Seven days in medicine: 9-15 August 2017

BMJ 2017; 358 doi: (Published 17 August 2017) Cite this as: BMJ 2017;358:j3892

Maternity services

Nine in 10 obstetric units have unfilled rotas

Some 88% of obstetric units in Britain surveyed from January to March said that they had had problems filling registrar rotas in the previous three months, the National Maternity and Perinatal Audit found. Lesley Regan, president of the Royal College of Obstetricians and Gynaecologists, described the rota gaps as “particularly worrying.” The audit found that 19% of services had no midwife led units and that 3% did not have a consultant led unit. (Full story doi:10.1136/bmj.j3855)

C-section may raise risk of hysterectomy complications

Women who have had one caesarean delivery had 31% higher odds of reoperation after hysterectomy than women who have had only vaginal deliveries, and women with two or more caesarean deliveries had 35% higher odds, a study of Danish nationwide registers found. Surgical complications were 16% higher in women who had had one caesarean and 30% higher in those with two or more, a study published in JAMA Surgery found. This supports efforts to prevent caesarean deliveries that are not clinically indicated, said the authors. (Full story doi:10.1136/bmj.j3804)

Cancer Drugs Fund

Three quarters of drugs are now approved by NICE

Of 24 drugs in England’s Cancer Drugs Fund that the National Institute for Health and Care Excellence (NICE) was asked to appraise, 18 have now been approved in final or draft guidance. Five drugs are still being appraised, and one has been withdrawn. Carole Longson, director of the NICE centre for health technology evaluation, said, “More cancer drugs than ever are being recommended for routine use because companies are working hard to provide cost effective solutions. We are also applying flexibility in cases where drugs show promise, meaning people get access through the new …

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