The impact of a blended multidisciplinary training for the management of obstetric haemorrhage in Mbeya, Tanzania.

Background: The Maternal Mortality Rate (MMR) in Tanzania is 78 times higher than that of the UK. Obstetric haemorrhage accounts for two-thirds of these deaths in Mbeya, Tanzania. A lack of healthcare providers' (HCPs') competencies has been the key attribute.

A research agenda to improve incidence and outcomes of assisted vaginal birth.

Access to emergency obstetric care, including assisted vaginal birth and caesarean birth, is crucial for improving maternal and childbirth outcomes. However, although the proportion of births by caesarean section has increased during the last few decades, the use of assisted vaginal birth has declined. This is particularly the case in low- and middle-income countries, despite an assisted vaginal birth often being less risky than caesarean birth.

Does hospital variation in intrapartum-related perinatal mortality among caesarean births reflect differences in quality of care? Cross-sectional study in 21 hospitals in Burkina Faso.

Objectives: To examine hospital variation in crude and risk-adjusted rates of intrapartum-related perinatal mortality among caesarean births.

Design: Secondary analysis of data from the DECIDE (DECIsion for caesarean DElivery) cluster randomised trial postintervention phase.

Setting: 21 district and regional hospitals in Burkina Faso.

Myo-inositol nutritional supplement for prevention of gestational diabetes (EMmY): a randomised, placebo-controlled, double-blind pilot trial with nested qualitative study.

Objectives: To determine the feasibility and acceptability of conducting a randomised trial on the effects of myo-inositol in preventing gestational diabetes in high-risk pregnant women.

Design: A multicentre, double-blind, placebo-controlled, pilot randomised trial with nested qualitative evaluation.

Setting: Five inner city UK National Health Service hospitals PARTICIPANTS: Multiethnic pregnant women at 12 and 15 weeks' gestation with risk factors for gestational diabetes.

Adverse pregnancy outcomes in women with diabetes-related microvascular disease and risks of disease progression in pregnancy: A systematic review and meta-analysis.

Background: The rise in the global prevalence of diabetes, particularly among younger people, has led to an increase in the number of pregnant women with preexisting diabetes, many of whom have diabetes-related microvascular complications. We aimed to estimate the magnitude of the risks of adverse pregnancy outcomes or disease progression in this population.

Methods And Findings: We undertook a systematic review and meta-analysis on maternal and perinatal complications in women with type 1 or 2 diabetic microvascular disease and the risk factors for worsening of microvascular disease in pregnancy using a prospective protocol (PROSPERO CRD42017076647).

Simulation-based teaching and models for caesarean sections: a systematic review to evaluate the tools for the 'See One, Practice Many, Do One' slogan.

Purpose Of Review: Caesarean sections are the most commonly performed procedure globally. Simulation-based training for caesarean sections can provide healthcare practitioners a safe and controlled environment to develop this life-saving skill. We systematically reviewed the use of simulation-based training for caesarean section and its effectiveness.

Effectiveness and acceptability of metformin in preventing the onset of type 2 diabetes after gestational diabetes in postnatal women: a protocol for a randomised, placebo-controlled, double-blind feasibility trial—Optimising health outcomes with Metformin to prevent diAbetes After pregnancy (OMAhA).

Introduction: Up to half of all women diagnosed with gestational diabetes mellitus develop type 2 diabetes within 5 years after delivery. Metformin is effective in preventing type 2 diabetes in high-risk non-pregnant individuals, but its effect when commenced in the postnatal period is not known. We plan to assess the feasibility of evaluating metformin versus placebo in minimising the risk of dysglycaemia including type 2 diabetes after delivery in postnatal women with a history of gestational diabetes through a randomised trial.

Revisiting the basis for haemoglobin screening in pregnancy.

Purpose Of Review: Anaemia affects up to 50% of pregnancies worldwide, and is associated with maternal and neonatal morbidity and mortality. Prevention and management of anaemia remains a priority. Despite this, there is ongoing debate on the optimal approach to identifying anaemia in pregnant women and the best strategies for prevention and management.

Should UK specialty trainee doctors in Obstetrics and Gynaecology have more opportunities to work in global women's health?

The Royal College of Obstetricians and Gynaecologists (RCOG) has a long history of advocacy for women's health, nationally and internationally. There is a demand and interest in global women's health among a sample of junior doctors training in obstetrics and gynaecology in the UK. There is ongoing debate regarding whether this desire should be nurtured, opportunities created and barriers addressed, both in the interest of training and as a means of addressing global health inequity.

Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: a systematic review and meta-analysis.

Background: Universal and timely access to a caesarean section is a key requirement for safe childbirth. We identified the burden of maternal and perinatal mortality and morbidity, and the risk factors following caesarean sections in low-income and middle-income countries (LMICs).

Methods: For this systematic review and meta-analysis, we searched electronic databases including MEDLINE and Embase (from Jan 1, 1990, to Nov 20, 2017), without language restrictions, for studies on maternal or perinatal outcomes following caesarean sections in LMICs.

Type of obstetric anesthesia administered and complications in women with preeclampsia in low- and middle-income countries: A systematic review.

Background: Delivery is often expedited with cesarean section, necessitating anesthesia, to prevent complications in women with preeclampsia. Anesthesia-associated risks in these women from low- and middle-income countries (LMICs) are not known.

Methods: We searched major databases (until February 2017) for studies on general vs.

Accuracy of tests used to detect infection with Chlamydia trachomatis in asymptomatic pregnant women: a systematic review.

Purpose Of Review: Infection with Chlamydia trachomatis in pregnancy is linked to increased risk of miscarriage, stillbirth, and preterm birth. Currently, PCR or DNA-based tests are the gold standard when detecting the infection; however, they are costly and require access to specialist equipment. The aim of this systematic review was to assess the accuracy of available tests to detect infection in an asymptomatic pregnant population.

Accuracy of on-site tests to detect anemia during prenatal care.

Background: Anemia is a substantial contributor to poor pregnancy outcomes in low- and middle-income countries. Access to laboratory facilities is limited; therefore, on-site testing warrants attention.

Objectives: To determine the accuracy of on-site tests to detect anemia in pregnancy.

Anaesthesia-related maternal mortality in low-income and middle-income countries: a systematic review and meta-analysis.

Background: The risk factors contributing to maternal mortality from anaesthesia in low-income and middle-income countries and the burden of the problem have not been comprehensively studied up to now. We aimed to obtain precise estimates of anaesthesia-attributed deaths in pregnant women exposed to anaesthesia and to identify the factors linked to adverse outcomes in pregnant women exposed to anaesthesia in low-income and middle-income countries.

Methods: In this systematic review and meta-analysis, we searched major electronic databases from inception until Oct 1, 2015, for studies reporting risks of maternal death from anaesthesia in low-income and middle-income countries.