Showing papers in "Obstetrics, Gynaecology & Reproductive Medicine in 2013"

TL;DR: The changes in cardiac physiology encountered in pregnancy that may unmask pre-existing cardiac disease and the effects of individual cardiac diseases in this context are described.

TL;DR: A conservative surgical technique called the ‘Triple P Procedure' which involves p eri-operative placental localization and delivery of the fetus via transverse uterine incision above the upper border of the placenta; p elvic devascularization; and p lacental non-separation with myometrial excision and reconstruction of the uterine wall has been described as a safe and effective alternative.

TL;DR: This work presents some common gastrointestinal and liver disorders focussing on the diagnosis, management and effects on pregnancy outcomes, and some common disorders related or unrelated to pregnancy.

TL;DR: The global target of eliminating mother-to-child-transmission (MTCT) requires a major and sustained effort to improve access to testing, antiretroviral therapy and expert multidisciplinary care.

TL;DR: 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 are discussed.

TL;DR: Attempts to reduce undermining that include awareness raising, local leadership, good role modelling and improving how the authors feedback to trainees are reported are reported.

TL;DR: Common bacterial STIs are focused on and practical issues for their management, including the issues of sensitivity about sexual health and behaviour, are discussed.

TL;DR: The current indications for assisted reproduction and the preparatory steps before starting treatment are reviewed and the treatment cycle including its main clinical and laboratory aspects, and the complications associated with treatment are summarized.

TL;DR: In this article, the authors explain aspects of handover in a hospital setting, particularly for those working shift patterns and on call duty, and incorporate situational briefing techniques such as the WHO surgical check list, and mnemonics or aid memoirs such as SBAR or SHARING.

TL;DR: Any delay in postoperative recovery especially with flank pain should raise the suspicion of urinary tract injury and prompt diagnostic evaluation should be undertaken, and surgical repair should be done by specialists with sufficient expertise and woman should be followed up to improve patient satisfaction and reduce litigation rates.

TL;DR: Evidence from recent systematic reviews supports the use of synthetic mesh for central and recurrent anterior compartment prolapse and the lack of strict premarketing approval and post marketing surveillance along with the acceptance of the mesh without robust evidence remains an issue.

TL;DR: In UK access to publicly funded ART is often restricted to couples and single women fulfilling certain criteria, agreed locally comprising of: female age, body mass index (BMI) and smoking status, which is in conflict with ethical principles of patient autonomy and justice.

TL;DR: The impact of obstetric interventions in labour on delivery related perinatal death, including rising rates of caesarean delivery, is complex and unclear.

TL;DR: Advice on antenatal vaccination should be based on the balance of risks and benefits to mother and fetus, and some of the issues surrounding commonly used vaccines are discussed and current UK guidelines are presented.

TL;DR: This review focuses on the physiology and current management of thyroid dysfunction and the rarer endocrine disorders in pregnancy, and includes current guidance on vitamin D supplementation.

TL;DR: In this paper, the authors show that although maternal diabetes and rare genetic syndromes may be the cause of large fetal size, most of these pregnancies will in fact be normal, maternal and perinatal risks do increase with increasing fetal size.

TL;DR: The need for new definitions and a standardized classification system for menstrual disorders and other contributors to the problem of abnormal uterine bleeding are described and their use is encouraged in routine clinical practice, medical education and scientific research.

TL;DR: Modern management of overactive bladder involves posterior tibial nerve stimulation, Botulinum toxin or sacral neuromodulation before surgery and it is these therapies that will be the focus of this review.

TL;DR: There is a lack of high quality evidence that they substantially improve important outcomes such as birth weight, prematurity, mortality or serious morbidity, so some promising new therapies are outlined, which may change the way these conditions are managed in the future.

TL;DR: The role of ultrasound in both benign and malignant gynaecology, early pregnancy and obstetrics is discussed, with the findings of common female pelvic and obstetric pathology considered and related to current evidence-based practice.

TL;DR: In the UK, the National Health Service (NHS) underwent its most significant reform in 2008 during its 60th anniversary when Lord Darzi led the NHS Next Stage Review, and clinicians were appointed to clinical programme boards in Strategic Health Authorities to lead change in services to improve patient outcomes.

TL;DR: Primary amenorrhoea is one such condition that can be caused by genetic, endocrine or structural disorders during the development of reproductive organs or may be constitutional in nature.

TL;DR: The basic principles required to undertake diagnostic and operative hysteroscopic surgery are discussed, the newer procedures available are discussed and the current evidence behind the use of hysteroscopy in the clinical setting is highlighted.

TL;DR: In this article, a detailed approach to clarify the risk-benefit relationship, general and safe principles of prescribing medications where uncertainty often exists, and the importance of communicating clearly with patients and engaging them in decision making and treatment are discussed.

TL;DR: Research is ongoing regarding therapeutic HPV vaccination and second generation prophylactic vaccines to prevent more cases of cancer and it is likely that the benefits will be seen over a 15–20 year period.

TL;DR: Revalidation provides a new method to achieve an emphasis on the development of robust outcome measures and the needs of the patient are central to all these developments.

TL;DR: The most common causes of menstrual dysfunction are reviewed, using case histories for illustration, to include menstrual dysfunction around the time of menarche, ovulatory and anovulatory dysfunctional uterine bleeding, polycystic ovarian syndrome, uterine fibroids and dysfunctional bleeding around the perimenopause.

TL;DR: Adolescence is a time of enormous physical and emotional development, the diagnosis and management of primary amenorrhoea requires dedicated teams to manage the complexities of transitioning between the paediatric and adult age group.

TL;DR: Recommendations for pre-operative risk assessment and methods for approaching complications in benign gynaecological surgery are focused on.