Long term infant subcutaneous retention of a fragment of fetal scalp electrode following caesarean section

The authors present the case of an uncommon yet potentially fatal complication after the use of a scalp electrode for intrapartum fetal heart rate monitoring. A 25-year-old nulliparous woman in spontaneous term labour had a fetal scalp electrode applied and subsequently required an emergency cesarean section. After discharge home, the mother noticed a swelling on her baby’s head, where the scalp electrode had been attached. Healthcare providers neglected the mother’s repeated concerns about the nature of the swelling. Seven months later, a metal spiral was expelled from the baby’s head which appeared to be a broken part of the scalp electrode. The remaining metal was removed with no further signs or complications. We are aware of only a few similar cases which have been reported in the published literature

Using complaints from obstetric care for improving women’s birth experiences – a cross sectional study

Abstract Introduction Staff shortages and quality in obstetric care is a concern in most healthcare systems and a hot topic in the public debate that has centred on complaints about deficient care. However there has been a lack of empirical data to back the debate. The aim of this study was to analyse and describe complaints in obstetric care. Further, to compare the obstetric complaint pattern to complaints from women about other hospital services. Materials and methods We used the Healthcare Complaints Analysis Tool to code, analyse and extract contents of obstetric complaint cases in a region of Denmark between 2016 and 2021. We compared the obstetric complaint pattern to all other hospital complaint cases in the same period regarding female patients at a large University Hospital in a cross-sectional study. Results Complaints regarding obstetric care differed from women’s complaints regarding other healthcare services. Women from obstetric care raised more problems per complaint, and tended to complain more about relational issues indicated by odds for complaints about staff shortage four times higher in the obstetric care group. Women from obstetric care had a lower proportion of compensation claims. Conclusion Systematic complaint analysis acknowledged women’s experience in obstetric care and may point to areas that potentially need further attention. Complaints from obstetric care show that women experience deficiencies related to relational problems like recognition and individualized support compared to complaints from women receiving other hospital healthcare services

Diagnosis of preeclampsia with soluble Fms-like tyrosine kinase 1/placental growth factor ratio:an inter-assay comparison

The angiogenic factor ratio soluble Fms-kinase 1 (sFlt-1)/placental growth factor (PlGF) is a novel diagnostic tool for preeclampsia. We compared the efficacy of the KRYPTOR (BRAHMS) automated assays for sFlt-1 and PlGF with the Elecsys (Roche) assays in a routine clinical setting. Preeclamptic women (n = 39) were included shortly after the time of diagnosis. Normotensive control pregnancies were matched by gestational age (n = 76). The KRYPTOR assays performed comparably or superior to Elecsys (sFlt-1/PlGF area under the curve 0.746 versus 0.735; P = .09; for non-obese 0.820 versus 0.805, P = .047). For early-onset preeclampsia, KRYPTOR area under the curve increased to 0.929 with a 100% specificity for preeclampsia at cut-off 85 and an 88.9% sensitivity for preeclampsia at cut-off 33. For women with preeclampsia and preterm delivery or Hemolysis, Elevated Liver enzymes, Low Platelet count (HELLP) syndrome, the KRYPTOR sFlt-1/PlGF ratio was manifold increased (P < .01). The sFlt-1/PlGF ratio proved especially useful in early-onset preeclampsia, preeclampsia with preterm delivery or HELLP, and among non-obese women