Approaches to improve and adapt maternal mortality estimations in low- and middle-income countries: A scoping review.

Background: In the absence of robust vital registration systems, many low- and middle-income countries (LMICs) rely on national surveys or routine surveillance systems to estimate the maternal mortality ratio (MMR). Although the importance of MMR estimates in ending preventable maternal deaths is acknowledged, there is limited research on how different approaches are used and adapted, and how these adaptations function.

Objectives: To assess methods for estimating maternal mortality in LMICs and the rationale for these modifications.

Out of sight, out of mind? Evidence from cross-sectional surveys on hidden caesarean sections among women with stillbirths in Ghana, 2007 and 2017.

Background: Caesarean section (CS) rates in women experiencing stillbirth have not been studied with nationally representative data. Two Ghana Maternal Health Surveys (GMHS) have captured pregnancy and mode of birth data for all women including those with stillbirths. We compared CS rates between women with live births and stillbirths, and identified socio-economic and pregnancy-related factors associated with CS in stillbirths.

Pneumomediastinum complicating diabetic ketoacidosis.

Pneumomediastinum is an uncommon finding in patients with diabetic ketoacidosis (DKA) and may occur spontaneously or secondary to an effort rupture of the oesophagus. Excluding oesophageal rupture is important, as delaying treatment increases the risk of mortality. We discuss a case of DKA complicated by vomiting, pneumomediastinum, pneumopericardium and air in the epidural space.

Health workers' perspectives on informed consent for caesarean section in Southern Malawi.

Objective: Informed consent is a prerequisite for caesarean section, the commonest surgical procedure in low- and middle-income settings, but not always acquired to an appropriate extent. Exploring perceptions of health care workers may aid in improving clinical practice around informed consent. We aim to explore health workers' beliefs and experiences related to principles and practice of informed consent.

Pre-post implementation survey of a multicomponent intervention to improve informed consent for caesarean section in Southern Malawi.

Objective: Surgical informed consent is essential prior to caesarean section, but potentially compromised by insufficient communication. We assessed the association between a multicomponent intervention and women's recollection of information pertaining to informed consent for caesarean section in a low-resource setting, thereby contributing to respectful maternity care.

Design: Pre-post implementation survey, conducted from January to June 2018, surveying women prior to discharge.