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ADVANCING PRACTICE Reducing maternal sepsis

Neesha Ridley

Midwifery Lecturer at University of Central Lancashire

 (September 2016)

Despite significant advances in the diagnosis and management of sepsis, sepsis in the puerperium remains an important cause of maternal death (Royal College of Obstetricians and Gynaecologists (RCOG) 2012). To ensure the best outcome for women who are septic, timely diagnosis and treatment is required, together with the appropriate management by midwives and other members of the multidisciplinary team. As the rates of maternal death due to sepsis are decreasing, midwives should be aware of how to educate women in the prevention of sepsis, using national recommendations. This article addresses the need for health care professionals to be aware of the signs and symptoms of sepsis and the importance of a prompt referral to an appropriate place to initiate treatment of the septic woman.

ADVANCING PRACTICE From pregnancy to palliative care: advancing professional midwifery practice?

Valerie Peacock

Children’s hospice nurse specialist at Northern Ireland Children’s Hospice

Dr Jayne Price

Associate professor (Children’s nursing) at Kingston University and St George’s University

Sharon Nurse

Senior lecturer in midwifery education at Queen’s University Belfast

 (November 2015)

Historically midwives may have not considered palliative care as a part of their professional role. Enhanced technologies and antenatal screening have broadened the boundaries of care. However do midwives truly embrace the philosophy of palliative care into their practice? This paper presents the discussion round a case study that demonstrates the evolving area of advanced practice: perinatal palliative care. What we highlight is that midwives in fact have an important collaborative role to play in ensuring that palliative care for the baby and family starts as soon as a life-limiting condition is recognised, thus ensuring best care and support are provided for those parents and families for whom pregnancy sadly leads to palliative care. Five key lessons for practice are outlined.

ADVANCING PRACTICE The power of two: Reflections on the MBRRACE-UK maternal and perinatal deaths reports and the London Maternity Strategic Clinical Network 

Victoria Morgan

Lead facilitator at Every birth a safe birth

 (September 2015)

The UK maternal mortality rate is 10 per 100,000 maternities and is falling. The decrease is due to fewer deaths from direct causes; there has been no significant change in the indirect rate over the last 10 years. The UK mortality rate for babies is six stillbirths and neonatal deaths per 100,000 births. Local rates vary from 5.4–7.1. The variation is not due to normal variation or demographic factors. The London Maternity Strategic Clinical Network uses a multi-disciplinary team approach to improve maternity user experience. The Northern New England Cardiovascular Disease Study Group (NNE CVDSG) meet to share data, observe clinical practice and make changes. Maternity units may wish to consider adapting the NNE CVDSG approach to improve their quality of maternity care.