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dc.contributor.authorWilliamson, Megan
dc.contributor.authorNewnham, Amy
dc.contributor.authorCorrin, India
dc.contributor.authorSaxena, Dolly
dc.contributor.authorBilagi, Ashwini
dc.contributor.authorEmovon, Emmanuel
dc.contributor.authorLeung, Elaine
dc.date.accessioned2024-09-12T13:03:31Z
dc.date.available2024-09-12T13:03:31Z
dc.date.issued2024-09-05
dc.identifier.citationWilliamson M, Newnham A, Corrin I, Saxena D, Bilagi A, Emovon E, Leung EY. Reducing maternal infection after assisted vaginal birth in a diverse and deprived population. BMJ Open Qual. 2024 Sep 5;13(3):e002913. doi: 10.1136/bmjoq-2024-002913en_US
dc.identifier.urihttp://hdl.handle.net/20.500.14200/5719
dc.description.abstractPostpartum maternal sepsis is a leading cause of maternal mortality and morbidity. A single dose of prophylactic antibiotics following assisted vaginal births has been shown to significantly reduce postpartum maternal infection in a landmark multicentre randomised controlled trial, which led to its national recommendation. This project aimed to improve the local implementation of prophylactic antibiotics following assisted vaginal births to reduce postnatal maternal infections.Using a prospectively collated birth register, data were collected retrospectively on prophylactic antibiotics administration and postnatal maternal infection rates after assisted vaginal births at the Sandwell and West Birmingham Hospitals National Health Service Trust in North-West Birmingham of the UK. The data were collected from routinely used electronic health records over three audit cycles (n=287) between 2020 and 2023.A mixed-method approach was used to improve the use of prophylactic antibiotics: (1) evidence-based journal clubs targeting doctors in training, (2) presentations of results after all three audit cycles at our and (3) expedited a formal change of local guidelines to support prophylactic antibiotics use.Prophylactic antibiotic administration increased from 13.2% (December 2021) to 90.7% (July 2023), associated with a reduction in maternal infection rates (18.2% when prophylaxis was given vs 22.2% when no prophylaxis was given). However, we observed a gradual increase in the overall postnatal maternal infection rates during the project period.Our repeat audit identified prophylactic antibiotics were regularly omitted after deliveries in labour ward rooms (59.3%), compared with 100% of those achieved in theatre. After further interventions, prophylactic antibiotics administration rates were comparable between these clinical areas (>90%) in 2023.Together, we have demonstrated a simple set of interventions that induced sustainable changes in practice. Further evaluation of other modifiable risk factors and infection rates following all deliveries is warranted in view of the gradual increase in the overall postnatal maternal infection rates.en_US
dc.language.isoenen_US
dc.publisherBMJ Publishing Groupen_US
dc.subjectObstetrics. Midwiferyen_US
dc.subjectGynaecologyen_US
dc.titleReducing maternal infection after assisted vaginal birth in a diverse and deprived populationen_US
dc.typeArticleen_US
dc.source.journaltitleBMJ Open Qualityen_US
rioxxterms.versionNAen_US
dc.contributor.trustauthorWilliamson, Megan
dc.contributor.trustauthorNewnham, Amy
dc.contributor.trustauthorCorrin, India
dc.contributor.trustauthorSaxena, Dolly
dc.contributor.trustauthorBilagi, Ashwini
dc.contributor.trustauthorEmovon, Emmanuel
dc.contributor.trustauthorLeung, Elaine
dc.contributor.departmentObstetrics and Gynaecologyen_US
dc.contributor.roleMedical and Dentalen_US
dc.contributor.affiliationSandwell and West Birmingham NHS Trust; University of Birminghamen_US
oa.grant.openaccessnaen_US


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