Cargando…

Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage

OBJECTIVE: To establish whether national guidelines for postpartum hemorrhage (PPH) reflect new scientific evidence on misoprostol, and determine the challenges faced in their implementation. METHODS: A web‐based survey was sent by email to 130 national societies of obstetrics and gynecology (FIGO M...

Descripción completa

Detalles Bibliográficos
Autores principales: Morris, Jessica L., Khatun, Samia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379921/
https://www.ncbi.nlm.nih.gov/pubmed/30387124
http://dx.doi.org/10.1002/ijgo.12704
_version_ 1783562750853644288
author Morris, Jessica L.
Khatun, Samia
author_facet Morris, Jessica L.
Khatun, Samia
author_sort Morris, Jessica L.
collection PubMed
description OBJECTIVE: To establish whether national guidelines for postpartum hemorrhage (PPH) reflect new scientific evidence on misoprostol, and determine the challenges faced in their implementation. METHODS: A web‐based survey was sent by email to 130 national societies of obstetrics and gynecology (FIGO Member Associations) in 2016. The survey, composed of 18 questions, covered national guidelines on PPH with particular reference to misoprostol, the creation of national guidelines, and challenges to implementation. RESULTS: Completed surveys were received from 69 societies, for a 53% response rate. The key findings were that many countries lacked comprehensive, up‐to‐date, evidence‐based national guidelines providing guidance on misoprostol use; recommended regimens were very different in the national guidelines as well as between international and regional guidelines that are most often used as referencing documents; and there are a variety of challenges to implementation of guidelines. CONCLUSION: There is a need, especially in countries with high maternal mortality, to establish mechanisms that ensure the existence of up‐to‐date, comprehensive, evidence‐based guidelines on PPH. This can be difficult given conflicting guidance at the international level. Regional and international societies should prioritize clinical updates and ensure their dissemination and implementation.
format Online
Article
Text
id pubmed-7379921
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-73799212020-07-27 Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage Morris, Jessica L. Khatun, Samia Int J Gynaecol Obstet Figo Special Article OBJECTIVE: To establish whether national guidelines for postpartum hemorrhage (PPH) reflect new scientific evidence on misoprostol, and determine the challenges faced in their implementation. METHODS: A web‐based survey was sent by email to 130 national societies of obstetrics and gynecology (FIGO Member Associations) in 2016. The survey, composed of 18 questions, covered national guidelines on PPH with particular reference to misoprostol, the creation of national guidelines, and challenges to implementation. RESULTS: Completed surveys were received from 69 societies, for a 53% response rate. The key findings were that many countries lacked comprehensive, up‐to‐date, evidence‐based national guidelines providing guidance on misoprostol use; recommended regimens were very different in the national guidelines as well as between international and regional guidelines that are most often used as referencing documents; and there are a variety of challenges to implementation of guidelines. CONCLUSION: There is a need, especially in countries with high maternal mortality, to establish mechanisms that ensure the existence of up‐to‐date, comprehensive, evidence‐based guidelines on PPH. This can be difficult given conflicting guidance at the international level. Regional and international societies should prioritize clinical updates and ensure their dissemination and implementation. John Wiley and Sons Inc. 2018-11-21 2019-01 /pmc/articles/PMC7379921/ /pubmed/30387124 http://dx.doi.org/10.1002/ijgo.12704 Text en © 2018 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Figo Special Article
Morris, Jessica L.
Khatun, Samia
Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage
title Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage
title_full Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage
title_fullStr Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage
title_full_unstemmed Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage
title_short Clinical guidelines—the challenges and opportunities: What we have learned from the case of misoprostol for postpartum hemorrhage
title_sort clinical guidelines—the challenges and opportunities: what we have learned from the case of misoprostol for postpartum hemorrhage
topic Figo Special Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7379921/
https://www.ncbi.nlm.nih.gov/pubmed/30387124
http://dx.doi.org/10.1002/ijgo.12704
work_keys_str_mv AT morrisjessical clinicalguidelinesthechallengesandopportunitieswhatwehavelearnedfromthecaseofmisoprostolforpostpartumhemorrhage
AT khatunsamia clinicalguidelinesthechallengesandopportunitieswhatwehavelearnedfromthecaseofmisoprostolforpostpartumhemorrhage