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Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 20, 2009 Category: OBGYN Authors: Alec McEwan Tags: Self-assessment Source Type: journals

How to write and how to answer EMQsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article briefly outlines the process of examination construction, the advantages and disadvantages of extended matching questions and an approach to such questions when writing and answering examination papers. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 20, 2009 Category: OBGYN Authors: Julian L. Burton Tags: Ethics/Education Source Type: journals

Management of the critically ill obstetric patientEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Obstetric critical illnesses represent a small but important proportion of all intensive care unit (ICU) admissions in the UK. They are challenging to the critical care team because of the unique physiology and specific medical disorders seen in this population. Maternal mortality is fortunately rare, but devastating when it occurs, with the commonest causes of death being cardiac disease and venous thromboembolism. Massive obstetric haemorrhage, pre-eclampsia and genital tract sepsis are also important causes, and these are reflected in the reasons for ICU admission in the obstetric population. Maternal mortalit...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 20, 2009 Category: OBGYN Authors: Laura Claire Price, Sarah Germain, Duncan Wyncoll, Catherine Nelson-Piercy Tags: Reviews Source Type: journals

The implications of obesity on pregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Obesity is a modern day epidemic. The incidence appears to be rapidly increasing in both developed and developing countries and has become much more obvious in the last decade. It is regarded as one of the major risk factors in pregnant women and has particularly gained recognition in obstetric practice due to its potentially adverse effects on pregnancy and the fetus.There is evidence to show that obesity in pregnancy contributes to increased morbidity and mortality in both mother and baby. It is associated with adverse outcomes such as preeclampsia, gestational diabetes, thromboembolism, fetal abnormalities and...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 20, 2009 Category: OBGYN Authors: Rekha Wuntakal, Tony Hollingworth Tags: Reviews Source Type: journals

Thromboembolism and thrombophilia in pregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article discusses the risk factors for VTE in pregnancy, the management of the pregnant woman at risk both antenatally and postpartum and the acute management of VTE when it occurs during pregnancy.The thrombophilias, both heritable and acquired are becoming increasingly recognised as a cause of morbidity and mortality both within and outside pregnancy. There has been recent increased interest in the thrombophilias and their link with recurrent miscarriage, pre-eclampsia, abruption and intrauterine growth restriction. The relationship between the thrombophilias and adverse pregnancy outcome is addressed in detail with...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 20, 2009 Category: OBGYN Authors: Catherine J. Calderwood, Omar I. Thanoon Tags: Reviews Source Type: journals

Ultrasound prenatal diagnosis of structural abnormalitiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: One of the major roles of ultrasound in pregnancy is the detection of structural abnormalities. Ultrasound screening has become an accepted part of antenatal practice. However there is a wide variety in the practice between different centers. The majority of fetal anomalies are diagnosed by ultrasound in the second trimester. However, a number of abnormalities are amenable to diagnosis as early as 11–14 weeks gestation. National guidelines have been adopted in an attempt to standardize the practice in the UK. Prenatal detection rate is higher in countries with a national screening program. Prenatal ultrasound i...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 20, 2009 Category: OBGYN Authors: Jessica Moore, Amar Bhide Tags: Reviews Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 20, 2009 Category: OBGYN Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 1, 2009 Category: OBGYN Authors: Alec McEwan Tags: Self-assessment Source Type: journals

Consultant presence in the hospitalEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ideally all women suffering an obstetric complication or a gynaecological emergency should be attended by a fully trained specialist. In the UK, this means a consultant or Certificate of Completion of Specialist Training (CCST) holder. The Royal College of Obstetricians and Gynaecologists (RCOG) is working towards this. The number of hours of consultant presence on the labour ward recommended by the College was set out in the document ‘Safer Childbirth’. Another document – ‘Standards in Maternity Care’ – clearly recommends an incremental increase in consultant presence on the labour ward up to 168 hours a week ...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 1, 2009 Category: OBGYN Authors: D. Rennie Urquhart, Tahir A. Mahmood Tags: Ethics/ Education Source Type: journals

Choice of contraceptionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Although we now have many contraceptives, couples still have a negative perception of their personal choices. Many know little about methods other than the combined pill and the condom and, in particular, knowledge of long-acting methods is very poor. A woman's choice of contraceptive will be influenced by many factors and her requirements will change with time. New contraceptives have appeared in the past couple of years but women are not always aware of their characteristics. As prescribers, it is our responsibility to ensure that couples are given sufficient and appropriate information to enable them to make d...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 1, 2009 Category: OBGYN Authors: Anne Szarewski Tags: Problem-based Learning Source Type: journals

Principles of surgical techniqueEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The principles in relation to gynaecological surgery are detailed. The importance of preoperative management, counselling, consent, surgical approaches, prophylaxis and proactive postoperative management are discussed. Gynaecological conditions are varied and descriptions of the individual surgical procedures are not included. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 1, 2009 Category: OBGYN Authors: Syeda Batool Mazhar, Mahmood I. Shafi Tags: Reviews Source Type: journals

Advances in foetal therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The past few years have seen rapid advances in the understanding and management of foetal disease. The development of high-resolution and three-dimensional/four-dimensional ultrasound and the ability to analyse foetal DNA in the maternal blood have proved to be exciting innovations. In-utero foetal therapy is, however, still limited by the complications of preterm labour and premature rupture of membranes and the further development of endoscopic procedures is dependent on improvements in the management of these complications. Moreover, application of foetal therapy in clinical practice has been restrained by ins...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 1, 2009 Category: OBGYN Authors: Mona Saad Moghazy Ahmed Salman, David K. James, George J. Bugg Tags: Reviews Source Type: journals

Screening for gynaecological conditionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Well-organised cervical screening programmes have reduced the mortality from cervical cancer by up to 50% in the developed world. Despite the successful development of human papilloma virus vaccines there is likely to remain a need for cervical screening for the foreseeable future. In contrast, the value of mass screening for ovarian cancer remains unproven, although current screening methods can detect early stage disease in asymptomatic individuals. Breast screening does appear to be associated with a reduction in mortality in women aged 50–69 years but disagreement remains about its value in younger and olde...
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 1, 2009 Category: OBGYN Authors: I.M. Symonds Tags: Reviews Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - November 1, 2009 Category: OBGYN Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - September 22, 2009 Category: OBGYN Authors: Alec McEwan Tags: Self-assessment Source Type: journals

Placental gene therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Gene therapy uses genetic material as a drug delivery vehicle to express therapeutic proteins. Placental gene therapy may be useful for correction of two important obstetric conditions, foetal growth restriction and pre-eclampsia in which there is a failure of the physiological trophoblast remodelling of the uterine spiral arteries in early pregnancy. The patient in this scenario is the foetus. Placental gene therapy might be justifiable when: there is reasonable certainty that the foetus will suffer irreversible and substantial harm without the intervention; the intervention is safe and effective; the risk to t...
Source: Obstetrics, Gynaecology and Reproductive Medicine - September 22, 2009 Category: OBGYN Authors: Anna L. David, Richard Ashcroft Tags: Ethics/Education Source Type: journals

Psychosexual problemsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Sexual problems commonly present in gynaecology clinics. They require both a physical and psychological approach to their management due to the combination of mind and body involvement in sexual activity. The skills involved in psychosexual medicine can be practised by all gynaecologists as they use the consultation and examination to recognise and treat the underlying problem in addition to addressing any physical factors. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - September 22, 2009 Category: OBGYN Authors: Claudine Domoney Tags: Problem-based Learning Source Type: journals

Connective tissue disorders and dermatological disorders in pregnancyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Connective tissue disorders, particularly those that are autoimmune, are being seen with increasing frequency in the pregnant population. The care of these patients in pregnancy ranges from the routine to the complicated, with some of the conditions posing significant risks both to the mother and the foetus.Dermatological conditions are often encountered in pregnancy and again range from the benign to those resulting in serious foetal and maternal morbidity, with a number being specific to pregnancy.An important issue for both groups of disorders is the use of particular medications during pregnancy. Those with p...
Source: Obstetrics, Gynaecology and Reproductive Medicine - September 22, 2009 Category: OBGYN Authors: Fergus McCarthy, Sarah J. Germain Tags: Reviews Source Type: journals

Imaging of the female pelvisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Recent advances in cross-sectional imaging have led to an increasingly important role for radiology in the management of gynaecological conditions. Multiple imaging modalities are utilised to investigate the female pelvis including: ultrasound; computed tomography; magnetic resonance imaging; and positron emission tomography/computed tomography. Each modality has a different role in screening, diagnosis, staging, treatment selection and follow-up. This review will discuss the various imaging techniques and recommended roles for each modality and how these modalities are best employed in the imaging of the female ...
Source: Obstetrics, Gynaecology and Reproductive Medicine - September 22, 2009 Category: OBGYN Authors: Susan Freeman, Frances Hampson, Helen Addley, Penelope Moyle, Evis Sala Tags: Reviews Source Type: journals

Polycystic ovarian syndrome: diagnosis and management of related infertilityEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory infertility accounting for about 75% of cases. It is defined as a syndrome of ovarian dysfunction associated with hyperandrogenism and polycystic ovary morphology. The diagnosis of PCOS is based on the presence of at least two of three criteria including: (1) olig-/anovulation; (2) hyperandrogenaemia (clinical and/or biochemical); and (3) polycystic ovaries on ultrasound scan. Several treatment options are available for women with anovulatory infertility related to PCOS including weight reduction, clomiphene citrate (CC), gonadotropins, la...
Source: Obstetrics, Gynaecology and Reproductive Medicine - September 22, 2009 Category: OBGYN Authors: Saad A.K. Amer Tags: Reviews Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - September 22, 2009 Category: OBGYN Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - August 14, 2009 Category: OBGYN Authors: Alec McEwan Tags: Self-assessment Source Type: journals

Revalidation and recertificationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Chief Medical Officer (CMO) of England published his report entitled ‘Trust, assurance and safety – the regulation of health professionals in the 21st century’ in February 2007. Within this document, proposals were made for health professionals to revalidate their registration periodically to demonstrate their continued fitness to practise. In the following year another report was published: ‘Medical Revalidation – Principles and Next Steps: the report of the Chief Medical Officer for England's working group’. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - August 14, 2009 Category: OBGYN Authors: Mahmood I. Shafi Tags: Ethics/ Education Source Type: journals

Medico-legal problems in obstetricsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: For a claim to succeed, both ‘Breach of Duty’ and ‘Causation’ need to be established. In medico-legal cases, the records and all documentation will be reviewed in detail; case records should be as clear, concise and accurate as possible. Deviation from protocols or guidelines does not necessarily constitute Breach of Duty, however, the reason for deviating from any protocol should be clearly stated within the medical records.Obstetric cases frequently involve cardiotocographs; to avoid retrospective over-interpretations of the changes in the foetal heart rate pattern, it is helpful to refer to recognised,...
Source: Obstetrics, Gynaecology and Reproductive Medicine - August 14, 2009 Category: OBGYN Authors: Philip N. Baker Tags: Problem-based Learning Source Type: journals

Ovarian hyperstimulation syndrome: pathophysiology, prevention and managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Ovarian hyperstimulation syndrome (OHSS) is the most important short-term complication of fertility treatment involving ovarian stimulation. The pathophysiology is mediated by vasoactive mediators released by hyperstimulated ovaries under the influence of human chorionic gonadotrophin (hCG) and is characterised by ovarian enlargement, increased vascular permeability, intravascular dehydration and their sequelae. A number of pre-treatment patient characteristics and ovarian response parameters are used in practice to predict the risk of OHSS but current methods have a poor predictive value. In women with risk fact...
Source: Obstetrics, Gynaecology and Reproductive Medicine - August 14, 2009 Category: OBGYN Authors: Alka Prakash, Tulay Karasu, Raj Mathur Tags: Reviews Source Type: journals

Malpositions and malpresentations of the foetal headEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article will describe these conditions, the clinical features associated with them and how to recognise and manage them. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - August 14, 2009 Category: OBGYN Authors: Serap Akmal, Sara Paterson–Brown Tags: Reviews Source Type: journals

The science and ethics of human admixed embryosEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Human admixed embryos contain various combinations of animal and human material but are nevertheless predominantly human. A new Human Fertilisation and Embryology Bill is due to come into force in October 2009 that will make provisions for research using four categories of human admixed embryos: cytoplasmic hybrids, true hybrids, transgenic embryos and chimeric embryos. The science underpinning this research relates to nuclear reprogramming and embryonic stem cell technology amongst others. The information gathered holds great promise for providing in-depth understanding of the molecular basis of disease as well ...
Source: Obstetrics, Gynaecology and Reproductive Medicine - August 14, 2009 Category: OBGYN Authors: Hayden Homer, Melanie Davies Tags: Reviews Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - August 14, 2009 Category: OBGYN Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - July 14, 2009 Category: OBGYN Authors: Alec McEwan Tags: Self-assessment Source Type: journals

Single embryo transferEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The traditional policy of transferring more than one embryo in an attempt to increase success rates is responsible for the high numbers of multiple pregnancies associated with in-vitro fertilisation. Elective single embryo transfer is the most effective way of reducing multiples and the associated risks of maternal and perinatal morbidity. In selected patients, the combination of such a policy with the opportunity to transfer additional frozen thawed embryos in successive cycles can lead to cumulative livebirth rates similar to those following double embryo transfer. Appropriate eligibility criteria, improvement ...
Source: Obstetrics, Gynaecology and Reproductive Medicine - July 14, 2009 Category: OBGYN Authors: D.S. Milingos, S. Bhattacharya Tags: Ethics/ Education Source Type: journals

Postpartum collapseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Postpartum collapse is rare in modern obstetrics and if not promptly diagnosed and effectively managed, can prove fatal. We provide a synopsis of the diagnosis and management of the most serious causes of postpartum maternal collapse and reflect on the recommendations of the latest Confidential Enquiry Report. Initiatives to improve maternal mortality and morbidity from postpartum collapse are also considered. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - July 14, 2009 Category: OBGYN Authors: S. Nanda, L.K. Penna Tags: Case-based Learning Source Type: journals

Dyspareunia in gynaecological practiceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Dyspareunia is defined as genital pain experienced just before, during or after sexual intercourse. It can significantly affect quality of life. It is a symptom of a variety of disease states with components of both physical and psychological dysfunction.It is important to obtain a comprehensive sexual history and perform a systematic examination of the lower genital tract to exclude any underlying pathology. Further investigations such as ultrasound rarely offer additional information. Diagnostic laparoscopy is an invasive procedure that is of limited use in the management of dyspareunia but may help detect pelv...
Source: Obstetrics, Gynaecology and Reproductive Medicine - July 14, 2009 Category: OBGYN Authors: Sambit Mukhopadhyay, Edward Morris Tags: Reviews Source Type: journals

Non-HIV sexually transmitted infectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: This review covers in broad terms developments in epidemiology, diagnosis and management of sexually transmitted infections. It does not cover human immunodeficiency virus (HIV) and hepatitis because the management of these two conditions is rarely if ever undertaken by gynaecologists. Management of all sexually transmitted infections is being standardised by the British Association of Sexual Health and HIV and their protocols are heavily quoted from here. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - July 14, 2009 Category: OBGYN Authors: Daniel Hay, Eimear Kieran Tags: Reviews Source Type: journals

Drugs in reproductive medicineEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Reproductive medicine encompasses much beyond the treatment of infertility. However, for the purpose of this article, we will focus primarily on the drugs in current use for the treatment of anovulatory infertility (where the aim of treatment is to achieve monofollicular development) and for in-vitro fertilisation (where multifollicular development in is the goal). Since the discovery and isolation of gonadotrophin (i.e. follicle-stimulating hormone, luteinising hormone and human chorionic gonadotrophin) and gonadotrophin-releasing hormone, an extensive variety of pharmacotherapeutic preparations have been develo...
Source: Obstetrics, Gynaecology and Reproductive Medicine - July 14, 2009 Category: OBGYN Authors: Monique D. Sterrenburg, Nick S. Macklon Tags: Reviews Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - July 14, 2009 Category: OBGYN Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 25, 2009 Category: OBGYN Authors: Alec McEwan Tags: Self-assessment Source Type: journals

Priorities in obstetrics and gynaecology in the developing worldEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Every minute of every day a woman in the developing world dies of an avoidable cause of death. For every woman dying there are at least another 20 women who are left with severe morbidity. These deaths can be prevented. The interventions required are clear, inexpensive and effective. Yet they are not universally available or accessible. The call for action has been made, yet the speed of progress is slow. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 25, 2009 Category: OBGYN Authors: Priya Agrawal, Nynke van den Broek Tags: Ethics/ Education Source Type: journals

Complications of laparoscopic surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Laparoscopic surgery has become the mainstay of surgical management of many benign and some malignant gynaecological conditions. Safety is of the highest priority in any surgical procedure and the next generation of laparoscopic surgeons require both practical and theoretical training in order to maximise surgical success and minimise complications. Training has become more structured and credentialed, with input from the Royal College of Obstetricians and Gynaecologists and other bodies to devise comprehensive educational objectives and guidance. These case-based scenarios illustrate some of the common problems ...
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 25, 2009 Category: OBGYN Authors: William L. Ledger Tags: Case-based Learning Source Type: journals

Medico-legal issues in gynaecologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Gynaecologists, like other healthcare professionals, have a legal obligation to adhere to a reasonable standard of care while acting in their professional capacity (the ‘duty of care’). A breach of this duty, whether due to proximate causes such as poor decision-making or to remote causes such as destitute safety culture in the organisation, could lead to litigation. This review discusses the burden and causes of litigation in gynaecology and outlines the process taken by a medico-legal claim. Failure to diagnose, intra-operative complications, unnecessary surgery, consent issues, poor supervision and retenti...
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 25, 2009 Category: OBGYN Authors: Leroy C. Edozien Tags: Reviews Source Type: journals

Vaginal birth after Caesarean section: a practical evidence-based approachEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article provides a practical evidence-based approach to the antenatal and intrapartum management of such women. A gestation-specific strategy is suggested. Women with an uncomplicated pregnancy and single previous lower segment Caesarean delivery may be managed in shared community care following counselling by a consultant midwife. It is important to provide complete informed consent detailing the risks and benefits for the woman that are individualised to her circumstances. It is estimated that planned vaginal birth after Caesarean exposes the woman to an additional 0.25% risk (or 1 in 400) for experiencing an advers...
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 25, 2009 Category: OBGYN Authors: George Goumalatsos, Rajesh Varma Tags: Reviews Source Type: journals

Vulvodynia managementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Vulvodynia is the cause of chronic vulval pain in the absence of skin disease and infection. It is considered difficult to manage by health professionals notably doctors. The reasons for this difficulty is that some patients will have a number of issues that need addressing, which falls out of the remit of gynaecologists’ training. As clinicians we should be able to assess and diagnose patients and then triage patients to the various disciplines related to vulval pain management depending on the individual needs of the patient. This review outlines the problem and offers some ideas on treatment. (Source: Obstet...
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 25, 2009 Category: OBGYN Authors: Ruchika Dhar, David Nunns Tags: Reviews Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 25, 2009 Category: OBGYN Source Type: journals

Self-assessmentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 1, 2009 Category: OBGYN Authors: Alec McEwan Tags: Self-assessment Source Type: journals

Midwifery-led birthing unitsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article outlines the evolution of these units, and the industry required to maintain them in the light of changing healthcare. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 1, 2009 Category: OBGYN Authors: Michele Mohajer, Angela Hughes, Swati Ghosh Tags: Ethics/Education Source Type: journals

Intrapartum deaths: missed opportunitiesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Although fetal and perinatal death remains a common event in obstetric practice, only a minority of these deaths occur during, or as a consequence of, events during labour or delivery. Unfortunately, many of these deaths are associated with substandard care. In some cases, avoidance of labour altogether, with delivery by Caesarean section, will prevent such adverse events and these risk factors can be determined antenatally. For most women, ostensibly ‘low-risk’ for such problems at the onset of labour, good midwifery and obstetric care, with the judicious use of fetal monitoring and intervention when concern...
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 1, 2009 Category: OBGYN Authors: Andrew C.G. Breeze, Christoph C. Lees Tags: Reviews Source Type: journals

Prevention and treatment of osteoporosis in women: an updateEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Approximately 45% of all women will suffer at least one osteoporotic fracture during their lifetime. Until recently, 25–50% of postmenopausal women were on hormone therapy often with prevention of osteoporosis as their main motivation. Following the Women’s Health Initiative, however, the use of hormone therapy has decreased by 30–40% in several countries. Fortunately, several other options for pharmacological intervention have been demonstrated to decrease the risk of fractures in randomised studies. Anti-catabolic drugs include calcium plus vitamin D, oestrogen, raloxifene, and bisphosphonates (e.g. alend...
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 1, 2009 Category: OBGYN Authors: Kim Brixen, Moustapha Kassem, Bo Abrahamsen Tags: Reviews Source Type: journals

Palliative care in gynaecological oncologyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Gynaecological malignancy accounts for significant patient morbidity and mortality. Clinical aims focus upon palliative management and supportive care when potentially curative treatment options are exhausted. Patients with recurrent, advancing or terminal disease may suffer severe and distressing physical and psychological effects associated with both cancer diagnosis and treatments. It is of paramount importance that patients, families and carers are provided with the assistance they need to have as high a quality of life as possible.This review focuses upon the provision of relief from pain and other distressi...
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 1, 2009 Category: OBGYN Authors: Julia Palmer, Alan Gillespie Tags: Reviews Source Type: journals

The postmenopausal bladderEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This article provides an overview on the aetiology and diagnosis of postmenopausal urinary dysfunction and reviews the evidence for the role of hormone therapy in its treatment. (Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 1, 2009 Category: OBGYN Authors: Shaaheen Khazali, Tim Hillard Tags: Reviews Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Obstetrics, Gynaecology and Reproductive Medicine)
Source: Obstetrics, Gynaecology and Reproductive Medicine - June 1, 2009 Category: OBGYN Source Type: journals