Impact of deep or ovarian endometriosis on pelvic pain and quality of life: prospective cross-sectional ultrasound study.

Objective: To assess whether premenopausal women diagnosed with deep or ovarian endometriosis on transvaginal sonography (TVS) were more likely to suffer from dyspareunia and pelvic pain symptoms, and have a lower quality of life, compared to women without sonographically diagnosed deep or ovarian endometriosis.

Methods: This was a prospective, cross-sectional study carried out between February 2019 and October 2020 at the general gynecology clinic at University College London Hospital, London, UK. All premenopausal women aged 18-50 years, who were examined consecutively by a single experienced examiner and underwent a detailed TVS scan, were eligible for inclusion.

Ectopic pregnancy.

Ectopic pregnancy, defined as the implantation of a developing pregnancy outside of the endometrial cavity of the uterus, is the leading cause of early-pregnancy maternal mortality. The majority of ectopic pregnancies implant in a fallopian tube. Acute complications may include rupture of the fallopian tube or rupture of ectopic pregnancy, haemorrhage and hypovolaemic shock, or occur secondary to treatments such as emergency surgery or blood transfusions, and ultimately increase the risk of maternal death.

Three-Dimensional Volume Ultrasound Assessment of Cesarean Scar Niche and Cervix in Pregnant Women: A Reproducibility Study.

Objective: To assess the reproducibility of standardized 3-dimensional (3D) ultrasound volume analysis of the dimensions and the position of cesarean birth (CB) scar niche relative to the cervix in pregnant women.

Methods: This prospective single-center study in women with 1 previous CB ≥8 cm cervical dilatation acquired ultrasound volumes between 11 and 24 weeks' gestation in a mid-sagittal plane. Two experienced operators processed the volumes using virtual organ computer-aided analysis.

Outcome Reporting in Studies Investigating Treatment for Caesarean Scar Ectopic Pregnancy: A Systematic Review.

Background: Caesarean scar ectopic pregnancy (CSEP) is associated with significant maternal and foetal morbidity. However, the optimal treatment remains unknown.

Objectives: The aim of this study was to review outcomes reported in studies on CSEP treatment and outcome reporting quality.

An age-related nomogram for antral follicle count: an observational study of 3821 women.

Research Question: What is the relationship between antral follicle count (AFC) and chronological age, and what are the expected values for AFC?

Design: This was a retrospective cohort study at a specialist gynaecological ultrasound centre in London, UK. Women presenting to a gynaecology diagnostic unit for investigation of symptoms or routine check-up, and undergoing transvaginal ultrasound (TVUS) examinations, between 1 January 2017 and 22 September 2022 were included in this study.

Results: In total, 8821 TVUS records from 7573 patients were analysed.

Freedom for some, but not for Mum: the reproductive injustice associated with pandemic 'Freedom Day' for perinatal women in the United Kingdom.

Introduction: Healthcare services for pregnant and postpartum ('perinatal') women were reconfigured significantly at the advent and for the duration of the SARS-CoV-2 pandemic, and despite the United Kingdom announcing 'Freedom Day' on 19 July 2021 (whereafter all legal lockdown-related restrictions were lifted), restrictions to maternity (antenatal, intrapartum, and postnatal) services remained. This study presents data from eight perinatal women about their experiences of psychosocial wellbeing and maternity care in the post-'Freedom Day' epoch.

Methods: Semi-structured interviews were conducted virtually, with data recorded, transcribed, and analysed by hand.

Preliminary findings on the experiences of care for women who suffered early pregnancy losses during the COVID-19 pandemic: a qualitative study.

Background: Women who suffer an early pregnancy loss require specific clinical care, aftercare, and ongoing support. In the UK, the clinical management of early pregnancy complications, including loss is provided mainly through specialist Early Pregnancy Assessment Units. The COVID-19 pandemic fundamentally changed the way in which maternity and gynaecological care was delivered, as health systems moved to rapidly reconfigure and re-organise services, aiming to reduce the risk and spread of SARS-CoV-2 infection.

Development of deep pelvic endometriosis following acute haemoperitoneum: a prospective ultrasound study.

Study Question: Is acute haemoperitoneum that is managed conservatively a precursor of deep endometriosis?

Summary Answer: Our study provides evidence to suggest that acute haemoperitoneum may lead to the development of deep endometriosis in a significant proportion of cases.

What Is Known Already: A recent pilot study was the first to suggest that acute haemoperitoneum could be a precursor of deep endometriosis. However, the sample size was small, and the follow-up was not standardized owing to unknown rates of clot absorption and development of endometriosis.

Obstetric outcomes in women with pelvic endometriosis: a prospective cohort study.

Objective: To determine whether obstetric outcomes differ between women with endometriosis and those without, where all women undergo first-trimester screening for endometriosis.

Design: A prospective observational cohort study.

Setting: The Early Pregnancy Unit at University College London Hospital, United Kingdom.

Amniotic sac diameter reference interval in early pregnancy between 7 and 10 weeks' gestation.

Objective: To establish a normal reference interval for amniotic sac diameter (ASD) between 7 + 0 and 9 + 6 weeks' gestation and its relative size in relation to gestational sac diameter (GSD) and the embryo crown-rump length (CRL).

Methods: This was a prospective, cross-sectional study of consecutive women presenting to the Early Pregnancy Unit, University College Hospital, London, UK, between August 2022 and June 2023. We included live, normally sited, singleton pregnancies with a normal 20-week anomaly scan.

Ultrasound study of natural progression of ovarian endometrioma.

Objective: To determine the natural progression of ovarian endometrioma in women who are managed expectantly.

Methods: This was a retrospective cohort study of 83 women with evidence of ovarian endometrioma who were managed expectantly between April 2007 and May 2022. The study was conducted in the Department of Women's Health, University College London Hospitals and The Gynecology Ultrasound Centre, London, UK.

Prediction of spontaneous preterm birth in women with previous full dilatation cesarean delivery.

Background: A previous term (≥37 weeks' gestation), full-dilatation cesarean delivery is associated with an increased risk for a subsequent spontaneous preterm birth. The mechanism is unknown. We hypothesized that the cesarean delivery scar characteristics and scar position relative to the internal cervical os may compromise cervical function, thereby leading to shortening of the cervical length and spontaneous preterm birth.

Development of a single-visit protocol for the management of pregnancy of unknown location following in vitro fertilization: a retrospective study.

Study Question: Can women with pregnancy of unknown location (PUL) following in vitro fertilization (IVF) be risk-stratified regarding the subsequent need for medical intervention, based on their demographic characteristics and the results of serum biochemistry at the initial visit?

Summary Answer: The ratio of serum hCG to number of days from conception (hCG/C) or the initial serum hCG level at ≥5 weeks' gestation could be used to estimate the risk of women presenting with PUL following IVF and needing medical intervention during their follow-up.

What Is Known Already: In women with uncertain conception dates presenting with PUL, a single serum hCG measurement cannot be used to predict the final pregnancy outcomes, thus, serial levels are mandatory to establish a correct diagnosis. Serum progesterone levels can help to risk-stratify women at their initial visit but are not accurate in those taking progesterone supplementation, such as women pregnant following IVF.

Women's experiences of early pregnancy loss services during the pandemic: A qualitative investigation.

Problem: Early pregnancy losses [EPL] are common, varied, and require different courses of management and care.

Background: In the UK, women who suspect or suffer a pregnancy loss are usually provided specialist care in early pregnancy assessment units [EPAUs]. Their configuration has recently been evaluated, but recommendations for change in-line with best practice for optimum outcomes were unable to be implemented due to the COVID-19 pandemic health system shock.

Ovarian ectopic pregnancy: clinical characteristics, ultrasound diagnosis and management.

Objective: To compare the clinical, ultrasound and biochemical characteristics of ovarian ectopic pregnancy (OEP) with those of tubal ectopic pregnancy (TEP).

Methods: This was a retrospective case-control study of women with OEP and those with TEP seen at a single center between December 2010 and February 2021. OEP was defined as a pregnancy located completely or partially within the ovarian parenchyma, seen separately to a corpus luteum, if a corpus luteum was present within the ipsilateral ovary.

Prior-Guided Attribution of Deep Neural Networks for Obstetrics and Gynecology.

Obstetrics and gynecology (OB/GYN) are areas of medicine that specialize in the care of women during pregnancy and childbirth and in the diagnosis of diseases of the female reproductive system. Ultrasound scanning has become ubiquitous in these branches of medicine, as breast or fetal ultrasound images can lead the sonographer and guide him through his diagnosis. However, ultrasound scan images require a lot of resources to annotate and are often unavailable for training purposes because of confidentiality reasons, which explains why deep learning methods are still not as commonly used to solve OB/GYN tasks as in other computer vision tasks.

Intra- and interobserver reproducibility of transvaginal ultrasound for the detection and measurement of endometriotic lesions of the bowel.

Introduction: The number and invasion depth of endometriotic bowel lesions, total length of bowel affected by endometriosis, lesion-to-anal verge distance, and extent of pouch of Douglas obliteration are important factors in preoperatively determining risk and complexity of endometriosis surgery. The intra- and interobserver reproducibility of transvaginal ultrasound in the evaluation of many of these parameters has not yet been investigated. Our study aimed to assess the intra- and interobserver reproducibility of transvaginal ultrasound between an experienced and less experienced examiner for all of these parameters.

Natural history of endometriosis in pregnancy: ultrasound study of morphology of deep endometriosis and ovarian endometrioma.

Objective: To assess the morphological appearance of deep endometriosis and ovarian endometrioma in pregnancy using pelvic ultrasound examination.

Methods: This was a prospective observational cohort study conducted over 3 years at University College London Hospital, which is a tertiary level referral unit for early pregnancy complications and an accredited endometriosis center. All women who participated provided written consent and were invited for surveillance ultrasound examination at the time of their routine scans in pregnancy.

Effectiveness of treatment options for tubal ectopic pregnancy: A systematic review and network meta-analysis.

Background: Tubal ectopic pregnancy (TEP) is a common gynaecological emergency. Several medical and surgical treatment options exist, but it is not clear which is the safest and most effective treatment.

Objectives: To compare the effectiveness of expectant, medical and surgical treatment options for TEP using a systematic review and network meta-analysis.