Spontaneous pneumomediastinum: A report of two cases at a district general hospital.

Spontaneous pneumomediastinum is a rare condition thought to be caused by excessive Valsalva manoeuvre during the second stage of labour. Women with pneumomediastinum typically presents with chest pain or tightness, dyspnoea, and a tearing sensation around the neck. It is commonly diagnosed with a chest radiograph but further imaging may be necessary to exclude more sinister conditions with similar clinical features.

COVID-19 and maternity care in South East London: shared working and learning initiative.

The SARS-CoV-2 COVID-19 pandemic has had an immediate and profound impact on how healthcare systems organise and deliver services and specifically, there is a disproportionate negative impact on Black, Asian and Minority Ethnic groups and other risk factors. This has required clinical leaders to respond at pace to meet patient's care needs, while supporting staff working in a volatile, uncertain, complex and ambiguous environment. During the initial wave and then the later waves within our South East London sector, there were new challenges as everyone faced a novel disease necessitating real-time learning and reflection.

Beyond Guidelines: Effectiveness of a Programme in Achieving Operative Laparoscopy for all Women Requiring Surgical Management of Ectopic Pregnancy.

Background/aims: Operative laparoscopy (OL) is considered the gold standard surgical treatment of ectopic pregnancy (EP). We questioned whether a training programme to foster OL treatment is able to ensure that all women needing surgical management are treated by OL irrespective of the site of EP, haemodynamic status and clinical complexity.

Methods: A 13-year cohort study of 963 women who underwent surgical management was conducted.

Factors that determine patient satisfaction after surgical treatment of ectopic pregnancy: improving the patient journey!

Objectives: The aim of our study is to identify factors that influence the woman's perception of satisfaction during the process of treatment for this potentially life threatening condition. To evaluate the patient characteristics and factors surrounding the diagnosis and subsequent management of women with ectopic pregnancy and the influence of these on the overall satisfaction rates after discharge from hospital in order to improve quality of care.

Study Design: This is a prospective cohort study undertaken over a period of 4 years (January 2009-December 2012) in a busy early pregnancy unit, in a London university hospital, catering to a multi-ethnic diverse population.

Ectopic pregnancy with Implanon® as a method of contraception in a woman with a previous ectopic pregnancy - case report.

Objectives: To present a rare case of tubal ectopic pregnancy in a woman using Implanon® after a previous contralateral ectopic pregnancy that had occurred without contraceptive use.

Case: A 26-year-old woman presented with an ectopic pregnancy conceived whilst having an etonogestrel implant (Implanon®) in situ. A laparoscopic salpingectomy was performed and the implant was removed.

Operative laparoscopy as the mainstay method in management of hemodynamically unstable patients with ectopic pregnancy.

Study Objective: To determine the safety and sustainability of operative laparoscopy in hemodynamically unstable women with ectopic pregnancy according to the effect of operator experience on success rates, whether the volume of hemoperitoneum affects the operative method used, and requirements for admission to the intensive care unit (ICU) and administration of blood transfusion.

Design: Prospective cohort study (Canadian Task Force classification II-A).

Setting: University hospital.

Laparoscopic management of a 16-week ruptured rudimentary horn pregnancy: a case and literature review.

Introduction: Pregnancy in a rudimentary horn is although rare, but is associated with the risk of rupture and life threatening hemorrhage. With the use of ultrasound the diagnosis can be made before symptoms occur. Management usually consists of excision of the rudimentary horn along with the pregnancy and the ipsilateral tube, traditionally by laparotomy.