Women's Awareness of Periconceptional Use of Folic Acid Before and After Their Antenatal Visits.

Objective: The aim of this study is to assess women's awareness of the benefit and use of folic acid during pregnancy and to assess whether their knowledge has improved following hospital visits.

Method: This is a prospective survey conducted in a large teaching hospital in the UK. The survey questionnaire consisted of 28 questions about demographic variables, behavioral variables, and knowledge about folic acid and neural tube defects (NTDs).

Instrumental vaginal delivery--back to basics.

Assisted vaginal delivery using forceps or a vacuum extractor is an essential part of obstetric practice. Operative vaginal delivery rates in the UK have remained stable between 10% and 15%, yielding safe and satisfactory outcomes for the majority of mothers and their babies. However, there has been an increase in medico-legal cases due to an increasing awareness of the potential morbidity for both the mother and the baby.

Management of Cervical Fibroid during the Reproductive Period.

This is a case report of a 29-year-old lady who presented with excessive vaginal discharge and sessile cervical fibroid arising from the vaginal portion of the cervix. She was not suitable for uterine artery embolization as she has never previously been pregnant before. She was encouraged to get pregnant and to avoid surgical excision which can lead to hysterectomy.

Renal angiomyolipoma and lymphangioleiomyomatosis in pregnancy.

This is a literature review for management of angiomyolipoma (AML), lymphangioleiomyomatosis (LAM) and tuberous sclerosis (TS) during pregnancy, prompted by a case of a 23-year-old woman who presented with generalised itching at 31 weeks' gestation and was found to have a large vascular retroperitoneal mass in the lower pole of the left kidney. Magnetic resonance imaging (MRI) was suggestive of angiomyolipoma with multiple large aneurysms and haemorrhage within the tumour. She was delivered at 38 weeks by elective caesarean section, to avoid the risk of rupture and bleeding from the aneurysms during labour.

Pregnancy management following bariatric surgery.

Bariatric surgery is gaining in popularity, due to globally increasing rates of obesity. In the UK, this has manifested as a 14-fold increase in bariatric surgery between 2004 and 2010, making it necessary to develop strategies to manage women who become pregnant following bariatric surgery. This review paper has explored all the current evidence in the literature and provided a comprehensive management strategy for pregnant women following bariatric surgery.

Operative interventions in the management of major postpartum haemorrhage.

In many recent studies in the developed world, the incidence of postpartum haemorrhage (PPH) has been rising, though the mortality has come down, suggesting improvement in the management of this condition. Since the publication of the RCOG guidelines in 2009 for management of PPH and the Sheffield guidelines for the use of Rusch balloon along with the initial small case series (Keriakos and Mukhopadhyay 2006), many units have introduced the guidelines into clinical practice. This has led to the reduction of surgical intervention in our unit.

Pelvic girdle pain during pregnancy and puerperium.

Pelvic girdle pain (PGP) is a term used specifically to pregnancy-related pain in the lumbosacral, sacroiliac and symphysis pubis joints. Pregnancy-induced hormonal and physical changes increase the risk of musculoskeletal problems in pregnancy. The severity of these conditions varies from mild self-limiting pain to a severe disabling condition.

Review of the recent literature on the mode of delivery for singleton vertex preterm babies.

Choosing the safest method of delivery and preventing preterm labour are obstetric challenges in reducing the number of preterm births and improving outcomes for mother and baby. Optimal route of delivery for preterm vertex neonates has been a controversial topic in the obstetric and neonatal community for decades and continues to be debated. We reviewed 22 studies, most of which have been published over the last five years with an aim to find answers to the clinical questions relevant to deciding the mode of delivery.

Managing Major Postpartum Haemorrhage following Acute Uterine Inversion with Rusch Balloon Catheter.

Acute postpartum uterine inversion is a relatively rare complication. The uterus inverts and the uterine fundus prolapses to or through the dilated cervix. It is associated with major postpartum haemorrhage with or without shock.

Sheffield modified technique for external cephalic version.

External cephalic version (ECV) is the manipulation of the fetus, through the maternal abdomen, to a cephalic presentation. The incidence of caesarean section for breech presentation has increased markedly in the last 20 years. External version has become more popular in the past 10 years because of the increasing evidence of risks from vaginal breech delivery, increasing demand on the reduction of caesarean sections, a strong safety record, and high success rate of ECV of up to 80%.

Obstetric management and perinatal outcome of extreme prematurity: a retrospective study.

The aim of this retrospective study is to evaluate the obstetric management and perinatal outcome of extreme prematurity (22-27 weeks) in a busy teaching hospital between April 2004 and March 2005. A total of 57 babies were delivered in 49 women representing 0.9% of total births.

The use of the Rusch balloon for management of severe postpartum haemorrhage.

Tamponade techniques using a uterine balloon in management of postpartum haemorrhage has been reported increasingly in recent years. The aim of this retrospective study is to evaluate the use of the Rusch hydrostatic balloon in the management of severe postpartum haemorrhage not controlled by medical measures. All women had risk factors for PPH.

Screening for Down's syndrome: experience of two district general hospitals having different screening strategies.

The aim of this retrospective study is to determine the rate of reduction in the number of Down's syndrome babies delivered in two hospitals having different screening strategies. The total number of Down's syndrome babies during the study period was 0.6/1000 births at Birch Hill Hospital and 1.