Publications by authors named "Natalie Nunes"
Background: Tubal ectopic pregnancies can cause substantial morbidity or even death. Current treatment is with methotrexate or surgery. Methotrexate treatment fails in approximately 30% of women who subsequently require rescue surgery.
View Article and Find Full Text PDFTrial Design: A randomised, parallel-group, double-blind, placebo-controlled multicentre study with health economic and nested qualitative studies to determine if mifepristone (Mifegyne, Exelgyn, Paris, France) plus misoprostol is superior to misoprostol alone for the resolution of missed miscarriage.
Methods: Women diagnosed with missed miscarriage in the first 14 weeks of pregnancy were randomly assigned (1 : 1 ratio) to receive 200 mg of oral mifepristone or matched placebo, followed by 800 μg of misoprostol 2 days later. A web-based randomisation system allocated the women to the two groups, with minimisation for age, body mass index, parity, gestational age, amount of bleeding and randomising centre.
Background: The anti-progesterone drug mifepristone and the prostaglandin misoprostol can be used to treat missed miscarriage. However, it is unclear whether a combination of mifepristone and misoprostol is more effective than administering misoprostol alone. We investigated whether treatment with mifepristone plus misoprostol would result in a higher rate of completion of missed miscarriage compared with misoprostol alone.
View Article and Find Full Text PDFArticle Synopsis
- Progesterone is important for a healthy pregnancy, and some smaller studies suggest it might help women who have bleeding early in pregnancy.
- This study looked at how effective vaginal progesterone is for pregnant women with bleeding in the first 12 weeks and also checked if it was worth the cost.
- Over 4,100 women participated, and while the live birth rate was slightly higher in the progesterone group, the difference wasn't huge, and previous miscarriages affected some results.
Article Synopsis
- - A study assessed thyroid dysfunction in asymptomatic women aged 16 to 41 who have experienced miscarriage or subfertility while trying to conceive, involving nearly 20,000 participants across UK hospitals from 2011 to 2016.
- - The study found that 4.8% of women had abnormal thyroid function, with 0.2% having overt hypothyroidism and 0.3% overt hyperthyroidism; notable rates of subclinical hypothyroidism increased significantly when TSH levels were defined more strictly.
- - Factors linked to higher rates of thyroid dysfunction included a BMI of 35.0 kg/m² or higher, Asian ethnicity, and a history of subfertility, while 9.5%
Background: Bleeding in early pregnancy is strongly associated with pregnancy loss. Progesterone is essential for the maintenance of pregnancy. Several small trials have suggested that progesterone therapy may improve pregnancy outcomes in women who have bleeding in early pregnancy.
View Article and Find Full Text PDFBackground: Thyroid peroxidase antibodies are associated with an increased risk of miscarriage and preterm birth, even when thyroid function is normal. Small trials indicate that the use of levothyroxine could reduce the incidence of such adverse outcomes.
Methods: We conducted a double-blind, placebo-controlled trial to investigate whether levothyroxine treatment would increase live-birth rates among euthyroid women who had thyroid peroxidase antibodies and a history of miscarriage or infertility.
Background: Adnexal tumours are frequently diagnosed in asymptomatic postmenopausal women due to more liberal use of modern high-resolution imaging. This study's objective was to determine if there would be a difference in the intervention rates when using the Simple Rules Management Protocol (SRMP) as compared to the Risk of Malignancy Index in the Royal College of Obstetricians and Gynaecologists guideline (RMI/RCOG).
Methods: This was a prospective randomised controlled trial with the participants and the researchers non-blinded, and the surgeons and pathologists blinded.
Objectives: This study aimed to assess the accuracy of the International Ovarian Tumour Analysis (IOTA) logistic regression models (LR1 and LR2) and that of subjective pattern recognition (PR) for the diagnosis of ovarian cancer.
Methods And Materials: This was a prospective single-center study in a general gynecology unit of a tertiary hospital during 33 months. There were 292 consecutive women who underwent surgery after an ultrasound diagnosis of an adnexal tumor.
Introduction: Detection of asymptomatic adnexal tumours in postmenopausal women has increased due to wider use of diagnostic ultrasound and imaging quality improvements. Reliable methods to differentiate between benign and malignant tumours are required to avoid delays in treating ovarian cancer and to prevent unnecessary interventions for benign lesions. In the UK, the Royal College of Obstetricians and Gynaecologists has issued guidance for the management of adnexal cysts in postmenopausal women, which is considered standard in routine clinical practice.
View Article and Find Full Text PDFObjective: To describe the presentation and outcome of a patient with an unusual association of VATER/VACTERL syndrome (vertebra/anus/cardiac/trachea/esophogus/radius/renal/limb) and noncommunicating functioning uterine horn and a unicornuate uterus.
Design: Descriptive case report.
Setting: A foundation trust in the United Kingdom.