of the evidence.

Background: Conflicting evidence on maternal and fetal safety of vaginal and cesarean childbirth after a previous cesarean makes patients and practitioners uncertain about pursuing a trial of labor or an elective repeat cesarean delivery. This review systematically evaluated and summarized the evidence related to women's preference for delivery.

Methods: The Cochrane Database of Systematic Reviews and Registry of Controlled Trials and the MEDLINE, HealthSTAR, PsycINFO, and CINAHL databases were searched from 1980 to August 2002.

Safety of vaginal birth after cesarean: a systematic review.

Objective: To evaluate the benefits and harms of vaginal birth after cesarean compared with repeat cesarean delivery.

Data Sources: The computerized databases MEDLINE, EMBASE, HealthSTAR, Cochrane CENTRAL, and National Centre for Reviews and Dissemination Database of Abstracts of Reviews of Effectiveness, along with reference lists and national experts, were used to conduct this review.

Methods Of Study Selection: All studies that reported data for maternal or infant outcomes in women with prior cesarean delivery were eligible.

Predicting vaginal birth after cesarean delivery: a review of prognostic factors and screening tools.

Objective: Our purpose was to identify the factors associated with vaginal delivery after trial of labor in patients with a prior cesarean and to evaluate the effectiveness of existing screening tools.

Study Design: Studies were identified through MEDLINE and HealthSTAR (1980-2002), reference list reviews, and suggestions of national experts.

Results: Thirteen of the 100 eligible studies provided fair to good quality evidence for the predictive nature of 12 factors.

Frequency and predictors for postpartum fecal incontinence.

Objective: The goal of this study was to describe the frequency of postpartum fecal incontinence and to examine associated delivery events in a group of women participating in a validation study of a postpartum fecal incontinence survey.

Study Design: A self-administered survey of fecal incontinence symptoms and delivery events was administered to 50 women seen for their 6-week postpartum appointments. An analysis of association between postpartum fecal incontinence and individual delivery characteristics was performed.