UK O&G trainees' attitudes to caesarean delivery for maternal request.

We assessed the attitudes of UK Obstetrics and Gynaecology (O&G) trainees towards a caesarean delivery for maternal request (CDMR); and identified differences in attitude towards patients requesting CDMR and preferences for their own mode of delivery. An internet survey was constructed with questions covering trainees' personal preferences towards and experience of CDMR; attitudes to CDMR; and how they might treat patients making this request. From 02/2013 to 06/2013, the survey was sent electronically via email to all UK Deaneries to be forwarded to O&G trainees.

Single-knot versus multiple-knot technique of perineal repair: a randomised controlled trial.

Purpose: An important factor influencing the outcome of perineal repair is the repair technique. This study was done to determine if there is a difference in post perineal repair pain scores following the use of the standard multiple-knot technique (MKT) of perineal repair and a single-knot technique (SKT).

Methods: We randomised 260 women who sustained a second-degree perineal tear at the University of Benin Teaching Hospital, Benin City, Nigeria and had perineal repair using either a SKT or a MKT between 1 July 2014 and 28 February 2015.

An analysis of the outcomes of cervical cone biopsies performed in a low resource setting.

Following skills transfer to this low resource setting, we carried out a descriptive analysis of the outcomes of all cone biopsies performed for women with cervical intra-epithelial neoplasia 3 (CIN 3). We also compared two methods of cone biopsy. All the women had follow-up smear tests at 6 and 18 months.

The knowledge, practice and opinion of midwives' in the UK on their training in obstetric perineal repair.

Purpose: To investigate the knowledge and practice of perineal repair by midwives' in the UK, as well as their perception of the adequacy of their training.

Methods: An anonymous structured questionnaire survey was conducted. Standard statistical comparative analysis was performed between groups.

Consent for gynaecological procedure: what do women understand and remember?

Purpose: To determine patients' understanding and recall of consent information and risks associated with their procedure following gynaecological surgery.

Method: Patients planned for routine gynaecological surgery were invited to participate in the study by completing a self-administered questionnaire 4-6 h after day-surgery and 24 h after in-patient surgery. Collated data were analysed using standard statistical methods.

Understanding and recollection of the risks associated with cesarean delivery during the consent process.

Objective: To investigate women's recall of information provided during the consent process for cesarean delivery, specifically the associated risks, 24 hours after the procedure.

Methods: A prospective questionnaire-based study was conducted at the Barnet and Chase Farm Hospitals NHS Trust between May 2009 and August 2010. Women who had undergone a cesarean delivery (planned or emergency) completed a self-administered questionnaire 24 hours after delivery.

Is induced labour in the nullipara associated with more maternal and perinatal morbidity?

Purpose: To ascertain any differences in foetomaternal outcomes in induced and spontaneous labour among nulliparous women delivering at term.

Methods: A retrospective matched cohort study consisting of 403 nulliparous women induced at ≥ 292 days and 806 nulliparous women with spontaneous labour at 285-291 days.

Results: Compared to those in spontaneous labour, women who had induction of labour were three times more likely to have a caesarean delivery (OR 3.

Clinico-pathological study of cervical polyps.

Objective: To determine the incidence of malignancy in cervical polyps and determine the effect of age and parity on clinical presentation.

Methods: A retrospective analysis of histological diagnosis and demographic information relating to 294 polyps was undertaken. Comparison was made between premenopausal and postmenopausal women as well as women with and without recurrent polyps.

Impact of a structured, hands-on, surgical skills training program for midwives performing perineal repair.

Objective: To evaluate the effect of structured hands-on training for midwives performing perineal repair.

Methods: The training was performed using models and ox tongues. A total of 719 midwives completed an anonymous questionnaire prior to and immediately after training.

A randomised controlled trial of amniotomy and immediate oxytocin infusion versus amniotomy and delayed oxytocin infusion for induction of labour at term.

Background: There is uncertainty as to the optimal time interval between amniotomy and oxytocin administration when inducing labour. The aim of this study was to compare the efficacy of amniotomy and immediate oxytocin infusion with amniotomy and delayed oxytocin infusion for induction of labour at term.

Method: A total of 123 women were randomly chosen to receive either amniotomy and immediate oxytocin infusion (referred to as the 'immediate group') or amniotomy and delayed oxytocin infusion (referred to as the 'delayed group').

A multi-centre audit on the use of vaginal prostaglandin for the induction of labour.

To induce labour, the National Institute for Health and Clinical Excellence (NICE) guideline recommend a maximum total dose of 6 mg of prostaglandin E(2) tablet or 4 mg of prostaglandin E(2) gel for women with an unfavourable cervix (3 mg gel for all other women). To determine clinicians' compliance with these recommendations, the data of 1,424 women, who were induced at 10 obstetric units in England, were reviewed. A higher-than-recommended total dose was administered in 11% of the sample.

The incidence of uterine leiomyoma and other pelvic ultrasonographic findings in 2,034 consecutive women in a north London hospital.

New generation technologies provide alternative ways of assessing the female pelvis, and provide improved estimates of the incidence of uterine leiomyoma. To determine the incidence of uterine leiomyoma and other incidental findings, the request forms for pelvic ultrasound scan and the scan results of 2,034 consecutive women was reviewed. There were 586 women with scan-detected uterine leiomyoma giving an incidence of 29.

Preferred and actual delivery mode after a cesarean in London, UK.

Objective: To determine the delivery mode preferred by pregnant women with 1 previous cesarean delivery and to investigate the relationship between preferred and actual mode of delivery.

Method: We reviewed the records of 215 women who were delivered in a London hospital with a history of 1 cesarean delivery. Women who planned an elective repeat cesarean section (ERCS) were compared with those who planned a vaginal birth after cesarean (VBAC).

Impact of prolonged referral interval on colposcopic outcomes in women with moderate or severe dysplasia.

Objective: To ascertain the impact of long referral to first colposcopy interval on disease outcome in women with high-grade cervical smear tests.

Methods: Data from 316 women categorized into Group 1 (seen 180 days after referral) and Group 2 (seen within 180 days of referral) were analyzed using chi2 test with Yates correction. Odds ratios (OR) and 95% confidence intervals (CI) were calculated.

Caesarean delivery at full cervical dilatation versus caesarean delivery in the first stage of labour: comparison of maternal and perinatal morbidity.

Objective: To compare perinatal and maternal morbidity associated with caesarean sections performed in the first with that performed in the second stages of labour.

Patients And Methods: Comparative analyses between nulliparous women with singleton term pregnancies who had a caesarean section in the first stage of labour and those who had a second stage caesarean section were completed using standard statistical methods. A subgroup analysis, according to indication for caesarean section, was also performed.

Vernix caseosa peritonitis.

Vernix caseosa peritonitis (VCP) is a rare and serious complication of caesarean section. It is thought to occur as a result of spillage of amniotic fluid and or meconium into the maternal peritoneal cavity at caesarean section. It manifests as an acute abdomen days to weeks after a seemingly uncomplicated caesarean section.

Are we complying with NICE guidelines on the use of prostaglandin E2 for induction of labour? A survey of obstetric units in the UK.

To determine whether obstetric units in the UK comply with the recommendations by the National Institute for Clinical Excellence (NICE) on the maximum doses of intravaginal prostaglandin for induction of labour, a cross-sectional telephone survey of all obstetric units in the UK listed on Dr Foster's website was undertaken. The maximum doses recommended by NICE were exceeded by 86.4% (76/88) and 61.

Salvage autotransfusion versus homologous blood transfusion for ruptured ectopic pregnancy.

Objective: To compare the clinical outcomes of simple salvage autotransfusion and homologous blood transfusion in the management of ruptured ectopic pregnancies.

Methods: Standard statistical analysis was done and relative risk (RR) and 95% confidence interval (CI) were calculated for 112 women randomized to salvage autotransfusion or donor blood transfusion following ruptured ectopic pregnancy.

Results: More women in the autologous group received more than 1000 mL of blood (RR, 6.

Late pre-term (32 - 36 weeks) birth in a North London hospital.

Most of the complications of pre-term delivery arise in the 1 - 2% of births before 32 weeks' gestation. However, late pre-term birth (32 - 36 weeks' gestation) is still worrying for the mother and clinician. In a retrospective study that compared the management and outcome of 103 singleton pregnancies delivered between 32 and 36 weeks' of gestation with 103 age-matched controls that delivered at term, a short inter-pregnancy interval, early pregnancy bleeding, pre-labour spontaneous rupture of membranes, a history of pre-term delivery and Asian race or single marital status were found to be significant factors.

External cephalic version (ECV): experience in a sub-Saharan African hospital.

External cephalic version (ECV) is not a popular procedure in developing countries such as Nigeria. Over a 3-year period, we prospectively studied women who had ECV in a Nigerian University Teaching hospital. Comparative analysis was made between the successful ECV and the unsuccessful ECV groups.

Recurrent stillbirths: a matched case-control study of unexplained stillbirths at term.

The aim of this study was to assess the recurrent risk of an unexplained stillbirth at term. A total of 75 women who delivered stillbirths were matched for maternal age and parity with 75 controls. After excluding explained stillbirths, matched cases and controls were compared for maternal age, length of gestation, birth weight and 'interval to next birth'.

Post-coital bleeding: a rare and unusual presentation of cervical endometriosis.

Introduction: Often due to benign conditions such as cervical ectopy, post-coital bleeding is a distressing symptom for the patient. However, for the clinician, the identification of the etiology is important in order to effect proper treatment.

Case Report: We present a case referred to the colposcopy clinic because of post-coital bleeding and a smear report of 'groups of benign glandular cells of endometrial origin'.