FAQs

These questions have been asked by UKMidSS reporters and others during the set-up phase of UKMidSS and during the studies we have conducted so far. If you have a question which is not answered here please contact us on ukmidss@npeu.ox.ac.uk

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UKMidSS

Why does UKMidSS only cover alongside midwifery units (AMUs) and not other midwifery-led settings for birth?

UKMidSS currently covers all AMUs because they account for around 80% of women who start labour care in a midwifery-led setting. Resources permitting, we hope to expand to include other midwifery-led settings in future.

How do you decide what studies to run using UKMidSS?

The topics for the first three studies were decided upon after consultation with senior midwives, the Royal College of Midwives and maternity care researchers in the NPEU and elsewhere. Suggestions for further studies have been discussed at our Study Days and are considered by the UKMidSS Steering Group. If you have an idea for a study please get in touch.

I’m a UKMidSS Reporter, but I don’t know what I’m supposed to do – can you help?

Yes, thank you for contributing to UKMidSS! As a UKMidSS Reporter you are our main point of contact for UKMidSS in your AMU. You are also responsible for reporting data to us every month for UKMidSS studies. There is more information in the Guide for UKMidSS Reporters in your site file. The recorded webinars on our Information for Reporters page are also a good place to start. If you’re having problems, contact us on ukmidss@npeu.ox.ac.uk

Previous PPH Study

When does the study start and how long will it last?

The study will start on 1st August 2018 and continue for 12 calendar months, until 31st July 2019. You should start identifying your cases from 1st August and you will receive your first monthly report request email (for your figures for August) on 1st September.

What is a 'case'?

For the Previous PPH Study a 'case' is any woman who is admitted for labour care to an AMU, and from information recorded at booking or during pregnancy, is known to have:

  • Had a PPH ≥ 500ml in a previous pregnancy (of at least 24 completed weeks' gestation)
    OR
  • Received a blood transfusion for a PPH before discharge home in a previous pregnancy (of at least 24 completed weeks' gestation)
Does a 'case' have to give birth in the AMU? What if they transfer during labour to the obstetric unit?
For this study 'cases' do not have to give birth in the AMU. It is really important that all women who, on admission, are known to have had a PPH≥ 500 ml in a previous pregnancy, and are admitted for labour care to the midwifery led unit, are reported as cases, irrespective of where they end up giving birth.
What figures do I need to report each month?
  • The number of cases in the midwifery unit in the previous month.
  • The number of women who were admitted for labour care in the midwifery unit in the previous month.
  • The number of women who gave birth in the midwifery unit in the previous month.
In our unit we don’t admit women who have had a previous PPH – should we still take part in UKMidSS?

Yes, absolutely! We know that admission criteria vary, but to make sure that the results of UKMidSS studies are as useful as possible it’s really important that everyone takes part. Then we get a true picture of what is happening across the UK.

In our unit we often see women in the latent phase of labour who may stay for a while before going home again, or who may transfer for obstetric triage. Do we include these women when deciding if a woman is a ‘case’ or in our ‘number of women admitted for labour care’?

No. When considering whether a woman is a ‘case’ and when counting the number of women admitted for labour care, please only include those women who go on to give birth in that admission (irrespective of where they end up giving birth).

Do we still have to identify two controls for each case for this study?

No, for this study we are only asking you to select one control for each case

Why are you asking for data about a 'control' as well as the 'case'?

One of the things we want to do in this study is compare the characteristics and care of the 'case', i.e the woman who are known to have had a previous PPH, with another more typical woman who gave birth in the midwifery unit who did not have a PPH. To do this we need to collect data on a 'control' or comparison woman.

How do we identify the 'control' – can we just choose any comparison woman?

It's really important that the control is identified carefully and in the same way everywhere. That way we know that our comparison group is representative of women giving birth in AMUs. For each case, we are asking you to identify one control. To identify the control, make a note of the date and time the case was admitted. Then check your unit birth register or electronic records to find the multiparous woman who was admitted to the AMU immediately before the case. That woman is your control for that case.

What happens if one of the multiparous women admitted immediately before the case was also a case?

In this instance you should go further back in your register to identify the non-case woman who was admitted before each case. For example, if you have two cases who were admitted one after the other, your controls for these two cases would be the two multiparous, non case women who were admitted immediately before the first case.

What happens once I report a case?

In your confirmation email you will see a unique Case ID, beginning PP_ for each case you report. You should record each Case ID in the Case Log in your white UKMidSS folder alongside identifying details for each woman. We then ask you to send us detailed data on the case and one control, or comparison woman, for each case.

How do I send you data on our cases and controls?

When you report a case, data collection forms for each case and control are created automatically in OpenClinica, our data entry system. When you send us a monthly report you will receive a link to access OpenClinica in your confirmation email.

You will also need a username and password for OpenClinica. If you do not have these, please contact us.

Note: Case IDs and data collection forms are created automatically in OpenClinica when you report a case. You do not ever need to click on the Add New Subject link in OpenClinica.

Once you have access to the woman’s electronic or paper notes you can enter the data in the forms in OpenClinica. We have put sample forms on our website before the start of the study – these are for information only and should not be used to send us data. There is a detailed guide to entering data using OpenClinica in your white UKMidSS folder and on our website: https://www.npeu.ox.ac.uk/ukmidss/reporters.

For the case and control forms, Section 1 contains questions intended to check (a) whether the woman fits the case definition and (b) whether the control has been correctly selected. When entering data in any form, Section 1 should always be completed first.

Can we only enter the more detailed data on our cases at the end of the month? It might be harder to track down women's notes once they've gone home.

At the beginning of every month we will ask you to report on your cases for the previous month. As soon as you report a case a unique 'Case ID' and data collection forms will be automatically generated for that woman and you will be able to enter data using OpenClinica. If you wish to identify cases and collect the data you will need from women's notes as you go along you may use our Sample Data Collection Forms to record the data prior to entering it on OpenClinica at a later date. These can be found on the UKMidSS website.

I've already used OpenClinica to enter data on cases and controls for the Severe Obesity Study and the Neonatal Admission Study cases in OpenClinica but I can't see my Previous PPH cases - where are they?

To see your Previous PPH cases you need to click on the Change Study/Site link at the top of the screen in OpenClinica. You will then be able to switch to see your Previous PPH cases. To check that you are looking at the correct screen, for the Previous PPH Study you should see UKMidSS: Previous PPH at the top of the screen and your Case IDs should all begin with PP_.

I've reported a case, but realise that I made a mistake and the woman wasn't a case after all. What should I do?

Please contact us on ukmidss@npeu.ox.ac.uk and give us the Case ID of the woman concerned. Please do not 'stop' or change the 'status' of the case in OpenClinica in any way.

Do we have to respond to the monthly reporting emails within a certain period of time?

We don't have a time limit, but you will receive an email every month so it will be easier for you if you don't get too far behind. We will contact you to remind you if we haven't hear from you for a couple of months.

Neonatal Admission Study

What is a 'case'?

For the Neonatal Admission Study a 'case' is any woman who gives birth in the midwifery unit and whose baby is:

  • Admitted to neonatal care (neonatal intensive care, high dependency care or special care) within 48 hours of birth or before discharge home, whichever is sooner, for at least four hours, OR
  • Stillborn or dies within 48 hours of birth without admission to neonatal care.

Do NOT include:

  • Any woman who gives birth in the midwifery unit and whose baby is admitted to transitional care only (i.e. on a dedicated transitional care ward or within a postnatal ward).
  • Any woman who gives birth in the midwifery unit and whose baby is admitted to neonatal care for less than four hours.
  • Any women whose baby is confirmed to have died before the start of care in the midwifery unit.
Does a 'case' have to give birth in the AMU? What if they transfer during labour to the obstetric unit?

For this study 'cases' do have to give birth in the AMU. If a woman receives some of her labour care in the AMU, but is transferred before birth she should not be reported as a case.

When you ask for the total number of women giving birth in the unit, is this in the AMU/birth centre or in the hospital as a whole?

We are only ever interested in the numbers for your AMU/birth centre. So, each month we need to know the total number giving birth in your AMU/birth centre.

I've reported a case, but realise that I made a mistake and the woman wasn't a case after all. What should I do?

Please contact us on ukmidss@npeu.ox.ac.uk and give us the Case ID of the woman concerned. Please do not 'stop' or change the 'status' of the case in OpenClinica in any way.

Do we have to respond to the monthly reporting emails within a certain period of time?

We don't have a time limit, but you will receive an email every month so it will be easier for you if you don't get too far behind. We will contact you to remind you if we haven't hear from you for a couple of months.

Why are you asking for data about 'controls' as well as the 'cases'?

One of the things we want to do in this study is compare the characteristics and care of 'cases', i.e the women whose baby was admitted to neonatal care, with other more typical women who gave birth in the midwifery unit whose baby was not admitted. To do this we need to collect data on 'controls' or comparison women.

How do we identify the 'controls' – can we just choose any comparison women?

It's really important that controls are identified carefully and in the same way everywhere. That way we know that our comparison group is representative of women giving birth in AMUs. For each case, we are asking you to identify two controls. To identify these controls, make a note of the date and time the case gave birth. Then check your unit birth register or electronic records to find the two women who gave birth in the AMU immediately before the case. These women are your controls for that case.

What happens if one of the two women admitted immediately before a case was also a case?

In this instance you should go further back in your birth register to identify the two non-case women who gave birth immediately before each case. For example, if you have two cases who gave birth one after the other, your controls for those two cases would be the four women admitted who gave birth immediately before the first case.

Can we only enter the more detailed data on our cases at the end of the month? It might be harder to track down women's notes once they've gone home.

At the beginning of every month we will ask you to report on your cases for the previous month. As soon as you report a case a unique 'Case ID' and data collection forms will be automatically generated for that woman and you will be able to enter data using OpenClinica. If you wish to identify cases and collect the data you will need from women's notes as you go along you may use our Sample Data Collection Forms to record the data prior to entering it on OpenClinica at a later date.

I have identified a woman as a case and retrieved the notes for data entry, but her baby has not yet been discharged from neonatal care. Should I go ahead and enter the data?

You have two options: (1) You can wait and enter data after the baby has been discharged, or (2) You can enter data now. If you choose option 2 we will then schedule a short four-question update form in OpenClinica, for completion once the baby has been discharged.

I've already used OpenClinica to enter data on cases and controls for the Severe Obesity Study, but I can't see my Neonatal Admission Study cases in OpenClinica - where are they?

To see your Neonatal Admission Study cases you need to click on the Change Study/Site link at the top of the screen in OpenClinica. You will then be able to switch to see your Neonatal Admission Study cases. To check that you are looking at the correct screen, for the Neonatal Admission Study you should see UKMidSS: Neonatal Admission at the top of the screen and your Case IDs should all begin with NA_.

Technical issues

Do we need any particular software to report to UKMidSS?

Our reporting and data collection systems use email and web browsers, the programme that you use to access the internet. UKMidSS should work with the following browsers, but in every case we recommend updating your browser to the latest possible version:

  • Internet Explorer (version 11 or later)
  • Microsoft Edge (all versions)
  • Firefox (version 47 or later)
  • Chrome (version 49 or later)

If you use Google Chrome to access OpenClinica you will see a message saying that Firefox and Internet Explorer are recommended. Don’t worry, Google Chrome will work just as well. If you have any problems please email us on ukmidss@npeu.ox.ac.uk

I haven’t received my OpenClinica password, or my OpenClinica password doesn’t work. What should I do?

Please email us on ukmidss@npeu.ox.ac.uk