Surveillance of pregnant women with potential exposure to Zika virus following travel.

Aim: To describe the experience of a single fetal medicine unit in evaluating pregnant women with potential exposure to Zika virus (ZIKV) following travel.

Method: Between February 2016 and June 2017, a multidisciplinary team evaluated pregnant women by developing a local pathway based on Public Health England guidance. All pregnant women were offered serial fetal ultrasound scans (USS).

Higher prevalence and earlier appearance of geriatric phenotypes in old adults with type 2 diabetes mellitus.

Aims: To compare the prevalence of cognitive dysfunction, depression, lower mobility performance, disability and falls in older community-dwelling individuals with type 2 diabetes mellitus (T2DM) and in controls of similar age.

Methods: We conducted a cross-sectional study in primary health care settings in 3 semi-urban regions in Greece. Were assessed 403 community-dwelling older persons (age ≥65 years, median: 73), 198 with and 205 without diabetes.

Case report: successful open resection of a symptomatic giant liver haemangioma during the second trimester of pregnancy.

Liver haemangiomas are consistently reported to be the commonest benign liver tumours and are most often incidental findings in asymptomatic individuals. Large lesions can become symptomatic, spontaneously rupture or result in a consumptive coagulopathy known as Kasabach-Merrit Syndrome. It is believed that the female sex hormones, particularly oestrogen, have an influence on haemangioma development and growth.

Early fetal growth in progesterone-treated IVF pregnancies.

Purpose: The aim of this study was to compare fetal growth in the first and second trimesters of pregnancy and final birth weights between two groups of women: (a) spontaneous conceptions with reliable menstrual dates and (b) IVF pregnancies on progesterone supplementation during the first trimester.

Methods: We included in the study 73 singleton IVF pregnancies and 138 singleton spontaneous pregnancies. Exclusion criteria were: medications or presence of medical conditions affecting fetal growth.

Spontaneous live unilateral twin ectopic pregnancy - A case presentation.

The incidence of ectopic pregnancy has increased in recent years and now is around one in 100 pregnancies. However, the incidence of live twin ectopic pregnancy in a spontaneous conception is still quite rare. A 34-year-old gravida 3, para 0 presented in the Early Pregnancy Unit with a positive pregnancy test, lower abdominal pain and vaginal spotting.

Vibration effects on static balance and strength.

The purpose of this study was to investigate the effects of a vibration training protocol and a conventional strength training program consisting of similar exercises on knee extensors and flexors strength and postural sway in middle-aged women. 38 women were randomly assigned into a Vibration Group (n=12, static and dynamic exercises on a vibration plate, frequency: 15-25 Hz, amplitude: 2-12.8 cm), a Strength Group (n=16, same exercises without vibration) and a Control Group (n=10).

How do you solve the problem of recurrent miscarriage?

Recurrent miscarriage is the loss of two or more consecutive pregnancies and affects 1% of couples trying to conceive. It has proven to be frustrating for both patient and clinician. The majority of investigations and treatments offered remain controversial.

Menstrual problems in university students: an electronic mail survey.

Objective: To establish the prevalence of menstrual-related problems among university students.

Materials And Methods: A questionnaire regarding gynecological, bleeding and family history was sent by electronic mail (e-mail) to all female students attending University College London (UCL).

Results: A total of 767 students aged 18-39 years replied; 71% had a regular menstrual cycle.

Outpatient medical management of missed miscarriage using misoprostol.

We wanted to evaluate the efficacy, safety and acceptability of misoprostol for outpatient management of missed miscarriage. This was a prospective observational study conducted in the early pregnancy unit of a university teaching hospital involving women attending the unit with a diagnosis of missed miscarriage. All women with a missed miscarriage of <12 weeks' gestation and opting to have medical management were eligible for inclusion.

Is primary postpartum haemorrhage a good predictor of inherited bleeding disorders?

A study was conducted to evaluate the value of screening for inherited bleeding disorders in women with primary postpartum haemorrhage (PPH). Over a 2-year period, women identified to have PPH (defined as >500 mL blood loss for spontaneous vaginal delivery, >700 mL for instrumental deliveries and >1000 mL for caesarean sections within 24 h of delivery) were invited to participate in this study testing for a possible underlying bleeding disorder at 3-9 months post-delivery. Women known to have an inherited bleeding disorder were excluded.

Screening for factor XI deficiency amongst pregnant women of Ashkenazi Jewish origin.

A pilot study was conducted over a 6-month period to evaluate antenatal screening for factor XI (FXI) deficiency amongst Ashkenazi Jewish women booking for their pregnancy in a single obstetric unit. Fifty-four women of Ashkenazi Jewish origin were recruited during their visit for the routine first trimester ultrasound scan. They completed a questionnaire about their personal bleeding symptoms and had blood taken for FXI levels (FXI:C).

Identification and management of women with inherited bleeding disorders: a survey of obstetricians and gynaecologists in the United Kingdom.

A mail survey of members and fellows of Royal College of Obstetricians and Gynaecologists was carried out to determine current practices of obstetricians and gynaecologists in the United Kingdom in the management of women with inherited bleeding disorders. In total, 3929 questionnaires were sent, 707 returned and analysis was limited to 545 valid questionnaires. In the past 5 years, 91% have managed women with inherited bleeding disorders.

Prevalence of Chlamydia trachomatis and bacterial vaginosis in women presenting to the early pregnancy unit.

A total of 674 women attending the early pregnancy unit during the study period were offered screening with high vaginal and endocervical swabs and 516 agreed to participate in the study. The overall prevalence of chlamydia was 1.96% (95% CI 0.

Psychological outcome in women undergoing termination of pregnancy for ultrasound-detected fetal anomaly in the first and second trimesters: a pilot study.

Objective: To ascertain and compare psychological morbidity following first- and second-trimester termination for fetal anomaly.

Methods: This was a cohort study of 30 women aged 20-40 years in a north London teaching hospital, 14 of whom had had a first-trimester termination and 16 a second-trimester termination for fetal anomaly. The main outcome measures were questionnaire data (General Health Questionnaire-28, Beck Depression Inventory, Perinatal Grief Scale, Impact of Event Scale (IES)) at 6 weeks, 6 months and 12 months after termination.

The use of levonorgestrel-releasing intrauterine system for treatment of menorrhagia in women with inherited bleeding disorders.

Background: The levonorgestrel-releasing intrauterine system (LNG-IUS) is used commonly by gynaecologists as a contraceptive and to treat menorrhagia. However, its efficacy has not been examined in women with inherited bleeding disorders.

Design: A prospective pilot study.

Second trimester maternal serum biochemical screening for Down's syndrome: experience of a single obstetric unit.

The objective of this study was to assess the effects of mid-trimester biochemical screening on the prenatal diagnosis of Down's syndrome. All patients booked for antenatal care at the Royal Free Hospital are offered a double marker biochemical screening test (alpha-fetoprotein and free beta human chorionic gonadotrophin). The results of double marker screening tests and the notes of all cases of trisomy 21 from 1 April 1993 to 31 March 1995 were reviewed.

von Willebrand disease in women with menorrhagia: a systematic review.

Objective: To determine the prevalence of von Willebrand disease in women presenting with menorrhagia.

Design: Systematic review of studies evaluating the prevalence of von Willebrand disease in women with menorrhagia.

Setting: Hospital outpatient clinics (mainly gynaecological) and population surveys.

Travel in pregnancy: pregnant women's experiences and knowledge of health issues.

Background: Long-distance travel is becoming increasingly common, and there are few evidence-based recommendations for pregnant women in this area. We aimed to investigate our patients in the third trimester to establish how common foreign travel was, how much knowledge they had, and where they had obtained information.

Methods: We performed a questionnaire survey of our patients in the third trimester in 2001 at the time of a routine ultrasound scan.

Patient acceptance of transvaginal sonography in the early pregnancy unit setting.

Objective: To establish the acceptability of transvaginal scanning in patients attending an early pregnancy unit (EPU) due to problems in early pregnancy such as vaginal bleeding.

Methods: An unselected group of pregnant women who were less than 8 weeks' gestation were invited to complete a questionnaire before the transvaginal scan regarding their views about the pregnancy and about the scan itself. They were asked to complete a second questionnaire after the scan had been performed.

Examination of fetal nasal bone and repeatability of measurement in early pregnancy.

Objective: To evaluate the examination and measurement of fetal nasal bone at 10-14 weeks of gestation.

Methods: The study included 501 fetuses in 496 consecutive pregnant women attending for the routine first-trimester ultrasound examination. The presence or absence of the fetal nasal bone was determined in the mid-sagittal plane and the length was measured by one of four examiners (measurement A; n = 501).

The use of three-dimensional ultrasound for fetal gender determination in the first trimester.

The objective of this study was to examine the accuracy of fetal gender prediction at a routine first trimester scan using three-dimensional (3D) ultrasound. 200 women were recruited for this study and they agreed to have a transvaginal scan for their routine first trimester scan for fetal anatomy and nuchal thickness measurement. 3D volumes were obtained and stored.