Selina A Brown

Publications (2)3.96 Total impact

• Article: Uptake and adherence to long-acting reversible contraception post-abortion.

  Sally B Rose, Beverley A Lawton, Selina A Brown
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  ABSTRACT: This study aimed to increase use of long-acting reversible contraceptive (LARC) methods by women post-abortion. Ten-week intervention at a public abortion clinic involving free access to three LARC methods (DMPA, LNG-IUS, Multiload Cu375); posters promoting LARC; updated information for clinic staff. Outcome measures: change in the proportion of women choosing LARC prior to and during the intervention; rate of follow-up and method retention at 6 weeks and at 6 months post-abortion. Use of post-abortion LARC increased significantly from 44% at baseline (226/510) to 61% (310/510) during the intervention (p<.001). Use of LNG-IUS increased almost sixfold from 6% to 36%. Follow-up rates were 71% at 6 weeks (221/310) and 74% at 6 months (184/249). Method retention was 89% at 6 weeks (197/221) and 86% at 6 months (159/184). Uptake of LARC by women post-abortion can be achieved by increasing access to these methods - by eliminating cost and raising awareness and benefits of long-acting methods among both clinicians and patients.
  Contraception 10/2010; 82(4):345-53. · 2.72 Impact Factor
• Article: Audit of severe acute maternal morbidity describing reasons for transfer and potential preventability of admissions to ICU.

  Beverley A Lawton, Leona F Wilson, Richard A Dinsdale, Sally B Rose, Selina A Brown, John Tait, Carolyn L Coles, Amanda McCaw
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  ABSTRACT: Maternal mortality is a rare event in the developed world. Assessment of severe acute maternal morbidity (SAMM) is therefore an appropriate measure of the quality of maternity care. The aim of the study was to conduct a retrospective audit of SAMM cases (pregnant women admitted to a New Zealand Intensive Care Unit) to describe clinical, socio-demographic characteristics, pregnancy outcomes and preventability. Severe acute maternal morbidity cases were reviewed by a multidisciplinary panel to determine reasons for admission to ICU, to classify organ-system dysfunction and to determine whether the SAMM case was preventable or not. Inclusion criteria were: admission to ICU between 2005 and 2007 during pregnancy or within 42 days of delivery. Twenty-nine SAMM cases were reviewed, of which 10 (35%) were deemed preventable. The most common reasons for transfer to ICU were: the need for invasive vascular monitoring, hypotension and disseminated intravascular coagulation. The most frequent types of preventable events were: inadequate diagnosis/recognition of high-risk status, inappropriate treatment, communication problems and inadequate documentation. All five SAMM cases of septicaemia were deemed preventable. Of the ten preventable cases, three were Maori (50% of the Maori in total audit), four were Pacific (67% of the Pacific in total audit) and three were women of 'other' ethnicities (17.6%, 3 of 17 in the audit). An audit of SAMM cases describing reasons for transfer to ICU and preventability is feasible. We recommend that a prospective national SAMM audit process be introduced in New Zealand as a quality of care measure.
  Australian and New Zealand Journal of Obstetrics and Gynaecology 08/2010; 50(4):346-51. · 1.24 Impact Factor