Biomedical subjects

Joanne Morrison

Publications and source records attributed to Joanne Morrison.

3 recordsLinked to original sources

PubMed2003

Cesarean section on demand.

The safety of cesarean section has improved dramatically over the past 50 years. During the past 20 years a greater awareness of and discussion about the symptomatic morbidity that can result for women following vaginal delivery has occurred and women's expectations for the outcome of pregnancy for them and their babies has increased. A culture of choice has been promoted in recent years, but contrary to the anticipated demand for less obstetric intervention by those promoting choice, there has been an increase in demand for delivery by cesarean section rather than the reverse. With the balance in favor of benefit for the baby from delivery by cesarean section, it is now difficult to sustain the argument favoring vaginal delivery rather than planned cesarean section, using maternal morbidity and mortality statistics. A critical evaluation of the costs indicates that there are probably few grounds for denying women their request for cesarean section for economic reasons. It seems likely, therefore, that in the near future those advising women on the options for delivery will need to ensure that the risks of vaginal delivery are explained as well as those for planned cesarean section.

Cesarean Section↗

PubMed2003

Audit of the care of women requesting induced abortion.

This paper describes a prospective audit of all induced abortions performed between May and July 2000, in a Buckinghamshire district general hospital, to evaluate practice compared to the Royal College of Obstetricians and Gynaecologists Guidelines (RCOG Evidence-Based Guideline No. 7, 2000). Areas for improvement were identified and department guidelines were produced to address these. This audit highlights how change can be implemented when local practice is audited against national guidelines.

Abortion, Induced↗

PubMed2003

'Two week wait' standards for suspected gynaecological malignancy. On target, but missing the point?

OBJECTIVE: To assess the two-week rapid access referral system for UK general practitioners introduced in April 2000 for women suspected of having a gynaecological cancer. STUDY DESIGN: An audit of details of women referred between 1st April 2000 and 31st March 2003 via the two-week rapid access system to one gynaecological consultant who performs gynaecological oncology surgery at the John Radcliffe Hospital, Oxford. MAIN OUTCOME MEASURES: Information on waiting times, clinical indication (postmenopausal bleeding, suspicious pelvic mass, vulval lesions, or "other" symptoms including postcoital vaginal bleeding, suspicious lesions of the cervix or vagina), and subsequent diagnosis were recorded. Data on all other women in whom a diagnosis of a gynaecological malignancy was made during the same period following referral to the same consultant's routine gynaecological outpatient clinic were also collected. RESULTS: The target time of two weeks to see a consultant was met for 94% of women referred via the rapid access system. The response time declined slightly with increasing numbers of referrals. However, the majority of women with a gynaecological malignancy were not referred via the rapid access system. CONCLUSIONS: To accommodate the two-week rapid access referrals and achieve UK government targets, there was a reduction in appointments for routine outpatient referrals. However, as the majority of women with gynaecological malignancy presented via traditional referral routes, there is a danger that their diagnoses are being delayed.

Adult↗