Journal of Obstetrics and Gynaecology

Massive obstetric haemorrhage (MOH) remains a leading cause of maternal mortality worldwide, accounting for up to 50% of maternal deaths in some countries and currently constitutes the seventh commonest cause of death in the United Kingdom with a rate of 0.6/100,000 maternities.

Optimum management of this condition require up to date knowledge of relevant treatment modalities (such as Tranexamic Acid and interventional radiology), competent surgical techniques and an appreciation of non-technical skills (i.e. human factors). In particular, decision making and speed of action by the most experienced clinician present (often the registrar) is paramount so that obstetric haemorrhage could be controlled before it deteriorated to coagulopathy and ultimately maternal death.

For this issue, the editors aim to garner a collection of articles to cover the broad aspects pertaining to MOH for the benefit of clinicians and patients alike.

The potential applications encompass a wide spectrum and include, but are not restricted to, the following areas:

• Human factors in MOH.
• Cell salvage technology in MOH.
• Top tips on bedside visual estimation of blood loss.
• Pelvic packing in PPH: A review of worldwide literature.
• The role of Interventional Radiology in MOH.
• The role of Tranexamic Acid in MOH: Review of Evidence
• Placenta Accreta Spectrum.
• Management of women who decline blood transfusion.
• Uterine compression sutures: Which ones should we use?

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Guest Advisors:

Mr Wai Yoong (MBBCh BAO Belf, MD London, FRCOG UK, Chartered Institute of Ergonomics and Human Factors Tech Mem) is a consultant Obstetrician and Urogynaecologist at North Middlesex University Hospital London and an Honorary Senior Lecturer at University College London and Associate Professor at St George’s International School of Medicine. He was awarded his MD degree (University of London) for research on sickle cell disease and later completed a Urogynaecology Fellowship in Australia. He has a special interest in patient safety and holds Technical Membership of Chartered Institute of Ergonomics and Human Factors. Wai is a founder trustee of Haemorrhage After Childbirth Foundation, a charity dedicated to teaching surgical and human factors skills on how to manage obstetric haemorrhage in developing and developed countries. He was awarded the RCOG Sims Black Travelling Professorship (2014) and the RCOG Bernhard Baron Travelling Scholarship (2018) to Jordan and Argentina respectively. Wai has been a GMC Fitness to Practice Medical Assessor since 2011 and is also O&G Clinical Advisor for Healthcare Safety Investigation Branch (HSIB). His book “Operative Procedures for MRCOG and Beyond” (Wiley Blackwell Publications) was awarded Best O&G book in the BMA Medical Book Awards in 2021. He is the Deputy Editor in Chief of The Obstetrician and Gynaecologist and also an Associate Editor of The Journal of Obstetrics and Gynaecology.

Wai was the Guest Advisor for the recent article collection “The Effect of the COVID-19 Pandemic on Obstetrics and Gynaecology Practice” to be published by The Journal of Obstetrics and Gynaecology.

Mr Wasim Lodhi (MBBCh FRCOG PGCert Med Ed) is a consultant obstetrician and gynaecologist from North Middlesex University Hospital with a special interest in outpatient operative hysteroscopy. He has a postgraduate certificate in Medical Education and is currently the Clinical Director of his department. Wasim is Honorary Senior Lecturer at University College London and Associate Professor at St George’s International School of Medicine. He is a co-organiser of the RCOG Masterclass in Massive Obstetric Haemorrhage and has facilitated at Harassment and Undermining workshops nationally. He was past National Convenor of Basic Practical Skills course and is the Chairperson of the RCOG Pakistan Liaison Group (Royal College of Obstetricians and Gynaecologists).  He is faculty member of the RCOG MRCOG parts I and II courses as well as being an examiner of the new MRCOG part III course. He is a founder trustee of Haemorrhage After Childbirth Foundation, a charity dedicated to teaching skills to doctors and midwives on how to manage obstetric haemorrhage.  His book “Operative Procedures for MRCOG and Beyond” (Wiley Blackwell Publications) was awarded Best O&G book in the BMA Medical Book Awards in 2021.

Dr. Hashviniya Sekar (MBBS MRCOG) is an ST5 trainee at Royal London Hospital.

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